View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0065	ICR Reference No: 198708-0938-013
Status: Historical Active	Previous ICR Reference No: 198605-0938-002
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: MEDICARE - REQUEST TO ESTABLISH ELIGIBILITY IN THE MEDICARE AND/OR MEDICAID PROGRAM TO PROVIDE OUTPATIENT PHYSICAL THERAPY AND/OR SPEECH PATHOLOGY SERVICES - OUTPATIENT ....
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: 08/07/1987
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/07/1987
	Date Received in OIRA: 08/07/1987
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1989	06/30/1989	06/30/1989
Responses	53	0	53
Time Burden (Hours)	548	0	783
Cost Burden (Dollars)	0	0	0

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