View Information Collection (IC)

View Information Collection (IC)

States - Data submission
No Modified

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10320 CMS-10320.FINAL State Instructions and Instrument (5-5-10). CMS-10320.FINAL State Instructions and Instrument (5-5-10).pdf Yes No Fillable Fileable Signable
Form 00 HIOS Issuer Data Entry Form hios_issuer_data_entry_form_05022011.xls Yes Yes Fillable Printable

Health Health Care Services


50 0
State, Local, and Tribal Governments
   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 50 0 0 0 50 0
Annual IC Time Burden (Hours) 8 0 0 0 8 0
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.