BLS 231 Checklist

U.S. Department of Labor
Bureau of Labor Statistics
IPP Checklist

OMB No. 1220-0025

M45

The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will
hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act
(44 U.S.C. 3572) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent. Per the Federal
Cybersecurity Enhancement Act of 2015, Federal information systems are protected from malicious activities through cybersecurity screening of transmitted
data.
Public Burden Statement: We estimate it will take an average of 1 hour for this collection of information, including time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and reviewing the collection of information. If you have any comments regarding this
estimate or any other aspect of this information collection, including suggestions for reducing this burden, please send them to the Bureau of Labor Statistics,
Division of International Prices, 1220-0025, 2 Massachusetts Avenue, N.E., Washington, DC 20212. The OMB control number for IPP's voluntary survey is
1220-0025. Without a currently valid number, BLS would not be able to conduct this survey.

30
PHARMACEUTICAL PRODUCTS
Table of Contents
I. Checklist Materials

_____________________________________________________________ 1

A. Checklist Area Description
B. Exclusions
C. Common Initiation Problems
D. Additional Checklist Area Information
E. Customs Ruling Online Search System
(CROSS)
F. Terminology

II. Product Checklist

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_____________________________________________________________ 4

3001 - GLANDS AND OTHER ORGANS FOR
ORGANO-THERAPEUTIC USES, DRIED,
WHETHER OR NOT POWDERED; EXTRACTS
OF GLANDS OR OTHER ORGANS OR OF
THEIR SECRETIONS FOR ORGANOTHERAPEUTIC USES; HEPARIN AND ITS
SALTS; OTHER HUMAN OR ANIMAL
SUBSTANCES PREPARED FOR
THERAPEUTIC OR PROPHYLACTIC USES,
NOT ELSEWHERE SPECIFIED OR INCLUDED
3002 - HUMAN BLOOD; ANIMAL BLOOD
PREPARED FOR THERAPEUTIC,
PROPHYLACTIC OR DIAGNOSTIC USES;
ANTISERA, OTHER BLOOD FRACTIONS AND
IMMUNOLOGICAL PRODUCTS, WHETHER OR
NOT MODIFIED OR OBTAINED BY MEANS OF
BIOTECHNOLOGICAL PROCESSES;
VACCINES, TOXINS, CULTURES OF MICROORGANISMS AND SIMILAR PRODUCTS
3003 - MEDICAMENTS (EXCLUDING GOODS
OF HEADING 3002, 3005 OR 3006)
CONSISTING OF TWO OR MORE
CONSTITUENTS WHICH HAVE BEEN MIXED
TOGETHER FOR THERAPEUTIC OR
PROPHYLACTIC USES, NOT PUT UP IN
MEASURED DOSES OR IN FORMS OR
PACKAGING FOR RETAIL SALE
3004 - MEDICAMENTS (EXCLUDING GOODS
OF HEADING 3002, 3005 OR 3006)
CONSISTING OF MIXED OR UNMIXED
PRODUCTS FOR THERAPEUTIC OR
PROPHYLACTIC USES, PUT UP IN MEASURED
DOSES (INCLUDING THOSE IN THE FORM OF
TRANSDERMAL ADMINISTRATION SYSTEMS)
OR IN FORMS OR PACKAGING FOR RETAIL
SALE
3005 - WADDING, GAUZE, BANDAGES AND
SIMILAR ARTICLES (FOR EXAMPLE,
DRESSINGS, ADHESIVE PLASTERS,

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Table of Contents
POULTICES), IMPREGNATED OR COATED
WITH PHARMACEUTICAL SUBSTANCES OR
PUT UP IN FORMS OR PACKAGING FOR
RETAIL SALE FOR MEDICAL, SURGICAL,
DENTAL OR VETERINARY PURPOSES
3006 - PHARMACEUTICAL GOODS SPECIFIED
IN NOTE 4 TO THIS CHAPTER

III. Transaction Checklist
end of toc

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10

_____________________________________________________________ 11
Page 2

I. Checklist Materials
Checklist Code: 30
Checklist Title: PHARMACEUTICAL PRODUCTS
A. Checklist Area Description
Except where the context otherwise requires, the headings of this chapter apply only to
products of a organotherapeutic, therapeutic, prophylactic or diagnostic use; or articles
used for medical, surgical, dental or veterinary purposes.

