PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
HOME HEALTH AGENCY STATEMENT OF REIMBURSABLE COST - HOSPITAL BASED HOME HEALTH AGENCY STATEMENT OF REIMBURSABLE COST
Migrated
2500
18000
0
Form
SSA-1728
Total burden requested under this ICR:
2500
18000
0
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