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State Operations Manual Appendix L Guidance for Surveyors: Ambulatory Surgical Centers (Rev. 76, 12-22-11) Transmittal for Appendix L Part I Ambulatory Surgical Center Survey Protocol Introduction

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What is cms appendix l form?

CMS Appendix L form is a form used for reporting specific information on prescription drugs covered under the Medicare Part D program.

Who is required to file cms appendix l form?

Pharmaceutical manufacturers participating in the Medicare Part D program are required to file CMS Appendix L form.

How to fill out cms appendix l form?

To fill out CMS Appendix L form, the pharmaceutical manufacturers need to provide detailed information about each covered drug, including product name, National Drug Code (NDC), ingredient information, dosage form, strength, and package size.

What is the purpose of cms appendix l form?

The purpose of CMS Appendix L form is to ensure transparency and accountability in the Medicare Part D program by reporting accurate information about prescription drugs covered under the program.

What information must be reported on cms appendix l form?

The CMS Appendix L form requires reporting of information such as product name, NDC, ingredient information, dosage form, strength, package size, and any changes or updates to drug labeling and safety information.