B. Exclusions
Certain products are excluded from chapter 30, even if they can be used in a medical
setting:
1. Foods or beverages, other than nutritional preparations for intravenous administration.
2. Preparations, such as tablets, chewing gum or patches (transdermal systems), intended
to assist smokers to stop smoking (heading 2106 or 3824).
3. Plasters specially calcined or finely ground for the use in dentistry. These fall under
heading 2520.
4. Aqueous distillates or solutions of essential oils, suitable for medicinal uses. These
fall under heading 3301.
5. Preparations of headings 3303 to 3307, even if they have therapeutic/prophylactic
properties.
6. Soap, or other products of heading 3401, containing added medicaments
7. Preparations with a basis of plaster for use in dentistry. These fall under 3407.
8. Blood albumin not prepared for therapeutic or prophylactic uses. These fall under
heading 3502.

C. Common Initiation Problems
None

D. Additional Checklist Area Information
N/A

E. Customs Ruling Online Search System (CROSS)
The purpose of this section is to help identify examples of NESOI classified items and
obtain clarification for any 10 digit classification code. The primary manner in which to
comprehensively define the scope of a Harmonized code described as "Other" is by process
of elimination. That is, the code should be compared to what is covered by its related
Harmonized codes or sub-headings. Another tool to help identify and classify items is the
Customs Rulings Online Search System (CROSS) system. CROSS is a database that holds all
classification rulings that have been handed down by Customs. Though primarily intended
for imports, HTS and Schedule B code overlap allows the CROSS database to be used for
exports as well.
In order to access CROSS, please click on the following link or type it into your browser:

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Checklist Code: 30
Checklist Title: PHARMACEUTICAL PRODUCTS
http://rulings.cbp.gov/. Make sure that the Collection selection is set to "All" (not "HQ"
or "NY") to capture all applicable rulings, and make sure that the NAFTA filter is off.
Using the Search bar at the top of the screen you may search by Customs ruling number, or
by HTSUSA number. When searching by HTSUSA number, the format must be 1234.56.7890, with
periods between the fourth and fifth and sixth and seventh digits. Searches may also be
done above the 10 digit level.
It should be kept in mind that CROSS is not an exhaustive source of NESOI items nor does
it cover rulings for every 10 digit code. Rulings may also apply to more than one HTSUSA
number, and since new rulings are constantly being handed down by Customs, previous
rulings may be amended or overturned at any time.
If you have any questions regarding a Customs ruling please contact the IPP Classification
team ([email protected]) via the IPPQues process.

F. Terminology

Arachidonic Acid – A precursor of prostaglandins, a liquid unsaturated fatty acid C20H32O2
that occurs in most animal fats; consider essential in animal nutrition
Blood Albumin – The main protein of human plasma; binds with water, cations, fatty acids,
hormones, bilirubin, thyroxine, and drugs
Catgut – an absorbable suture material, prepared from the intestines of mammals, used to
close surgical wounds. It can be treated with chromic salts to delay absorption and
enhance strength
Colloidal Solutions – a mixture with properties between those of a solution and fine
suspension
Hemostatics – A medical product which is used to cause bleeding to stop
Immunological – relating to the structure and function of the immune system, innate and
acquired immunity, and laboratory techniques involving the interaction of antigens with
specific antibodies
Insulin – A natural hormone made by the pancreas that controls the level of glucose in the
blood; cells cannot use glucose without insulin

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Checklist Code: 30
Checklist Title: PHARMACEUTICAL PRODUCTS
Laminaria – A genus of 31 species of brown algae, all of which share the common name
“kelp”
Leukotrienes – One of a group of chemicals produced by the body that accompanies
inflammation; believed to play a major role in causing the symptoms of hay fever and
asthma
Mucilage – A gelantinous substance of various plants that contains protein and
polysaccharides and is similar to plant gums; sometimes used as an adhesive
Opacifying – To cause to become opaque
Ostomy – A surgical procedure which creates an opening in the body for the discharge of
body wastes
Organotherapy – The treatment of disease with preparations derived from animal endocrine
organs or glandular extracts such as insulin and thyroxin
Pectic Substance – Any of various water-soluble substances that bind adjacent cell walls
in plant tissues to yield a gel
Prophylactic – Guarding from or preventing the spread or occurrence of disease or
infection
Prostaglandins – One of a number of hormone-like substances that participate in a wide
range of body functions; derived from arachidonic acid
Sterile – Free of all forms of microbial life, including transmissible agents.
Sterilization can be achieved through application of the proper combinations of heat,
chemicals, irradiation, high pressure and filtration.
Therapeutic – Of or pertaining to the treating or curing of disease
Thromboxane – A substance made by platelets that causes blood clotting and constriction of
blood vessels. This is related to prostaglandins and is derived from arachidonic acids
Thyroxin – an iodine-containing hormone, produced by the thyroid, which increases the rate
of cell metabolism and regulates growth

