Authorization form for the MEPS-MPC Provider Survey

Medical Expenditure Panel Survey (MEPS) COVID-19 Changes

OMB: 0935-0118

IC ID: 204197

Information Collection (IC) Details

View Information Collection (IC)

Authorization form for the MEPS-MPC Provider Survey
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Attachment 25 Attachment 25 HC Authorization Form for the MEPS MPC Provider Attachment 25 HC Authorization Form for the MEPS MPC Provider.pdf Yes Yes Fillable Fileable

Health Immunization Management

 

12,804 0
   
Individuals or Households
 
   100 %

  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 69,142 0 0 0 0 69,142
Annual IC Time Burden (Hours) 3,457 0 0 0 0 3,457
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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