Prosthetic Authorization And Invoice

PROSTHETIC AUTHORIZATION AND INVOICE

OMB: 2900-0336

IC ID: 174658

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PROSTHETIC AUTHORIZATION AND INVOICE
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 10-2421 No No


    

438,863 0
   
Private Sector Businesses or other for-profits
 
   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 438,836 0 0 0 0 438,836
Annual IC Time Burden (Hours) 30,718 0 0 0 0 30,718
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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