Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Uniform Institutional Provider Bill and Supporting Regulations in 42 CFR 424.5 New 858881 7194 0 Form and Instruction CMS-1450 (UB04) Front Uniform Institutional Providers Form
Form and Instruction CMS-1450 (UB04) Back Uniform Institutional Providers Form
Total burden requested under this ICR: 858881 7194 0  
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