Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Hospital Outpatiennt Quality Data Program - Data Validation (CY 2017) Unchanged 500 6000 0
Hospital Outpatient Quality Data Program - Administrative (CY 2017) Unchanged 3300 138600 0
Hospital Outpatient Quality Data Program - Data Abstraction (CY 2014) Unchanged 1628800 949590 0
Hospital Outpatient Quality Data Program - Data Abstraction (CY 2015) Unchanged 1628800 949590 0
Hospital Outpatient Quality Data Program - Data Abstration (CY 2016) Unchanged 1679700 979265 0
Hospital Outpatient Quality Data Program - Data Validation (CY 2014) Unchanged 24000 6000 0
Hospital Outpatient Quality Data Program - Data Validation (CY 2015) Unchanged 24000 6000 0
Hospital Outpatient Quality Data Program - Data Validation (CY 2016) Unchanged 24000 6000 0
Hospital Outpatient Quality Data Program - Notice of Participation (CY 2014) Unchanged 16000 2672 0 Form and Instruction CMS-10250 Request for Reconsideration Part 1
Form and Instruction CMS-10250 Request for Reconsideration Part 2
Form and Instruction CMS-10250 Extroadinary Circumstances
Form and Instruction CMS-10250 Notice of Participation
Hospital Outpatient Quality Data Program - Notice of Participation (CY 2015) Unchanged 16000 2672 0 Form and Instruction CMS-10250 Notice of Participation
Hospital Outpatient Quality Data Program - Notice of Participation Web based (CY 2017) Unchanged 19800 3307 0
Hospital Outpatient Quality Data Program -- Data Abstration (CY 2017) Unchanged 19800 3005685 0
Hospital Outpatient Quality Data Program -Web based OP-31 (CY 2017) Unchanged 660 111 0
Hospital Outpatient Quality Program - Notice of Participation (CY 2016) Unchanged 29700 4960 0 Form and Instruction CMS-10250 Notice of Participation
Total burden requested under this ICR: 5115060 6060452 0  
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