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Federal forms, ICRs, and supporting documents

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Assessment of Unreimbursed Care among Community Primary Care Physicians

IC 46414 under ICR 200612-0935-002 · OMB 0935-0129.

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IC Document
IC Document
Information Collection (IC) Details

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Assessment of Unreimbursed Care among Community Primary Care Physicians
 
No New
 
Voluntary
 
5 CFR 1320.6

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Other Attachment 4 11-21-06.doc No No Paper Only

Health Health Care Services

 

780 0
   
Private Sector Businesses or other for-profits
 
   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 780 0 780 0 0 0
Annual IC Time Burden (Hours) 195 0 195 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
revised IC Unreimbursed Care Paper Survey 3-22-07.doc 03/28/2007
passback AHRQ Response to OMB comments regarding URC 3-22-07.doc 03/28/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.