Information Collection Requirements In 42 Cfr Part 405, Conditions Of Coverage For Portable X-ray Suppliers

INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 405, CONDITIONS OF COVERAGE FOR PORTABLE X-RAY SUPPLIERS

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0338 can be found here:

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	INFORMATION COLLECTION REQUIREMENTS IN 42 CFR PART 405, CONDITIONS OF COVERAGE FOR PORTABLE X-RAY SUPPLIERS	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-R-43				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 463	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	463	463
Annual IC Time Burden (Hours)	1,173	1,173
Annual IC Cost Burden (Dollars)	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.