Information Collection Request

Assessment of Unreimbursed Care among Community Primary Care Physicians

ICR 200612-0935-002 · OMB 0935-0129 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Supporting Statement 11-21-06 v3.doc Supporting Statement B Uploaded 2006-11-21 Available
Attachment 4 11-21-06.doc Supplementary Document Uploaded 2006-11-21 Available
Attachment 3 11-21-06.doc Supplementary Document Uploaded 2006-11-21 Available
Attachment 2 11-21-06.doc Supplementary Document Uploaded 2006-11-21 Available
Supporting Statement 11-21-06 v3.doc Supporting Statement A Uploaded 2006-11-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
46414 Assessment of Unreimbursed Care among Community Primary Care Physicians Other-Other New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2010 36 Months From Approved
780 0 0
195 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Assessment of Unreimbursed Care among Community Primary Care Physicians

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 780 0 0 780 0 0
Annual Time Burden (Hours) 195 0 0 195 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No