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Information Collection

Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System

IC 43676 under ICR 200703-0938-002 · OMB 0938-0984.

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Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Certification Statement for Electronic File Interchange Organizations that Submit NPI Data to the National Plan and Provider Enumeration System
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10175 Electronic File Interchange Organization (EFIO) Certification Statement CMS-10175.Revised Instrument.8-29-06.doc Yes No Fillable Fileable

Health Health Care Services

 

1,000 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 1,000 0 0 0 0 1,000
Annual IC Time Burden (Hours) 3,000 0 0 0 0 3,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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