Information Collection

2019 Updated B Reader Certification Examination

IC 237867 under ICR 201610-0920-009 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 4-- Example Mulitple Choice Questions.docx	Other-WORD
Attachment 1--Screen shots of the BViewer© computer software used for testing.docx	Other-Screenshots
Attachment 2--2.8 Chest Radiograph Classification Form.pdf Att 2 2.8 CHEST RADIOGRAPH CLASSIFICATION	IC Document
Attachment 3--2019 B Reader Exam Invite (email or phone script).docx ATT 3_Email Invite	IC Document
Attachment 5--2.12 CWHSP-PhysicianCert-2.12-508.pdf Att 5_PHYSICIAN APPLICATION FOR CERTIFICATION	IC Document
GenICRequestTemplate_B Reader Pilot.docx Request for Approval	IC Document
SSA_Formative Research and Tool Development Generic_9.18.19.doc SupSta A	IC Document
SSB_2019 B 9.18.19.docx SupSta B	IC Document

IC Title:

2019 Updated B Reader Certification Examination

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 20 CFR 718 Standards for Determining 42 CFR 37 Specifications for medical

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-WORD					No		Paper Only
Other-Screenshots					Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: CDC/ATSDR Privacy Act System of Records Notice 0920-0149, Morbidity Studies in Coal Mining, Metal and Non-Metal Mining and General Industry

FR Citation: 51 FR 42476

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att 2 2.8 CHEST RADIOGRAPH CLASSIFICATION		09/25/2019
ATT 3_Email Invite		09/25/2019
Att 5_PHYSICIAN APPLICATION FOR CERTIFICATION		09/25/2019
Request for Approval		09/25/2019
SupSta A		09/25/2019
SupSta B		09/25/2019

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

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