OMB control number
Patient Intake Data Form For The National Home Health Agency Prospective Payment Demonstration
OMB 0938-0570 · HHS/CMS.
OMB 0938-0570
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 PATIENT INTAKE DATA FORM FOR THE NATIONAL HOME HEALTH AGENCY PROSPECTIVE PAYMENT DEMONSTRATION |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 199311-0938-005 | Reinstatement with change of a previously approved collection | 1993-11-15 | Approved without change | |
| 199008-0938-006 | New collection (Request for a new OMB Control Number) | 1990-08-08 | Approved without change |