Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Prepaid Health Plan Cost Report (HCPPS) Modified 30 800 0 Form 276-99
Form CMS-276
Form CMS-276
Instruction
Form CMS-276
Prepaid Health Plan Cost Report (HMO) Modified 76 3572 0 Form CMS-276
Instruction
Form CMS-276
Form CMS-276
Form CMS-276
Total burden requested under this ICR: 106 4372 0  
To view an IC, click on IC Title