Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Account Discrepancy
Unchanged
20
5
0
Form and Instruction
30
Account Discrepancy
Accreditation
Unchanged
10
8
0
Form and Instruction
6
Accreditation
Agent Registration (Initial)
Unchanged
100
25
0
Form and Instruction
26
Agent Registration (Initial)
Agent Registration (Renewal & Update)
Unchanged
100
25
0
Form and Instruction
27
Agent Registration (Renewal & Update)
Authorized Agent Designation
Unchanged
1290
323
0
Form and Instruction
29
Authorized Agent Designation
Civil Judgment
Unchanged
10
8
0
Form and Instruction
13
Civil Judgement
Continuous Query
Unchanged
387767
31021
0
Form and Instruction
21
Continuous Query
Correction, Revision to Action, Correction of Revision to Action, Void, Action on Appeal
Unchanged
38785
9696
0
Form and Instruction
1
Correction, Revision to Action, Correction of Revision to Action, Void, Action on Appeal
Criminal Conviction (Guilty Plea or Trial)
Unchanged
1023
767
0
Form and Instruction
9
Criminal Conviction (Guilty Plea or Trial)
DEA/Federal Licensure
Unchanged
499
374
0
Form and Instruction
4
DEA/Federal Licensure
Deferred Conviction or Pre-Trial Diversion
Unchanged
126
95
0
Form and Instruction
10
Deferred Conviction or Pre-Trial Diversion
Electronic Transfer of Funds (ETF) Authorization
Unchanged
562
141
0
Form and Instruction
28
Electronic Transfer of Funds (ETF) Authorization
Entity Registration (Initial)
Unchanged
35915
35915
0
Form and Instruction
24
Entity Registration (Initial)
Entity Registration (Renewal & Update)
Unchanged
15461
1237
0
Form and Instruction
25
Entity Registration (Renewal & Update)
Exclusion/Debarment
Unchanged
2402
1802
0
Form and Instruction
14
Exclusion/Debarment
Government Administrative
Unchanged
2682
2012
0
Form and Instruction
15
Government Administrative
Health Plan Action
Unchanged
561
421
0
Form and Instruction
16
Health Plan Action
Injunction
Unchanged
10
8
0
Form and Instruction
12
Injunction
Medical Malpractice Payment
Unchanged
14193
10645
0
Form and Instruction
2
Medical Malpractice Payment
Nolo Contendere (no contest) plea
Unchanged
63
47
0
Form and Instruction
11
Nolo Contendere (no contest) plea
One Time Query for an Individual
Unchanged
986552
78924
0
Form and Instruction
17
One Time Query for an Individual
One Time Query for an Organization
Unchanged
18892
1511
0
Form and Instruction
18
One Time Query for an Organization
Peer Review Organization
Unchanged
10
8
0
Form and Instruction
5
Peer Review Organization
Professional Society
Unchanged
71
53
0
Form and Instruction
8
Professional Society
Request for Secretarial Review
Modified
83
664
0
Form and Instruction
23
Dispute Resolution
Self-Query on an Individual
Unchanged
154824
65026
0
Form and Instruction
19
Self-Query on an Individual
Self-Query on an Organization
Unchanged
1095
460
0
Form and Instruction
20
Self-Query on an Organization
State Licensure
Unchanged
28700
21525
0
Form and Instruction
3
State Licensure
Subject Statement and Dispute
Unchanged
3347
2510
0
Form and Instruction
22
Subject Statement and Dispute
Title IV Clinical Privileges Actions
Unchanged
962
722
0
Form and Instruction
7
Title IV Clinical Privileges Actions
Total burden requested under this ICR:
1696115
265978
0
To view an IC, click on IC Title