Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Preparation and Issuance of Model Notices (section 423.120(c)(6)) Unchanged 95000 7885 0 Other-Part C and D Sample Precluded Provider Letter
Business Continuity Plans under 422.504(o) and 423.505(p) Modified 99 15920 0 Form CMS-10141
Form CMS-10141
Form CMS-10141
Form CMS-10141
Instruction
Form CMS-10141
Form CMS-10141
Instruction
Instruction
Creation of Model Notices (Plans) (section 423.120(c)(6)) Unchanged 212 636 0 Instruction
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Medicare Prescription Drug Benefit Program (Benes) Modified 11736619 3003602 0
Medicare Prescription Drug Benefit Program (Plans) Modified 616933733 9178691 5751142 Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
State Eligibility Determinations (423.904(b)) and Reporting (423.910(d)) Unchanged 600102 13260 0
System Programming (Plans) (section 423.120(c)(6)) Unchanged 30 93600 0
Total burden requested under this ICR: 629365795 12313594 5751142  
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