OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Electronic Medical Documentation Interoperability (EMDI) Workgroup Survey (CMS-10679)

IC 235900 under ICR 201904-0938-017 · OMB 0938-1185.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
IC Document
Information Collection (IC) Details

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Electronic Medical Documentation Interoperability (EMDI) Workgroup Survey (CMS-10679)
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10679 EMDI_Workgroup_Participation_Survey CMS-10679 - EMDI_Workgroup_Participation_Survey.docx Yes Yes Fillable Fileable

Health Health Care Services

 

120 0
   
Private Sector Businesses or other for-profits
 
   0 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 120 0 120 0 0 0
Annual IC Time Burden (Hours) 40 0 40 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Electronic Medical Documentation Interoperability (EMDI) Workgroup Survey CMS-10679 - EMDI_Workgroup Survey_PRA_Generic_Clearance_Template-Final.docx 04/30/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.