State Plan Under Title XIX of the Social Security Act (Base plan pages)
State Plan Under Title XIX of the Social Security Act (Base plan pages, Attachments, Supplements to Attachments)
OMB: 0938-0193
IC ID: 7877
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0193 can be found here:
Documents and Forms
Document Name Document Type |
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Form and Instruction |
Other-Exhibt A |
Other-Exhibit A1 |
Other-Exhibit AA |
Other-Exhibit AB |
Other-Exhibit AC |
Other-Exhibit AD |
Other-Exhibit AE |
Other-Exhibit AF |
Other-Exhibit AG |
Other-Exhibit D and E |
Other-Exhibit F and G |
Other-Exhibit H and J |
Other-Exhibit N |
Other-Exhibit O |
Other-Exhibit P |
Other-Exhibit Y |
Other-FMG |
Other-Exhibit R S T U |
Form and Instruction |
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IC Document |
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IC Document |
Information Collection (IC) Details