Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Application for Suppliers (Form A) New 337 2696 0 Form and Instruction CMS-10169 Application for Suppliers
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Bidding Form (Form B) New 337 24264 0 Form and Instruction CMS-10169 Form B - Bidding Form
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Quarterly Reporting Form (Form C) New 1424 474 0 Form and Instruction CMS-10169 Form C Quarterly Report
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Subcontracting Disclosure New 100 28 0 Form and Instruction CMS-10169 Subcontracting Disclosure Form
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Form D) Removed 0 0 0 Form and Instruction CMS-10169 CMS-10169.REVISED RFB Form D
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Forms A, B, C) Removed 0 0 0 Form and Instruction CMS-10169 CMS-10169.RFB Form C
Form and Instruction CMS-10169 CMS-10169.RFB Form A
Form and Instruction CMS-10169 CMS-10169.RFB Form B
Requests for Bids (RFB) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (Subcontracting) Removed 0 0 0
Round 1 Re-Compete for the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program; Beneficiary Survey (Form D) New 14667 7333 0 Form and Instruction CMS-10169 Beneficiary Survey
Total burden requested under this ICR: 16865 34795 0  
To view an IC, click on IC Title