OMB control number

Delegated Provider Admissions Summary

OMB 0938-0070 · HHS/CMS.

OMB 0938-0070

Latest Forms, Documents, and Supporting Material

Document Name
DELEGATED PROVIDER ADMISSIONS SUMMARY Form

All Historical Document Collections

198203-0938-013 Approved with change	No material or nonsubstantive change to a currently approved collection	1982-03-30
197710-0938-004 Approved without change	New collection (Request for a new OMB Control Number)	1977-10-14