Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Quarterly Utilization Report (CMS-R-144) Modified 224 12096 0 Form CMS-R-144
Instruction
Instruction
Instruction
State Agency Contact Form (CMS-368) Modified 10 5 0 Form CMS-368
Total burden requested under this ICR: 234 12101 0  
To view an IC, click on IC Title