Information Collection Request
Medicare EDI Enrollment Form and EDI Registration (CMS-10164 A/B)
ICR 202405-0938-014 · OMB 0938-0983 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0983 can be found here:
Forms and Documents
Document Name | Status |
|---|---|
Form |
Modified |
Supporting Statement A | 2024-05-15 |
Form CMS-10164A Medicare EDI Enrollment Form and EDI Registration
CMS-10164 A&B.Supporting Statement Part A (final).docxIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 8845 | Modified |
Medicare EDI Enrollment Form and EDI RegistrationICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0983 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 201902-0938-005 |
| Agency Tracking No | CM |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |