Information Collection

2012 CPT Pretest NAMCS-1 (line 9)

IC 196406 under ICR 201111-0920-001 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Document Name Document Type
2012 CPT Pretest NAMCS-1 (line 9) Form
Att Z - NAMCS 2011 Panel CPT Code Pretest Att z 2011 namcs-1 - pretest.pdf Form
Att AA Changes to NAMCS-1 and NAMCS-201 Items for Survey Year 2012 CPT Code PRETEST.PDF Att AA - NAMCS-2012 changes to CPT Code Pretest IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	2012 CPT Pretest NAMCS-1 (line 9)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Att Z - NAMCS 2011 Panel CPT Code Pretest	Att z 2011 namcs-1 - pretest.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title: Health Resources Utilization Statistics	FR Citation: 49 FR 37693

Number of Respondents: 17	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	17	-83	100
Annual IC Time Burden (Hours)	10	-15	25
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Att AA - NAMCS-2012 changes to CPT Code Pretest	Att AA Changes to NAMCS-1 and NAMCS-201 Items for Survey Year 2012 CPT Code PRETEST.PDF	11/07/2011

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