PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Insurance Common Claims Form and Supporting Regulations at 42 CFR Part 424 Subpart C
Modified
970174260
33067757
0
Form and Instruction
CMS-1500 (08-05)
Health Insurance Claim Form
Total burden requested under this ICR:
970174260
33067757
0
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The .gov means it's official.
The site is secure.
