Attachment A Crosswalk: Model of Care Matrix Document: Initial and Renewal Submission
Crosswalk Attachment A CMS 10565 OMB 0938-1296 Final.docx
Initial and Renewal Model of Care Submissions, and Off-cycle Submission of Summaries of Model of Care Changes (CMS-10565)
Attachment A Crosswalk: Model of Care Matrix Document: Initial and Renewal Submission
OMB: 0938-1296
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1296 can be found here:
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pdf| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |