Information Collection Request

Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)

ICR 202303-0938-002 · OMB 0938-0976 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10146 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) Form Modified Available
Form CMS-10146 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) Form Modified Missing upstream
Non-Substantive Memo Spanish Version Request.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-03-01 Available
Non-Substantive Memo Spanish Version Request.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-03-01 Repair queued
2023 CMS-10146 - Supporting Statement Updated_v508.docx Supporting Statement A Uploaded 2022-12-20 Available
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 Available
CMS-10146 - Crosswalkv508.pdf Supplementary Document Uploaded 2022-12-05 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
37928 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) Form Modified
37928 Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) Form Modified

ICR Details

Record metadata
Active
HHS/CMS
0938-0976
No material or nonsubstantive change to a currently approved collection
202212-0938-006
CM-CPC
2023-03-02
1969-12-31