(CMS-10644) LAN Forum Registration Form

Generic Clearance for the Heath Care Payment Learning and Action Network (CMS-10575)

OMB: 0938-1297

IC ID: 226053

Information Collection (IC) Details

View Information Collection (IC)

(CMS-10644) LAN Forum Registration Form
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10644 LAN Forum Registration Form CMS-10644 GenIC14 LAN Forum Registration Screenshot.png Yes Yes Fillable Fileable

Health Health Care Services

 

2,500 1,000
   
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 2,500 0 2,500 0 0 0
Annual IC Time Burden (Hours) 83 0 83 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10644 Supporting Statement CMS-10644 GenIC14 LAN Forum Registration Form.docx 03/14/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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