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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Uniform Health Insurance Claim Form
Migrated
166622
28538
0
Form
OWCP-92(UB-92)
Total burden requested under this ICR:
166622
28538
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.
