Attachment 88 – MPC Hospital Provider Authorization Form Package, One Point of Contact for Medical and Patient Account Records

Attachment 88 MPC Hospital_MRPA_AF_Packet.doc

Medical Expenditure Panel Survey - Household and Medical Provider Components

Attachment 88 – MPC Hospital Provider Authorization Form Package, One Point of Contact for Medical and Patient Account Records

OMB: 0935-0118

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0935-0118 can be found here:

2024-07-02 - Revision of a currently approved collection

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