Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
1135 Waiver Request Automated Process Unchanged 6699 6699 0 Form and Instruction CMS-10752
Acute Hospital Care at Home Unchanged 496 1625 0 Form and Instruction CMS-10752
Form and Instruction CMS-10752
Form and Instruction CMS-10752
Total burden requested under this ICR: 7195 8324 0  
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