Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
42 CFR 495.10(a) (b) (hospital) (2011) New 5011 2506 0
42 CFR 495.10(a)-(c) -- (EPs) (2011) average New 521600 260800 0
42 CFR 495.10(d) - (EPs) (2012) average New 57998 28999 0
42 CFR 495.10(d) - (hospital) (2012) New 401 201 0
42 CFR 495.10(e)(1) - (EPs) (2011) average New 95500 47750 0
42 CFR 495.10(e)(2) - (EPs) (2012) average New 96500 48250 0
42 CFR 495.202(b)(2) (2012) EPs-final ID New 12 6 0
42 CFR 495.202(b)(2) (2012) EPs-preliminary ID New 12 6 0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-final ID New 12 3 0
42 CFR 495.202(b)(2) (2012) MA-affiliated hospitals-preliminary ID New 12 3 0
42 CFR 495.204(b)(2) (2012) Revenue reporting New 12 480 0
42 CFR 495.204(b)(4) (2012) EPs-method New 2 3 0
42 CFR 495.204(b)(5) or (b)(6)(2012) EPs-salary New 12 700 0
42 CFR 495.210(b) (2012) EPs-attestation New 12 480 0
42 CFR 495.306(a)(1)(i) New 139600 69800 0
42 CFR 495.306(a)(1)(ii)(A) New 139600 69800 0
42 CFR 495.306(a)(2) New 4933 2467 0
42 CFR 495.316 New 56 280 0
42 CFR 495.330(a) - average New 56 280 0
42 CFR 495.348(c) New 56 28 0
42 CFR 495.348(e) New 56 28 0
42 CFR 495.348(f) New 56 280 0
42 CFR 495.350--average New 56 56 0
42 CFR 495.352 -- average New 56 280 0
42 CFR 495.366 -- average New 56 280 0
42 CFR 495.8 (a)(1)- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (EPs) (2011) New 521600 4885827 0
42 CFR 495.8 (a)(1)- Menu Set Objectives/Measures average (EPs) (2011) New 521600 877853 21700000000
42 CFR 495.8 (a)(2)- Menu Set Objectives/ Measures average (EPs) (2012) New 527254 887368 4500000000
42 CFR 495.8 (a)(2)- Ambulatory Quality Measures (EPs) (2012) New 527254 263627 0
42 CFR 495.8 (b)(1)-- EHR Technology Used, Core Set Objectives/Measures & Quality Measures (hospitals/CAHs) (2011) New 5011 46101 0
42 CFR 495.8 (b)(2)- Hospital Quality Measures (hospitals/CAHs) (2012) New 5011 2506 0
42 CFR 495.8 (b)(2)- Menu Set Objectives/ Measures average (hospitals/CAHs) (2012) New 5011 10523 5000000000
42 CFR 495.8 (b)(2)-- EHR Technology Used & Core Set Objectives/Measures (hospitals/CAHs) (2012) New 5011 43596 0
42 CFR 495.8(a)(2) - EHR Technology Used & Core Set Objectives/Measures (EPs) (2012) New 527254 4675161 0
42 CFR 495.8(b)(1) - Menu Set Objectives/ Measures average (hospitals/CAHs) (2011) New 5011 10523 20600000000
42CFR495.306(a)(1)(ii)(B) New 139600 69800 0
Total burden requested under this ICR: 3851294 12306651 51800000000  
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