Collection of Drug Event Data from Contracted Part D Providers For Payments

Collection of Prescription Drug Data from MA-PD, PDP and Fallout Plans/Sponsors for Medicare Part D Payments (CMS-10174) - IRA

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-0982 can be found here:

Documents and Forms

Document Name Document Type
PDEGuidance_PRA Disclosure Statement.pdf Instruction
PDEGuidance_PRA Disclosure Statement.pdf Instruction
Copy of PDE Inbound File Layout Final_20250101.xlsx Instruction
Copy of PDE Inbound File Layout Final_20250101.xlsx Instruction
Copy of PDE Outbound File Layout Final_20250101.xlsx Instruction
Copy of PDE Outbound File Layout Final_20250101.xlsx Instruction

Information Collection (IC) Details

IC Title:	Collection of Drug Event Data from Contracted Part D Providers For Payments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	PDEGuidance_PRA Disclosure Statement.pdf	Yes	No	Printable Only
Instruction	Copy of PDE Inbound File Layout Final_20250101.xlsx	Yes	Yes	Printable Only
Instruction	Copy of PDE Outbound File Layout Final_20250101.xlsx	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 856	Number of Respondents for Small Entity: 149

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,499,064,780	-173,310	1,499,238,090
Annual IC Time Burden (Hours)	2,998	0	2,998
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.