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: 198501-0938-013
Status: Historical Active	Previous ICR Reference No: 198308-0938-008
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: STATE MEDICAID QUALITY CONTROL SAMPLE SELECTION LISTS
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/05/1985
	Date Received in OIRA: 01/11/1985
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/1988	04/30/1988	01/31/1985
Responses	648	0	636
Time Burden (Hours)	20,736	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.