OMB Number: 0915-0366; Expiration date: XX/XX/202X
Entities Survey: Module 28
Number of questions: 4
Authorized Agents: Reporting Related Demographics
Q 28.1. For how many organizations did your agency provide NPDB reporting services between January 2018 and December 2020?
Type a number: ________
Do not know (please explain) _________
Q 28.2. What is the average number of reports to the NPDB that your organization submitted per month between January 2018 and December 2020?
Please enter a number: _______
Q 28.3. For how many practitioners do you typically report per month?
Type a number: ___
Q 28.4. For what types of organizations did your organization provide reporting services between January 2018 and December 2020? (Please select all that apply.)
Hospital or Hospital System
Health Plan
Other Health Care Entities (e.g., Group Practice, Community Health Center, Clinic, Urgent Care or Ambulatory Health Care Facility or another health care organization that is not a hospital)
Medical Malpractice Payer
Professional Society
State Licensing Board or Certification Authority
Federal Licensing Agency
Other State Agency
Other Federal Agency
Other (Please Explain)__________
Piping Logic:
Survey will be directed to Module 29 next.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Microsoft User |
| File Modified | 0000-00-00 |
| File Created | 2021-04-12 |