Completing Lines Eighteen through Twenty-Two - Reason for Return

70.23 - Completing Lines Eighteen through Twenty-Two - Reason for Return (Inactive) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) A3-3898.23 Line 18 - Incomplete - The intermediary enters the number of applications returned to the applicant because the application was incomplete. Line 19 - Unverifiable Information - The intermediary enters the number of applications returned to the applicant because the application included unverifiable information. Line 20 - Not Signed - The intermediary enters the number of applications returned to the applicant because the applicant did not sign the certification statement. Line 21 - Invalid Billing Agreement - The intermediary enters the number of applications returned to the applicant because the billing agreement did not meet CMS requirements. Line 22 - Other - The intermediary enters the number of applications returned to the applicant for any reason other than the ones indicated on lines 18 through 21.