OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Enrollment Procces (Part D sponsors) (423.32)

IC 240724 under ICR 202512-0938-014 · OMB 0938-1378.

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

View Information Collection (IC)

Enrollment Procces (Part D sponsors) (423.32)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 423.32(c)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10718 Enrollment Form CY 2027 - Model MA PDP Indiv Enrollment Request Form.docx Yes Yes Fillable Printable

Health Health Care Services

Medicare Advantage Prescription Drug (MARx) System  83 FR 6591

60 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 8,700,438 0 0 582,028 0 8,118,410
Annual IC Time Burden (Hours) 1,740,086 0 0 116,404 0 1,623,682
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].