Information Collection

Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352 through 411.361

IC 8655 under ICR 200407-0938-006 · OMB 0938-0846.

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Information Collection (IC) Details

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IC Title:	Physicians' Referrals to Health Care Entitles With Which They Have Financial Relationships and Supporting Regulations in 42 CFR, Sections 411.352 through 411.361	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	CMS-10047				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 62,824	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	Previously Approved
Annual Number of Responses for this IC	62,824	62,823	1
Annual IC Time Burden (Hours)	422,008	422,007	1
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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