Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
491.11 - Program Evaluation - Existing FHQCs New 7874 23622 0
491.11 - Program Evaluation - New FQHCs New 425 4250 0
491.11 - Program Evaluation - New RHCs Modified 30 300 0
491.11 Program Evaluation - Existing RHCs Modified 4160 12480 0
491.9(b) - Patient Care Policies - Existing FQHCs New 7824 15748 0
491.9(b) Patient Care Policies - Existing RHCs Modified 4160 8320 0
491.9(b) Patient Care Policies - New FQHCs New 425 4250 0
491.9(b) Patient Care Policies - New RHCs Modified 30 300 0
Total burden requested under this ICR: 24928 69270 0  
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