OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Summary of Eligibility and Payment Review Findings

IC 46148 under ICR 202408-0938-027 · OMB 0938-1012.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Summary of Eligibility and Payment Review Findings
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10184 Monthly Sample Selection List -CMS-10184.Monthly Sample Selection List.doc Yes Yes Fillable Fileable

Health Health Care Services

 

34 0
   
State, Local, and Tribal Governments
 
   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 0 0 -34 0 34 0
Annual IC Time Burden (Hours) 0 0 -3,400 0 3,400 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.