Indian Health Service, Hospital, Dental And Other Contract Health Service Reports

INDIAN HEALTH SERVICE, HOSPITAL, DENTAL AND OTHER CONTRACT HEALTH SERVICE REPORTS

OMB: 0915-0020

IC ID: 110063

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INDIAN HEALTH SERVICE, HOSPITAL, DENTAL AND OTHER CONTRACT HEALTH SERVICE REPORTS
 
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-64 No No


    

2,350 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 340,000 0 0 85,000 0 255,000
Annual IC Time Burden (Hours) 66,550 0 0 23,200 0 43,350
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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