Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Prior Quarter Adjustment Statement (PQAS) (CMS-304A) Modified 2952 82656 0 Form CMS-304a
Instruction
Instruction
Instruction
Reconciliation of State Invoice (ROSI) (CMS-304) Modified 2068 144760 0 Instruction
Form CMS-304
Instruction
Instruction
Total burden requested under this ICR: 5020 227416 0  
To view an IC, click on IC Title