OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Detailed Explanation of Non-Coverage (42 CFR 422.626(e)(1)), and Notice of Medicare Non-Coverage (42 CFR 422.624(b)(1))

OMB 0938-0910 · HHS/CMS.

OMB 0938-0910
Latest Forms, Documents, and Supporting Material
Document
Name
Supplementary Document
Supplementary Document
Supplementary Document
Justification for No Material/Nonsubstantive Change
Supplementary Document
Supplementary Document
Supplementary Document
Supplementary Document
Supporting Statement A
All Historical Document Collections
Approved without change
 No material or nonsubstantive change to a currently approved collection 2011-06-20
Approved without change
 No material or nonsubstantive change to a currently approved collection 2010-11-15
Approved without change
 Revision of a currently approved collection 2010-08-10
Approved without change
 No material or nonsubstantive change to a currently approved collection 2009-02-06
Approved without change
 No material or nonsubstantive change to a currently approved collection 2008-08-08
Approved without change
 Extension without change of a currently approved collection 2007-03-23
Approved with change
 New collection (Request for a new OMB Control Number) 2003-11-26