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

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:

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

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 %

	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

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.