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
Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form
New
20000
5000
0
Form and Instruction
CMS-10220
CMS-10220 Type 1 - Individual Enrollment Security Consent Form
Form and Instruction
CMS-10220
CMS-10220 Type 2 - Organization Enrollment Security Consent Form
Provider Enrollment Chain and Ownership System (PECOS) Web Security Consent Form
New
157500
39375
0
Form and Instruction
CMS-10220
Organization Enrollment Security Consent Form
Form and Instruction
CMS-10220
Individual Enrollment Security Consent Form
Total burden requested under this ICR:
177500
44375
0
To view an IC, click on IC Title
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