OMB control number
Medicare Managed Care Disenrollment Form
OMB 0938-0507 ยท HHS/CMS.
OMB 0938-0507
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Medicare Managed Care Disenrollment Form |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 200306-0938-010 | Extension without change of a currently approved collection | 2003-06-19 | Approved without change | |
| 200004-0938-005 | Reinstatement without change of a previously approved collection | 2000-04-24 | Approved without change | |
| 199610-0938-004 | Reinstatement with change of a previously approved collection | 1996-10-17 | Approved without change | |
| 198804-0938-001 | Extension without change of a currently approved collection | 1988-04-18 | Approved without change | |
| 198704-0938-001 | New collection (Request for a new OMB Control Number) | 1987-04-27 | Approved without change |