Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Preparation and Issuance of Model Notices (section 423.120(c)(6)) Modified 15000 1245 0 Form and Instruction CMS-10141
Business Continuity Plans under 422.504(o) and 423.505(p) Modified 99 4960 0
Medicare Prescription Drug Benefit Program (Benes) Modified 4630100 1157525 0
Medicare Prescription Drug Benefit Program (Plans) Modified 662883048 53332340 584811068 Instruction
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
Form and Instruction CMS-10141
State Eligibility Determinations (423.904(b)) and Reporting (423.910(d)) Unchanged 600102 13260 0
Total burden requested under this ICR: 668128349 54509330 584811068  
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