Information Collection

Home Health Care Demonstration, Inpatient Costs Vs. Home Health

IC 37566 under ICR 199605-0704-003 · OMB 0704-0265.

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Information Collection (IC) Details

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IC Title:	HOME HEALTH CARE DEMONSTRATION, INPATIENT COSTS VS. HOME HEALTH	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD 2534				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,000	-3,000	6,000
Annual IC Time Burden (Hours)	1,500	-1,500	3,000
Annual IC Cost Burden (Dollars)	0	0	0

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Title	Document	Date Uploaded

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