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Medicare: Intermediary Request to Hospitals for Medical Information on Inpatient Claims for Statutorily Excluded Services -- SSA 1862; 42 CFR 411.15; 60 FR 181

IC 7890 under ICR 199611-0938-001 · OMB 0938-0224.

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Medicare: Intermediary Request to Hospitals for Medical Information on Inpatient Claims for Statutorily Excluded Services -- SSA 1862; 42 CFR 411.15; 60 FR 181
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-9026 No No


    

5,258 0
   
Private Sector Businesses or other for-profits
 
   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 20,355 0 20,355 0 0 0
Annual IC Time Burden (Hours) 5,088 0 5,088 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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