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 | Type |
|---|---|
 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All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201411-0938-010 | Revision of a currently approved collection | 2015-02-27 | Approved without change | |
| 201305-0938-006 | New collection (Request for a new OMB Control Number) | 2013-05-14 | Approved with change | |
| 201207-0938-002 | New collection (Request for a new OMB Control Number) | 2012-07-12 | Comment filed on proposed rule |