Provider Network Coverage - Provider Discontinuation

Provider Network Coverage Data Collection (CMS-10594)

OMB: 0938-1302

IC ID: 219311

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Information Collection (IC) Details

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Provider Network Coverage - Provider Discontinuation
No Modified
Required to Obtain or Retain Benefits
45 CFR 156.156(f) 45 CFR 156.230(e)

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

Health Health Care Services


747 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 747 0 0 376 0 371
Annual IC Time Burden (Hours) 551,276 0 0 550,905 0 371
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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