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Authorization form for the MEPS-MPC Provider and Pharmacy Survey
Medical Expenditure Panel Survey - Household and Medical Provider Components
OMB: 0935-0118
IC ID: 204197
OMB.report
HHS/AHRQ
OMB 0935-0118
ICR 202401-0935-001
IC 204197
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0935-0118 can be found here:
2024-07-02 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Attachment 25
Authorization form for the MEPS-MPC Provider and Pharmacy Survey
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
Form and Instruction
Attachment 24 Authorization Form for the MEPS MPC Pharmacy Survey
Attachment 24 HC Authorization Form for the MEPS MPC Pharmacy.pdf
Form and Instruction
Information Collection (IC) Details
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