OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Payments for Services Furnished by Certain Primary Care Providers and Supporting Regulations in 42 CFR 438.6, 438.804, 447.400, and 447.410 (CMS-10422)

OMB 0938-1170 · HHS/CMS.

OMB 0938-1170

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10422 State Plan Requirements - Amending FFS Rate Form
Responses to Comments Received.docx Supplementary Document
CMS-10422 - Supporting Statement part A [rev 11-18-2014 by OSORA PRA].doc Supporting Statement A
Primary Care Provider Payment Increases
State Plan Requirements - Amending FFS Rate Form
Primary Care Services Furnished by Physicians with a Specified Specialty or Subspeciality

All Historical Document Collections

201411-0938-009 Withdrawn and continue	Revision of a currently approved collection	2014-11-19
201211-0938-002 Approved without change	New collection (Request for a new OMB Control Number)	2012-11-13
201205-0938-003 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2012-05-16