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Intake And Follow-up Survey Of Medicare Beneficiaries In Staff-assisted Home Dialysis Demonstration

IC 114062 under ICR 199203-0938-006 · OMB 0938-0606.

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INTAKE AND FOLLOW-UP SURVEY OF MEDICARE BENEFICIARIES IN STAFF-ASSISTED HOME DIALYSIS DEMONSTRATION
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form HCFA-R-7 No No


    

1,320 0
   
Individuals or Households
 
   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 1,320 0 1,320 0 0 0
Annual IC Time Burden (Hours) 440 0 440 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.