ASPData revised _AddendumA revised 2009 110108

ASPData revised _AddendumA revised 2009 110108.csv

Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations

ASPData revised _AddendumA revised 2009 110108

OMB: 0938-0921

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Manufacturer's Name,11-Digit National Drug Code,"Manufacturer's
 Average Sales Price",Number of ASP Units,"Wholesale 
Acquisition Cost ",Name of Drug or Biological,Strength of the Product,"Volume
 Per Item",Number of Items Per NDC,"Expiration Date
of Last Lot Sold",Date of First Sale,Number of CAP Units Excluded,FDA Application Number,FDA Final Pre-Marketing Approval Date,FDA Approval Type,Descriptive Data Corrected
Currently collected data elements,,,,,,,,,,,,Proposed New Data Elements,,,






















"According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0938-0921."
"The time required to complete this information collection is estimated to average (40 hours) per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. "
CMS 10110 approval pending
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