OMB control number
Request For Medicare Payment
OMB 9999-0011 ยท REGS/RMS.
OMB 9999-0011
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 REQUEST FOR MEDICARE PAYMENT |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 198710-9999-001 | New collection (Request for a new OMB Control Number) | 1987-10-01 | Approved without change |