OMB control number
Intermediary's Request To Hospitals For Medical Information On Outpatient Claims
OMB 0938-0433 · HHS/CMS.
OMB 0938-0433
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 INTERMEDIARY'S REQUEST TO HOSPITALS FOR MEDICAL INFORMATION ON OUTPATIENT CLAIMS |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 198506-0938-008 | New collection (Request for a new OMB Control Number) | 1985-06-24 | Approved without change |