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Medicare Provider Cost Report Reimbursement Questionnaire and Supporting Regulations in 42 CFR 413.20, 413.24, and 415.60 (CMS-339)
OMB 0938-0301
OMB.report
HHS/CMS
OMB 0938-0301
OMB 0938-0301
Latest Forms, Documents, and Supporting Material
Document
Name
Form CMS-339 Medicare Provider Cost Report Reimbursement Questionnaire (Exhibit 1)
Form and Instruction
Form CMS-339 Medicare Provider Cost Report Reimbursement Questionnaire (Exhibit 2)
Form and Instruction
CMS-339 Supporting Statement Part A - FINAL 4-18-17.doc
Supporting Statement A
Medicare Provider Cost Report Reimbursement Questionnaire (Exhibit 1)
Form and Instruction
Medicare Provider Cost Report Reimbursement Questionnaire (Exhibit 2)
Form and Instruction
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201704-0938-004
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2017-04-20
201611-0938-006
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2016-11-23
201305-0938-011
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2013-05-20
200903-0938-003
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2009-03-10
200604-0938-011
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2006-04-25
200509-0938-009
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2005-09-16
200208-0938-017
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2002-08-29
200203-0938-006
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2002-03-29
200107-0938-003
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2001-07-05
199805-0938-001
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1998-05-07
199702-0938-008
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No material or nonsubstantive change to a currently approved collection
1997-02-22
199505-0938-004
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Revision of a currently approved collection
1995-05-15
199406-0938-001
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Extension without change of a currently approved collection
1994-06-30
199403-0938-006
Approved with change
No material or nonsubstantive change to a currently approved collection
1994-03-11
199306-0938-009
Approved without change
Revision of a currently approved collection
1993-06-11
199006-0938-003
Approved without change
Revision of a currently approved collection
1990-06-25
198811-0938-006
Approved without change
Revision of a currently approved collection
1988-11-22
198510-0938-007
Approved without change
Revision of a currently approved collection
1985-10-11
198308-0938-014
Approved without change
New collection (Request for a new OMB Control Number)
1983-08-18
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