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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
Nombramiento de un Representante
Appointment of Representative and Supporting Regulations in 42 CFR 405.910 (Provider Supplier)
Modified
366656
91664
0
Form and Instruction
CMS-1696
Nombramiento de un Representante
Total burden requested under this ICR:
407396
101849
0
To view an IC, click on IC Title