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Health Insurance Cost Sharing Collection- 2020
Medical Expenditure Panel Survey - Household and Medical Provider Components
OMB: 0935-0118
IC ID: 236893
OMB.report
HHS/AHRQ
OMB 0935-0118
ICR 202401-0935-001
IC 236893
( )
⚠️ Notice: This information collection may be referencing outdated material.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 107a
Health Insurance Cost Sharing Collection- 2020
Form and Instruction
107a Attachment 107a.Protocol A (Medicare)
Attachment 107a.Protocol A (Medicare)_final OMB_v2.docx
Form and Instruction
107b Attachment 107b.Protocol B (Employer)
Attachment 107b.Protocol B (Employer)_final OMB_v2.docx
Form and Instruction
107c Attachment 107c.Protocol C (Private with Medicare)_
Attachment 107c.Protocol C (Private with Medicare)_final OMB_v2.docx
Form and Instruction
107d Attachment 107d.Protocol D (Other)
Attachment 107d.Protocol D (Other)_final OMB_v2.docx
Form and Instruction
Information Collection (IC) Details
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