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Beneficiary Survey
Value in Opioid Use Disorder Treatment Demonstration (CMS-10728)
OMB: 0938-1388
IC ID: 242934
OMB.report
HHS/CMS
OMB 0938-1388
ICR 202305-0938-016
IC 242934
( )
Documents and Forms
Document Name
Document Type
Form CMS-10728
Beneficiary Survey
Form and Instruction
CMS-10728 Beneficiary Health Survey
PRA-OUD-Demo-Health Survey-Instrument (SF-36)_02.2020-CLEAN.docx
Form and Instruction
Information Collection (IC) Details
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