Information Collection Request
Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID) (CMS-10798)
ICR 202302-0938-012 · OMB 0938-1428 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-1428 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form and Instruction |
Modified |
Form and Instruction |
Modified |
Justification for No Material/Nonsubstantive Change | 2023-02-15 |
Justification for No Material/Nonsubstantive Change | 2023-02-15 |
Supporting Statement A | 2023-02-15 |
Supporting Statement A | 2023-02-15 |
Supplementary Document | 2023-02-15 |
Supplementary Document | 2023-02-15 |
Form CMS-10798 Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID)
Non-sub Change Request Memo CMS 10798_clean.docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 254490 | Modified | ||
| 254490 | Modified |
Application for Enrollment in Part B Immunosuppressive Drug Coverage (Part B-ID)ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1428 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202302-0938-010 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 2023-02-16 |
| Requested Expiration Date | 1969-12-31 |