Information Collection Request

Submission of Information for the Hospital Outpatient Quality Data Program

ICR 200810-0938-018 · OMB 0938-1044 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Submission of Information for the Hospital Outpatient Quality Data Program Form and Instruction Modified Available
CMS-10250 Supporting Statement Part B_FINAL.doc Supporting Statement B Uploaded 2008-10-20 Available
CMS-10250 Supporting Statement - Part A _FINAL.doc Supporting Statement A Uploaded 2008-10-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
183593 Submission of Information for the Hospital Outpatient Quality Data Program Form and Instruction Modified
183592 Submission of Information for the Hospital Outpatient Quality Data Program Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Submission of Information for the Hospital Outpatient Quality Data Program CMS-10250, CMS-10250 CMS-10259. HOPQDRP Attestation Form ,   CMS-10250. Notice of Participation
Submission of Information for the Hospital Outpatient Quality Data Program



Reginfo record details
  No