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View Information Collection (IC)

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End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR 405.2112
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 405.2110 42 CFR 405.2112

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-685 Yes Yes Fillable Fileable
Instruction Yes Yes Fillable Fileable

Health Health Care Services

 

18 0
   
Private Sector Not-for-profit institutions
 
   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 0 0 0 0 36
Annual IC Time Burden (Hours) 108 0 0 0 0 108
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk 04/29/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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