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DOL Home > Find It! By Form > DOL Form |
DOL Form OWCP-1500
Agency: | OWCP |
Title: | OWCP-1500, Health Insurance Claim Form |
Form Description: | OWCP-1500, Health Insurance Claim Form: This information is required to reimburse health care providers for services rendered to injured employees covered under OWCP-administrative programs. |
OMB Control Number: | 1240-0044 |