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)

Independent Rural Health Center/Freestanding Federally Qualified Health Center Cost Report and Supp. Regs in 42 CFR Sections 413.20 and 413.24

OMB: 0938-0107

IC ID: 7853

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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)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 413.20 42 CFR 413.24

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction pr2_29.pdf Yes No Printable Only
Form CMS-222-92 INDEPENDENT RURAL HEALTH CLINIC/FREESTANDING FEDERALLY QUALIFIED HEALTH CENTER WORKSHEETSTATISTICAL DATA AND CERTIFICATION STATEMENT R11P229f.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

 

3,264 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 3,264 0 -2,548 0 0 5,812
Annual IC Time Burden (Hours) 163,200 0 -127,400 0 0 290,600
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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