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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Corrective Action Report
Modified
34
34000
0
Form
CMS-10184
Summary of Eligibility and Payment Review Findings
Monthly Sampling Lists
Modified
408
40800
0
Form
CMS-10184
Monthly Sample Selection List
Payment Error Rate Measurement - State Medicaid and CHIP Eligibility (MEQC Substitution)
Modified
19
407094
0
Form and Instruction
CMS-10184
MEQC Substitution
Form
CMS-10184
MEQC substitution Detailed Case Review Findings
Reinstatement of Prior Burden Estimates for CMS-10184E
Modified
204
20400
0
Form and Instruction
CMS-10184
MEQC substitution Summary of Findings
Reporting Individual Payment Findings
Modified
408
40800
0
Form
CMS-10184
Detailed Payment Review Findings
Reporting Individual Review Findings
Modified
408
40800
0
Form
CMS-10184
Detailed Active Case Review Findings
Form
CMS-10184
Review Findings
Review Findings
Modified
34
324870
0
Form
CMS-10184
Monthly Sample Selection List
Sampling Plan
Modified
34
34000
0
Instruction
Form
CMS-10184
Monthly Sample Selection List
Summary of Eligibility and Payment Review Findings
Modified
34
3400
0
Form and Instruction
CMS-10184
Monthly Sample Selection List
Total burden requested under this ICR:
1583
946164
0
To view an IC, click on IC Title