View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0041	ICR Reference No: 198110-0938-008
Status: Historical Active	Previous ICR Reference No: 197701-0938-003
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: THIRD PARTY PREMIUM BILLING REQUEST
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/18/1981
	Date Received in OIRA: 10/19/1981
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/1984	11/30/1984	11/30/1981
Responses	10,000	0	10,000
Time Burden (Hours)	2,500	0	2,500
Cost Burden (Dollars)	0	0	0

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