Refunding Of Federal Share Of Overpayments Made To Medicaid Providers

REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS

OMB: 0938-0535

IC ID: 166329

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REFUNDING OF FEDERAL SHARE OF OVERPAYMENTS MADE TO MEDICAID PROVIDERS
 
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-R-104 No No


    

2,600 0
   
State, Local, and Tribal Governments
 
   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 2,600 0 0 0 0 2,600
Annual IC Time Burden (Hours) 148,200 0 0 0 0 148,200
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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