View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0829	ICR Reference No: 200403-0938-004
Status: Historical Active	Previous ICR Reference No: 200103-0938-007
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Medicare+Choice Appeal Notices, "Notice of Denial of Medical Coverage", "Notice of Denial of Payment" and supporting regulations in 42 CFR 422.568
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/28/2004
	Date Received in OIRA: 03/17/2004
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2007	05/31/2007	05/31/2004
Responses	71,200	0	29,892
Time Burden (Hours)	7,120	0	2,994
Cost Burden (Dollars)	0	0	0

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