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Medicare - Rural Health Clinics-requests For Medical Information Hcfa-pub. 13-3 Intermediary Manual Sec. 3640.14

IC 113112 under ICR 199005-0938-001 · OMB 0938-0209.

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MEDICARE - RURAL HEALTH CLINICS-REQUESTS FOR MEDICAL INFORMATION HCFA-PUB. 13-3 INTERMEDIARY MANUAL SEC. 3640.14
 
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-9001 No No


    

470 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 24,440 0 0 24,440 0 0
Annual IC Time Burden (Hours) 6,110 0 0 6,110 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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