Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.
State Plan Under Title XIX of the Social Security Act (Base plan pages)	Modified	1120	22400	0	Form and Instruction	CMS-179
					Other-Exhibt A
					Other-Exhibit A1
					Other-Exhibit AA
					Other-Exhibit AB
					Other-Exhibit AC
					Other-Exhibit AD
					Other-Exhibit AE
					Other-Exhibit AF
					Other-Exhibit AG
					Other-Exhibit D and E
					Other-Exhibit F and G
					Other-Exhibit H and J
					Other-Exhibit N
					Other-Exhibit O
					Other-Exhibit P
					Other-Exhibit Y
					Other-FMG
					Other-Exhibit R S T U
Total burden requested under this ICR:		1120	22400	0
To view an IC, click on IC Title