Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Mode Experiment Modified 4710 612 0 Form CMS-10500
Other-Cover Letter
Form and Instruction CMS-1500
National Implementation New 2808900 365157 0 Form CMS-10500
Other-Cover Letter
Form and Instruction CMS-10500
Preparing Patient Records New 9463 321742 0 Form CMS-10500
Total burden requested under this ICR: 2823073 687511 0  
To view an IC, click on IC Title