OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool ("PAT")

OMB 0938-0941 · HHS/CMS.

OMB 0938-0941

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-10136 Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) - MCMP DemonstrationForm and Instruction
Form CMS-10136 Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) -EHR DemonstrationForm and Instruction
Form CMS-10136 Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) - PGP DemonstrationForm and Instruction
Supporting Statement - Part B - PGP TD_062112.docxSupporting Statement B
2Supporting_Statement_-_Part_A_PGPTD.pdfSupporting Statement A
Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) - MCMP Demonstration Form and Instruction
Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) -EHR Demonstration Form and Instruction
Medicare Demonstration Ambulatory Care Quality Measure Performance Assessment Tool (PAT) - PGP Demonstration Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
201205-0938-008 Reinstatement without change of a previously approved collection 2012-05-22 Approved with change
201106-0938-013 Revision of a currently approved collection 2011-06-15 Withdrawn and continue
200809-0938-015 Revision of a currently approved collection 2008-09-26 Approved with change
200511-0938-002 Extension without change of a currently approved collection 2005-11-03 Approved with change
200502-0938-006 New collection (Request for a new OMB Control Number) 2005-02-18 Approved without change