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CMS-10868 - Supporting Statement_A (CMS-4204-P version 2) (updated)
CMS-10868 - Supporting Statement_A (CMS-4204-P version 2) (updated).docx
Medicare Change of Status Notice (MCSN) (CMS-10868)
OMB: 0938-1467
OMB.report
HHS/CMS
OMB 0938-1467
ICR 202401-0938-012
CMS-10868 - Supporting Statement_A (CMS-4204-P version 2) (updated)
( Supporting Statement A )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1467 can be found here:
2024-10-18 - New collection (Request for a new OMB Control Number)
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