FinancialDataTemplate Instructions

Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110) - IRA

FinancialDataTemplate Instructions

OMB: 0938-0921

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Overview
Manufacturers have the option to use this template to upload product data into ASP.
You will enter the financial data for upload on the "Financial Data Template" worksheet.
Data can be uploaded during the 30-day submission period after the end of the quarter.
It is recommended to upload this template no later than 5 days prior to the submission due date each quarter.
There is a separate template to upload product data.
Requested Information
For each NDC or Alternate ID, enter the following:
column a. Manufacturer Name
column b. NDC1
column c. NDC2
column d. NDC3
column e. Alternate ID
column f. Manufacturer's Average Sales Price
column g. Number of ASP Units
column h. Wholesale Acquisition Cost
column i. Average Wholesale Price
Do not change the column names.
Column Guidelines
Column Name

Format

Allowed/Sample Values

Required/optional

Manufacturer Name

alphanumeric

maximum of 250 characters

Required

NDC1
NDC2
NDC3

5-digit number
4-digit number
2-digit number

e.g. 12345
e.g. 1234
e.g. 12

Required
Required
Required

Alternate ID

alphanumeric

maximum of 23 characters

Required

Manufacturer's Average Sales Price

numeric

maximum of 10 digits and 3 decimal places

Required

Number of ASP Units

numeric

maximum of 10 digits and 3 decimal places

Required

Wholesale Acquisition Cost

numeric

maximum of 10 digits and 3 decimal places

Required

Average Wholesale Price

numeric

maximum of 10 digits and 3 decimal places

Optional

Notes
When entering product data for the same Manufacturer more than once, be sure the spelling
matches.
Special characters (comma, dash, period) allowed
Not required if the product has an Alternate ID
Leading zero allowed
Not required if the product has an Alternate ID
Not required if the product has an Alternate ID
Not required if the product has an NDC.
Must match product ID exactly as listed publicly.
Special characters (colon, dash, period) allowed

Must have three decimal places (XXXXXXXXXX.XXX).
Can be positive, negative, or 0.000
Must have three decimal places (XXXXXXXXXX.XXX).
Can be positive, negative, or 0.000
Must have three decimal places (XXXXXXXXXX.XXX).
Can be positive, negative, or 0.000
Must have three decimal places (XXXXXXXXXX.XXX).
Can be positive, negative, or 0.000


File Typeapplication/pdf
File TitleInstructions
AuthorMichelle Berman
File Modified2024-01-24
File Created2024-01-24

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