View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

End Stage Renal Disease Medical Information System ESRD Facility Survey and Supporting Regulations in 42 CFR 405.2133
 
No Modified
 
Mandatory
 
20 CFR 422.Subpart E 45 CFR 5.5b 42 CFR 405.2133 20 CFR 401..

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-2744A&B Yes Yes Fillable Fileable
Instruction Yes No Printable Only
Form CMS-2744 B Yes Yes Fillable Fileable

Health Health Care Services

End Stage Renal Disease (ESRD) Program Management and Medical Information System (PMMIS)  72 FR 26126

7,726 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 7,726 0 -102 0 7,828 0
Annual IC Time Burden (Hours) 15,452 0 -15,860 0 31,312 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Crosswalk 06/03/2025
Crosswalk for 30-day comments CMS-2744 A and B 09/29/2025
CMS-2744A redline 09/29/2025
CMS-2744B redline 09/29/2025
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.