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 30-dayx.docx Supporting Statement A
CMS-10725 - Attachment 3 Crosswalk.pdf Supplementary Document
CMS-10725 - Attachment 2 External Response to Public Comments_8-10-2020.pdf Supplementary Document
Identification of QHPs
PBM - Annual Submission of Prescription Benefit Information Form and Instruction
One-Time Technical Build