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End Stage Renal Disease (esrd) Medical Case Review

IC 114010 under ICR 199210-0938-001 · OMB 0938-0574.

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END STAGE RENAL DISEASE (ESRD) MEDICAL CASE REVIEW
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-1 No No


    

18 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 216 0 216 0 0 0
Annual IC Time Burden (Hours) 25,056 0 25,056 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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