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  
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