Contractor Information Collection Interim Payment Adjustment Forms For Hospitals/snfs

CONTRACTOR INFORMATION COLLECTION INTERIM PAYMENT ADJUSTMENT FORMS FOR HOSPITALS/SNFS

OMB: 0938-0180

IC ID: 113046

Documents and Forms
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no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

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CONTRACTOR INFORMATION COLLECTION INTERIM PAYMENT ADJUSTMENT FORMS FOR HOSPITALS/SNFS
 
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 9019 No No
Form 91 No No


    

10,800 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 26,856 0 0 26,856 0 0
Annual IC Time Burden (Hours) 429,696 0 0 429,696 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.

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