OMB control number
Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C
OMB 0938-0999 · HHS/CMS.
OMB 0938-0999
Latest Forms, Documents, and Supporting Material
Document Name |
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Form and Instruction |
Supplementary Document |
Supporting Statement A |
Form CMS-1500(08-05) Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C
CMS-1500(08-05).Record of Information Clearances.docx
CMS-1500(0805)_Supporting_Statement_Part_A.pdf
Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C All Historical Document Collections
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Approved without change |
Reinstatement without change of a previously approved collection | 2012-11-28 | |
|
Approved without change |
Extension without change of a currently approved collection | 2007-06-29 | |
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Approved without change |
New collection (Request for a new OMB Control Number) | 2006-06-27 |