ICR Documents

Supporting Statement A Document Date Uploaded CMS-P-0015A Final Supporting Statement - Part A.docx 10/29/2013 Supporting Statement B Document Date Uploaded MCBS Supporting Statement - Part B.pdf 10/25/2013 Supplementary Documents Title Document Document Type Date Uploaded Table of Contents Attachments TOC.pdf Supplementary Document 10/25/2013 Attachment 2 - Publications attachment 2.zip Supplementary Document 10/25/2013 Attachment 3 - Letter, Brochure, Agreement Attachment 3.zip Supplementary Document 10/25/2013 Attachment 7 - Consent Forms attachment07.pdf Supplementary Document 10/25/2013 Attachment 9 - Impact of Nonsresponse on MCBS Estimates attachment09.pdf Supplementary Document 10/25/2013 Attachment 10 - Primary Sampling Unit Breakdown attachment10.pdf Supplementary Document 10/25/2013 Nonsub Change Request - Attachment A Attachment A - R73 DUQ.pdf Supplementary Document 06/24/2015 Nonsub Change Request - Attachment B Attachment B - R73 HFQ.pdf Supplementary Document 06/24/2015 Nonsub Change Request - Attachment C Attachment C - R73 IAQ.pdf Supplementary Document 06/24/2015 Nonsub Change Request - Attachment D Attachment D - R73 USQ PPIC PAQ.pdf Supplementary Document 06/24/2015 Attachment A - R74 PVQ (Sept 2015) Attachment A - R74 PVQ (Sept 2015).pdf Supplementary Document 09/24/2015 Attachment B - R74 KNQ (Sept 2015). Attachment B - R74 KNQ (Sept 2015).pdf Supplementary Document 09/24/2015 Attachment C - R74 Medical Provider Terminology (Sept 2015) Attachment C - R74 Medical Provider Terminology (Sept 2015).pdf Supplementary Document 09/24/2015 Attachment A - R75 IAQ (JAN 2016). Attachment A - R75 IAQ (JAN 2016).pdf Supplementary Document 01/15/2016 Attachment B - R75 PVQ (JAN 2016) Attachment B - R75 PVQ (JAN 2016).pdf Supplementary Document 01/15/2016 MCBS Nonsubstantive change request MCBS Nonsubstantive change request.doc Justification for No Material/Nonsubstantive Change 06/24/2015 MCBS Nonsubstantive change request (Sept 2015). MCBS Nonsubstantive change request (Sept 2015).doc Justification for No Material/Nonsubstantive Change 09/24/2015 0938-0568 - MCBS Nonsubstantive change request_R75 (JAN 2016) 0938-0568 - MCBS Nonsubstantive change request_R75 (JAN 2016).doc Justification for No Material/Nonsubstantive Change 01/15/2016 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received