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Federal forms, ICRs, and supporting documents

Information Collection

Accepting New Patients Indicator UPIN (Unique Physician Identifi- cation Number) Participating Physicians Directory

IC 8744 under ICR 200703-0938-015 · OMB 0938-0905.

Documents and Forms
Document Name
Document Type
Other-Template
Information Collection (IC) Details

View Information Collection (IC)

Accepting New Patients Indicator UPIN (Unique Physician Identifi- cation Number) Participating Physicians Directory
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Template CMS-10091 accepting new pts template.doc Yes Yes Paper Only

Health Health Care Services

 

10,980 0
   
Private Sector Businesses or other for-profits
 
   100 %

  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 10,980 0 0 0 0 10,980
Annual IC Time Burden (Hours) 915 0 0 0 0 915
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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