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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
HEALTH INSURANCE CLAIM FORM/ REQUEST FOR MEDICARE PAYMENT
Migrated
121000000
15266667
0
Form
HCFA-1500,
Form
HCFA-1490S,
Total burden requested under this ICR:
121000000
15266667
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
