CMS-367b Monthly Pricing Data

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

CMS-367b Data Entry Screenshots_09.2021

OMB: 0938-0578

Document [pdf]
Download: pdf | pdf
Online Monthly Pricing Data Entry Screen in MDP (CMS-367b)

Form CMS-367b (Exp. 02/28/2023) is used by manufacturers on a monthly basis, to transmit pricing data for each of their covered outpatient drugs to CMS either electronically or via file
transfer. The use of Form CMS-367b on a monthly basis by manufacturers is considered mandatory under the authority of Section 1927 of the Social Security Act and the National Drug Rebate
Agreement. Under the Privacy Act of 1974 any personally identifying information obtained will be kept private to the extent of the law. According to the Paperwork Reduction Act of 1995, no
persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-0578. The
time required to complete this information collection is estimated to average 44.8 hours per response, including the time to review instructions, gather the data needed, and complete and review
the information collection. If you have comments concerning the accuracy of the time estimate or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn:
PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.


File Typeapplication/pdf
File TitleCMS-367b Data Entry Screenshots_09.2021
SubjectCMS-367b Data Entry Screenshots_09.2021
AuthorANDREA WELLINGTON
File Modified2022-03-21
File Created2021-09-14

© 2024 OMB.report | Privacy Policy