Pharmacy Benefit Manager Transparency (CMS-10725)

ICR 202404-0938-029

OMB: 0938-1394

Federal Form Document

Forms and Documents

Document Name	Status
Form CMS-10725 PBM - Annual Submission of Prescription Benefit Information Form and Instruction	Modified
CMS-10725 - Supporting_Statement A_rev.docx Supporting Statement A	2024-04-30
CMS-10725_PBM Transparency_Supporting Statement B_04.12.24.docx Supporting Statement B	2024-04-30
Section 1150A - PHARMACY BENEFIT MANAGERS TRANSPARENCY REQUIREMENTS.pdf Supplementary Document	2021-04-20

IC Document Collections

IC ID	Document Title	Status
243638	Identification of QHPs	Modified
243637	PBM - Annual Submission of Prescription Benefit Information Form and Instruction	Modified
243636	One-Time Technical Build	Modified