Comment

Comment by xdmr

For comparison, here's the first bit of an Anthem file (which contains some of the data that's just another row in the Humana record), along with the first record

  "reporting_entity_name": "Excellus BlueCross BlueShield",
  "reporting_entity_type": "Health Insurance Issuer",
  "last_updated_on": "2022-06-14",
  "version": "1.0.0",
  "provider_references": [
    {
      "provider_group_id": 302.1518360704,
      "location": "https://mrf.healthsparq.com/exc-egress.nophi.kyruushsq.com/prd/mrf/EXC_I/EXC/providerReference/Providers/S-000000001063.json"
    }
  ],
  "in_network": [
    {
      "negotiation_arrangement": "ffs",
      "name": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a benefi",
      "billing_code_type": "HCPCS",
      "billing_code_type_version": "2022",
      "billing_code": "G0081",
      "description": "Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a benefi",
      "negotiated_rates": [
        {
          "negotiated_prices": [
            {
              "negotiated_type": "fee schedule",
              "negotiated_rate": 51.1,
              "expiration_date": "9999-12-31",
              "service_code": [
                "11"
              ],
              "billing_class": "professional"
            }
          ],
          "provider_references": [
            302.1518360704
          ]
        }
      ]
    },
parent xdmr 4 years ago

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