Information Collection Request

Hospital Outpatient Quality Data Program (HOPQDRP) (CMS-10250)

ICR 201909-0938-003 · OMB 0938-1109 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Hospital Outpatient Quality Reporting Form and Instruction Modified Available
CMS-10250 HO-2019-05-07-V1-Supporting-Statement-A-CY2020.docx Supporting Statement A Uploaded 2019-09-24 Available
CMS-10250 HO-2019-05-07-V1-Supporting-Statement-B-CY2020.docx Supporting Statement B Uploaded 2019-09-24 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217995 Hospital Outpatient Quality Reporting Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2022 36 Months From Approved 01/31/2022
3,125,100 0 3,125,100
1,387,670 0 1,387,670
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Hospital Outpatient Quality Reporting CMS-10250 Validation Review for Reconsideration Request



Reginfo record details
  No