TVT Registry form for TMVR

(CMS–10531) Transcatheter Mitral Valve Repair (TMVR) National Coverage Decision (NCD)

OMB: 0938-1274

IC ID: 215704

Information Collection (IC) Details

View Information Collection (IC)

TVT Registry form for TMVR
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10531 TVT Registry 2-1_tvt_mitralleafletclipdcf with disclosure statement on page 1.pdf Yes Yes Fillable Fileable

Health Public Health Monitoring

 

3,897 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 3,897 0 0 -103 4,000 0
Annual IC Time Burden (Hours) 4,092 0 0 -108 4,200 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk for TVT form TVT Registry Form Changes.pdf 07/16/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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