Information Collection

New Services for Botulinum Toxin Injections Category

IC 281493 under ICR 202607-0938-012 · OMB 0938-1368.

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Information Collection (IC) Details

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IC Title:	New Services for Botulinum Toxin Injections Category	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 419.80-419.83

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: 792	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 70 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	102,657	102,657
Annual IC Time Burden (Hours)	41,555	41,555
Annual IC Cost Burden (Dollars)	1,957,592	1,957,592

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