View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0065	ICR Reference No: 198406-0938-005
Status: Historical Active	Previous ICR Reference No: 198212-0938-013
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: REQUEST TO ESTABLISH ELIGIBILITY IN THE MEDICARE AND/OR MEDICAID PROGRAM TO PROVIDE OUTPATIENT PHYSICAL THERAPY AND/OR SPEECH PATHOLOGY SERVICES
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/23/1984
	Date Received in OIRA: 06/25/1984
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1986	06/30/1986
Responses	53	0	0
Time Burden (Hours)	462	0	0
Cost Burden (Dollars)	0	0	0

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