Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration and Supporting Regulations in 42 CFR, 405.2133; PL 95-292; CFR Parts.... Modified 130000 97500 0 Form and Instruction CMS-2728 End State Renal Disease Medical Evidence Report
Total burden requested under this ICR: 130000 97500 0  
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