OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Provider Chain Operator Data

IC 112606 under ICR 198107-0938-003 · OMB 0938-0039.

Documents and Forms
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Information Collection (IC) Details

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PROVIDER CHAIN OPERATOR DATA
 
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 HCFA-1885A No No


    

20,000 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested 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 20,000 0 0 20,000 0 0
Annual IC Time Burden (Hours) 5,000 0 0 5,000 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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