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II. Product Checklist
SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3001
Product Checklist Title: GLANDS AND OTHER ORGANS FOR ORGANO-THERAPEUTIC USES, DRIED,
WHETHER OR NOT POWDERED; EXTRACTS OF GLANDS OR OTHER ORGANS OR OF THEIR
SECRETIONS FOR ORGANO-THERAPEUTIC USES; HEPARIN AND ITS SALTS; OTHER HUMAN OR ANIMAL
SUBSTANCES PREPARED FOR THERAPEUTIC OR PROPHYLACTIC USES, NOT ELSEWHERE SPECIFIED
OR INCLUDED
Description: Glands, extracts, heparin and other substances are used in the medical industry for blood
anticoagulants as well as for many other therapeutic and prophylactic uses.
01 Product Number:

Item Comments

001 ________

_________________________________________

02 Type of Product:

_________________________________________

001 Extract of gland/other organs/secretion
002 Glands and other organs
003 Other

_________________________________________

_________________________________________
03 Processing:
(for glands and organs only)
001 Dried
002 Powder
003 Other

_________________________________________
_________________________________________

_________________________________________
(Please specify)
04 Type of Organ
(for glands and organs only)
001 Liver
002 Other
_________________________________________
(Please specify)
05 Other Features
001
_________________________________________
_________________________________________
_________________________________________
_________________________________________

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SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3002
Product Checklist Title: HUMAN BLOOD; ANIMAL BLOOD PREPARED FOR THERAPEUTIC, PROPHYLACTIC
OR DIAGNOSTIC USES; ANTISERA, OTHER BLOOD FRACTIONS AND IMMUNOLOGICAL PRODUCTS,
WHETHER OR NOT MODIFIED OR OBTAINED BY MEANS OF BIOTECHNOLOGICAL PROCESSES;
VACCINES, TOXINS, CULTURES OF MICRO-ORGANISMS AND SIMILAR PRODUCTS
Description: All human blood, animal blood prepared for therapeutic, prophylactic or diagnostic uses, antisera, other
blood fractions and immunological products. Covered within the heading are products derived from blood, as well
as modified thrombomodulins, modified haemoglobins, as well as cross-linked haemoglobins and blood albumin.
Immunological products, used for diagnostic or therapeutic purposes and for immunological tests, covered within
this heading included monoclonal antibodies (MABs), antibody fragments, conjugates, and fragment conjugates.
Vaccines, toxins, cultures of micro-organisms (excluding yeasts), viruses, human, animal and vegetable and antiviruses, as well as bacteriophage. Diagnostic kits are classified here when the essential character of the kit is given
by any of the products of this heading.
The expression "modified immunological products" applies to peptides and proteins (other than goods of heading
2937) with are directly involved in the regulation of immunological processes, such as monoclonal antibodies
(MABs), antibody fragments, antibody conjugates and antibody fragment conjugates, interleukins, interferons (IFN),
chemokines and certain tumor necrosis factors (TNF), growth factors (GF), hematopoietins and colony stimulating
factors (CSF).
01 Product Number:

Item Comments

001 ________

_________________________________________

02 Blood Product:

_________________________________________

001 Malaria diagnostic test kit
002 Antisera and other blood fractions________ (Please
specify)
003 Human blood plasma
004 Normal human blood sera
005 Human immune blood sera
006 Fetal bovine serum (FBS)
007 Immunological product, unmixed, not put up for retail
sale________ (Please specify)
008 Immunological product, mixed, not put up for retail
sale________ (Please specify)
009 Immunological product, put up for retail
sale________ (Please specify)
010 Vaccine:________ (Please specify)
011 Ferment:________ (Please specify)
012 Whole human blood
013 Antiallergenic preparation:________ (Please
specify)
014 Other antisera, blood fractions, or immunological
products________ (Please specify)
015 Other

