Download:
pdf |
pdf2019 (old version)
2020 (new version)
Type of Change
Reason for Change
Burden Change
Header:
MEDICAID DRUG REBATE
Header:
MEDICAID DRUG REBATE PROGRAM
Rev
To align Header verbiage across all forms
N/A
Header: Fax
Header: Email
Rev
The Fax field is no longer relevant
N/A
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
| File Type | application/pdf |
| File Title | CMS Form-304 Reconciliation of State Invoice (ROSI)_Crosswalk_07.2021.xlsx |
| Author | LOKG |
| File Modified | 2020-11-03 |
| File Created | 2020-11-03 |