OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Third Party Premium Billing Request and Supporting Regulations in 42 CFR 408.6 and 408.202

OMB 0938-0041 · HHS/CMS.

OMB 0938-0041
Latest Forms, Documents, and Supporting Material
Document
Name
All Historical Document Collections
Approved with change
 Revision of a currently approved collection 2003-10-01
Approved without change
 Extension without change of a currently approved collection 2000-08-29
Approved without change
 Reinstatement without change of a previously approved collection 1997-08-05
Approved without change
 Reinstatement with change of a previously approved collection 1993-12-21
Approved without change
 Reinstatement with change of a previously approved collection 1990-08-14
Approved with change
 No material or nonsubstantive change to a currently approved collection 1989-06-15
Approved with change
 No material or nonsubstantive change to a currently approved collection 1989-04-12
Approved with change
 No material or nonsubstantive change to a currently approved collection 1989-04-10
Approved with change
 No material or nonsubstantive change to a currently approved collection 1989-04-03
Approved without change
 Extension without change of a currently approved collection 1987-04-29
Approved without change
 Reinstatement with change of a previously approved collection 1984-12-03
Approved without change
 Extension without change of a currently approved collection 1981-10-19
Approved without change
 Extension without change of a currently approved collection 1977-01-13
Approved without change
 Reinstatement with change of a previously approved collection 1977-01-10