Information Collection

Re-abstraction Study: Pulling & Refiling Medical Records

IC 213884 under ICR 201411-0920-004 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Att I - 2015 Reabstraction Burden.docx	Other-Burden Placeholder
Att E - 2014 Reabstraction PRF.docx 2014 Re-abstraction Study Screenshots	IC Document

IC Title:

Re-abstraction Study: Pulling & Refiling Medical Records

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Burden Placeholder			Att I - 2015 Reabstraction Burden.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: 09-20--0167 Health Resources Utilization Statistics

FR Citation: 49 FR 37697

Number of Respondents: 7,729

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	231,870	231,870
Annual IC Time Burden (Hours)	3,865	3,865
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2014 Re-abstraction Study Screenshots	Att E - 2014 Reabstraction PRF.docx	11/13/2014

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