Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Documents and forms in this information collection

Document Name	Document Type
Form CMS-P-0015A Facility Screener Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Cost Payment Summary Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Demographic Income Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A End Questionaire Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Enumeration Summary Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Home Health Summary Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A nterviewer Remarks Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Mobility of Beneficiaries Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Post Statement Cost Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Access to Care Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Chronic Pain Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Dental, Vision, and Hearing Care Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Drug Coverage Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Emergency Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Health Insurance Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Home Health Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Housing_Characteristics Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Income_and_ Assets Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Inpatient Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Institutional Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Introduction Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Medical Provider Utilzation Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Nicotine Alcohol Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A No Statement Cost Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Other Medical Expense Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Outpatient Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Prescribed Medicine Utilization Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Satisfaction Care Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Statement Cost Series Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Beneficiary Knowledge Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Preventive Care Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Usual Source of Care Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Showcards and Reference Cards Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Facility Showcards Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Residence History Missing Data Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Residence History Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Use of Health Services Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Background_Questionnaire Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Background_Questionnaire MIssing Data Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Expenditures Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Questionaire Missing Data Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Questionaire Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Health_Insurance Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Health_Status Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
Form CMS-P-0015A Health Status Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Form
CMS-P-0015A Cost Payment Summary 2018_Cost_Payment_Summary_CPS.pdf	Form
CMS-P-0015A Demographic Income 2018_Demographics_Income_DIQ.pdf	Form
CMS-P-0015A End Questionaire 2018_End_END.pdf	Form
CMS-P-0015A Enumeration Summary 2018_Enumeration_Summary_ENS.pdf	Form
CMS-P-0015A Home Health Summary 2018_Home_Health_Summary_HHS.pdf	Form
CMS-P-0015A nterviewer Remarks 2018_Interviewer_Remarks_IRQ.pdf	Form
CMS-P-0015A Mobility of Beneficiaries 2018_Mobility_MBQ.pdf	Form
CMS-P-0015A Post Statement Cost 2018_Post_Statement_Cost_PSQ.pdf	Form
CMS-P-0015A Access to Care 2019_Access_to_Care_ACQ.pdf	Form
CMS-P-0015A Chronic Pain 2019_Chronic_Pain_CPQ.pdf	Form
CMS-P-0015A Dental, Vision, and Hearing Care Utilization 2019_Dental_Vision_Hearing_Util_DVH.pdf	Form
CMS-P-0015A Drug Coverage 2019_Drug_Coverage_RXQ.pdf	Form
CMS-P-0015A Emergency Utilization 2019_Emergency_Utilization_ERQ.pdf	Form
CMS-P-0015A Health Insurance 2019_Health_Insurance_HIQ.pdf	Form
CMS-P-0015A Home Health 2019_Home_Health_Util_HHQ.pdf	Form
CMS-P-0015A Housing_Characteristics 2019_Housing_Charcs_HAQ.pdf	Form
CMS-P-0015A Income_and_ Assets 2019_Income_and_ Assets_IAQ.pdf	Form
CMS-P-0015A Inpatient Utilization 2019_Inpatient_Utilization_IPQ.pdf	Form
CMS-P-0015A Institutional Utilization 2019_Institutional_Util_IUQ.pdf	Form
CMS-P-0015A Introduction 2019_Introduction_INQ.pdf	Form
CMS-P-0015A Medical Provider Utilzation 2019_Medical_Provider_Util_MPQ.pdf	Form
CMS-P-0015A Nicotine Alcohol 2019_Nicotine_Alcohol_Use_NAQ.pdf	Form
CMS-P-0015A No Statement Cost 2019_No_Statement_Cost_NSQ.pdf	Form
CMS-P-0015A Other Medical Expense 2019_Other_Medical_Expenses_OMQ.pdf	Form
CMS-P-0015A Outpatient Utilization 2019_Outpatient_Util_OPQ.pdf	Form
CMS-P-0015A Prescribed Medicine Utilization 2019_Prescribed_Med_Util_PMQ.pdf	Form
CMS-P-0015A Satisfaction Care 2019_Satisfacation_Care_SCQ.pdf	Form
CMS-P-0015A Statement Cost Series 2019_Statement_Cost_Series_STQ.pdf	Form
CMS-P-0015A Beneficiary Knowledge 2020_Beneficiary_Knowledge_KNQ.pdf	Form
CMS-P-0015A Preventive Care 2020_Preventive_Care_PVQ.pdf	Form
CMS-P-0015A Usual Source of Care 2020_Usual_Source_Of_Care_USQ.pdf	Form
CMS-P-0015A Showcards and Reference Cards 2020CommShowcards.pdf	Form
CMS-P-0015A Facility Showcards 2018FacilityShowcards508.pdf	Form
CMS-P-0015A Facility Screener Fac2018_Facility_Screener_FACSCREEN.pdf	Form
CMS-P-0015A Residence History Missing Data Fac2018_Residence_History_Missing_Data_RHM.pdf	Form
CMS-P-0015A Residence History Fac2018_Residence_History_RH.pdf	Form
CMS-P-0015A Use of Health Services Fac2018_Use_of_Health_Services_US.pdf	Form
CMS-P-0015A Background_Questionnaire Fac2019_Background_Questionnaire_BQ.pdf	Form
CMS-P-0015A Background_Questionnaire MIssing Data Fac2019_Background_Questionnaire_Missing_Data_BQM.pdf	Form
CMS-P-0015A Expenditures Fac2019_Expenditures_EX.pdf	Form
CMS-P-0015A Questionaire Missing Data Fac2019_Facility_Questionnaire_Missing_Data_FQM.pdf	Form
CMS-P-0015A Questionaire Fac2019_Facility_Questionnaire_FQ.pdf	Form
CMS-P-0015A Health_Insurance Fac2019_Health_Insurance_IN.pdf	Form
CMS-P-0015A Health_Status Fac2019_Health_Status_HS.pdf	Form
CMS-P-0015A Health Status Attachment A - R88 HFQ.PDF	Form
Summary of Questionnaire Changes_OMB Passback.pdf Crosswalk	IC Document

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