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Federal forms, ICRs, and supporting documents

Information Collection

Section 493.1359- 493.1489-1491

IC 264337 under ICR 202606-0938-021 · OMB 0938-0612.

Documents and Forms
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IC Document
IC Document
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Section 493.1359- 493.1489-1491
 
No Unchanged
 
Mandatory
 
42 CFR 493.1359- 493.1489-1491

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

Health Health Care Services

 

34,082 0
   
State, Local, and Tribal Governments
 
   0 %

  Requested 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 34,082 0 0 0 0 34,082
Annual IC Time Burden (Hours) 238,574 0 0 0 0 238,574
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk 2024.01.29_CMS3326F Crosswalk with Dtags and IGs_DRAFT_pk.xlsx 06/03/2024
Crosswalk 2024.01.29_CMS3326F-Crosswalk w D-tags_DRAFT_PK.docx 06/03/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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