Information Collection

Integrated Quality Control Review Worksheet

IC 112862 under ICR 198509-0938-006 · OMB 0938-0094.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0094 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	INTEGRATED QUALITY CONTROL REVIEW WORKSHEET	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-316				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 55	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	43,481	3,936	39,545
Annual IC Time Burden (Hours)	522,021	21,611	500,410
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded

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