Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Request for Medicare Payment Modified 1 1 0 Form and Instruction G-740S (06-18)
Form and Instruction CMS-1500 (02-12)
Form and Instruction G-740S (03-13)
Total burden requested under this ICR: 1 1 0  
To view an IC, click on IC Title