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Federal forms, ICRs, and supporting documents

Information Collection

Sponsor (Report to CMS)

IC 257782 under ICR 202504-0938-005 · OMB 0938-1441.

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Information Collection (IC) Details

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Sponsor (Report to CMS)
 
No Unchanged
 
Mandatory
 
42 CFR 423.2500 - 423.2536

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

Health Health Care Services

 

1 0
   
Private Sector Businesses or other for-profits
 
   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 36,982 0 0 0 0 36,982
Annual IC Time Burden (Hours) 1,232 0 0 0 0 1,232
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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