Medicare - Information Collection Requirements In Hcfa-pub. 14-3 Carrier Manual Sections 2070.2, 3060.2.d., 4110.2 And 4110.4 - Physician/supplier Background Information

OMB 0938-0461

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MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION Form

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198905-0938-001 Approved without change	Reinstatement with change of a previously approved collection	1989-05-03
198512-0938-005 Approved without change	New collection (Request for a new OMB Control Number)	1985-12-31