OMB control number
[Medicaid] Survey of Retail Prices (CMS-10241)
OMB 0938-1041 ยท HHS/CMS.
OMB 0938-1041
CMS is performing a "Survey of Retail Prices: Payment and Utilization Rates, and Performance Rankings." This study is divided into two parts. Part I focuses on the retail community pharmacy consumer prices. It also includes reporting by the States of payment and utilization rates for the 50 most widely prescribed drugs, and comparing State drug payment rates with the national retail survey prices. The template for States to use to complete (Effective July 1, 2013, CMS has suspended Part I of the nationwide retail survey for collecting information about consumer purchase prices, pending funding decisions.) Part II of this contract focuses on the retail community pharmacy ingredient costs. This segment provides for a survey of the average acquisition costs of all covered outpatient drugs purchased by retail community pharmacies. The prices will be updated on at least a monthly basis.
The latest form for [Medicaid] Survey of Retail Prices (CMS-10241) expires 2026-12-31 and is listed under ICR 202512-0938-013.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
| Form and Instruction | |
| Form and Instruction | |
| Form and Instruction | |
| Justification for No Material/Nonsubstantive Change | |
| Justification for No Material/Nonsubstantive Change | |
| Supporting Statement B | |
| Supporting Statement B | |
| Supporting Statement A | |
| Form and Instruction | |
| Form and Instruction | |
| Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202512-0938-013 | No material or nonsubstantive change to a currently approved collection | 2025-12-11 | Approved without change | |
| 202310-0938-004 | Revision of a currently approved collection | 2023-10-20 | Approved without change | |
| 202109-0938-001 | Revision of a currently approved collection | 2021-09-02 | Approved with change | |
| 201805-0938-013 | Extension without change of a currently approved collection | 2018-05-23 | Approved with change | |
| 201503-0938-009 | Revision of a currently approved collection | 2015-03-27 | Approved without change | |
| 201203-0938-002 | Revision of a currently approved collection | 2012-03-05 | Approved with change | |
| 201103-0938-006 | Extension without change of a currently approved collection | 2011-03-20 | Approved without change | |
| 200801-0938-005 | New collection (Request for a new OMB Control Number) | 2008-01-14 | Approved without change |