Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Authorization to Disclose Personal Health Information Modified 2000000 500000 0 Form and Instruction CMS-10106 Medicare Authorization to Disclose Personal Health Information
Form and Instruction CMS-10106 Medicare Authorization to Disclose Personal Health Information (Spanish)
Total burden requested under this ICR: 2000000 500000 0  
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