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Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biological and Supporting Regulations (CMS-10110)
 
No Modified
 
Mandatory
 
42 CFR 414 Subpart J Section 800-806

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Instruction Yes Yes Paper Only
Form CMS-10110 Yes Yes Paper Only

Health Health Care Services

 

180 0
   
Private Sector Businesses or other for-profits
 
   95 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 720 0 240 0 0 480
Annual IC Time Burden (Hours) 28,800 0 11,040 0 0 17,760
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
ASPData revised _AddendumA revised 2009 110108 03/09/2009
Addendum B document for 2009 renewal 112108 03/09/2009
ASPData revised _AddendumA revised 2009 with example data 110108 03/09/2009
ASPData revised _AddendumA revised 2009 with example data 112108 03/09/2009
Addendum B track changes document for 2009 renewal 112108 03/09/2009
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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