Regulatory Collection Filing
Health Insurance Claims Form, UB-04 CMS 1450
RCF 202401-0720-001CF · Host ICR 202306-0938-002 · OMB 0938-0997
RCF Summary
| Host OMB Control No. | 0938-0997 |
|---|---|
| Host ICR Reference No. | 202306-0938-002 |
| Agency/Subagency | DOD/DODOASHA |
| Status | Active |
| Type of RCF | RCF Recertification |
| OIRA Conclusion Action | Approved |
| Date Received in OIRA | 2024-01-02 |
| Conclusion Date | 2024-01-02 |
| Related Links | OMB 0938-0997 · ICR 202306-0938-002 · Previous RCF 202008-0720-002CF · Retrieve Notice of Action (NOA) |