Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Claims Data and Other Record Reports Preparation (42 CFR 456.709) Modified 208 1040 0
Interventions (42 CFR 456.711) Modified 208 24960 0
Medicaid Drug Ulilization Review (DUR) Annual Report (42 CFR 456.712 and 438.3) Modified 52 3380 0 Form CMS-R-153
Form CMS-R-153
Form CMS-R-153
Form CMS-R-153
Review of Claims Data and Other Record Reports (42 CFR 456.711) Modified 208 12480 0
Total burden requested under this ICR: 676 41860 0  
To view an IC, click on IC Title