OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

End of Enrollment Budget Report

IC 216248 under ICR 202604-0938-015 · OMB 0938-1119.

Documents and Forms
Document Name
Document Type
Other-Data Elements
Other-Data Elements
Information Collection (IC) Details

View Information Collection (IC)

End of Enrollment Budget Report
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Data Elements CMS-10371 - Performance_Review-Data_Elements.pdf Yes Yes Paper Only

Health Health Care Services

 

20 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 20 0 0 0 0 20
Annual IC Time Burden (Hours) 440 0 0 0 0 440
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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