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Health Prepayment Data Card Coding Sheet

IC 166192 under ICR 198904-0938-050 · OMB 0938-0161.

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HEALTH PREPAYMENT DATA CARD CODING SHEET
 
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-1929 No No


    

156 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 156 0 0 0 0 156
Annual IC Time Burden (Hours) 4,586 0 0 0 0 4,586
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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