Information Collection Request

Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110)

ICR 202007-0938-011 · OMB 0938-0921 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
cms_10110_supporting_statement_part_a.docx Supporting Statement A Uploaded 2020-08-10 Repair queued
crosswalk_document_for_cms_10110_041420.pdf Supplementary Document Uploaded 2020-08-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
8767 Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110) Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved 02/28/2021
1,200 720
15,600 9,360
0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110) CMS-10110, CMS-10110 ASP Addendum macro ,   Addendum B

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,200 720 0 0 480 0
Annual Time Burden (Hours) 15,600 9,360 0 0 6,240 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No