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

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

OMB: 0938-1016

IC ID: 203539

Information Collection (IC) Details

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Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Quarterly Reporting Form (Form C)
 
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 Quarterly Report 508_CMS-10169_Form_C.pdf Yes No Fillable Printable

Health Health Care Services

 

1,247 867
   
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 0 0 -2,494 0 0 2,494
Annual IC Time Burden (Hours) 0 0 -831 0 0 831
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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