_________________________________________
_________________________________________
_________________________________________

_________________________________________
(Please specify)
03 Medical Application:
(for vaccines only)
001 For human medicine
002 For veterinary medicine

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SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3003
Product Checklist Title: MEDICAMENTS (EXCLUDING GOODS OF HEADING 3002, 3005 OR 3006)
CONSISTING OF TWO OR MORE CONSTITUENTS WHICH HAVE BEEN MIXED TOGETHER FOR
THERAPEUTIC OR PROPHYLACTIC USES, NOT PUT UP IN MEASURED DOSES OR IN FORMS OR
PACKAGING FOR RETAIL SALE
Description: This heading covers medicinal preparations for use in the internal or external treatment or prevention
of human or animal ailments. These preparations are obtained by mixing together two or more substances.
However, if put up in measured doses or in forms or packaging for retail sale, they should be classified under 3004.
Products in this heading are treated as unmixed if they are (1) dissolved in water, (2) any good of chapter 28 or 29,
and (3) simple vegetable extracts of heading 1302, merely standardized or dissolved in any solvent. Products in
this heading is considered mixed if they are (1) colloidal solutions and suspensions (other than colloidal sulfur), (2)
vegetable extracts obtained by the treatment of mixtures of vegetable materials, and (3) salts and concentrates
obtained by evaporating natural mineral waters.
01 Medicinal Preparations:
001 Containing penicillins or derivatives thereof, with a
penicillanic acid structure, or streptomycins or their
derivatives
002 Containing other antibiotics or hormones
003 Containing insulin
004 Containing artificial mixtures of natural hormones
005 Containing alkaloids or derivatives thereof but not
containing hormones or other products of heading
2937, or antibiotics
006 Containing ephedrine or its salts
007 Containing pseudoephdrine or its salts
008 Containing norephedrine or its salts
009 Containing antimalarial active principles
010 Other:
_________________________________________
02 Other Features:
(Select all that apply)
001 Product Identifier (product name/number, if
available):
_________________________________________
002 Brand name and generic name (for brand name
drugs only. Example: Prozac/Fluoxetine):

005 Major Components (e.g., hormones, antibiotics,
chemical compounds, etc):
_________________________________________
(Please specify)
006
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Item Comments
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________

_________________________________________
(Please specify)
003 Patent expiration date (if known, patented drugs
only):
_________________________________________
(Please specify)
004 End use:
_________________________________________
(Please specify)
Group continued...

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SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3004
Product Checklist Title: MEDICAMENTS (EXCLUDING GOODS OF HEADING 3002, 3005 OR 3006)
CONSISTING OF MIXED OR UNMIXED PRODUCTS FOR THERAPEUTIC OR PROPHYLACTIC USES, PUT UP
IN MEASURED DOSES (INCLUDING THOSE IN THE FORM OF TRANSDERMAL ADMINISTRATION
SYSTEMS) OR IN FORMS OR PACKAGING FOR RETAIL SALE
Description: These medicaments are either mixed or unmixed, in measured doses and in packaging for retail sale.
Products in this heading are treated as unmixed if they are (1) dissolved in water, (2) any good of chapter 28 or 29,
and (3) simple vegetable extracts of heading 1302, merely standardized or dissolved in any solvent. Products in
this heading is considered mixed if they are (1) colloidal solutions and suspensions (other than colloidal sulfur), (2)
vegetable extracts obtained by the treatment of mixtures of vegetable materials, and (3) salts and concentrates
obtained by evaporating natural mineral waters.
Chapters 28 and 29 cover most inorganic and organic chemicals. Heading 1302 covers vegetable saps and
extracts; pectic substances, pectinates and pectates; mucilages and thickeners, which are derived from vegetable
products.
007 Preparations primarily affecting the electrolytic,
caloric or water balance
008 Other

