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Federal forms, ICRs, and supporting documents

Information Collection

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

IC 45535 under ICR 202008-0938-012 · OMB 0938-1011.

Documents and Forms
Document Name
Document Type
Instruction
Instruction
Instruction
Instruction
Form
Form
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 Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction CAS data elements 2020.pdf Yes Yes Fillable Fileable
Form CMS-10199 CMS-10199.stent data entry CAS Data Entry Form 2020.pdf Yes Yes Fillable Fileable
Instruction FINAL_CAS Data Entry and Submission Instructions_6_15_2015 2020.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

1,420 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 2,840 0 0 100 0 2,740
Annual IC Time Burden (Hours) 29,820 0 0 1,050 0 28,770
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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