Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Prior Quarter Adjustment Statement (PQAS, CMS-304A) Modified 2440 68320 0 Form CMS-304a
Instruction
Instruction
Instruction
Reconciliation of State Invoice (ROSI, CMS-304) Modified 1708 119560 0 Instruction
Form CMS-304
Instruction
Instruction
Total burden requested under this ICR: 4148 187880 0  
To view an IC, click on IC Title