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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
GenIC #3 - Alternative Benefit Plans (ABPs)
New
56
728
0
Form
CMS-10434 (#3)
GenIC #3 - Screen Shots (Alternative Benefit Plans)
GenIC #1 - Initial Application
New
56
476
0
Form
CMS-10434 (#1)
Initial Application
Form
CMS-10434 (#1)
Initial Application (SPA Administration)
Form
CMS-10434 (#1)
MACPro Homepage
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
GenIC #2 - CHIP State Plan Eligibility
New
56
1568
0
Form
CMS-10434 (#2)
CHIP Admin
Form
CMS-10434 (#2)
CHIP Eligibility
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Instruction
Total Burden Actually Used for Information Collections Under Currently Approved ICR:
168
2772
0
Total Burden Currently Requested for Information Collections Under Currently Approved ICR:
0
0
0
To view an IC, click on IC Title