PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
PECOS Web Security Consent Form - Individuals
Removed
0
0
0
Form and Instruction
CMS-10220
Security Consent and Surrogate Authorization Form
PECOS Web Security Consent Form - Organizations
Removed
0
0
0
Form and Instruction
CMS-10220
Security Consent and Surrogate Authorization Form
Security Consent and Surrogate Authorization Form - Providers
New
226100
226100
0
Form and Instruction
CMS-10220
Security Consent Form
Total burden requested under this ICR:
226100
226100
0
To view an IC, click on IC Title
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