POMS Reference

NL 00725: Modernized Claims System (MCS) Notices

TN 22 (12-17)

MPDC19 Medicare Part D - Caption

Medicare Prescription Drug Plan Enrollment

MPDC31 IRMAA D - Caption

Information About The Prescription Drug Coverage Income Related Monthly Adjustment Amount

MPD348 IRMAA D Deducted from CMA

We deducted  (1)  for  (2)  prescription drug coverage income-related monthly adjustment amount from the check  (3)  will receive for  (4)  on or about  (5)  .

(1) Money amount

(2) BGN plus BLN, possessive/”your”

(3) “she”/“he”/“you”

(4) COM in format July 2013

(5) date in format January 3, 2013

MPD349 IRMAA D Deducted from MBP

The monthly deduction for  (1)  prescription drug coverage income-related monthly adjustment amount is  (2)  .

(1) BGN plus BLN, possessive/'your”

(2) Money amount