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Information Collection

Medicare - Information Collection Requirements In Som Section 2280 And Rom - Section - 5223 Dialysis At Home Program

IC 166320 under ICR 198904-0938-018 · OMB 0938-0510.

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MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN SOM SECTION 2280 AND ROM - SECTION - 5223 DIALYSIS AT HOME PROGRAM
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-112 No No


    

100 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 100 0 0 0 0 100
Annual IC Time Burden (Hours) 366 0 0 0 0 366
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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