Pharmacy Billing Requirements

ICR 201901-1240-005

OMB: 1240-0050

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2019-01-25
Supplementary Document
2012-11-05
Supplementary Document
2012-11-05
Supplementary Document
2012-11-05
IC Document Collections
IC ID
Document
Title
Status
38474 Modified
ICR Details
1240-0050 201901-1240-005
Historical Active 201601-1240-010
DOL/OWCP
Pharmacy Billing Requirements
Revision of a currently approved collection   No
Regular
Approved without change 03/13/2019
Retrieve Notice of Action (NOA) 02/13/2019
  Inventory as of this Action Requested Previously Approved
09/30/2019 6 Months From Approved 05/31/2019
1,381,903 0 1,453,300
24,203 0 24,421
0 0 0

The NCPDP Standardized Pharmacy Billing Data Requirements are the electronic billing format used by pharmacies throughout the country to request payment for prescription drugs through data clearinghouses. They identify the provider, claimant, prescribing physician, drug by NDC (National Drug Code) number, prescription volume and charge. Similar data elements are required to process paper-based pharmacy bills.

US Code: 42 USC 7384 et seq Name of Law: EEOICPA
   US Code: 5 USC 8101 et seq Name of Law: FECA
   US Code: 30 USC 901 et seq Name of Law: BLBA
  
None

1240-AA08 Final or interim final rulemaking 84 FR 3026 02/08/2019

  80 FR 72296 11/18/2015
80 FR 72296 11/18/2015
No

1
IC Title Form No. Form Name
Pharmacy Billing Requirements

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,381,903 1,453,300 0 0 -71,397 0
Annual Time Burden (Hours) 24,203 24,421 0 0 -218 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There has been a decrease in the number of bill submission. As a result there is a decrease in burden hours from 24,421 to 24,203 which is an adjustment decrease of 218 burden hours.

$2,770,641
No
    Yes
    Yes
No
No
No
Uncollected
Yoon Ferguson 202 693-0701 ferguson.yoon@dol.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/13/2019


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