QE Specifications Worksheet

Purpose of this document

The Qualified Entity (QE) Specifications Worksheet is required for all QE requests. It collects detailed requester information, project data extract details, shipping information, and method of payment. It also includes a Part D event justification tab that is required for all requests that include Part D data. The QE Specifications Worksheet is used by the data distributor to generate a cost invoice and to collect data extraction information.

Note: There are other versions of the specifications worksheet for state agencies and all other RIF requests.

Who uses this document

All QEs submitting data requests must include a completed QE Specifications Worksheet.

Document Version:
07/2023
Format:
Microsoft Excel