Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
1135 Waiver Request Automated Process Modified 3730 3730 0 Form and Instruction CMS-10752 Waiver Inquiry Form
Form and Instruction CMS-10752 Helath Care Facility Status Collection Form
Acute Hospital Care at Home Unchanged 290 1899 0 Form and Instruction CMS-10752 Acute Hospital at Home
Total burden requested under this ICR: 4020 5629 0  
To view an IC, click on IC Title