CMS-855-S Medicare Enrollment Application: Durable Medical Equipme

Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers (Form 855S)

CMS- 855S - DMEPOS Supplier PECOS Screen Shots - Word - 508

Change of Enrollment Information

OMB: 0938-1056

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1056 can be found here:

2023-09-20 - Revision of a currently approved collection

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PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.
Larger screen shot so that the text is readable.

You may also access these screens at https://pecos.cms.hhs.gov.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

PECOS Screen Shots for PRA package for CMS 855S - Medicare Enrollment Application - Durable
Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Suppliers.

File Type	application/pdf
File Title	855S DMEPOS Supplier PECOS Screen Shots - 04092015
Author	CMS
File Modified	2015-12-04
File Created	2015-12-04