OMB control number

Medical Cost Data

OMB 0960-0469 · SSA.

OMB 0960-0469

Latest Forms, Documents, and Supporting Material

Document Name
MEDICAL COST DATA Form

All Historical Document Collections

199111-0960-008 Approved without change	Extension without change of a currently approved collection	1991-11-21
198904-0960-023 Approved with change	No material or nonsubstantive change to a currently approved collection	1989-04-18
198901-0960-015 Approved without change	New collection (Request for a new OMB Control Number)	1989-01-27