Request for Reconsideration of Part A Medicare Claim and Supporting Regulations in 42 CFR, 405.711

Request for Reconsideration of Part A Medicare Claim and Supporting Regulations in 42 CFR, 405.711

OMB: 0938-0045

IC ID: 7800

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Request for Reconsideration of Part A Medicare Claim and Supporting Regulations in 42 CFR, 405.711
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-2649 No No


    

62,000 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 62,000 0 0 0 0 62,000
Annual IC Time Burden (Hours) 15,500 0 0 0 0 15,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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