CMS-10289 Optional Dental-only Justification for Non-Material change

CMS-10289 Optional Dental-only Justification for Non-Material change.doc

Optional Dental-only Supplemental Coverage SPA Template (CMS-10289)

CMS-10289 Optional Dental-only Justification for Non-Material change

OMB: 0938-1075

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The change to the template is necessary to correct and error in the description of populations eligible for supplemental dental services as allowed under section 501 of CHIPRA.


File Typeapplication/msword
AuthorCMS
Last Modified ByCMS
File Modified2010-10-19
File Created2010-10-19

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