Pharmacy Benefit Manager Transparency (CMS-10725)

OMB 0938-1394

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-10725 PBM - Annual Submission of Prescription Benefit Information Form and Instruction
CMS-10725 - Supporting_Statement A_rev.docx Supporting Statement A
CMS-10725_PBM Transparency_Supporting Statement B_04.12.24.docx Supporting Statement B
Section 1150A - PHARMACY BENEFIT MANAGERS TRANSPARENCY REQUIREMENTS.pdf Supplementary Document
Identification of QHPs
PBM - Annual Submission of Prescription Benefit Information Form and Instruction
One-Time Technical Build