OMB control number
Medicare Managed Care Disenrollment Form
OMB 0938-0507 · HHS/CMS.
OMB 0938-0507
Latest Forms, Documents, and Supporting Material
Document Name |
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Medicare Managed Care Disenrollment Form All Historical Document Collections
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Approved without change |
Extension without change of a currently approved collection | 2003-06-19 | |
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Approved without change |
Reinstatement without change of a previously approved collection | 2000-04-24 | |
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Approved without change |
Reinstatement with change of a previously approved collection | 1996-10-17 | |
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Approved without change |
Extension without change of a currently approved collection | 1988-04-18 | |
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Approved without change |
New collection (Request for a new OMB Control Number) | 1987-04-27 |