340B Program Registrations amp; Certifications for Sole Community Hospitals

340B Drug Pricing Program Forms

OMB: 0915-0327

IC ID: 203463

Information Collection (IC) Details

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340B Program Registrations amp; Certifications for Sole Community Hospitals
 
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 and Instruction 1 13+14 340B Registration Rural Referral Centers and Sole Community Hospitals (Orphan Drug) 13+14 340B Registration Rural Referral Centers and Sole Community Hospitals (Orphan Drug).docx Yes Yes Fillable Fileable

Health Health Care Services

 

60 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   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 60 0 0 0 0 60
Annual IC Time Burden (Hours) 120 0 0 0 0 120
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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