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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
State Drug Rebate (Medicaid)
Modified
224
12101
0
Form
CMS-368
State Agency Contact Form
Form
CMS-R-144
Medicaid Drug Rebate Invoice
Instruction
Instruction
Instruction
Total burden requested under this ICR:
224
12101
0
To view an IC, click on IC Title