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Medicare Clinical Laboratory Services Competitive Bidding Demonstration Project: Bidding Form

IC 45032 under ICR 200608-0938-004 · OMB 0938-1008.

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Medicare Clinical Laboratory Services Competitive Bidding Demonstration Project: Bidding Form
 
No New
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10193 The Medicare Clinical Laboratory Competitive Biddin CMS 10193 LAB Application Form (without Track Changes) 07 06 06 -- jk edits 7-13-06.doc Yes Yes Fillable Printable
Instruction CMS 10193 LAB Competitive Bidding Application Instructions (without Track Changes) 07 06 06 --lebovic 7-12-06.doc Yes Yes Fillable Fileable

Health Health Care Services

 

70 0
   
State, Local, and Tribal Governments
 
   95 %

  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 70 70 0 0 0 0
Annual IC Time Burden (Hours) 7,000 7,000 0 0 0 0
Annual IC Cost Burden (Dollars) 4,113 4,113 0 0 0 0

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