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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 for Institutional Providers
Modified
217470
41120
0
Form and Instruction
CMS-855A
Medicare Enrollment Application - Institutional Providers
REH Completion of CMS-855A Change of Information
New
23
23
0
Form and Instruction
CMS-855A
Medicare Enrollment Application - Institutional Providers
Total burden requested under this ICR:
217493
41143
0
To view an IC, click on IC Title
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The .gov means it's official.
The site is secure.
