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Questionnaire To Conduct Periodic National State-specific Medicare Beneficiary Surveys

IC 116750 under ICR 199209-0990-001 · OMB 0990-0181.

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QUESTIONNAIRE TO CONDUCT PERIODIC NATIONAL STATE-SPECIFIC MEDICARE BENEFICIARY SURVEYS
 
No Migrated
 
Voluntary
 

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


    

2,090 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 2,090 0 2,090 0 0 0
Annual IC Time Burden (Hours) 697 0 697 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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