Information Collection

Information Collection Requirements Concerning Claims Processing Assessment System (cpas) And Currently Approved Hcfa-r-83 To Be Consolidated With The Aforementioned

IC 113724 under ICR 199103-0938-002 · OMB 0938-0438.

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Information Collection (IC) Details

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IC Title:	INFORMATION COLLECTION REQUIREMENTS CONCERNING CLAIMS PROCESSING ASSESSMENT SYSTEM (CPAS) AND CURRENTLY APPROVED HCFA-R-83 TO BE CONSOLIDATED WITH THE AFOREMENTIONED	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?
Form	HCFA-R-91	No	No
Form	R-83	No	No
Form	331, 503	No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	51	51
Annual IC Time Burden (Hours)	66,185	66,185
Annual IC Cost Burden (Dollars)	0	0

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