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Agenda
Reg Review
ICR
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
Form and Instruction
CMS-855-S
Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Enrollment of MA Providers, Suppliers, and First-Tier, Downstream, and Related Entities (FDRs) (section 422.222)
Modified
10666
42664
0
Form and Instruction
CMS-855S
Medicare Durable Medical Equipment Supplier Enrollment Application
Form and Instruction
CMS-855S
Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Initial Enrollment
Modified
10323
20648
0
Form and Instruction
CMS-855S
Medicare Durable Medical Equipment Supplier Enrollment Application
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
Form and Instruction
CMS-855-S
Medicare Enrollment Application: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Suppliers
Total burden requested under this ICR:
111262
96677
0
To view an IC, click on IC Title