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Request for Review of Part B Medicare Claim
OMB 3220-0100
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OMB 3220-0100
OMB 3220-0100
Latest Forms, Documents, and Supporting Material
Document
Name
Request for Review of Part B Medicare Claim
Form
All Historical Document Collections
200210-3220-002
Approved without change
Extension without change of a currently approved collection
2002-10-03
199909-3220-002
Approved without change
Extension without change of a currently approved collection
1999-09-20
199606-3220-002
Approved without change
Extension without change of a currently approved collection
1996-06-21
199306-3220-002
Approved without change
Extension without change of a currently approved collection
1993-06-24
199005-3220-005
Approved without change
Extension without change of a currently approved collection
1990-05-22
198705-3220-001
Approved without change
Extension without change of a currently approved collection
1987-05-28
198406-3220-001
Approved without change
Extension without change of a currently approved collection
1984-06-22
198107-3220-001
Approved without change
Extension without change of a currently approved collection
1981-07-06
198105-3220-021
Approved with change
No material or nonsubstantive change to a currently approved collection
1981-05-28
198103-3220-040
Approved with change
No material or nonsubstantive change to a currently approved collection
1981-03-21
198003-3220-005
Approved without change
Revision of a currently approved collection
1980-03-05
197502-3220-009
Approved with change
No material or nonsubstantive change to a currently approved collection
1975-02-21
197502-3220-003
Approved without change
Extension without change of a currently approved collection
1975-02-10
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