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Information Collection

Managed Care Data Using the Uniform Institutional Providers Form

IC 37904 under ICR 200211-0938-003 · OMB 0938-0711.

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Information Collection (IC) Details

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Managed Care Data Using the Uniform Institutional Providers Form
 
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


    

211 0
   
Private Sector Businesses or other for-profits
 
   95 %

  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 1,353,500 0 0 0 0 1,353,500
Annual IC Time Burden (Hours) 6,533 0 0 0 0 6,533
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.