National Average Drug Acquisition Cost (NADAC) Survey

Survey of Retail Prices (CMS-10241)

OMB: 0938-1041

IC ID: 201423

Documents and Forms

Document Name Document Type
Form CMS-10241 National Average Drug Acquisition Cost (NADAC) Survey Form and Instruction
CMS-10241 NADAC Survey Tool (English) 20230801_NADAC Survey Tool - Clean Version_508.docx Form and Instruction
CMS-10241 NADAC Survey Tool (Spanish) 20230314_NADAC Notificacion de Encuesta e Instrucciones_508.docx Form and Instruction
20230801_DRAFT NADAC Survey Tool - Redline Version.docx NADAC Survey Tool: Track Change IC Document
0938-1041 Survey of Retail Prices (CMS-10241) Survey Crosswalk_508_.xlsx NADAC Survey Tool: Crosswalk IC Document