View Information Collection (IC)

View Information Collection (IC)

IC Title:	Burden Estimates	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 147.136

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			CMS-10338 Letter to Issuers.pdf		Yes	No	Fillable Fileable
Instruction			CMS-10338 Letter to Issuers in Territories.pdf		Yes	No	Fillable Fileable
Form and Instruction	CMS-10338	CMS-10338 abd_model_notice	CMS-10338 abd_model_notice.pdf		Yes	No	Fillable Fileable
Form and Instruction	CMS-10338	CMS-10338 final_iabd_model_notice	CMS-10338 final_iabd_model_notice.pdf		Yes	No	Fillable Fileable
Form and Instruction	CMS-10338	CMS-10338 external_final_decision_model_notice	CMS-10338 external_final_decision_model_notice.pdf		Yes	No	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 46,773	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 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	218,000,000	0	0	147,165,403	70,834,597	0
Annual IC Time Burden (Hours)	930,000	0	0	-267	930,267	0
Annual IC Cost Burden (Dollars)	52,000,000	0	0	15,224,933	36,775,067	0

Documents for IC

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.