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Information Collection

Contractors' Information Collection-- "state Medicaid Agency Verification Of Services Received"

IC 113190 under ICR 198112-0938-014 · OMB 0938-0231.

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Information Collection (IC) Details

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CONTRACTORS' INFORMATION COLLECTION-- "STATE MEDICAID AGENCY VERIFICATION OF SERVICES RECEIVED"
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-9033 No No


    

67,500 0
   
Individuals or Households
 
   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 810,000 0 0 810,000 0 0
Annual IC Time Burden (Hours) 202,500 0 0 202,500 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.