Information Collection

Medicare Prescription Drug Benefit Program (Benes)

IC 8823 under ICR 202412-0938-003 · OMB 0938-0964.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type

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IC Title:

Medicare Prescription Drug Benefit Program (Benes)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 42 CFR 423.38 42 CFR 423.56 42 CFR 423.32 42 CFR 423.578 42 CFR 423.34

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,630,100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	4,630,100	4,630,100
Annual IC Time Burden (Hours)	1,157,525	1,157,525
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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