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Evaluation Of The Cost And Utilization Patterns Of Various Physicians' Practice Arrangement

IC 116616 under ICR 198305-0990-001 · OMB 0990-0111.

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Information Collection (IC) Details

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IC Title:	EVALUATION OF THE COST AND UTILIZATION PATTERNS OF VARIOUS PHYSICIANS' PRACTICE ARRANGEMENT	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

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

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	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 Agency Discretion
Annual Number of Responses for this IC	15	15
Annual IC Time Burden (Hours)	135	135
Annual IC Cost Burden (Dollars)	0	0

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