Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification (A.S.) Complaint Form Modified 400 400 18256 Form and Instruction CMS-10148 HIPAA ADMINISTRATIVE SIMPLIFICATION (NON-PRIVACY/SECURITY) COMPLAINT FORM
Total burden requested under this ICR: 400 400 18256  
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