Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Private Sector -- Retiree Drug Subsidy (RDS) Payment Request and Instructions (CMS-10170) Modified 3000 453000 0 Instruction
Form CMS-10170
Public Respondents - Retiree Drug Subsidy (RDS) Payment Request and Instructions (CMS-10170) Modified 1500 226500 0 Instruction
Form CMS-10170
Total burden requested under this ICR: 4500 679500 0  
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