Medicare Drug Payment Exceptions Process

Medicare Drug Payment Exceptions Process

OMB: 0938-0913

IC ID: 8753

Documents and Forms
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Information Collection (IC) Details

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Medicare Drug Payment Exceptions Process
 
No Migrated
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10104 No No


    

1,100 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 4,500 0 4,500 0 0 0
Annual IC Time Burden (Hours) 4,500 0 4,500 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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