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Federal forms, ICRs, and supporting documents

Information Collection

Phone Surveys of Product/Service for Medicare Payment Validation and Supporting Regulations in 42 CFR, 405.502 (CMS-10112)

IC 8790 under ICR 201105-0938-004 · OMB 0938-0939.

Documents and Forms
Document Name
Document Type
Other-CMS Manual - Instructions for
Other-CMS-10112 - Instructions for I
Information Collection (IC) Details

View Information Collection (IC)

Phone Surveys of Product/Service for Medicare Payment Validation and Supporting Regulations in 42 CFR, 405.502 (CMS-10112)
 
No Modified
 
Voluntary
 
42 CFR 405.502

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-CMS Manual - Instructions for IR Determiniations 10112-manual.doc Yes No Printable Only
Other-CMS-10112 - Instructions for IR Determinations 10112-instructions.doc Yes No Printable Only

Health Health Care Services

 

4,000 750
   
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 4,000 0 0 0 0 4,000
Annual IC Time Burden (Hours) 16,000 0 0 0 0 16,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.