Submit a request

If your software application, services or solutions are provided to external clients, this is considered Distribution and will require a Distribution License Agreement. Please complete a Distribution License Request Form.

Does anyone outside of your organization have access to AMA Data File? Do you provide services or solutions to customers/clients outside of your organization that require the use of AMA Codeset(s)? If so, this is considered distribution and you must complete a Distribution License Request Form.

How many users internal to your organization will be accessing the data file or the application that it is used within (whether or not they see AMA codes directly).

Please provide the name of the institution, company, or other entity that will be publishing this content

Please list the organization's primary address including CITY, STATE, ZIP CODE

This is name of the person that will be handling this request

Check the box above to confirm that you are seeking to purchase the Data File.

If you will be using the data within a third-party system, that vendor most likely requires a Distribution License with the AMA and you may have to license directly with them. If you do not see your software vendor listed, please select "Other" and name the software vendor in the text box.

Billing Provider - A health care provider who renders medical services for which a fee is charged.

Billing Provider - A health care provider who renders medical services for which a fee is charged.

How many users will be accessing the software or application, whether or not they directly see AMA Data File content?

Please note the YEAR of the file that you are requesting.

This is a required field. Please enter any additional comments or details that are necessary to complete this request.

By checking this box, you affirm that you will comply with the Clickwrap Agreement (press CTRL+click to access and review in a new page )

Tax exempt organizations will need to upload a certificate of exemption

Multiple files can be uploaded using the button at the bottom of this form

Add file or drop files here