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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Medicare Enrollment Application
Modified
429450
856395
0
Form and Instruction
CMS-855B
Medicare Enrollment Application - Clinics/group Practices and Certain Other Suppliers
Form and Instruction
CMS-855(I)
Medicare Enrollment Application -Physicians and Non-Physician Practitioners
Form and Instruction
CMS-855(R)
Medicare Enrollment Application -REASSIGNMENT OF MEDICARE BENEFITS
Form and Instruction
CMS-855A
Medicare Enrollment Application - Institutional Providers
Total burden requested under this ICR:
429450
856395
0
To view an IC, click on IC Title