Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
CMS-304 and CMS-304a – One-Time System Updates New 749 17976 0
Prior Quarter Adjustment Statement (PQAS) (CMS-304a) Modified 2996 83888 0 Form CMS-304a
Instruction
Instruction
Instruction
Reconciliation of State Invoice (ROSI) (CMS-304) Modified 2096 146720 0 Instruction
Form CMS-304
Instruction
Instruction
Total burden requested under this ICR: 5841 248584 0  
To view an IC, click on IC Title