Information Collection

Voluntary 340B Repository Data Element Reporting Requirements

IC 276684 under ICR 202507-0938-024 · OMB 0938-1485.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1485 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10930 Voluntary 340B Repository Data Element Reporting Requirements	Form
Form CMS-10930 340B Repository Data Element Reporting Form Voluntary 340B Repository Data Element Reporting Requirements	Form
Appendix A _340B Data Elements Instruction_OSORA 508 Copy.pdf	Instruction
Appendix A _340B Data Elements Instruction_OSORA 508 Copy.pdf	Instruction
PRA Disclosure Statement_Inflation Rebate ICR.docx	Other-PRA Disclosure Statement
PRA Disclosure Statement_Inflation Rebate ICR.docx	Other-PRA Disclosure Statement
CMS-10930 340B Repository Data Element Reporting Form Appendix A_ 340B Repository Data Elements Collection Form_OSORA Copy Clean_07.09.25.xlsx	Form
CMS-10930 340B Repository Data Element Reporting Form Appendix A_ 340B Repository Data Elements Collection Form_OSORA Copy Clean_07.09.25.xlsx	Form

IC Title:

Voluntary 340B Repository Data Element Reporting Requirements

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CMS-10930	Yes	Yes	Fillable Fileable
Instruction		Yes	No	Printable Only
Other-PRA Disclosure Statement		Yes	No	Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,000

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: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	26,000	26,000
Annual IC Time Burden (Hours)	208,000	208,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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