OMB control number
Intermediary's Request To Hospitals For Medical Information On Outpatient Claims
OMB 0938-0433 · HHS/CMS.
OMB 0938-0433
Latest Forms, Documents, and Supporting Material
INTERMEDIARY'S REQUEST TO HOSPITALS FOR MEDICAL INFORMATION ON OUTPATIENT CLAIMS All Historical Document Collections
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Approved without change |
New collection (Request for a new OMB Control Number) | 1985-06-24 |