Form C-Semi Annual Report Screen Shot

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

OMB: 0938-1016

IC ID: 203539

Information Collection (IC) Details

View Information Collection (IC)

Form C-Semi Annual Report Screen Shot
 
No Modified
 
Mandatory
 
42 CFR 414.410

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form FORM C SEMI ANNUAL Report e-signature Connexion - Form C_esignature.pdf Yes Yes Fillable Fileable
Form and Instruction FORM C Semi Annual Report Screen Shot 1 Connexion - Form C1.pdf Yes Yes Fillable Fileable Signable
Form and Instruction FORM C Semi Annual Report Screen Shot 2 Connexion - Form C2.pdf Yes Yes Fillable Fileable Signable

Health Health Care Services

 

1,594 1,116
   
Private Sector Businesses or other for-profits
 
   100 %

  Requested 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 3,188 0 0 694 0 2,494
Annual IC Time Burden (Hours) 625 0 0 -206 0 831
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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