Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Claims Data and Other Record Reports Preparation (42 CFR 456.709) Modified 204 510 0
Interventions (42 CFR 456.711) Modified 204 12240 0
Medicaid Drug Ulilization Review (DUR) Annual Report (CMS-R-153) Modified 51 1632 0 Form CMS-R-153
Form CMS-R-153
Review of Claims Data and Other Record Reports (42 CFR 456.711) Modified 204 6120 0
Total burden requested under this ICR: 663 20502 0  
To view an IC, click on IC Title