01 Usage:
001 Veterinary
002 Other:
_________________________________________
02 Containing:
001
002
003
004
005
006

007
008
009
010
011

012
013

Alkaloids or derivatives thereof
Antigens or hyaluronic acid or its sodium salt
Ephedrine or its salts
Pseudoephdrine or its salts
Norephedrine or its salts
Hormones or other products of heading 2937
(natural or synthetic, including prostaglandins,
thromboxanes and leukotrienes; used primarily as
hormones)
Penicillins or derivatives thereof
Penicillanic acid structure
Streptomycins or their derivatives
Sulfonamides
Vitamins or other products of heading 2936 (natural
or synthetic vitamins andprovitamins, their
derivatives and intermixtures, whether or not in
solvent)
Other Antibiotic________ (Please specify)
Other

_________________________________________
(Please specify)
03 Primary Area of Affect:
(for non-veterinary alkaloids or derivatives thereof, only)
001 Antineoplastic and immunosuppressive
medicaments
002 Cardiovascular medicaments
003 Central Nervous System
004 Dermatological agents and local anesthetics
005 Digestive system
006 Eyes, ears or respiratory system

_________________________________________
(Please specify)
04 Type of Antibiotic:
(for medicaments containing antibiotics only)
001 Erythromycin
002 Penicillin G salts (Please specify)
003 Tetracycline
004 Other penicillins
005 Other
_________________________________________
(Please specify)
05 Number of Antibiotic:
(for medicaments containing antibiotics only)
001 Singles
002 Combination antibiotics
06 Type of Hormone:
(for products containing hormones only)
001 Insulin
002 Corticosteroid hormones, their derivatives or
structural analogues
003 Other
_________________________________________
(Please specify)
07 Type of Medicament:
001 Analgesics, antipyretics and nonhormonal antiinflammatory agent________ (Please specify)
002 Antacid
003 Anticonvulsant, hypnotic, sedative________ (Please
specify)
Group continued...

Group continued...

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004 Antidepressant, tranquilizer, and other
psychotherapeutic agents________ (Please
specify)
005 Antihistamine
006 Anti-infective medicament
007 Cough and cold preparation
008 Diuretic
009 Laxative
010 Tolmetin
011 Tolmetin sodium
012 Tolmetin sodium (anhydrous)
013 Other medicament affecting the central nervous
system________ (Please specify)
014 Other medicaments primarily affecting the digestive
system________ (Please specify)
015 Other medicaments primarily affecting the eyes, ears
or respiratory system________ (Please specify)
016 Other medicaments containing antimalarial active
principles________ (Please specify)
017 Other preparations primarily affecting the electrolytic,
caloric or water balance________ (Please specify)
018 Other
_________________________________________
(Please specify)
08 Is vitamin synthesized wholly or in part from aromatic
or modified aromatic industrial compounds? (for
products containing vitamins only)
001 Yes
002 No
09 Type of Vitamin:
(for products containing vitamins only)
001 Multiple vitamins, combined
002 Multiple vitamins, not combined
003 Single vitamins, combined
004 Single vitamins, not combined
005 Vitamin B2
006 Vitamin B12
007 Vitamin E
008 Other

005 Other Features:
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Item Comments
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________

_________________________________________
(Please specify)
10 Other Features:
(Select all that apply)
001 Generic name and, if applicable, brand name
_________________________________________
(for example: Prozac/fluoxetine)
002 Patent expiration date:________ (if known, patented
drugs only)
Method of obtainment by patient (choose one):
003 Over-the-Counter
004 Prescription
Group continued...

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SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3005
Product Checklist Title: WADDING, GAUZE, BANDAGES AND SIMILAR ARTICLES (FOR EXAMPLE,
DRESSINGS, ADHESIVE PLASTERS, POULTICES), IMPREGNATED OR COATED WITH PHARMACEUTICAL
SUBSTANCES OR PUT UP IN FORMS OR PACKAGING FOR RETAIL SALE FOR MEDICAL, SURGICAL,
DENTAL OR VETERINARY PURPOSES
Description: This heading covers articles such as wadding, gauze, bandages and the like, of textile, paper, plastic,
etc., for use in the medical, surgical, dental and veterinary areas.
01 Product Number:

Item Comments

001 ________

_________________________________________

02 Type:

_________________________________________

001 Adhesive dressings and other articles having an
adhesive layer
002 Other
_________________________________________
(Please specify)
03 Other Features:
(Select all that apply)
001 Product Identifier (product name/number, if
available):

