View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0080	ICR Reference No: 199404-0938-002
Status: Historical Active	Previous ICR Reference No: 199012-0938-014
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: APPLICATION FOR HEALTH INSURANCE BENEFITS UNDER MEDICARE FOR INDIVIDUAL WITH CHRONIC RENAL DISEASE
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: 06/16/1994
	Date Received in OIRA: 04/25/1994
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/1996	06/30/1996
Responses	21,000	0	0
Time Burden (Hours)	9,030	0	0
Cost Burden (Dollars)	0	0	0

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