​Data Collection for 340B Analysis

Pursuant to discussions that the Department of Health Care Services (DHCS) has been having with community clinics/health centers, as well as the California Primary Care Association, regarding the concerns raised about the impacts to funding levels for these providers who also operate pharmacies (or use contract pharmacies) that utilize the 340B program, we are requesting that all clinics/health centers complete the following data request template.

Data Template (Please use this file for submission to DHCS)
Data Template (ADA-compliant version for reference only)

Please download and complete the data template in full and submit via email to Clinic340BData@dhcs.ca.gov. DHCS is extending the due date for the 340B data request to Friday, October 11 after further discussions with the California Primary Care Association. Please ensure your submission is also in the Microsoft Excel format and not converted to PDF or any other format.

DHCS will be using this information in order to compile statewide data in order to inform future discussions within the Administration and with the Legislature and clinics/health centers. We appreciate your assistance in providing this data. 

Contact Us

For any other questions or concerns, please contact Clinic340BData@dhcs.ca.gov.

Last modified date: 10/23/2019 4:06 PM