Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Expanded Monitoring Site Review: Beneficiary Interview Form Modified 22000 3667 0 Form SSA-639 Expanded Monitoring Site Review Beneficiary Review Form
Other-Revised PA & PRA Statements
Site Review Questionnaires for Volume and Fee-for-Service Payees Modified 5000 10000 0 Form SSA-637 Expanded Monitoring Site Review Questionnaire for Volume and Fee for Service Payees
Other-Revised PA & PRA Statements
Total burden requested under this ICR: 27000 13667 0  
To view an IC, click on IC Title