In-Network Rate File

Transparency in Pricing Information (CMS-10715)

OMB: 0938-1429

IC ID: 249944

Information Collection (IC) Details

View Information Collection (IC)

In-Network Rate File CCIIO - 10715
 
No New
 
Mandatory
 
45 CFR 147.210(c)(1)(i)

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10715 APPENDIX 2: In-network Rate Machine-Readable File Data Elements CMS-10715-Transparency in Coverage_Appendix 2_Final .pdf Yes Yes Fillable Fileable
Form and Instruction CMS-10715 APPENDIX 3: The Allowed Amount Machine-Readable File Data Elements CMS-10715-Transparency in Coverage_Appendix 3_.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) 3,133,094 3,133,094 0 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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