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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.


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1215-0194 200108-1215-005
Historical Active 200011-1215-003
DOL/ESA
The NCPDP Universal Pharmacy Billing Form
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/03/2001
08/03/2001
  Inventory as of this Action Requested Previously Approved
03/31/2004 03/31/2004 01/31/2004
607,762 0 594,974
50,443 0 49,382
0 0 0