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) Unchanged 208 1040 0
Interventions (42 CFR 456.711) Unchanged 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
Proposed (CMS-4208-P, RIN 0938-AV40) ICRs Regarding Part D Coverage of Anti-Obesity Medications (ยง 423.100) and Application to the Medicaid Program New 39 1560 0
Review of Claims Data and Other Record Reports (42 CFR 456.711) Unchanged 208 12480 0
Total burden requested under this ICR: 715 43420 0  
To view an IC, click on IC Title