Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
(REVISED) CMS-10710. GenIC#15 – TRIPTK- Journey AI Survey - Medical Professionals New 300 1 0 Form and Instruction CMS-10710.GenIC#15
CMS-10710. GenIC #9 - Notice Testing: CMS Notice of Denial of Part D Drug Coverage (CMS-10146) New 24 24 0 Form and Instruction CMS-10146
Form and Instruction CMS-10146
CMS-10710. GenIC#13 - TRIPTK New 132 192 0 Form and Instruction CMS-10710
Form and Instruction CMS-10710
Form and Instruction CMS-10710
Form and Instruction CMS-10710
Form and Instruction CMS-10710
Form and Instruction CMS-10710
CMS-10710. GenIC#15 – TRIPTK- Journey AI Survey - Professionals New 300 100 0 Form and Instruction CMS-10710
CMS-10710.GenIC #6 - Marketplace IVR Customer Sat Survey (A11 Section 280) Unchanged 300000 25000 0 Form and Instruction CMS-10710.GenIC#6
CMS-10710.GenIC#10.- Notice Testing: CMS Notice of Denial of Medical Coverage (CMS-10003) New 24 24 0 Form and Instruction CMS-10003
Form and Instruction CMS-10003
CMS-10710.GenIC#4 - Healthcare.gov Web Satisfaction Survey (A11 Section 280) Unchanged 24000 1600 0 Form and Instruction CMS-10710.GenIC#4
CMS-10710.GenIC#4 - Healthcare.gov Web Satisfaction Survey (REVISON) New 24000 2 0 Form and Instruction CMS-10710.GenIC#4 (REVISION)
CMS-10710.GenIC#5 - Medicare.gov Web Sat Survey (A11 Section 280) Unchanged 360000 24000 0 Form and Instruction CMS-10710.GenIC#5
CMS-10710.GenIC#7 - Medicare IVR Customer Sat Survey (A11 Section 280) (30-day) Unchanged 1000000 83333 0 Form and Instruction CMS-10710.GenIc#7
CMS-10710.GenIC#8 - High Impact Trust Survey Medicare New 10000 500 0 Form and Instruction CMS-10710.GenIC #8
Facing Financial Shock Applicant Recruitment Survey (CMS-10900) New 1200 200 0 Form and Instruction CMS-10900
GenIC #11 - Notice Testing: CMS Notice of Change of Status (CMS-10868) New 24 24 0 Form and Instruction CMS-10710.GenIC#11
GenIC #12 – Usability and Cognitive Testing: HC.gov Application Enhancements for DACA Recipients New 48 48 0 Form and Instruction CMS-10710#12
GenIC#14 – TRIPTK- Journey AI Surveys Beneficiaries and Caregivers New 1100 366 0 Form and Instruction CMS-10710.GenIC#14
[Medicaid] Insure Kids Now Customer Feedback Survey (CMS-10910) New 100 3 0 Form and Instruction CMS-10910
[Medicaid] Medicaid.gov Customer Feedback Survey (CMS-10909) New 2643 88 0 Form and Instruction CMS-10909
[Medicaid] Medicaid.gov Feedback Survey (CMS-10911) New 1300 22 0 Form and Instruction CMS-10911
Form CMS-10911
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 1725195 135527 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
To view an IC, click on IC Title