Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Health Outcomes Survey (HOS) and Supporting Regulations 42 CFR 422.152 Modified 1737 244187 0 Form CMS-10203 Medicare Health Outcomes Survey (HOS 3.0)
Form CMS-10203 Medicare Health Outcomes Survey-Modified (HOS-M)
Other-Mailing materials
Total burden requested under this ICR: 1737 244187 0  
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