Information Collection Request
Medicare EDI Enrollment Form and EDI Registration (CMS-10164 A/B)
ICR 202405-0938-014 · OMB 0938-0983 · Received in OIRA
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0983 can be found here:
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10164A Medicare EDI Enrollment Form and EDI Registration |
Form | Modified | Repair queued |
 CMS-10164 A&B.Supporting Statement Part A (final).docx |
Supporting Statement A | Uploaded 2024-05-15 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 8845 |  Medicare EDI Enrollment Form and EDI Registration |
Form | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-0983 |
| Type of Information Collection | Reinstatement with change of a previously approved collection |
| Previous ICR Reference No | 201902-0938-005 |
| Agency Tracking No | CM |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |