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Appendix C-3 (EHB Prescription Drug Template)

ICR 201208-0938-009 · OMB 0938-1174 · Object 34306201.

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Document Metadata
File Typeapplication/octet-stream
File TitleAppendix C-3 (EHB Prescription Drug Template)
SubjectEHB, Prescription drugs, NDC, Formulary, Drug, Template, EHB prescription drugs, Essential Health Benefit, Submission, EHB presc
AuthorCenters for Medicare and Medicaid Services
File Modified2012-07-29
File Created2012-07-27
Conversion Statefailed_conversion