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Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC 2004 and 2005)
 
No Modified
 
Voluntary
 
5 CFR 1320.6

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability

Health Public Health Monitoring

 

132,548 0
   
Individuals or Households
 
   25 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 132,548 0 48,848 0 0 83,700
Annual IC Time Burden (Hours) 85,184 0 -164,664 0 0 249,848
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
MEPS-HC Survey Instrument 02 - RE-B (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 01 - RE-A (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 03 - PE (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 04 - CE (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 05 - HE (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 06 - CS (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 07 - ca (beta).pdf 09/01/2006
MEPS-HC Survey Instrument 08 - PP (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 09 -EV (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 10 - PV (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 11 - ED (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 12 - HS (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 13 - er (beta).pdf 09/01/2006
MEPS-HC Survey Instrument 14 - op (beta).pdf 09/01/2006
MEPS-HC Survey Instrument 15 - mv (beta).pdf 09/01/2006
MEPS-HC Survey Instrument 16 - DN (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 17 - HH (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 18 - OM (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 19 - PM (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 20 - CP (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 21 - FF (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 22 - dd (beta).pdf 09/01/2006
MEPS-HC Survey Instrument 23 - CN (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 24 - PC (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 25 - AP (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 26 - AC (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 27 - EM-O (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 28 - RJ (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 29 - EM (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 30 - EW (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 31 - HX (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 32 - HP (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 33 - HQ (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 34 - MC (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 35 - OE (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 36 - PR (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 37 - SP (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 38 - IN (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 39 - AS (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 40 - PD (Beta).pdf 09/01/2006
MEPS-HC Survey Instrument 41 - CL (BETA).pdf 09/01/2006
MEPS-HC Survey Instrument 42 - RS (Beta).pdf 09/01/2006
MEPS-MPC-Home Health HH Event Book Health Care.pdf 09/01/2006
MEPS-MPC-Home Health HH Event Book NonHealth Care.pdf 09/01/2006
MEPS-MPC-Home Health MPC Contact Guide HH.pdf 09/01/2006
MEPS-MPC-Hospital Carolyn Clancy Letter.pdf 09/01/2006
MEPS-MPC-Hospital Diagnosis Continue HS.pdf 09/01/2006
MEPS-MPC-Hospital Global Fee Continue HS .pdf 09/01/2006
MEPS-MPC-Hospital HS Brochure.pdf 09/01/2006
MEPS-MPC-Hospital HS Cover Sheet.pdf 09/01/2006
MEPS-MPC-Hospital HS Fax Return.pdf 09/01/2006
MEPS-MPC-Hospital HS PatientList.pdf 09/01/2006
MEPS-MPC-Hospital Med Event Form HS.pdf 09/01/2006
MEPS-MPC-Hospital MPC Contact Guide HS.pdf 09/01/2006
MEPS-MPC-Hospital Repeat Visit Continue HS.pdf 09/01/2006
MEPS-MPC-Hospital SBDFORM.doc 09/01/2006
MEPS-MPC-Hospital Service Charge Continue HS.pdf 09/01/2006
MEPS-MPC-Institutional Contact Guide IC.pdf 09/01/2006
MEPS-MPC-Institutional IC Event Form.pdf 09/01/2006
MEPS-MPC-Office Based Carolyn Clancy Letter.pdf 09/01/2006
MEPS-MPC-Office Based Diagnosis Continue OB.pdf 09/01/2006
MEPS-MPC-Office Based Global Fee Continue OB.pdf 09/01/2006
MEPS-MPC-Office Based Med Event Form OB.pdf 09/01/2006
MEPS-MPC-Office Based MPC Contact Guide OB.pdf 09/01/2006
MEPS-MPC-Office Based OB Brochure.pdf 09/01/2006
MEPS-MPC-Office Based OB Cover Sheet.pdf 09/01/2006
MEPS-MPC-Office Based OB Fax Return.pdf 09/01/2006
MEPS-MPC-Office Based OB PatientList.pdf 09/01/2006
MEPS-MPC-Office Based Repeat Visit Continue OB.pdf 09/01/2006
MEPS-MPC-Office Based Service Charge Continue OB.pdf 09/01/2006
MEPS-MPC-Pharmacy Carolyn Clancy Letter.pdf 09/01/2006
MEPS-MPC-Pharmacy Contact Guide Pharm.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm Brochure.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm Component Data Form.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm Cover Sheet.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm CustomerList.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm Fax Return.pdf 09/01/2006
MEPS-MPC-Pharmacy Pharm PtRequest.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Carolyn Clancy Letter.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Diagnosis Continue SBD.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Global Fee Continue SBD.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Med Event Form SBD.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors MPC Contact Guide SBD.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors MPC Patient Data Form SBD.rtf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Repeat Visit Continue SBD.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors SBD Brochure.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors SBD Cover Sheet.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors SBD Fax Return.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors SBD PatientList.pdf 09/01/2006
MEPS-MPC-Sep. Billing Doctors Service Charge Continue SBD.pdf 09/01/2006
MEPS-MPC-Fax Package Contact Person Call Records.doc 09/01/2006
MEPS-MPC-Fax Package Doris Lefkowitz Ltr.doc 09/01/2006
MEPS-MPC-Fax Package MPC DATA FORM.rtf 09/01/2006
MEPS-MPC-Fax Package MPC List Interviewer Version.rtf 09/01/2006
MEPS-MPC-Fax Package MPC Patient Data Form SBD.rtf 09/01/2006
MEPS-MPC-Fax Package Thomas McKenna Ltr.doc 09/01/2006
MEPS-MPC-Table of Contents TOC.doc 09/01/2006
MEPS-HC-Advance Letters & Screener Questionnaires MEPS Attachments[1].pdf 09/01/2006
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.