Error Report Submission

Dispute Resolution for Discarded Drug Refunds (CMS-10835)

OMB: 0938-1435

IC ID: 256302

Documents and Forms
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Document Type
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Information Collection (IC) Details

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Error Report Submission
 
No Modified
 
Voluntary
 
42 CFR 414.940

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

Health Health Care Services

 

10 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 10 10 0 0 0 0
Annual IC Time Burden (Hours) 400 400 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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