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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Quality Measures and Procedures for Hospital Reporting of Quality Data
Modified
17600
7951695
0
Form and Instruction
CMS-10210
Data Accuracy and Completeness Form
Form and Instruction
CMS-10210
Hospital VPB Review and Corrections Form
Form and Instruction
CMS-10210
Extraordinary Circumstances Form
Form and Instruction
CMS-10210
Inpatient Withholding Data form
Form and Instruction
CMS-10210
IQR Measure Exception Form
Form and Instruction
CMS-10210
IQR Notice of Participation Form
Form and Instruction
CMS-10210
IQR Reconsideration Request Form
Form and Instruction
CMS-10210
CAUTI Validation Template
Form and Instruction
CMS-10210
CDI Validation Template
Form and Instruction
CMS-10210
CLABSI Validation Template
Form and Instruction
CMS-10210
MRSA Validation Template
Form and Instruction
CMS-10210
Validation Review for Reconsideration Request
Form and Instruction
CMS-10210
VBP Appeal Request Form
Total burden requested under this ICR:
17600
7951695
0
To view an IC, click on IC Title