Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Data Files Submission Modified 340 340 0 Form and Instruction Form #4
Data Use Agreement Modified 75 4 0 Form and Instruction Form #2
Health Plan Information Modified 300 150 0 Form and Instruction Form #3
Registration Form and Data Submission Modified 85 7 0 Form and Instruction 1
Total burden requested under this ICR: 800 501 0  
To view an IC, click on IC Title