Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Dual Eligible Special Needs Plan Contract with the State Medicaid Agency Modified 525 22432 0 Form and Instruction CMS-10796
Form and Instruction CMS-10796
Form and Instruction CMS-10796
Total burden requested under this ICR: 525 22432 0  
To view an IC, click on IC Title