OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application To Be a Qualified Entity to Receive Medicare Data for Performance Measurement / Reapplication / Annual Report Worksheet (CMS-10394)

ICR 202404-0938-006 · OMB 0938-1144 · Received in OIRA

Forms and Documents
Document
Name
Status
Form and Instruction
 Modified
Supplementary Document
2024-04-08
Supporting Statement A
2024-04-08
IC Document Collections
IC ID
Document
Title
Status
198017 Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/CMS
OMB Control No0938-1144
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202203-0938-012
Agency Tracking NoOEDA
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31