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Complex 255210 Page: 1 LLP ***NOT APPROVED FOR SUBMISSION DAT Provider CCN: 140174 In Lieu of Form CMS255210 Period : From: 01/01/2013 To: 12/31/2013 Run Date: 05/29/2014 Run Time: 17:42 Version:
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Not approved for submission refers to any document or information that has not been given the necessary approvals to be submitted to the relevant authorities.
The person or entity responsible for the document or information is required to file not approved for submission.
Not approved for submission should be filled out with the necessary details and explanations as to why the document or information has not been approved.
The purpose of not approved for submission is to notify the relevant authorities of any document or information that has not been approved for submission.
Not approved for submission must report the details of the document or information that has not been approved, as well as the reasons for the lack of approval.
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