Allowed Amount File

Transparency in Pricing Information (CMS-10715)

OMB: 0938-1429

IC ID: 249967

Information Collection (IC) Details

View Information Collection (IC)

Allowed Amount File CCIIO - 10715
 
Yes Modified
 
Mandatory
 
45 CFR 147.212(b)(1)(ii)

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 (Appendix 2) In-network Rate File Data Elements(clean)_10.07.24.docx Yes Yes Fillable Fileable
Form and Instruction CMS-10715 APPENDIX 3: The Allowed Amount Machine-Readable File Data Elements CMS-10715 (Appendix 3) Allowed Amount Machine-Readable File(clean)_10.07.24.docx Yes Yes Fillable Fileable

Health Health Care Services

 

836 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   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 10,032 0 0 1,869 0 8,163
Annual IC Time Burden (Hours) 130,416 0 0 -1,486,412 0 1,616,828
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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