Information Collection Request

Medication Therapy Management Program Improvements - Standardized Format (CMS-10396)

ICR 202403-0938-008 · OMB 0938-1154 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10396_Supporting Statement_A clean.docx Supporting Statement A Uploaded 2024-03-18 Repair queued
60 day comment summary.xlsx Supplementary Document Uploaded 2024-03-14 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
199672 Conducting CMRs with the standardized format and Fulfillment burden Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2025 36 Months From Approved
2,382,774 0 0
1,588,595 0 0
1,829,970 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Conducting CMRs with the standardized format and Fulfillment burden

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,382,774 0 0 0 -4,181 2,386,955
Annual Time Burden (Hours) 1,588,595 0 0 0 -2,788 1,591,383
Annual Cost Burden (Dollars) 1,829,970 0 0 0 -389,898 2,219,868


Reginfo record details
  No