Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Abstraction and Reabstraction for the ACS module of the NHDS Modified 33 8 0 Other-Word
NHDS Facility Questionaire Part A - D Modified 167 668 0 Other-WORD
NHDS Survey Presentation Modified 167 167 0 Other-Word
NHDS Survey Presentation for the ACS (Interview w/Hospital Executive and Staff) Modified 11 11 0 Other-Word
Post Induction - Facility Questionnaire (Part D) Modified 333 666 0 Other-WORD
Quarterly Transmission of UB -04 Data Modified 2000 2000 0 Other-WORD
Total burden requested under this ICR: 2711 3520 0  
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