Information Collection

(medicare) Uniform Institutional Provider Bill

IC 113328 under ICR 198601-0938-006 · OMB 0938-0279.

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Documents and Forms

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Information Collection (IC) Details

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IC Title:	(MEDICARE) UNIFORM INSTITUTIONAL PROVIDER BILL	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-1450				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 61	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	61,180,449	135,678,681	-100,498,232	26,000,000
Annual IC Time Burden (Hours)	4,431,103	-1,328,184	983,796	4,775,491
Annual IC Cost Burden (Dollars)	0	0	0	0

Documents for IC

Title	Document	Date Uploaded

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