View Information Collection Request (ICR) Package

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View ICR - OIRA Conclusion

OMB Control No: 0720-0006	ICR Reference No: 200911-0720-006
Status: Historical Active	Previous ICR Reference No: 200606-0720-001
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: TRICARE DoD/CHAMPUS Medical Claim Patient's Request for Medical Payment
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/14/2010
	Date Received in OIRA: 11/16/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2013	36 Months From Approved
Responses	3,000,000	0	0
Time Burden (Hours)	750,000	0	0
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,000,000	600,000	2,400,000
Annual Time Burden (Hours)	750,000	150,000	600,000
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Increase in number of respondents.

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