TRICARE Retail Refunds Request User Account Access

ICR 202511-0720-004

OMB: 0720-0032

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2025-11-26
IC Document Collections
ICR Details
0720-0032 202511-0720-004
Received in OIRA 202207-0720-001
DOD/DODOASHA 0720-0032
TRICARE Retail Refunds Request User Account Access
Extension without change of a currently approved collection   No
Regular 11/26/2025
  Requested Previously Approved
36 Months From Approved 11/30/2025
1,200 1,200
9,600 9,600
474,240 474,240

DoD is extending information collections requirements under current OMB Control Number 0720-0032. Pharmaceutical manufacturers will base refund calculation on difference between average non-Federal price of drug sold by pharmaceutical manufacturer to wholesalers, represented by most recent annual non-Federal average manufacturing prices (non-FAMP) and corresponding Federal Ceiling Price (FCP) or, at discretion of pharmaceutical manufacturer, difference between FCP and direct commercial contract sales price attributable to applicable National Drug Code.

US Code: 10 USC 1074g(f) Name of Law: Pharmacy benefits program
  
None

Not associated with rulemaking

  90 FR 34250 07/21/2025
90 FR 54312 11/26/2025
No

1
IC Title Form No. Form Name
TRICARE Retail Refunds Request User Account Access

  Total Request 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 1,200 1,200 0 0 0 0
Annual Time Burden (Hours) 9,600 9,600 0 0 0 0
Annual Cost Burden (Dollars) 474,240 474,240 0 0 0 0
No
No

$912,260
No
    No
    No
No
No
No
No
Amanda Grifka 555 555-5555 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/26/2025


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