Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Burden Estimates - Appeals Modified 489975255 861470 142092824 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 Modified 5636 4635 0
Total burden requested under this ICR: 489980891 866105 142092824  
To view an IC, click on IC Title