Medicare Participating Physician Or Supplier Agreement And Medicare Participating Physician Or Supplier Agreement (new Physicians Suppliers)

MEDICARE PARTICIPATING PHYSICIAN OR SUPPLIER AGREEMENT AND MEDICARE PARTICIPATING PHYSICIAN OR SUPPLIER AGREEMENT (NEW PHYSICIANS SUPPLIERS)

OMB: 0938-0373

IC ID: 166274

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MEDICARE PARTICIPATING PHYSICIAN OR SUPPLIER AGREEMENT AND MEDICARE PARTICIPATING PHYSICIAN OR SUPPLIER AGREEMENT (NEW PHYSICIANS SUPPLIERS)
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-460 No No
Form 463 No No


    

272,880 0
   
State, Local, and Tribal Governments
 
   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 272,880 0 0 0 0 272,880
Annual IC Time Burden (Hours) 43,661 0 0 0 0 43,661
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.

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