Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Modified 43199 44165 0 Form and Instruction CMS-P-0015A Comm2017R77KNQ
Form and Instruction CMS-P-0015A 2019CommShowcards_ForOMB30Day
Form and Instruction CMS-P-0015A Comm2017R78IAQ
Form and Instruction CMS-P-0015A Comm2017R79DIQ
Form and Instruction CMS-P-0015A Comm2017R79END
Form and Instruction CMS-P-0015A Comm2017R79ENS
Form and Instruction CMS-P-0015A Comm2017R79ERQ
Form and Instruction CMS-P-0015A Comm2017R79HAQ
Form and Instruction CMS-P-0015A Comm2017R79HHQ
Form and Instruction CMS-P-0015A Comm2017R79HHS
Form and Instruction CMS-P-0015A Comm2017R79INQ
Form and Instruction CMS-P-0015A Comm2017R79IPQ
Form and Instruction CMS-P-0015A Comm2017R79IUQ
Form and Instruction CMS-P-0015A Comm2017R79MBQ
Form and Instruction CMS-P-0015A Comm2017R79OPQ
Form and Instruction CMS-P-0015A Comm2017R79PMQ
Form and Instruction CMS-P-0015A Comm2017R79PSQ
Form and Instruction CMS-P-0015A Comm2018R80ACQ
Form and Instruction CMS-P-0015A Comm2018R80USQ
Form and Instruction CMS-P-0015A Comm2018R81RXQ
Form and Instruction CMS-P-0015A Comm2018R82HFQ
Form and Instruction CMS-P-0015A Comm2018R82NAQ
Form and Instruction CMS-P-0015A Comm2018R82SCQ
Form and Instruction CMS-P-0015A Comm2019R83CPS
Form and Instruction CMS-P-0015A Comm2019R83DVH
Form and Instruction CMS-P-0015A Comm2019R83HIQ
Form and Instruction CMS-P-0015A Comm2019R83MPQ
Form and Instruction CMS-P-0015A Comm2019R83NSQ
Form and Instruction CMS-P-0015A Comm2019R83OMQ
Form and Instruction CMS-P-0015A Comm2019R83STQ
Form and Instruction CMS-P-0015A Comm2019R84CPQ
Form and Instruction CMS-P-0015A Comm2019R85PVQ
Form and Instruction CMS-P-0015A Attachment 4 Facility Screener
Form and Instruction CMS-P-0015A 2019FacilityShowcards_ForOMB
Form and Instruction CMS-P-0015A Fac2017R79RH
Form and Instruction CMS-P-0015A Fac2017R79RHM
Form and Instruction CMS-P-0015A Fac2017R79US
Form and Instruction CMS-P-0015A Fac2019R85BQ
Form and Instruction CMS-P-0015A Fac2019R85BQM
Form and Instruction CMS-P-0015A Fac2019R85EX
Form and Instruction CMS-P-0015A Fac2019R85FQ
Form and Instruction CMS-P-0015A Fac2019R85FQM
Form and Instruction CMS-P-0015A Fac2019R85HS
Form and Instruction CMS-P-0015A Fac2019R85IN
Form and Instruction CMS-P-0015A OMB Facility Specs Guide
Total burden requested under this ICR: 43199 44165 0  
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