2024-22578. Agency Information Collection Activities: Proposed Collection; Comment Request  

  • Exhibit 1—Estimated Annualized Burden Hours

    Form name Number of respondents Number of responses per POC Hours per response Total burden hours
    1. Eligibility/Registration Form 85 1 3/60 5
    2. Medical Office Site Information Form 85 30 5/60 213
    3. Data Use Agreement 85 1 3/60 5
    4. Data File(s) Submission 85 1 1 85
    Total NA NA NA 308

    Exhibit 2—Estimated Annualized Cost Burden

    Form name Total burden hours Average hourly wage rate * Total cost burden
    1. Eligibility/Registration Form 5 $64.58 $323
    2. Medical Office Site Information Form 213 64.58 13,756
    3. Data Use Agreement 5 64.58 323
    ( print page 80249)
    4. Data File(s) Submission 85 64.58 5,489
    Total 308 NA 19,891
    * Mean hourly wage rate of $64.58 for Medical and Health Services Managers (SOC code 11-9111) was obtained from the May 2023 National Industry-Specific Occupational Employment and Wage Estimates, NAICS 621100—Offices of Physicians located at https://www.bls.gov/​oes/​current/​naics4_​621100.htm.

Document Information

Published:
10/02/2024
Department:
Agency for Healthcare Research and Quality
Entry Type:
Notice
Action:
Notice.
Document Number:
2024-22578
Dates:
Comments on this notice must be received by November 1, 2024.
Pages:
80247-80249 (3 pages)
PDF File:
2024-22578.pdf