Regulatory Collection Filing

RCF 202401-0720-001CF

OMB 0938-0997 · Health Insurance Claims Form, UB-04 CMS 1450

Array
(
    [refNbr] => 202401-0720-001CF
    [obm] => 0938-0997
    [icr] => 202306-0938-002
    [status] => Active
    [agency] => DOD/DODOASHA
    [title] => Health Insurance Claims Form, UB-04 CMS 1450
    [typeRCF] => RCF Recertification
    [oiraAction] => Approved
    [oiraNOA] => 524630
    [termsOfClearance] =>    
    [previousRCF] => 202008-0720-002CF
    [agencyTrackingNo] => 
    [conclusionDate] => 2024-01-02
    [dateReceived] => 2024-01-02
)

Document