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  
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