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Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Batch Data Submission Form

IC 186857 under ICR 201609-0938-017 · OMB 0938-1052.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Information Collection (IC) Details

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Consolidated Renal Operations in a Web Enabled Network (CROWNWeb) Batch Data Submission Form
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10268 Crownweb Batch Data Submission Authorization form 2_CROWNWeb Batch Data Submission Authorization Form 28Sep2016.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

3,000 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 400 0 0 0 0 400
Annual IC Time Burden (Hours) 34 0 0 0 0 34
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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