Registrations and Recertifications for Entities other than Hospitals

Enrollment and Re-Certification of Entities in the 340B Drug Pricing Program and Collection of Manufacturer Data to Verify 340B Drug Pricing Program Ceiling Price Calculations

OMB: 0915-0327

IC ID: 190347

Information Collection (IC) Details

View Information Collection (IC)

Registrations and Recertifications for Entities other than Hospitals
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 2.1 340B Registration CHC and FQHCLA.pdf 340B Registration-Community Health Center.pdf Yes Yes Fillable Fileable
Form and Instruction 2.2 340B Registration STD and TB.pdf 340B Registration-STD.TB.pdf Yes Yes Fillable Fileable
Form and Instruction 2.3 340B Registration-Covered Entities All Other Non-Hospitals.pdf 340B Registration-Covered Entities All Other.pdf Yes Yes Fillable Fileable
Form 2.4 340B Recertfication STD and TB.pdf 340B Recertfication-STD.TB.pdf Yes Yes Fillable Fileable
Form 2.5 340B Recertification CHC and FQHCLA.pdf 340B Recertification-Community Health Center and Look alike.pdf Yes Yes Fillable Fileable
Form 2.6 340B Recertification Covered Entities All Other Non-Hospital..pdf 340B Recertification-Covered Entities All Other.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

11,491 1,200
   
Private Sector Not-for-profit institutions
 
   100 %

  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 19,153 0 -298 0 0 19,451
Annual IC Time Burden (Hours) 6,070 0 -298 0 0 6,368
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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