View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0938-0080	ICR Reference No: 200908-0938-009
Status: Historical Active	Previous ICR Reference No: 200701-0938-018
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Application for Hospital Insurance Benefits Medicare for Individuals with End Stage Renal Disease and Supporting Regulations in 42 CFR 406.7 and 406.13
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: 10/26/2009
	Date Received in OIRA: 08/19/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2012	36 Months From Approved	10/31/2009
Responses	60,000	0	60,000
Time Burden (Hours)	25,990	0	25,990
Cost Burden (Dollars)	0	0	0

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