Emergency and Foreign Hospital Services Beneficiary Statement in Canadian/Mexican Travel Claims and Supporting Regulations in 42 CFR, Section 424.123

OMB 0938-0484

OMB 0938-0484
Latest Forms, Documents, and Supporting Material
Document
Name
Supporting Statement A
All Historical Document Collections
Approved without change
 Extension without change of a currently approved collection 2006-09-15
Approved with change
 Extension without change of a currently approved collection 2003-02-21
Approved without change
 Extension without change of a currently approved collection 2000-01-19
Approved without change
 Extension without change of a currently approved collection 1996-12-13
Approved without change
 Reinstatement with change of a previously approved collection 1994-01-31
Approved without change
 Reinstatement with change of a previously approved collection 1990-09-25
Approved without change
 New collection (Request for a new OMB Control Number) 1986-06-26
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