Data Collection for Medicare Facilities Performing Carotid Artery Stenting with Embolic Protection in Patients at High Risk for Carotid Endarterectomy

Data Collection for Medicare Facilities Performing Carotid Artery Stenting with Embolic Protection in Patients at High Risk for Carotid Endarterectomy

OMB: 0938-1011

IC ID: 45536

Information Collection (IC) Details

View Information Collection (IC)

Data Collection for Medicare Facilities Performing Carotid Artery Stenting with Embolic Protection in Patients at High Risk for Carotid Endarterectomy
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10199 CMS-10199.CAS Data Element CMS-10199 CAS Data Element List REVISED-1-5-07.doc Yes Yes Fillable Fileable
Instruction CMS-10199 CMS-10199.CAS Data Element List CMS-10199.CAS Data Element List.doc Yes Yes Fillable Fileable
Form CMS-10199 CMS-10199.stent data entry CMS-10199.stent data entry.xls Yes Yes Fillable Fileable
Form CMS-10199 CMS-10199.stent data entry CMS-10199.stent data entry.REVISED-1-5-07.xls Yes Yes Fillable Fileable

Health Health Care Services

 

250 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 250 0 250 0 0 0
Annual IC Time Burden (Hours) 125 0 125 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.

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