Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Burden Estimates - Appeals Modified 516575283 1195626 149806832 Instruction
Instruction
Form and Instruction CMS-10338 Adverse Benefit Determination Model Notice
Form and Instruction CMS-10338 Internal Adverse Benefit Determination
Form and Instruction CMS-10338 External Final Decision Model Notice
Total burden requested under this ICR: 516575283 1195626 149806832  
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