Part D Drug Management Program

Part D Drug Management Program (CMS-10874)

OMB: 0938-1465

IC ID: 264405

Documents and Forms

Document Name Document Type
Form CMS-10874 Part D Drug Management Program Form
CMS-10874 Initial Notice Initial DMP Notice.pdf Form
CMS-10874 Second Notice Second DMP Notice.pdf Form
CMS-10874 Alternate Second Notice Alternate Second DMP Notice.pdf Form
Instructions for Drug Management Program Notices.pdf Instruction
CMS-10874 Model Prescriber Inquiry Letter Model Prescriber Inquiry Letter.pdf Form
CMS-10874 Model Sponsor Information Transfer Memorandum Model Sponsor Information Transfer Memo.pdf Form