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View ICR - OIRA Conclusion

OMB Control No: 0720-0006	ICR Reference No: 199304-0720-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: CHAMPUS CLAIM FORM, PATIENT'S REQUEST FOR MEDICAL PAYMENT
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/30/1993
	Date Received in OIRA: 04/08/1993
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1996	06/30/1996
Responses	3,250,000	0	0
Time Burden (Hours)	812,500	0	0
Cost Burden (Dollars)	0	0	0

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