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Information Collection

Data Dictionary - Emergency Department (ED) Visits

IC 222533 under ICR 202503-0920-007 · OMB 0920-1175.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Data Dictionary - Emergency Department (ED) Visits 0920-1175
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1175 Data Dictionary - Emergency Department (ED) Visits Att4D Emergency Department Visits Form - Revised.docx Yes Yes Printable Only

Health Public Health Monitoring

 

37 0
   
State, Local, and Tribal Governments
 
   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 37 0 0 0 0 37
Annual IC Time Burden (Hours) 1,480 0 0 0 0 1,480
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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