View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0147	ICR Reference No: 198107-0938-011
Status: Historical Active	Previous ICR Reference No: 198101-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: STATE MEDICAID QUALITY CONTROL SAMPLE SELECTION LISTS
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 07/28/1981
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/28/1981
	Date Received in OIRA: 07/28/1981
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/1982	01/31/1982	12/31/1981
Responses	636	0	636
Time Burden (Hours)	20,352	0	20,352
Cost Burden (Dollars)	0	0	0

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.