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Attachment 76 – MPC Home Care Provider Authorization Form Package, Records to be Provided via Fax Anticipated
Attachment 76 MPC HomeHealth_Fax_AF_Packet.doc
Medical Expenditure Panel Survey - Household and Medical Provider Components
Attachment 76 – MPC Home Care Provider Authorization Form Package, Records to be Provided via Fax Anticipated
OMB: 0935-0118
OMB.report
HHS/AHRQ
OMB 0935-0118
ICR 202401-0935-001
IC 191102
Attachment 76 – MPC Home Care Provider Authorization Form Package, Records to be Provided via Fax Anticipated
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⚠️ Notice: This form may be outdated.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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