Organ Procurement Organization/Histcompatibility Laboratory Statement of Reimbursable Costs, Manual Instructions (CMS-216-94)

Organ Procurement Organization/Histocompatibility Laboratory Statement of Reimbursable Costs, manual instructions and supporting regulations contained in 42 CFR 413.20 and 413.24

OMB: 0938-0102

IC ID: 43650

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

View Information Collection (IC)

Organ Procurement Organization/Histcompatibility Laboratory Statement of Reimbursable Costs, Manual Instructions (CMS-216-94)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 413.24 42 CFR 413.20

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Cost Report CMS-216.pr2_33_toc.doc Yes Yes Paper Only
Other-Cost Report CMS-216.pr2_3300_to_3390.doc Yes Yes Paper Only
Other-Cost Report CMS-216.pr2_3395_to_3395.doc Yes Yes Paper Only
Other-Cost Report CMS-216.R4P233f.xls Yes Yes Paper Only

Health Health Care Services

 

115 0
   
Private Sector Businesses or other for-profits, 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 115 0 0 7 0 108
Annual IC Time Burden (Hours) 5,175 0 0 315 0 4,860
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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