Evaluation of the Electronic Health Records Demonstration (Office System Survey Val Form)

Evaluation of the Medicare Care Management Performance Demonstration and the Electronic Health Records Demonstration

OMB: 0938-1072

IC ID: 191858

Information Collection (IC) Details

View Information Collection (IC)

Evaluation of the Electronic Health Records Demonstration (Office System Survey Val Form)
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10273 Office System Survey Validation Form EHRD-OSS validation form 11-26-08.pdf Yes Yes Fillable Printable

Health Health Care Services

 

485 0
   
Private Sector Businesses or other for-profits
 
   90 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 97 0 0 0 0 97
Annual IC Time Burden (Hours) 134 0 0 0 0 134
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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