Information Collection

Physician Abstracts -Patient Record Form (NAMCS-30)

IC 213882 under ICR 201902-0920-021 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Form 0920-0234 Physician Abstracts -Patient Record Form (NAMCS-30)	Form and Instruction
0920-0234 Att D2 2016 NAMCS PRF 122115 Att D2 2016 NAMCS PRF 122115.docx	Form and Instruction
Att D3 - 2016 NAMCS PRF Final.docx Att D3 - 2016 NAMCS PRF Proposed Changes	IC Document

IC Title:

Physician Abstracts -Patient Record Form (NAMCS-30)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Removed

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
Form and Instruction	0920-0234	Att D2 2016 NAMCS PRF 122115	Att D2 2016 NAMCS PRF 122115.docx		Yes	No	Fillable Printable

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: 259

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 %

table that charts list of burden
	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-7,770	7,770
Annual IC Time Burden (Hours)	-1,813	1,813
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att D3 - 2016 NAMCS PRF Proposed Changes	Att D3 - 2016 NAMCS PRF Final.docx	02/10/2016

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