Thank you for your participation in the 2021 Colorado Medicaid Prescription Volume Survey. Please fill out all required fields below. For more information and a copy of the survey letter that was mailed to your pharmacy, click here. If you are a chain pharmacy or a pharmacy owner with five or more locations registered with Colorado Medicaid, please download and complete this Excel template and remit to email@example.com with “2021 Colorado TAPV Survey” in the subject line.
Note: COVID-19 vaccinations may be excluded from the TAPV count, per guidance received from the Centers for Medicare and Medicaid Services (CMS). This exclusion will be granted for the September 1, 2020, through August 31, 2021, reporting volume timeframe only.