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Form CMS-10398 #72 CMS-10398 #72 Expression of Interest Form
[Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
well-child-visit-ag-interest-form
GenIC #72 (New): Expressions of Interest in the Infant Well-Child Visit Affinity Group
OMB: 0938-1148
OMB.report
HHS/CMS
OMB 0938-1148
ICR 202401-0938-016
IC 248500
Form CMS-10398 #72 CMS-10398 #72 Expression of Interest Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1148 can be found here:
2024-09-27 - Reinstatement with change of a previously approved collection
2024-07-11 - Reinstatement without change of a previously approved collection
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