Information Collection

TVT Registry form for TMVR

IC 215704 under ICR 202109-0938-014 · OMB 0938-1274.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10531 TVT Registry form for TMVR	Form and Instruction
CMS-10531 TVT Registry tvt_v3_mitralleafetclip_dcf_1_26_2021-(1) (with PRA disclosure) 2021.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10531	TVT Registry	tvt_v3_mitralleafetclip_dcf_1_26_2021-(1) (with PRA disclosure) 2021.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,649

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	8,649	4,752	3,897
Annual IC Time Burden (Hours)	12,974	8,882	4,092
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.