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Crosswalk: Contact Form
CMS-368 State Agency Contact Form_Crosswalk_10.2021.pdf
Medicaid Drug Rebate Program (MDRP): Quarterly State Invoice (CMS-R-144) and State Agency Contact Form (CMS-368)
Crosswalk: Contact Form
OMB: 0938-0582
OMB.report
HHS/CMS
OMB 0938-0582
ICR 202111-0938-011
IC 8197
Crosswalk: Contact Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0582 can be found here:
2024-04-15 - Extension without change of a currently approved collection
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