Information Collection

Face-to-Face encounter, physician's burden for form completion, supporting regulation 424.22 (annual)

IC 195704 under ICR 201312-0938-020 · OMB 0938-1083.

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Information Collection (IC) Details

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IC Title:	Face-to-Face encounter, physician's burden for form completion, supporting regulation 424.22 (annual)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 424.22(a)(1)(v)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,926,420	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,926,420	2,926,420
Annual IC Time Burden (Hours)	243,868	243,868
Annual IC Cost Burden (Dollars)	0	0

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