Information Collection Request

Submission of Information for the Hospital Outpatient Quality Data Program

ICR 200908-0938-005 · OMB 0938-1044 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Submission of Information for the HOP QDRP - Notice of Participation Form Modified Available
CMS-10250 Supporting Statement Part B_FINAL.doc Supporting Statement B Uploaded 2009-08-18 Available
CMS-10250 Supporting Statement - Part A _FINAL.doc Supporting Statement A Uploaded 2009-08-18 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
183593 Submission of Information for the HOP QDRP - Notice of Participation Form Modified
183592 Submission of Information for the HOP QDRP - Chart Abstraction 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 HOP QDRP - Notice of Participation CMS-10250
Submission of Information for the HOP QDRP - Chart Abstraction



Reginfo record details
  No