Document
Prescription Drug Template
ICR 201902-0938-012 · OMB 0938-1187 · Object 89482101.
This document may belong to an older filing. More recent activity for OMB 0938-1187:
Document Viewer [xls]
Status: The document is viewable, but some background extraction is still pending.
Queue: Repair is queued and waiting for the next worker pass. (priority 70 · attempts 1 · next 2026-08-26 05:54:57)
Missing: html
Download: Source copy (xls) | pdf
Loading document viewer…
Document Metadata
| File Type | application/vnd.ms-excel |
|---|---|
| File Title | Prescription Drug Template |
| Subject | Formularies |
| Author | CMS |
| Last Modified By | O'Brien, Tayseer |
| File Modified | 2019-01-28 |
| File Created | 2012-02-01 |
| Conversion State | partial |