Information Collection Request

Supporting Statement For Paperwork Reduction Act Submissions - Request for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program and Suppo

ICR 200701-0938-012 · OMB 0938-1016 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10169 CMS-10169 Form D Form and Instruction New Available
Form CMS-10169 CMS-10169 Form D Form and Instruction New Available
Form CMS-10169 Form A CMS-10169 Form A Wizard Screens Form New Repair queued
Form CMS-10169 CMS-10169 Form New Available
Form CMS-10169 Form B CMS-10169 Form B-Screen shot Form New Available
Form CMS-10169 Form B CMS-10169 Form B- Tab Screens Form New Available
Form CMS-10169 CMS 10169 Form B Form New Available
Form CMS-10169 CMS-10169 Form A- Screenshots Form New Available
Form CMS-10169 CMS-10169 Form A Form New Available
Form CMS-10169 CMS-10169 Form C Form New Available
Form CMS-10169 CMS-10169 Form B Form New Available
Form CMS-10169 CMS-10169 Form A Form New Available
Form CMS-10169 CMS-10169 Form New Available
CMS-10169.List of Adjustments to Forms and Instructions.doc Supplementary Document Uploaded 2007-03-27 Available
CMS-10169.Respone to 30 day comment period comment to RFB.doc Supplementary Document Uploaded 2007-02-09 Available
CMS-10169.30-day Public Comment.txt Supplementary Document Uploaded 2007-02-09 Available
12-6-2006 revision to PRA Comments CLEAN.doc Supplementary Document Uploaded 2007-02-07 Available
CMS-10169 Public Comments - Batch #1.pdf Supplementary Document Uploaded 2007-02-07 Available
CMS-10169 DACC Public Comments.pdf Supplementary Document Uploaded 2007-02-07 Available
CMS-10169.Supporting Statement-Part A.FINAL-3-27-07.doc Supporting Statement A Uploaded 2007-03-27 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
46762 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form and Instruction NewCMS-10169 Form D
46762 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form and Instruction NewCMS-10169 Form D
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form A Wizard Screens
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form B-Screen shot
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form B- Tab Screens
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS 10169 Form B
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form A- Screenshots
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form A
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form C
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form B
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169 Form A
46761 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Instruction New
179238 Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Form NewCMS-10169

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2010 36 Months From Approved
39,946 0 0
1,090,826 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program CMS-10169, CMS-10169 ,  
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program CMS-10169, CMS-10169, CMS-10169, CMS-10169, CMS-10169, CMS-10169, CMS-10169 Form B, CMS-10169 Form B, CMS-10169, CMS-10169 Form A ,   ,   ,   ,   ,   ,   ,   ,   ,  
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program CMS-10169

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 39,946 0 0 39,946 0 0
Annual Time Burden (Hours) 1,090,826 0 0 1,090,826 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No