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Federal forms, ICRs, and supporting documents

Information Collection

ICRs Contained in 45 CFR Part 162; HIPAA Standards for Electronic Transactions

IC 8683 under ICR 201303-0938-017 · OMB 0938-0866.

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

View Information Collection (IC)

ICRs Contained in 45 CFR Part 162; HIPAA Standards for Electronic Transactions
 
No Modified
 
Mandatory
 
45 CFR Part 162  (To search for a specific CFR, visit the Code of Federal Regulations.)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction X091A1.pdf Yes No Fillable Fileable
Instruction X061A1.pdf Yes No Fillable Printable
Instruction X092A1.pdf Yes No Fillable Printable
Instruction X093A1.pdf Yes No Fillable Fileable
Instruction X094A1.pdf Yes No Fillable Fileable
Instruction X095A1.pdf Yes No Fillable Fileable
Instruction X098A1.pdf Yes No Fillable Fileable
Instruction X096A1.pdf Yes No Fillable Fileable
Instruction X097A1.pdf Yes No Fillable Fileable

Health Health Care Services

 

696,026 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   40 %

  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 6,960,260 0 0 3,560,260 3,400,000 0
Annual IC Time Burden (Hours) 6,960,260 0 0 6,960,259 1 0
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.