Download:
pdf |
pdf2019 (old version)
2020 (new version)
Type of Change
Reason for Change
Burden Change
File Format Header:
DDR QUARTERLY PRICING DATA FILE FORMAT
FOR TEXT FILE SUBMISSIONS TO CMS
File Format Header:
MEDICAID DRUG REBATE PROGRAM
MDP QUARTERLY PRICING DATA
FILE SUBMISSION TO CMS
Form CMS‐367a
FILE FORMAT
Effective: July 1, 2021
Rev
To align Header with other Medicaid Drug
Rebate Program documentation.
N/A
N/A
New File Format Column:
Ordinal Position
Coresponding Rows Numbered 1‐10
File Format ‐ Column Name Update:
Field Name (.TXT)
Header Row (.CSV
Add
To update File Format to include .CSV Ordinal
Numbering Column
N/A
Rev
To include .CSV Header Row in additon to the
.TXT Field Name
N/A
File Format ‐ Remarks Fields:
See Data Element Definition
File Format ‐ Remarks Fields:
See Data Definitions
Rev
Removed the word "Element" as it is not relevant N/A
File Format ‐ Position Fields:
1 ‐ 69
File Format ‐ Position Fields:
1 ‐ 73
Rev
File Format Field:
Package Size
File Format Field:
Average Manufacturer Price (AMP)
Size: 12
Position: 18 ‐ 29
Remarks: 99999.999999
File Format Field:
N/A
File Format Field:
Average Manufacturer Price
Size: 15
Position: 16 ‐ 30
Remarks: 99999999.999999
Del
N/A
Field positions were adjusted due to the
Increased AMP and BP Field Sizes from 12 digits
to 15.
Package Size Field is no longer required.
N/A
Rev
Update field size from 12 to 15 digits, and to
remove (AMP)
N/A
File Format Field:
Best Price (BP)
Size: 12
Position: 30 ‐ 41
Remarks: 99999.999999
File Format Field:
Nominal Price (NP)
File Format Field:
Customary Prompt Pay (CPP) Discount
File Format Field:
Best Price
Size: 15
Position: 31 ‐ 45
Remarks: 99999999.999999
File Format Field:
Nominal Price
File Format Field:
Customary Prompt Pay Discount
Rev
Updated field size from 12 to 15 digits, and to
remove (BP)
N/A
Rev
Removed abbreviation
N/A
Rev
Removed abbreviation
N/A
File Format ‐ Column Name Update:
Field
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
2019 (old version)
2020 (new version)
Type of Change
Reason for Change
Burden Change
Data Definitions Header:
Quarterly Pricing (CMS 367a Form) Data Element
Definitions
Data Definitions Header:
MEDICAID DRUG REBATE PROGRAM
MDP QUARTERLY PRICING DATA
FILE SUBMISSION TO CMS
Form CMS‐367a
DATA DEFINITIONS
Effective: July 1, 2021
Rev
To align Header with other Medicaid Drug
Rebate Program documentation.
N/A
Data Definitions ‐ Package Size:
Third segment of the NDC. Alpha‐numeric values; 2‐digit
field; right‐justified; zero‐padded.
Data Definitions ‐ Average Manufacturer Price (AMP):
...Numeric values; 12‐digit field: 5 whole numbers, the
decimal point (‘.’) and 6 decimal places; right‐justified;
zero‐padded for AMP values with fewer than 12 digits
Data Definitions ‐ Package Size:
N/A
Del
Package Size Field is no longer required.
N/A
Data Definitions: Average Manufacturer Price (AMP):
Rev
...Numeric values; 15‐digit field: 8 whole numbers, the decimal
point (‘.’) and 6 decimal places; right‐justified; zero‐padded for
AMP values with fewer than 15 digits.
Updated verbiage to account for increased field N/A
size from 12 ‐ 15 digits.
Data Definitions ‐ Best Price (BP): ...Numeric values; 12‐
digit field: 5 whole numbers, the decimal point (‘.’) and 6
decimal places; right‐justified; zero‐padded for BP values
with fewer than 12 digits.
Data Definitions: ‐ Best Price (BP): ...Numeric values; 15‐digit
field: 8 whole numbers, the decimal point (‘.’) and 6 decimal
places; right‐justified; zero‐padded for BP values with fewer
than 15 digits.
Updated verbiage to account for increased field N/A
size from 12 ‐ 15 digits.
Rev
Data Definitions ‐ Initial Drug:
Data Definitions ‐ Initial Drug:
Rev
...and must be active within the MDR Program at the time ...and must be active within the Medicaid Drug Rebate Program
it is reported as an Initial Drug.
at the time it is reported as an Initial Drug.
To align verbiage with other Medicaid Drug
Rebate Program documentation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
N/A
| File Type | application/pdf |
| File Title | CMS Form-367a_Quarterly Pricing_Crosswalk_07.2021.xlsx |
| Author | LOKG |
| File Modified | 2020-11-03 |
| File Created | 2020-11-03 |