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  3. OMB 0938-1169

OMB control number

Fee-for-Service Recovery Audit Prepayment Review Demonstration and Prior Authorization Demonstration (CMS-10421)

OMB 0938-1169 · HHS/CMS.

OMB 0938-1169
Latest Forms, Documents, and Supporting Material
Document
Name
CMS-10421 - Supporting Statement 30day.docx
Supporting Statement A
Signature Attestation
PMD Demonstration
Recovery Auditor Pre-payment review Demonstration
All Historical Document Collections
201802-0938-005
Withdrawn
Reinstatement without change of a previously approved collection 2018-02-07
201412-0938-011
Approved without change
Extension without change of a currently approved collection 2014-12-30
201406-0938-003
Approved without change
Revision of a currently approved collection 2014-06-09
201312-0938-007
Withdrawn and continue
No material or nonsubstantive change to a currently approved collection 2013-12-09
201205-0938-011
Approved with change
New collection (Request for a new OMB Control Number) 2012-05-31

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