Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Detailed Explanation of Non-Coverage (CMS-10124) Modified 369755 472305 0 Instruction
Form CMS-10124
Form CMS-10124
Notice of Provider Non-Coverage (CMS-10123) Modified 21000000 3500000 0 Instruction
Form CMS-10123
Form CMS-10123
Total burden requested under this ICR: 21369755 3972305 0  
To view an IC, click on IC Title