Data Collection for the Second Generation Social Health Maintenance Organization Demonstration

Data Collection for the Second Generation Social Health Maintenance Organization Demonstration

OMB: 0938-0709

IC ID: 8351

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Information Collection (IC) Details

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Data Collection for the Second Generation Social Health Maintenance Organization Demonstration
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-204 Yes Yes


    

40,393 0
   
Individuals or Households
 
   25 %

  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 69,717 0 -67,554 0 0 137,271
Annual IC Time Burden (Hours) 32,917 0 -100,735 0 0 133,652
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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