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Form CMS-18F5 Application for Part A (Hospital Insurance)
Application for Enrollment in Medicare Part A, Internet Claim (iClaim) Application Screen, Modernized Claims System and Consolidated Claim (CMS-18F5)
CMS 18_F_5-Final
Application for Part A (Hospital Insurance)
OMB: 0938-0251
OMB.report
HHS/CMS
OMB 0938-0251
ICR 202304-0938-004
IC 7908
Form CMS-18F5 Application for Part A (Hospital Insurance)
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0251 can be found here:
2024-08-29 - Reinstatement with change of a previously approved collection
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