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Form Approved OMB No. 09381230 Expires: 04/24DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICESAPPLICATION FOR ENROLLMENT IN MEDICARE PART B (MEDICAL INSURANCE) WHO CAN
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The OMB number 0938-0787 expires on 12/31/2025.
Health care providers participating in Medicare programs are required to file OMB number 0938-0787.
You can fill out OMB number 0938-0787 online through the official Medicare website or by mail.
The purpose of OMB number 0938-0787 is to collect information about Medicare providers and services.
The information reported on OMB number 0938-0787 includes provider details, services rendered, and billing information.
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