Information Collection Request
Fast Appeals Notices: NOMNC/DENC (CMS-10123/10124)
ICR 202407-0938-011 · OMB 0938-0953 · Received in OIRA
Forms and Documents
Document Name | Status |
|---|---|
Supporting Statement A | 2024-08-07 |
Supplementary Document | 2024-07-12 |
NOMNC-DENC_supportingstatement_2024_.docx
NOMNC_2024_Crosswalk_508.pdfIC Document Collections
| IC ID | Document Title | Status | |
|---|---|---|---|
| 8809 | Modified | ||
| 184965 | Modified |
Notice of Provider Non-Coverage (CMS-10123)ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0953 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202012-0938-012 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |