Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers

Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers

OMB: 0938-0978

IC ID: 8840

Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details

View Information Collection (IC)

Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers
 
No Migrated
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10171 Yes Yes


    

56,320 0
   
Private Sector Businesses or other for-profits
 
   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 2,153,767,270 0 0 0 0 2,153,767,270
Annual IC Time Burden (Hours) 1,017,914 0 0 0 0 1,017,914
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

© 2024 OMB.report | Privacy Policy