Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Request for Enrollment in Supplementary Medical Insurance and Supporting Regs in 42 CFR 407.10, 407.11 & 408.40 Modified 10000 2500 0 Form and Instruction CMS-4040SP
Form and Instruction CMS-4040
Total burden requested under this ICR: 10000 2500 0  
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