OMB control number
Supplemental to Form CMS-2552-10, Payment Adjustment for Domestic NIOSH-Approved Surgical N95 Respirators (CMS-10821)
OMB 0938-1425 · HHS/CMS.
OMB 0938-1425
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form CMS-10821 Supplemental to Form CMS-2552-10, Payment Adjustment for Domestic NIOSH-Approved Surgical N95 Respirators | Form |
 CMS-10821.Supporting Statement Part A (final rule).docx | Supporting Statement A |
 Supplemental to Form CMS-2552-10, Payment Adjustment for Domestic NIOSH-Approved Surgical N95 Respirators |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202212-0938-003 | New collection (Request for a new OMB Control Number) | 2022-12-02 | Approved without change | |
| 202207-0938-017 | New collection (Request for a new OMB Control Number) | 2022-07-28 | Comment filed on proposed rule |