OMB control number

Medicare Lifestyle Modification Program Demonstration

OMB 0938-0871 · HHS/CMS.

OMB 0938-0871

Latest Forms, Documents, and Supporting Material

Document Name
Medicare Lifestyle Modification Program Demonstration Form

All Historical Document Collections

200602-0938-006 Approved without change	Extension without change of a currently approved collection	2006-02-16
200205-0938-012 Approved without change	New collection (Request for a new OMB Control Number)	2002-05-20