OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Health Insurance Claim Form

OMB 0720-0001 ยท DOD/DODOASHA.

OMB 0720-0001

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS 1500 Health Insurance Claim FormForm and Instruction
CMS 1500 Supporting Statement.docSupporting Statement A
Health Insurance Claim Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201207-0720-001 Reinstatement without change of a previously approved collection 2012-07-05 Approved with change
200709-0720-003 Revision of a currently approved collection 2007-09-28 Approved without change
200402-0720-001 Reinstatement without change of a previously approved collection 2004-02-10 Approved without change
200007-0720-001 Reinstatement without change of a previously approved collection 2000-07-03 Approved without change
199612-0720-003 Reinstatement without change of a previously approved collection 1996-12-10 Approved without change
199407-0720-001 Revision of a currently approved collection 1994-07-26 Approved without change
199307-0720-001 Reinstatement with change of a previously approved collection 1993-07-12 Approved without change
199111-0720-001 Revision of a currently approved collection 1991-11-26 Approved without change
199106-0720-001 New collection (Request for a new OMB Control Number) 1991-06-14 Approved without change