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Independent Renal Dialysis Facility Cost Report and Supporting Regulations 42 CFR 413.20 and 42 CFR 413.24

IC 7893 under ICR 200705-0938-007 · OMB 0938-0236.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Independent Renal Dialysis Facility Cost Report and Supporting Regulations 42 CFR 413.20 and 42 CFR 413.24
 
Yes Modified
 
Mandatory
 
42 CFR 413.20 42 CFR 413.24

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-265-94 Independent Renal Dialysis Facility Cost Report CMS-265-94 pr2_34_toc.doc Yes Yes Paper Only
Instruction CMS-265-94 pr2_3400_to_3413.doc Yes Yes Paper Only
Instruction CMS-265-94 pr2_3495_to_3495.doc Yes Yes Paper Only

Health Health Care Services

 

4,885 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 4,885 0 1,293 0 0 3,592
Annual IC Time Burden (Hours) 957,460 0 253,428 0 0 704,032
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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