Information Collection

Part D Manufacturer Discount Program

IC 260984 under ICR 202509-0938-022 · OMB 0938-1451.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CMS-10846 Part D Manufacturer Discount Program	Form and Instruction
Form CMS-10846 HPMS Data Entry Fields Part D Manufacturer Discount Program	Form and Instruction
Form CMS-10846 TPA Data Entry Fields Part D Manufacturer Discount Program	Form and Instruction
CMS-10846 HPMS Data Entry Fields Appendix A. Manufacturer Discount Program HPMS Data Entry Fields - CMS-10846.pdf	Form and Instruction
CMS-10846 HPMS Data Entry Fields Appendix A. Manufacturer Discount Program HPMS Data Entry Fields - CMS-10846.pdf	Form and Instruction
CMS-10846 TPA Data Entry Fields Appendix B. Manufacturer Discount Program TPA Data Entry Fields - CMS-10846.pdf	Form and Instruction
CMS-10846 TPA Data Entry Fields Appendix B. Manufacturer Discount Program TPA Data Entry Fields - CMS-10846.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	CMS-10846				Yes	Yes	Fillable Printable
Form and Instruction	CMS-10846				Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 40

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
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	40	-619	659
Annual IC Time Burden (Hours)	320	-4,293	4,613
Annual IC Cost Burden (Dollars)	0	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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