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
Financial Review
Modified
100
3500
0
Form and Instruction
CMS-10328
CMS-10328_Self-Referral_Disclosure_Protocol_Form
Financial Review
Modified
100
1500
0
Form and Instruction
CMS-10328
CMS-10328_Physician_Information_Form
Total burden requested under this ICR:
200
5000
0
To view an IC, click on IC Title
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