Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Collection of Dental Benefit Information Modified 51 1530 0 Form CMS-10291
Form CMS-10291
Collection of Dental Provider Information Modified 204 8160 0 Form and Instruction CMS-10291
Other-Provider Information - Disclosure Statement
Total burden requested under this ICR: 255 9690 0  
To view an IC, click on IC Title