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Internal or external request for listing of therapy recommendation including criteria used to evaluate the response

IC 191463 under ICR 202306-0938-012 · OMB 0938-1078.

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Internal or external request for listing of therapy recommendation including criteria used to evaluate the response
 
No Unchanged
 
Mandatory
 
42 CFR 414.930

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

Health Health Care Services

 

845 0
   
Private Sector Not-for-profit institutions, 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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 100 0 0 0 0 100
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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