MIPS Feedback Request: 8 Quick Multiple Choice Questions (CMS-10683)

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

OMB: 0938-1185

IC ID: 233413

Information Collection (IC) Details

View Information Collection (IC)

MIPS Feedback Request: 8 Quick Multiple Choice Questions (CMS-10683)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10683 MIPS Feedback Request: 8 Quick Multiple Choice Questions CMS-10683. MIPS Feedback Request - 8 Quick Multiple Choice Questions.pdf https://www.surveymonkey.com/r/KVPZY3Y Yes Yes Fillable Fileable

Health Health Care Services

 

2,793 0
   
Individuals or Households
 
   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 2,793 0 2,793 0 0 0
Annual IC Time Burden (Hours) 186 0 186 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
CMS-10683.Generic_Clearance_Submission_Template_MIPS Feedback_ CMS-10683.Generic_Clearance_Submission_Template_MIPS Feedback_.doc 10/04/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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