Information Collection Request

Pharmacy Billing Requirements

ICR 202506-1240-001 · OMB 1240-0050 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
1240-0050 Pharmacy Billing Requirements 2025 7 28.docx Supporting Statement A Uploaded 2025-07-28 Available
1240-0050 Pharmacy Billing Requirements 2025 7 28.docx Supporting Statement A Uploaded 2025-07-28 Repair queued
Instructions for Required Data Elements for Pharmacy Bills.pdf Supplementary Document Uploaded 2025-07-10 Available
Instructions for Required Data Elements for Pharmacy Bills.pdf Supplementary Document Uploaded 2025-07-10 Repair queued
20 CFR 725.701 and 725.705 BLBA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Available
20 CFR 725.701 and 725.705 BLBA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Repair queued
20 CFR 30.701 EEOICPA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Repair queued
20 CFR 30.701 EEOICPA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Repair queued
20 CFR 10.801 FECA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Available
20 CFR 10.801 FECA Supporting Reg.pdf Supplementary Document Uploaded 2012-11-05 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
38474 Pharmacy Billing Requirements Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2028 36 Months From Approved 09/30/2025
777,528 0 874,414
12,994 0 14,481
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Pharmacy Billing Requirements

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 777,528 874,414 0 0 -96,886 0
Annual Time Burden (Hours) 12,994 14,481 0 0 -1,487 0
Annual Cost Burden (Dollars) 0 0 0 -8,296,224 8,296,224 0


Reginfo record details
  No