Kccq-10

(CMS-10443) Transcatheter Valve Therapy Registry and KCCQ-10

OMB: 0938-1202

IC ID: 204894

Information Collection (IC) Details

View Information Collection (IC)

KCCQ-10
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10443 KCCQ Form Kansas City Cardiomyopathy Questionnaire for Patients (with numbering) (with PRA disclosure).pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

14,871 0
   
Individuals or Households
 
   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 44,613 0 26,613 0 0 18,000
Annual IC Time Burden (Hours) 5,354 0 3,254 0 0 2,100
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.

© 2024 OMB.report | Privacy Policy