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Municipal Health Services Cost Report Form and Supporting Regulations 42 CFR 405.2470

IC 7868 under ICR 200312-0938-004 · OMB 0938-0155.

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Municipal Health Services Cost Report Form and Supporting Regulations 42 CFR 405.2470
 
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 CMS-255 Yes Yes


    

14 0
   
Private Sector Not-for-profit institutions
 
   100 %

  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 14 0 0 0 0 14
Annual IC Time Burden (Hours) 476 0 0 0 0 476
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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