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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CA-26, Authorization Request Form and Certification/Letter of Medical Necessity for Compounded Drugs
New
15500
7750
0
Form and Instruction
CA-26
Authorization Request Form and Certification/Letter of Medical Necessity for Compounded Drugs
CA-27, Authorization Request form and Certification/Letter of Medical Necessity for Opioie Medications
New
154500
77250
0
Form and Instruction
CA-27
Authoriization/Request Form and Certification/Letter of Medical Necessity for Opioid Medications
Total burden requested under this ICR:
170000
85000
0
To view an IC, click on IC Title