Medical Expense Report

Medical Expense Report (VA Form 21P-8416)

OMB: 2900-0161

IC ID: 28397

Information Collection (IC) Details

View Information Collection (IC)

Medical Expense Report 2900-0161
 
No Modified
 
Required to Obtain or Retain Benefits
 
38 CFR 3.262 38 CFR 3.272

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 21P-8416 Medical Expense Report 2900-0161 21P-8416(12-14).pdf https://www.vba.va.gov/pubs/forms/VBA-21P-8416-ARE.pdf Yes No Fillable Printable

General Government Legislative Functions

Compensation, Pension, Education, and Vocational Rehabilitation and Employment Records-VA (58VA21/22/28)  74 FR 29275

60,000 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 60,000 0 -36,400 0 0 96,400
Annual IC Time Burden (Hours) 30,000 0 -18,200 0 0 48,200
Annual IC Cost Burden (Dollars) 0 0 -974,845 0 0 974,845

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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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