Medicaid Statistical Information System (CMS-R-284)

Medicaid Statistical Information System (CMS-R-284)

OMB: 0938-0345

IC ID: 7980

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

View Information Collection (IC)

Medicaid Statistical Information System (CMS-R-284)
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Other msisdd99v5e.doc Yes Yes Fillable Fileable
Instruction SMM2700.doc No No Printable Only

Health Public Health Monitoring

 

51 0
   
State, Local, and Tribal Governments
 
   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 204 0 -8 0 0 212
Annual IC Time Burden (Hours) 2,040 0 -504 0 0 2,544
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
NPI Final Rule NPI-final rule.pdf 01/09/2007
Public Law 104-HIPAA PUBLIC LAW 104-hipaa.doc 01/09/2007
BBA Law bbalaw.doc 01/09/2007
MMA Law mmalaw.doc 01/09/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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