Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171)

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

OMB: 0938-0978

IC ID: 8840

Information Collection (IC) Details

View Information Collection (IC)

Coordination of Benefits between Part D Plans and Other Prescription Coverage Providers (CMS-10171)
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 423.464

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction PDP-Manual-Chapter 14_dis.pdf Yes Yes Printable Only

Health Health Care Services

 

57,227 0
   
Private Sector Businesses or other for-profits
 
   98 %

  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 248,018 0 55,856 -2,153,575,108 0 2,153,767,270
Annual IC Time Burden (Hours) 754,788 0 12,858 -275,984 0 1,017,914
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions SPAP_dis Instructions SPAP_dis.pdf 08/05/2010
Updated Automated TBT Guidance v2_dis Updated Automated TBT Guidance v2_dis.pdf 08/05/2010
MDBGpraestimate_COB_2-2010 MDBGpraestimate_COB_2-2010.xls 08/05/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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