OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Transparency Reports and Reporting of Physician Ownership or Investment Interests (CMS-10419)

OMB 0938-1173 · HHS/CMS.

OMB 0938-1173

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10419 403.906 and 404.908(a) - (g) - Applicable GPO Data Collection and Reporting Form and Instruction
Form CMS-10419 403.904 and 404.908(a) - (g) - Applicable Manufacturer Data Collection and Reporting Form and Instruction
CMS-10419.Response to 60 day comments PRA.docx Supplementary Document
CMS-10419_Crosswalk_.pdf Supplementary Document
CMS-10419 - Supporting Statement A rev 02 4 15mh -CLEAN.docx Supporting Statement A
403.906 and 404.908(a) - (g) - Applicable GPO Data Collection and Reporting Form and Instruction
403.904 and 404.908(a) - (g) - Applicable Manufacturer Data Collection and Reporting Form and Instruction

All Historical Document Collections

201411-0938-010 Approved without change	Revision of a currently approved collection	2015-02-27
201305-0938-006 Approved with change	New collection (Request for a new OMB Control Number)	2013-05-14
201207-0938-002 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2012-07-12