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Independent Rural Health Center/Freestanding Federally Qualified Health Center Cost Report and Supp. Regs in 42 CFR Sections 413.20 and 413.24 (CMS-222-92)

IC 7853 under ICR 201106-0938-003 · OMB 0938-0107.

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

View Information Collection (IC)

Independent Rural Health Center/Freestanding Federally Qualified Health Center Cost Report and Supp. Regs in 42 CFR Sections 413.20 and 413.24 (CMS-222-92)
 
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
Instruction pr2_2900_to_2910.doc Yes Yes Paper Only
Instruction pr2_29_toc.doc Yes Yes Paper Only
Instruction pr2_2990_to_2995.doc Yes Yes Paper Only
Form CMS-222-92 Independent Rural Health Clinic and Freestanding Federally Qualified Health Center Cost Report R9p229f.xlsx Yes Yes Paper Only

Health Health Care Services

 

5,812 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 5,812 0 0 2,653 0 3,159
Annual IC Time Burden (Hours) 290,600 0 0 132,650 0 157,950
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.