Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Advance Beneficiary Notice of Noncoverage (ABN) and Supporting Regulations in 42 CFR 411.404 and 411.408 Modified 52967771 6177101 0 Instruction
Form CMS-R-131 ABN
Form CMS-R-131 Spanish ABN
Total burden requested under this ICR: 52967771 6177101 0  
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