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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Medicare/Medicaid Health Insurance Common Claim Form and Instructions -- 42 CFR 424.32 and 414.40
Migrated
644802423
46797008
0
Form
1490U
Form
HCFA-1500
Form
L490S
Total burden requested under this ICR:
644802423
46797008
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.
