Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Adult SAQ Modified 7800 910 0 Form and Instruction 48
Authorization Form for the MEPS-MPC Provider and Pharmacy Survey Modified 38407 1920 0 Form and Instruction 52
Form and Instruction 53
Burdens and Economic Impacts of Medical Care SAQ New 8085 1348 0 Form and Instruction 63
Cancer SAQ Removed 0 0 0 Form and Instruction 2a
Diabetes Care SAQ Modified 1398 70 0 Form and Instruction 50
Home Care Providers Event Form Modified 2700 135 0 Form and Instruction 56
Form and Instruction 57
Hospitals Event Form Modified 23217 1161 0 Form and Instruction 60
Institutions (non-hospital) Event Form Modified 112 6 0 Form and Instruction 61
MEPS-HC Core Interview Modified 31708 46505 0 Form and Instruction 1
Form and Instruction 2
Form and Instruction 3
Form and Instruction 4
Form and Instruction 5
Form and Instruction 6
Form and Instruction 7
Form and Instruction 8
Form and Instruction 9
Form and Instruction 10
Form and Instruction 11
Form and Instruction 12
Form and Instruction 13
Form and Instruction 14
Form and Instruction 15
Form and Instruction 16
Form and Instruction 17
Form and Instruction 18
Form and Instruction 19
Form and Instruction 20
Form and Instruction 21
Form and Instruction 22
Form and Instruction 23
Form and Instruction 24
Form and Instruction 25
Form and Instruction 26
Form and Instruction 27
Form and Instruction 28
Form and Instruction 29
Form and Instruction 30
Form and Instruction 31
Form and Instruction 32
Form and Instruction 33
Form and Instruction 34
Form and Instruction 35
Form and Instruction 36
Form and Instruction 37
Form and Instruction 38
Form and Instruction 39
Form and Instruction 40
Form and Instruction 41
Form and Instruction 42
Form and Instruction 43
Form and Instruction 44
Form and Instruction 45
Form and Instruction 46
MEPS-HC Validation Interview Modified 1826 152 0 Form and Instruction 54a
Form and Instruction 54b
MPC Contact Guide/Screening Call Modified 38683 3224 0 Form and Instruction 55
Office Based Providers Form Modified 26040 1302 0 Form and Instruction 58
Pharmacies Event Form Modified 191306 9565 0 Form and Instruction 62
Preventive Care SAQ Modified 7800 910 0 Form and Instruction 49
Separately Billing Doctors Form Modified 5611 281 0 Form and Instruction 59
Total burden requested under this ICR: 384693 67489 0  
To view an IC, click on IC Title