Information Collection
End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration and Supporting Regulations in 42 CFR, 405.2133; PL 95-292; CFR Parts....
IC 7806 under ICR 201310-0938-004 · OMB 0938-0046.
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0046 can be found here:
Documents and Forms
| Document Name | Document Type |
|---|---|
Form CMS-2728End Stage Renal Disease Medical Evidence Report Medicare Entitlement and/or Patient Registration and Supporting Regulations in 42 CFR, 405.2133; PL 95-292; CFR Parts.... |
Form and Instruction |
CMS-2728 ESRD Medical Evidence Report/Medicare Entitlement and PaCMS-2728-U3-508.pdf | Form and Instruction |