Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Files Submission New 320 320 0 Form and Instruction Form #4 Screen Shots of Data Submission
Data Use Agreement Modified 60 3 0 Form and Instruction Form #2 Data Use Agreement
Health Plan Information Modified 320 160 0 Form and Instruction Form #3 Health Plan Information Form
Registration Form and Data Submission Modified 80 7 0 Form and Instruction Form #1 Registration Form
Total burden requested under this ICR: 780 490 0  
To view an IC, click on IC Title