Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CMS-R-144 – One-Time System Updates New 56 1344 0
Quarterly Utilization Report (CMS-R-144) Modified 224 12320 0 Form CMS-R-144 Medicaid Drug Rebate Invoice
Instruction
Instruction
Instruction
State Agency Contact Form (CMS-368) Modified 10 5 0 Form CMS-368 State Agency Contact Form
Total burden requested under this ICR: 290 13669 0  
To view an IC, click on IC Title