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Delivery Of Medical & Social Services To The Homebound Elderly, New York City -- Billing Forms

IC 113214 under ICR 198112-0938-022 · OMB 0938-0239.

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DELIVERY OF MEDICAL & SOCIAL SERVICES TO THE HOMEBOUND ELDERLY, NEW YORK CITY -- BILLING FORMS
 
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-245D No No
Form HCFA-246D No No


    

4 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) 667 0 0 667 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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