Information Collection Request
Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
ICR 202303-0938-002 · OMB 0938-0976 · Active
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0976 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form |
Modified |
Form |
Modified |
Justification for No Material/Nonsubstantive Change | 2023-03-01 |
Justification for No Material/Nonsubstantive Change | 2023-03-01 |
Supporting Statement A | 2022-12-20 |
Supporting Statement A | 2022-12-20 |
Supplementary Document | 2022-12-05 |
Supplementary Document | 2022-12-05 |
Form CMS-10146 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
Non-Substantive Memo Spanish Version Request.docx
CMS-10146 - Crosswalkv508.pdfIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 37928 | Modified | ||
| 37928 | Modified |
Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0976 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202212-0938-006 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 2023-03-02 |
| Requested Expiration Date | 1969-12-31 |