PQRI - Registry Based Reporting (Self-nominating)

Physician Quality Reporting Initiative

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1059 can be found here:

Documents and Forms

Document Name Document Type
2010_EHR_Warehouse_Measure_Specs-Release_Notes_073109_2.pdf Instruction
2010_EHR_Warehouse_Measure_Specifications_073109.pdf Instruction

Information Collection (IC) Details

IC Title:	PQRI - Registry Based Reporting (Self-nominating)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			2010_EHR_Warehouse_Measure_Specs-Release_Notes_073109_2.pdf		Yes	Yes	Fillable Fileable
Instruction			2010_EHR_Warehouse_Measure_Specifications_073109.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 50

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.