View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Durable Medical Equipment Regional Carrier, Certificate of Medical Necessity and Supporting Documentation
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-841 Yes Yes
Form 844-853 Yes Yes
Form 842 Yes Yes


    

137,300 0
   
Private Sector Businesses or other for-profits
 
   75 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,800,000 0 42,500 57,500 0 6,700,000
Annual IC Time Burden (Hours) 1,530,000 0 170,000 230,000 0 1,130,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
 
 
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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