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Evaluation of a Medication Therapy Management Program to Improve Patient Safety in Medicare Beneficiaries
Evaluation of a Medication Therapy Management Program to Improve Patient Safety in Medicare Beneficiaries
OMB: 0935-0136
IC ID: 180325
OMB.report
HHS/AHRQ
OMB 0935-0136
ICR 200705-0935-001
IC 180325
( )
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
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IC Title:
Evaluation of a Medication Therapy Management Program to Improve Patient Safety in Medicare Beneficiaries
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
5 CFR 1320.5
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,800
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
3,800
0
3,800
0
0
0
Annual IC Time Burden (Hours)
2,286
0
2,286
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.