? 423.910 (One-time System Update)

Monthly State File of Medicaid/Medicare Dual Eligible Enrollees (CMS-10143)

OMB: 0938-0958

IC ID: 235245

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§ 423.910 (One-time System Update)
 
No Modified
 
Mandatory
 
42 CFR 423.910

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

Health Health Care Services

 

36 0
   
State, Local, and Tribal Governments
 
   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 36 0 36 0 0 0
Annual IC Time Burden (Hours) 960 0 960 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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