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Monthly Statistical Report On Medical Care

IC 112696 under ICR 198311-0938-002 · OMB 0938-0060.

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MONTHLY STATISTICAL REPORT ON MEDICAL CARE
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-120 No No


    

54 0
   
State, Local, and Tribal Governments
 
   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 648 0 0 648 0 0
Annual IC Time Burden (Hours) 21,384 0 0 21,384 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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