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Request for Hearing for Part B Medicare Claim and Supporting Regulations in 42 CFR, 405.821

IC 7783 under ICR 200008-0938-007 · OMB 0938-0034.

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Information Collection (IC) Details

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Request for Hearing for Part B Medicare Claim and Supporting Regulations in 42 CFR, 405.821
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-1965 No No


    

55,000 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 55,000 0 0 0 0 55,000
Annual IC Time Burden (Hours) 9,167 0 0 0 0 9,167
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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