Information Collection

Part D Manufacturer Discount Program

IC 260984 under ICR 202307-0938-003 · OMB 0938-1451.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1451 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10846 Part D Manufacturer Discount Program	Form and Instruction
CMS-10846 HPMS Data Entry Fields Appendix A. Manufacturer Discount Program HPMS Data Entry Fields - CMS-10846.pdf	Form and Instruction
CMS-10846 HPMS Data Entry Fields Appendix A. Manufacturer Discount Program HPMS Data Entry Fields - CMS-10846.docx	Form and Instruction
CMS-10846 TPA Data Entry Fields Appendix B. Manufacturer Discount Program TPA Data Entry Fields - CMS-10846.pdf	Form and Instruction
CMS-10846 TPA Data Entry Fields Appendix B. Manufacturer Discount Program TPA Data Entry Fields - CMS-10846.docx	Form and Instruction

IC Title:

Part D Manufacturer Discount Program

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10846	HPMS Data Entry Fields	Appendix A. Manufacturer Discount Program HPMS Data Entry Fields - CMS-10846.docx		Yes	Yes	Fillable Printable
Form and Instruction	CMS-10846	TPA Data Entry Fields	Appendix B. Manufacturer Discount Program TPA Data Entry Fields - CMS-10846.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 659

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	659	659
Annual IC Time Burden (Hours)	4,613	4,613
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.