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Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534

IC 8184 under ICR 200707-0938-008 · OMB 0938-0578.

Documents and Forms
Document Name
Document Type
Form
Instruction
Other-Disclosure Statement
Form
IC Document
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Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534
 
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
Form CMS-367 a, b,c,d Pricing Data revised 367 for omb 6-28-07.doc No No Fillable Fileable
Instruction PRA Instructions to Labelers for CMS 6-28-07.doc No No Printable Only
Other-Disclosure Statement 367 disclosure statement 6-28-07.doc No No Paper Only

Health Health Care Services

 

540 100
   
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 8,640 6,360 0 0 0 2,280
Annual IC Time Burden (Hours) 127,872 73,092 0 0 0 54,780
Annual IC Cost Burden (Dollars) 6,393,600 6,393,600 0 0 0 0

Title Document Date Uploaded
Relevant Statute 367Relevant Statute.doc 02/20/2007
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.