Information Collection

Review of National Coverage Determinations and Local Coverage Determinations and Supporting Regulations in 42 CFR, Sections 426.400 and 426.500

IC 8751 under ICR 200703-0938-016 · OMB 0938-0911.

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IC Title:

Review of National Coverage Determinations and Local Coverage Determinations and Supporting Regulations in 42 CFR, Sections 426.400 and 426.500

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 426.400 42 CFR 426.500

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,040

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,040	1,040
Annual IC Time Burden (Hours)	4,160	4,160
Annual IC Cost Burden (Dollars)	0	0

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