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Medical group administrators : All other administrators (Attachment C)
AHRQ ACTION III – Measurement for Performance Improvement in Physician Practices
OMB: 0935-0233
IC ID: 222009
OMB.report
HHS/AHRQ
OMB 0935-0233
ICR 201606-0935-002
IC 222009
( )
Documents and Forms
Document Name
Document Type
Form 1
Medical group administrators : All other administrators (Attachment C)
Form
1 Medical group administrators : All other administrators
AHRQ MPI_Attachment C_Interview Protocol_v4 (6-14-2016).docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Medical group administrators : All other administrators (Attachment C)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
1
Medical group administrators : All other administrators (Attachment C)
AHRQ MPI_Attachment C_Interview Protocol_v4 (6-14-2016).docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
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
90
0
90
0
0
0
Annual IC Time Burden (Hours)
113
0
113
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.