View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

State Plan Under Title XIX of the Social Security Act (Base plan pages)
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-179 Yes Yes Fillable Fileable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable
Form CMS-179 Yes Yes Fillable Printable

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,120 0 0 0 1,120 0
Annual IC Time Burden (Hours) 22,400 0 0 0 22,400 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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