_________________________________________
_________________________________________
_________________________________________

_________________________________________
002 If Impregnated/Coated, Describe Pharmaceutical
Substance (if available):
_________________________________________
003 End Use (medical/dental/veterinary):
Derivation (choose one):
004 Fibrous
005 Animal
006 Other Features:
_________________________________________
_________________________________________
_________________________________________
_________________________________________

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SU ID:

Item Number:

Verified Sample Reference Period 10-digit TSUSA/Schedule B:
Verified Current 10-digit TSUSA/Schedule B:
Product Checklist Code: 3006
Product Checklist Title: PHARMACEUTICAL GOODS SPECIFIED IN NOTE 4 TO THIS CHAPTER
Description: This heading covers only the products listed below. These products are not to be classified anywhere
else.
004 End Use:

01 Product Number:
001 ________

_________________________________________

02 Type:
001 Blood-grouping reagents
002 Chemical contraceptive preparations based on
hormones, on other products of heading 2937 or on
spermicides (natural or synthetic)
003 Dental cements and other dental fillings; bone
reconstruction cements
004 First-aid boxes and kits
005 Gel preparations designed to be used in human or
veterinary medicine as a lubricant for parts of the
body for surgical operations or physical
examinations or as a coupling agent between the
body and medical instruments
006 Opacifying preparations for X-ray examinations;
diagnostic reagents designed to be administered to
the patient
007 Sterile surgical catgut, similar sterile suture materials
(including sterile absorbable surgical or dental
yarns), and sterile tissues adhesives for surgical
wound closure; sterile laminaria and sterile laminaria
tents; sterile absorbable surgical or dental
hemostatics; steril surgical or dental adhesion
barriers, whether or not absorbable, prostaglandins,
thromboxanes and leukotrienes; used primarily as
hormones
008 Other appliances identifiable for ostomy use
009 Other waste pharmaceuticals:

Sterility (choose one):
005 Sterile
006 Not sterile
007 If sterile, method of sterilization (if available):
_________________________________________
008 Other Features:
_________________________________________
_________________________________________
_________________________________________
_________________________________________
Item Comments
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________

_________________________________________
(Please specify)
03 Other Features:
(Select all that apply)
001 Product Identifier (product name/number, if
available):
_________________________________________
002 Generic name and, if applicable, brand name (for
example: Prozac/fluoxetine):
_________________________________________
003 Packaging (first aid kits only):
_________________________________________
Group continued...
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III. Transaction Checklist
Checklist Code: 30
Checklist Title: PHARMACEUTICAL PRODUCTS
01 Type of Sale
001
002
003
004
005

Market sale
Intra-company transfer, market-based
Intra-company transfer, cost-based
Intra-company transfer, other basis
Intra-company transfer, basis unknown

02 Is price related to class of seller?
001 Class does not affect the price
002 Class affects the price. Specify:
_________________________________________

03 Type of Price
001
002
003
004
005
006
007
008

Transaction price
Net price with all adjustments indicated
Estimated price
Average price
List price with some adjustments
List price
Index
Other
_________________________________________

04 Is price related to quantity or size ordered?
001 Not price determining
002 Price determining. Specify:
_________________________________________

05 Country from which Item was imported
001 Country or area:
_________________________________________

06 Repricing Cycle
001
002
003
004
005
006
007
008
009
010
011
012

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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec

Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y

O
O
O
O
O
O
O
O
O
O
O
O

P
P
P
P
P
P
P
P
P
P
P
P

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III. Transaction Checklist
Checklist Code: 30
Checklist Title: PHARMACEUTICAL PRODUCTS
07 Price Information
001 Unit of sale (unit priced):
_________________________________________
002 Delivery terms (price basis):
_________________________________________
003 Reported Price:
_________________________________________
004 Reference Month:
_________________________________________
005 Currency of Price:
_________________________________________
006 Duty:
_________________________________________

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Adj Type

Adj Description

Included

Order

Currency Format

Adj 1

D

S

Y/N

* % $

Adj 2

D

S

Y/N

* % $

Adj 3

D

S

Y/N

* % $

Adj 4

D

S

Y/N

* % $

Adj 5

D

S

Y/N

* % $

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Value

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