MEDICARE COVERAGE OF SCREENING MAMMOGRAPHY

ICR 199203-0938-008

OMB: 0938-0608

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
114064 Migrated
ICR Details
0938-0608 199203-0938-008
Historical Active
HHS/CMS
MEDICARE COVERAGE OF SCREENING MAMMOGRAPHY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/22/1992
Retrieve Notice of Action (NOA) 03/24/1992
Approved for use through 6/93 under the condition that the next submission for OMB review reflects the final rulemaking setting forth Medicare Conditions of Coverage for Mammography Screening.
  Inventory as of this Action Requested Previously Approved
06/30/1993 06/30/1993
5,781 0 0
23,124 0 0
0 0 0

THIS INFORMATION IS NEEDED TO DETERMINE IF A SUPPLIER OR INTERPRETING PHYSICIAN IS IN COMPLIANCE WITH PUBLISHED SAFETY AND ACCURACY REQUIREMENTS. RESPONDENTS ARE SCREENING MAMMOGRAPHY SUPPLIERS AND INTERPRETING PHYSICIANS.

None
None


No

1
IC Title Form No. Form Name
MEDICARE COVERAGE OF SCREENING MAMMOGRAPHY HCFA-R-145

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,781 0 0 5,781 0 0
Annual Time Burden (Hours) 23,124 0 0 23,124 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/24/1992


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