Information Collection Request

Medicare Part D Electronic Prescribing Tools (42 CFR 423.128(d)(4)-(5) and 423.160(b)(1)) (CMS-10755)

ICR 202508-0938-014 · OMB 0938-1396 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
CMS-10755 - Supporting Statement A_.docx Supporting Statement A Uploaded 2025-08-13 Available
CMS-10755 - Supporting Statement A_.docx Supporting Statement A Uploaded 2025-08-13 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
246280 Secure Electronic Prior Authorization for Medicare Part D Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2029 36 Months From Approved 02/28/2026
700,865 0 774
11,880 0 0
3,900,441 0 2,308,346





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Secure Electronic Prior Authorization for Medicare Part D

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 700,865 774 0 700,091 0 0
Annual Time Burden (Hours) 11,880 0 0 11,880 0 0
Annual Cost Burden (Dollars) 3,900,441 2,308,346 0 1,592,095 0 0


Reginfo record details
  No