Outpatient Prescription Pharmaceuticals

World Trade Center Health Program Enrollment, Appeals & Reimbursement

OMB: 0920-0891

IC ID: 198311

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Outpatient Prescription Pharmaceuticals
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 88.15 42 CFR 88.16

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

Health Health Care Services

09-20-0147 Occupational Health Epidemiological Studies and CCOICPA Program Records, and WTC Program Records HHS/CDC/NIOSH  76 FR 31212

150 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 39,150 0 0 0 0 39,150
Annual IC Time Burden (Hours) 653 0 0 0 0 653
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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