Allowed Amount File

Transparency in Pricing Information (CMS-10715)

OMB: 0938-1372

IC ID: 238760

Documents and Forms
Information Collection (IC) Details

View Information Collection (IC)

Allowed Amount File
 
No New
 
Mandatory
 
45 CFR 147.210(c)(1)(ii)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Guidance CMS-10715 - Appendix 2 - Negotiated Rate Data File.pdf Yes Yes Fillable Fileable
Other-Guidance CMS-10715 Appedndix 3 - Allowed Amounts Data File.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

980 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  Requested 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 8,163 8,163 0 0 0 0
Annual IC Time Burden (Hours) 523,053 523,053 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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