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Information Collection

Contractors' Information Collections--periodic Audit Of Provider/supplier Claims Data

IC 113140 under ICR 198111-0938-019 · OMB 0938-0215.

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Information Collection (IC) Details

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CONTRACTORS' INFORMATION COLLECTIONS--PERIODIC AUDIT OF PROVIDER/SUPPLIER CLAIMS 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-9015 No No


    

5,000 0
   
Private Sector 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 5,000 0 0 5,000 0 0
Annual IC Time Burden (Hours) 25,000 0 0 25,000 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.