156.1230(a)(1)

Program Integrity and Additional State Information Collections

OMB: 0938-1213

IC ID: 208533

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Document Type
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Information Collection (IC) Details

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156.1230(a)(1)
 
No Modified
 
Required to Obtain or Retain Benefits
 
45 CFR 156.1230(a)(1)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Health Care Services

 

1 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 1 1 0 0 0 0
Annual IC Time Burden (Hours) 610 610 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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