Information Collection

Ambulatory Surgical Centers Conditions for Coverage and Supporting Regulations -- 42 CFR 416.43 and 416.47

IC 8124 under ICR 199709-0938-008 · OMB 0938-0506.

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IC Title:

Ambulatory Surgical Centers Conditions for Coverage and Supporting Regulations -- 42 CFR 416.43 and 416.47

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Migrated

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-54				No	No

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,341

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,341	677	1,664
Annual IC Time Burden (Hours)	1	-16,639	16,640
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.