Information Collection Request

Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network (CROWNWeb) (CMS-10569)

ICR 202007-0938-002 · OMB 0938-1289 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form CMS-10569 : End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network Form and Instruction Unchanged Available
CMS-10569 Supporting Statement B CROWNWeb CY 2021 (6-2-2020).docx Supporting Statement B Uploaded 2020-07-16 Available
CMS-10569 Supporting Statement A CROWNWeb CY 2021 (6-23-2020).docx Supporting Statement A Uploaded 2020-07-17 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
217583 : End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
04/30/2023 36 Months From Approved 04/30/2023
523,314 0 523,314
3,329,109 0 3,329,109
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
: End-Stage Renal Disease Quality Incentive Program: Data Collection for Quality Measures Using the Consolidated Renal Operations in a Web-Enabled Network CMS-10569, CMS-10569 Letter to Facilities - data collection ,   EQRS Global App



Reginfo record details
  No