Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Medicare Current Beneficiary Survey (MCBS)

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0568 can be found here:

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Created 04/28/05

IA3

Valor Total de los Bienes

A. Menos de $5.000
B. $5.000 – $9.999
C. $10.000 – $19.999