Information Collection Request

Medicaid Drug Rebate Program - Manufacturers and Supporting Regulation at 42 CFR 447.534 (CMS-367)

ICR 202304-0938-029 · OMB 0938-0578 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form CMS-376a DDR Quarterly Pricing Data (CMS-367a) Form Modified Repair queued
Form CMS-367e CMS-367e – Quarterly VBP-MBP Data Form Unchanged Repair queued
Form CMS-367d Supplemental Data Sheet (CMS-367d) Form Modified Repair queued
CMS-367a-e - Supporting Statement A (2023 version 5).docx Supporting Statement A Uploaded 2023-05-03 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
8184 DDR Quarterly Pricing Data (CMS-367a) Form Modified
252237 CMS-367e – System Updates Removed
252230 CMS-367e – Quarterly VBP-MBP Data Form Unchanged
222507 Supplemental Data Sheet (CMS-367d) Form Modified
222506 DDR Product Data (CMS-367c) Instruction Modified
222505 DDR Monthly Pricing Data (CMS-367b) Instruction Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/CMS
OMB Control No0938-0578
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202203-0938-002
Agency Tracking NoCMCS
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31