Download:
pdf |
pdf2019 (old version)
2020 (new version)
Type of Change
Reason for Change
Burden Change
File Format Header:
DDR MONTHLY PRICING DATA FILE FORMAT
FOR TEXT FILE SUBMISSIONS TO CMS
File Format Header:
MEDICAID DRUG REBATE PROGRAM
MDP MONTHLY PRICING DATA
FILE SUBMISSION TO CMS
Form CMS‐367b
FILE FORMAT
Effective: July 1, 2021
Rev
To align Header with other Medicaid Drug Rebate N/A
Program documentation.
N/A
New File Format Column:
Ordinal Position
Coresponding Rows Numbered 1 ‐ 8
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 ‐ Position Fields:
1 ‐ 45
File Format ‐ Position Fields:
1 ‐ 46
Rev
N/A
File Format Field:
Package Size
File Format Field:
Average Manufacturer Price (AMP)
Size: 12
Position: 19 ‐ 30
Remarks: 99999.999999
Data Definitions Header:
Monthly Pricing (CMS 367b Form) Data Element Definitions
File Format Field:
N/A
File Format Field:
Average Manufacturer Price
Size: 15
Position: 17 ‐ 31
Remarks: 99999999.999999
Data Definitions Header:
MEDICAID DRUG REBATE PROGRAM
MDP MONTHLY PRICING DATA
FILE SUBMISSION TO CMS
Form CMS‐367b
DATA DEFINITIONS
Effective: July 1, 2021
Del
Field positions were adjusted due to the
increased Average Manufacturer Price field size
from 12 to 15 digits and the removal of the
Package Size field.
Package Size Field is no longer required.
Data Definitions ‐ Package Size:
Third segment of the NDC. Alpha‐numeric values; 2‐digit field;
right‐justified; zero‐padded.
Data Definitions ‐ Package Size:
N/A
File Format Column Name Update:
Field
N/A
Rev
Updated the field size from 12 to 15 digits, and to N/A
remove (AMP)
Rev
To align Header with other Medicaid Drug Rebate N/A
Program documentation.
Del
Package Size Field is no longer required.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
N/A
2019 (old version)
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.
2020 (new version)
Data Definitions ‐ Average Manufacturer Price (AMP):
...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 12 digits.
Type of Change
Rev
Reason for Change
Burden Change
Updated verbiage to account for increased field N/A
size from 12 ‐ 15 digits
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
File Type | application/pdf |
File Title | CMS Form-367b_Monthly Pricing_Crosswalk_07.2021.xlsx |
Author | LOKG |
File Modified | 2020-11-04 |
File Created | 2020-11-04 |