Information Collection

Physician's Burden for Form Completion, Elimination of Narrative Requirement 424.22

IC 191961 under ICR 201703-0938-015 · OMB 0938-1083.

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Information Collection (IC) Details

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IC Title:	Physician's Burden for Form Completion, Elimination of Narrative Requirement 424.22	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 409.44(c)(2)(i) 42 CFR 409.42(c)(1)(i) 42 CFR 424.22 42 CFR 409.44(c) 42 CFR 409.44(b) 42 CFR 409.42(c)(1)

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: 11,968	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: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,096,680	2,751,080	345,600
Annual IC Time Burden (Hours)	206,549	177,749	28,800
Annual IC Cost Burden (Dollars)	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.