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Information Collection

Collection of Data on Quality Indicators for Congestive Heart Failure Submitted by Medicare+Choice Organizations Requesting Extra Payments in CY2002 and CY2003 and Supporting Regulations...

IC 8642 under ICR 200106-0938-009 · OMB 0938-0840.

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Information Collection (IC) Details

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Collection of Data on Quality Indicators for Congestive Heart Failure Submitted by Medicare+Choice Organizations Requesting Extra Payments in CY2002 and CY2003 and Supporting Regulations...
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-10035 Yes Yes


    

125 0
   
Private Sector Businesses or other for-profits
 
   75 %

  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 125 0 125 0 0 0
Annual IC Time Burden (Hours) 11 0 11 0 0 0
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.