DDR Quarterly Pricing Data Specifications (CMS-367a)

Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

OMB: 0938-0578

IC ID: 8184

Information Collection (IC) Details

View Information Collection (IC)

DDR Quarterly Pricing Data Specifications (CMS-367a)
 
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 CMS-367a DDR Quarterly Pricing Data Specifications DDR Screenshots for CMS-367a_b_c_CLEAN_updated_7.12.16.docx Yes Yes Fillable Fileable
Instruction CMS-367 - Instructions to Labelers -CLEAN - updated 4_21_16.docx Yes Yes Fillable Fileable

Health Health Care Services

 

610 100
   
Private Sector Businesses or other for-profits
 
   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 2,440 0 -10,370 0 0 12,810
Annual IC Time Burden (Hours) 84,912 0 -3,527,691 0 0 3,612,603
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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