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
Expedited Review Notices and Supporting Regulations Contained in 42 CFR SEction 405.1200 and 405.1202
Modified
3100000
516666
0
Instruction
Form
CMS-10124
Detailed Explanation of Non-coverage
Form
CMS-10124
Detailed Explanation of Non-Coverage (Redline)
Form
CMS-10123
Notice of Medicare Provider Non-Coverage
Form
CMS-10123
Notice of Medicare Provider Non-Coverage (Redline
Instruction
Notice of Provider Non-Coverage (CMS-10123) and Detailed Explanation of Non-Coverage (CMS-10124)
New
15637
5472
0
Instruction
Form
CMS-10124
Detailed Explanation of Non-coverage
Form
CMS-10124
Detailed Explanation of Non-Coverage (Redline)
Form
CMS-10123
Notice of Medicare Provider Non-Coverage
Form
CMS-10123
Notice of Medicare Provider Non-Coverage (Redline
Instruction
Total burden requested under this ICR:
3115637
522138
0
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