Information Collection

Collection of Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug Plans (PDP and MA-PD) and Supporting Regulations in 42 CFR 423.48

IC 8806 under ICR 201312-0938-004 · OMB 0938-0951.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10150 Collection of Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug Plans (PDP and MA-PD) and Supporting Regulations in 42 CFR 423.48	Form and Instruction
CMS-10150 2014 Pricing Data Guidelines 2014 Pricing Data Guidelines 07.2013.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Collection of Drug Pricing and Network Pharmacy Data from Medicare Prescription Drug Plans (PDP and MA-PD) and Supporting Regulations in 42 CFR 423.48

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 42 CFR 423.48

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10150	2014 Pricing Data Guidelines	2014 Pricing Data Guidelines 07.2013.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 680

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	17,680	-520	18,200
Annual IC Time Burden (Hours)	70,720	34,320	36,400
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.