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Request for Review of Part B Medicare Claim and Supporting Regulations in 42 CFR Sec. 405.807

IC 7781 under ICR 200404-0938-002 · OMB 0938-0033.

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Information Collection (IC) Details

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Request for Review of Part B Medicare Claim and Supporting Regulations in 42 CFR Sec. 405.807
 
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 CMS-1964 Yes Yes


    

6,860,000 0
   
Individuals or Households
 
   5 %

  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 6,860,000 0 0 0 0 6,860,000
Annual IC Time Burden (Hours) 1,629,000 0 0 -86,000 0 1,715,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.