Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms

Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms

OMB: 0938-0952

IC ID: 8808

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Federal Funding of Emergency Health Services (Section 1011); Provider Payment Determination and On-Call Cost Forms
 
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-10130 No No


    

7,503,000 0
   
Private Sector Businesses or other for-profits
 
   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 7,512,000 0 1,800,000 0 0 5,712,000
Annual IC Time Burden (Hours) 634,000 0 0 0 0 634,000
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.

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