Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare/Medicaid Health Insurance Common Cliam Form, Instructions, and Supporting Regulations: 42 CFR 414.40, 424,32, 424.44 Migrated 695168330 44100662 0 Form HCFA-1490S
Form HCFA-1500
Form HCFA-1490U
Total burden requested under this ICR: 695168330 44100662 0  
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