Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
(ACPI) Advanced Practice Provider and their Proxies (Survey year: 2025 & 2027) Modified 6667 1667 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
EHR for Visit Data (quarterly) (Survey year: 2025-2027)_ACP staff Modified 12000 12000 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
(ACPI) Providers and their Proxies (Survey year: 2026) Modified 3333 833 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
EHR for Visit Data (quarterly) (2024) Modified 200 200 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
Form and Instruction 0920-0234
EHR for Visit Data (quarterly) (Survey yr: 2025-2027)_HC staff Modified 752 752 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
Health Center Component Facility Interview (Survey year: 2024) Modified 84 63 0 Form and Instruction 0920-0234
Health Center Component Facility Interview (Survey year: 2025 & 2027) Modified 221 166 0 Form and Instruction 0920-0234
NAMCS Provider Facility Interview (PFI) (Survey year: 2025 & 2027) Modified 3000 2250 0 Form and Instruction 0920-0234
Form and Instruction 0920-0234
NAMCS Tracing Questionnaire (Survey year: 2025 & 2027) _ Advanced Modified 6667 1111 0 Form and Instruction 0920-0234
NAMCS Tracing Questionnaire (Survey year: 2026) Modified 3333 556 0 Form and Instruction 0920-0234
Set-up Fee Questionnaire (H/C staff) (Survey year: 2024) Modified 17 4 0 Form and Instruction 0920-0234
Set-up Fee Questionnaire (H/C staff) (Survey year: 2025-2027) Modified 17 4 0 Form and Instruction 0920-0234
Total burden requested under this ICR: 36291 19606 0  
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