Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (Beneficiary) Modified 26827 6707 0
Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (Provider Supplier) Modified 241441 60360 0
Total burden requested under this ICR: 268268 67067 0  
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