Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Bidding Form (Form B)

Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program

OMB: 0938-1016

IC ID: 203538

Information Collection (IC) Details

View Information Collection (IC)

Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Bidding Form (Form B)
 
No Removed
 
Mandatory
 
42 CFR 414.410

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10169 Form B - Bidding Form Form B_2012.docx Yes Yes Fillable Fileable

Health Health Care Services

 

1,011 708
   
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 0 0 -337 0 0 337
Annual IC Time Burden (Hours) 0 0 -24,264 0 0 24,264
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Furnished Items screenshot Form B-1.jpg 07/25/2012
Expansion screenshot Form B-2.jpg 07/25/2012
Bid Select screenshot Form B-3.jpg 07/25/2012
Manufacturer screenshot Form B-4.jpg 07/25/2012
Bid (Certification) screenshot Form B-5.jpg 07/25/2012
Public Address Announcement screenshot Form B-6.jpg 07/25/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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