End Stage Renal Disease Medical Information System ESRD Facility Survey (42 CFR Section 405.2133)

End Stage Renal Disease Medical Information System ESRD Facility Survey (42 CFR Section 405.2133)

OMB: 0938-0447

IC ID: 8061

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End Stage Renal Disease Medical Information System ESRD Facility Survey (42 CFR Section 405.2133)
 
No Migrated
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-2744 No No


    

4,200 0
   
Private Sector Businesses or other for-profits
 
   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 4,200 0 0 439 0 3,761
Annual IC Time Burden (Hours) 33,600 0 0 3,512 0 30,088
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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