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Indian Health Service Contract Hospital Inpatient Report

IC 110066 under ICR 198408-0915-004 · OMB 0915-0021.

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Information Collection (IC) Details

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INDIAN HEALTH SERVICE CONTRACT HOSPITAL INPATIENT REPORT
 
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 HSA-43 No No


    

150 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 50,000 0 0 0 0 50,000
Annual IC Time Burden (Hours) 8,333 0 0 0 0 8,333
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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