Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Administrative Requirements for Section 6071 of the DRA Modified 410 5003 0 Form CMS-10249
Form CMS-10249
Instruction
Form CMS-64.9i, -64.9pi, -64.10i, and -64.910pi,
Form and Instruction CMS-10249
Form and Instruction CMS-10249
Other-Operational Protocol
Form CMS-10249
Instruction
Other-Portal Screenshot
Other-Portal Screenshot
Other-Portal Screenshot
Other-Portal Screenshot
Total burden requested under this ICR: 410 5003 0  
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