Information Collection Request

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

ICR 201911-0938-015 · OMB 0938-1109 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10250 Hospital Outpatient Quality Reporting Form and Instruction Unchanged Available
CMS-10250 -Supporting Statement B CY2020 11-13-19 V2.docx Supporting Statement B Uploaded 2019-11-26 Available
CMS-10250 Supporting Statement A CY2020 11-13-19 V2.docx Supporting Statement A Uploaded 2019-11-26 Available

IC Document Collections

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

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2023 36 Months From Approved 01/31/2022
3,125,100 0 3,125,100
1,387,119 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

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 3,125,100 3,125,100 0 0 0 0
Annual Time Burden (Hours) 1,387,119 1,387,670 0 -551 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No