Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Change of Enrollment Information	Modified	68681	17171	0	Form and Instruction	CMS-855(S)	Medicare Durable Medical Equipment Supplier Enrollment Application
Change of Enrollment Information	Modified	68681	17171	0	Form and Instruction	CMS-855-S	Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Initial Enrollment	Modified	5162	20648	0	Form and Instruction	CMS-855S	Medicare Durable Medical Equipment Supplier Enrollment Application
Initial Enrollment	Modified	5162	20648	0	Form and Instruction	CMS-855-S	Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Revalidation of enrollment information	Modified	21592	16194	0	Form and Instruction	CMS-855S	Medicare Durable Medical Equipment Supplier Enrollment Application
Revalidation of enrollment information	Modified	21592	16194	0	Form and Instruction	CMS-855-S	Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Total burden requested under this ICR:		95435	54013	0
To view an IC, click on IC Title