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Information Collection

Survey of Medicare Private Fee-for-service (PFFS) Enrollees and Nonenrollees

IC 8684 under ICR 200205-0938-001 · OMB 0938-0867.

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Information Collection (IC) Details

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Survey of Medicare Private Fee-for-service (PFFS) Enrollees and Nonenrollees
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10059 No No


    

6,322 0
   
Individuals or Households
 
   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 6,322 0 6,322 0 0 0
Annual IC Time Burden (Hours) 1,581 0 1,581 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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