Bundled Burden Summary Table
Bundled Burden Table (07-09-2015 submission).xlsx
Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
Bundled Burden Summary Table
OMB: 0938-1148
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1148 can be found here:
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| GenIC ID # |
Title |
Respondents |
Responses (per Respondent) |
Total Responses |
Time (per Response) (hr) |
Total Time (hr) |
| 7 |
CHIPRA Cycle III (Semi-Annual Report) |
n/a |
n/a |
n/a |
n/a |
n/a |
| 7 |
CHIPRA Cycle III (Final Report Addendum) |
41 |
1 |
41 |
2 |
82 |
| 7 |
CHIPRA Cycle IV |
n/a |
n/a |
n/a |
n/a |
n/a |
| 41 |
1095 B Reporting |
56 |
1 |
56 |
1 |
56 |
| TOTAL |
56 |
n/a |
97 |
n/a |
138.00 |
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |