Qualified Registry or QCDR Vendors - Self Nomination

Physician Quality Reporting System (PQRS) (CMS-10276)

OMB: 0938-1059

IC ID: 201578

Information Collection (IC) Details

View Information Collection (IC)

Qualified Registry or QCDR Vendors - Self Nomination
 
No Modified
 
Voluntary
 
42 CFR 414.90 42 CFR 414.92

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10276 Self Nomination Screen Shot - Self-nomination Form.docx Yes Yes Printable Only

Health Health Care Services

Performance Measurement and Reporting System  72 FR 52133

150 50
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 150 0 0 0 0 150
Annual IC Time Burden (Hours) 1,500 0 0 0 0 1,500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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