Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
2018 Physician Induction Inverview (NAMCS-1) Modified 122 61 6323 Form and Instruction none
2019 Traditional Provider Induction Interview (NAMCS-1) Modified 1097 549 17640 Form and Instruction none
Instruction
Form none
Induction Interview - Community Health Center Providers New 348 174 15267 Form and Instruction none
Form and Instruction none
Instruction
Induction Interview - Service Delivery Site (NAMCS-201) Modified 116 58 5250 Form and Instruction none
Form and Instruction none
Form and Instruction none
MU Physician Induction Interview Modified 2000 1500 48240 Form and Instruction none
MU Physician Pulling and Refiling EHR New 2000 2000 64320 Instruction
Patient Record Form (NAMCS-1) Removed 0 0 0 Form and Instruction 0920-0234
Physician Abstracts -Patient Record Form (NAMCS-30) Removed 0 0 0 Form and Instruction 0920-0234
Pulling and Refiling Medical Record Forms - CHC Provider and Staff Modified 10440 174 5638 Instruction
Pulling and Refiling Medical Record Forms - Tradtional Providers Modified 29760 496 16070 Instruction
Reabstraction Study - Traditional and CHC Providers Modified 30 1 16 Instruction
Instruction
Reinterview Study - Traditional Physician and CHC Staff New 100 25 804 Form and Instruction none
Total burden requested under this ICR: 46013 5038 179568  
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