Information Collection Request
Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)
ICR 202212-0938-006 · OMB 0938-0976 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0976 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10146 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) |
Form | Modified | Repair queued |
 2023 CMS-10146 - Supporting Statement Updated_v508.docx |
Supporting Statement A | Uploaded 2022-12-20 | Repair queued |
 CMS-10146 - Crosswalkv508.pdf |
Supplementary Document | Uploaded 2022-12-05 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 37928 |  Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0976 |
| Type of Information Collection | Extension without change of a currently approved collection |
| Previous ICR Reference No | 202002-0938-017 |
| Agency Tracking No | CM-CPC |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |