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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)
Modified
35998
42610
0
Form
CMS-P-0015A
Cost Payment Summary
Form
CMS-P-0015A
Demographic Income
Form
CMS-P-0015A
End Questionaire
Form
CMS-P-0015A
Enumeration Summary
Form
CMS-P-0015A
Home Health Summary
Form
CMS-P-0015A
nterviewer Remarks
Form
CMS-P-0015A
Mobility of Beneficiaries
Form
CMS-P-0015A
Post Statement Cost
Form
CMS-P-0015A
Access to Care
Form
CMS-P-0015A
Chronic Pain
Form
CMS-P-0015A
Dental, Vision, and Hearing Care Utilization
Form
CMS-P-0015A
Drug Coverage
Form
CMS-P-0015A
Emergency Utilization
Form
CMS-P-0015A
Health Insurance
Form
CMS-P-0015A
Home Health
Form
CMS-P-0015A
Housing_Characteristics
Form
CMS-P-0015A
Income_and_ Assets
Form
CMS-P-0015A
Inpatient Utilization
Form
CMS-P-0015A
Institutional Utilization
Form
CMS-P-0015A
Introduction
Form
CMS-P-0015A
Medical Provider Utilzation
Form
CMS-P-0015A
Nicotine Alcohol
Form
CMS-P-0015A
No Statement Cost
Form
CMS-P-0015A
Other Medical Expense
Form
CMS-P-0015A
Outpatient Utilization
Form
CMS-P-0015A
Prescribed Medicine Utilization
Form
CMS-P-0015A
Satisfaction Care
Form
CMS-P-0015A
Statement Cost Series
Form
CMS-P-0015A
Beneficiary Knowledge
Form
CMS-P-0015A
Preventive Care
Form
CMS-P-0015A
Usual Source of Care
Form
CMS-P-0015A
Showcards and Reference Cards
Form
CMS-P-0015A
Facility Showcards
Form
CMS-P-0015A
Facility Screener
Form
CMS-P-0015A
Residence History Missing Data
Form
CMS-P-0015A
Residence History
Form
CMS-P-0015A
Use of Health Services
Form
CMS-P-0015A
Background_Questionnaire
Form
CMS-P-0015A
Background_Questionnaire MIssing Data
Form
CMS-P-0015A
Expenditures
Form
CMS-P-0015A
Questionaire Missing Data
Form
CMS-P-0015A
Questionaire
Form
CMS-P-0015A
Health_Insurance
Form
CMS-P-0015A
Health_Status
Form
CMS-P-0015A
Health Status
Total burden requested under this ICR:
35998
42610
0
To view an IC, click on IC Title