Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)	Modified	4725	10800	0	Form and Instruction	CMS-R-262	CY 2008 Formulary File Record Layout
					Form	CMS-R-262	SECTION B - 6 - HOME HEALTH - BASE 1 SCREEN
					Form	CMS-R-262	SECTION B - 7A - PRIMARY CARE PHYSICIAN - BASE 1 SCREEN
					Form	CMS-R-262	SECTION B - 8A - OUTPATIENT DIAGNOSTIC PROCEDURES AND TESTS AND LAB SERVICES - BASE 1 SCREEN
					Other-Screen
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					Form	CMS-R-262	PRESCRIPTION DRUGS SECTION-ACTUARIALLY EQUIVALENT-DEDUCTIBLE AND PRE-ICL SCREEN
					Form	CMS-R-262	Medicare Prescription Drugs Section-Alternative
					Form	CMS-R-262	Medicare Prescription Drugs Section-Defined Stan
					Form	CMS-R-262	Medicare Prescription Druges Section-Part D-GE
					Form	CMS-R-262	Section A - A-1 Screen
					Form	CMS-R-262	Section B-1A-Inpartient Hospital Acute-Base
					Form and Instruction	CMS-R-262	Section B-2-SNF-Base 1 Screen
					Form	CMS-R-262	Section B-3-CORF-Base 1 Screen
					Form	CMS-R-262	Section B-4A-Emergency Care-Base 1 Screen
					Form	CMS-R-262	Section B-5-Partial Hospitalization-Base 1
					Form	CMS-R-262	Section B-9A-Outpatient Hospital-Base 1 Scre
Total burden requested under this ICR:		4725	10800	0
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