Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Authorization to Disclose Personal Health Information Modified 1298329 324582 0 Form and Instruction CMS-10106 1-800-MEDICARE Authorization to Disclose Personal Health Information
Form and Instruction CMS-10106 (Spanish Language Version) 1-800-MEDICARE Authorization to Disclose Personal Health Information
Total burden requested under this ICR: 1298329 324582 0  
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