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Information Collection

Medicare - Information Collection Requirements In Hcfa-pub. 14-3 Carrier Manual Sections 2070.2, 3060.2.d., 4110.2 And 4110.4 - Physician/supplier Background Information

IC 113787 under ICR 198905-0938-001 · OMB 0938-0461.

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MEDICARE - INFORMATION COLLECTION REQUIREMENTS IN HCFA-PUB. 14-3 CARRIER MANUAL SECTIONS 2070.2, 3060.2.D., 4110.2 AND 4110.4 - PHYSICIAN/SUPPLIER BACKGROUND INFORMATION
 
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 HCFA-R-89 No No


    

30,474 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 30,474 0 0 30,474 0 0
Annual IC Time Burden (Hours) 7,617 0 0 7,617 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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