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Pfi (2023- 2025)
National Ambulatory Medical Care Survey (NAMCS)
OMB: 0920-0234
IC ID: 247675
OMB.report
HHS/CDC
OMB 0920-0234
ICR 202210-0920-012
IC 247675
( )
Documents and Forms
Document Name
Document Type
Form 0920-0234
PFI (2023- 2025)
Form and Instruction
0920-0234 PFI (2023-2025)
Attachment E2_Draft NAMCS Provider Facility Interview.docx
Form and Instruction
0920-0234 PFI (2023-2025)
Attachment E2_Draft NAMCS Provider Facility Interview.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
PFI (2023- 2025)
Agency IC Tracking Number:
0920-2034
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-0234
PFI (2023-2025)
Attachment E2_Draft NAMCS Provider Facility Interview.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
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
3,000
0
1,000
0
0
2,000
Annual IC Time Burden (Hours)
2,250
0
750
0
0
1,500
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.