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Form CMS-10858 Appendix A and BSevere Supply Chain Disruption forms
Rebate Reduction Requests underSections 11101 and 11102 of the Inflation Reduction Act (CMS-10858) - IRA
508_Final clean 30 day notice Appendix A and B_Severe Supply Chain Disruption forms
Rebate Reduction Extension Request Form
OMB: 0938-1474
OMB.report
HHS/CMS
OMB 0938-1474
ICR 202405-0938-025
IC 268249
Form CMS-10858 Appendix A and BSevere Supply Chain Disruption forms
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1474 can be found here:
2024-07-19 - No material or nonsubstantive change to a currently approved collection
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