TPAs

Prescription Drug and Health Care Spending (CMS-10788)

Documents and Forms

Document Name Document Type
RxDC Reporting Instructions for 2023rev.pdf Instruction

Information Collection (IC) Details

IC Title:	TPAs	Agency IC Tracking Number:	CCIIO - 10788

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 45 CFR 149.740 45 CFR 149.730 45 CFR 149.720

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			RxDC Reporting Instructions for 2023rev.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 92	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: 0 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	92	0	92
Annual IC Time Burden (Hours)	171,585	-245,385	416,970
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.