Medicare Health Care Provider Enrollment Application and Supporting Regulations -- 42 CFR 405.2401; 410.40, .69; 491.2; 414.451, .52, .56, .60; 424.57, .73; 440.30

Medicare Health Care Provider Enrollment Application and Supporting Regulations -- 42 CFR 405.2401; 410.40, .69; 491.2; 414.451, .52, .56, .60; 424.57, .73; 440.30

OMB: 0938-0685

IC ID: 8277

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Medicare Health Care Provider Enrollment Application and Supporting Regulations -- 42 CFR 405.2401; 410.40, .69; 491.2; 414.451, .52, .56, .60; 424.57, .73; 440.30
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 855G No No
Form 855C No No
Form 855 No No
Form 855S No No


    

165,000 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 165,000 0 5,000 0 0 160,000
Annual IC Time Burden (Hours) 370,000 0 130,000 0 0 240,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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