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
Migrated
2800
112000
0
Form
HCFA 1728
Form
B, C, D
Form
AND 1728 A,
Total burden requested under this ICR:
2800
112000
0
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