PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
CY2013 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262
Modified
6070
56710
4366651
Other-MTMP - Fees Page Mockup
Other-MTMP - Resources Page Mockup
Other-Review Tool Page Mockup
Other-MTMP -Verification Page Mockup
Other-Plan ADD File Record Layout
Other-Plan Excluded Drugs Record Layout
Other-Plan Gap Coverage File Layout
Other-Plan Formulary Submission File Record Layout
Other-Plan Free First Fill File Record Layout
Other-Plan Home Infusion File Layout
Other-Plan Over The Counter File Record
Other-Plan Prior Authorization Record Layout
Other-Plan Step Therapy Record Layout
Other-Appendix_C_PBP 2014 screenshots_section
Other-Appendix_C_PBP 2014 screenshots_section_b
Other-Appendix_C_PBP_2014 screenshots _section_d
Other-Appendix_C_PBP 2014 screenshots_section_c
Other-Appendix_C_PBP_2014 screenshots_section_a
Total burden requested under this ICR:
6070
56710
4366651
To view an IC, click on IC Title
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