Information Collection Requirements Contained In Berc-371-fc, Appeals Procedures For Determinations That Affect Participation In Medicare

INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-371-FC, APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN MEDICARE

OMB: 0938-0508

IC ID: 166317

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INFORMATION COLLECTION REQUIREMENTS CONTAINED IN BERC-371-FC, APPEALS PROCEDURES FOR DETERMINATIONS THAT AFFECT PARTICIPATION IN MEDICARE
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-103 No No


    

50 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 50 0 0 0 0 50
Annual IC Time Burden (Hours) 250 0 0 0 0 250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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