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Federal forms, ICRs, and supporting documents

Information Collection

Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System

IC 8584 under ICR 202405-0938-019 · OMB 0938-0802.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Transitional Pass through payments related to Drugs, Biologicals, and Radiopharmaceuticals to determine eligibility under the Outpatient Prospective Payment System
 
No Modified
 
Required to Obtain or Retain Benefits
 
42 CFR 419.64

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10008 Drug and Biological Pass- Through Application Welcome to the Drug and Biological Pass-Through Application.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

35 2
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 35 0 0 5 0 30
Annual IC Time Burden (Hours) 560 0 0 80 0 480
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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