Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Burden Estimates - Appeals Modified 516575283 1195626 149806832 Other-Model - Notice of Internal Adverse Benefit Determination
Other-Model Notice of Adverse Benefit Determination
Other-Model Notice of Final External Review Decision
Internal Claims and Appeals and External Review Procedures Unchanged 5783 3066 0
Total burden requested under this ICR: 516581066 1198692 149806832  
To view an IC, click on IC Title