The name of the covered recipient.‘‘(ii) The business address of the covered recipientand, in the case of a covered recipient who is a physi-cian, the specialty and National Provider Identifierof the covered recipient.‘‘(iii) The amount of the payment or other transferof value.‘‘(iv) The dates on which the payment or othertransfer of value was provided to the covered recipient.‘‘(v) A description of the form of the payment orother transfer of value, indicated (as appropriate forall that apply) as—‘‘(I) cash or a cash equivalent;‘‘(II) in-kind items or services;‘‘(III) stock, a stock option, or any other owner-ship interest, dividend, profit, or other return oninvestment; or‘‘(IV) any other form of payment