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Agenda
Reg Review
ICR
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
40740
10185
0
Form and Instruction
CMS-1696
Appointment of Representative
Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (Provider Supplier)
Modified
366565
91664
0
Form and Instruction
CMS-1696
Appointment of Representative
Total burden requested under this ICR:
407305
101849
0
To view an IC, click on IC Title
An official website of the United States government
The .gov means it's official.
The site is secure.
