OMB control number

Report On Provider Participation In The Medicaid Program

OMB 0938-0262 · HHS/CMS.

OMB 0938-0262

Latest Forms, Documents, and Supporting Material

Document Name
REPORT ON PROVIDER PARTICIPATION IN THE MEDICAID PROGRAM Form

All Historical Document Collections

198507-0938-011 Disapproved	Reinstatement without change of a previously approved collection	1985-07-03
198308-0938-011 Approved without change	Extension without change of a currently approved collection	1983-08-25
198207-0938-003 Approved without change	New collection (Request for a new OMB Control Number)	1982-07-19