Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Prepaid Health Plan Cost Report (HCPPS) Modified 27 720 0 Instruction
Form CMS-276
Form CMS-276
Form CMS-276
Form CMS-276
Prepaid Health Plan Cost Report (HMO) Modified 30 1080 0 Instruction
Form CMS-276
Form CMS-276
Form CMS-276
Form CMS-276
Total burden requested under this ICR: 57 1800 0  
To view an IC, click on IC Title