View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Medicare+Choice Appeal Notices, "Notice of Denial of Medical Coverage", "Notice of Denial of Payment" and supporting regulations in 42 CFR 422.568
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10003 No No


    

211 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 71,200 0 0 41,308 0 29,892
Annual IC Time Burden (Hours) 7,120 0 0 4,126 0 2,994
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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