{
  "$schema": "http://json-schema.org/draft-07/schema#",
  "$id": "https://github.com/CMSgov/price-transparency-guide/blob/master/schemas/in-network-rates/in-network-rates.json",
  "definitions": {
    "in_network": {
      "type": "object",
      "properties": {
        "negotiation_arrangement": {
          "enum": [
            "ffs",
            "bundle",
            "capitation"
          ]
        },
        "name": {
          "type": "string",
          "minLength": 1
        },
        "billing_code_type": {
          "$ref": "#/definitions/billing_code_types"
        },
        "severity_of_illness": {
          "type": "string",
          "minLength": 1
        },
        "billing_code_type_version": {
          "type": "string",
          "minLength": 1
        },
        "billing_code": {
          "type": "string",
          "minLength": 1
        },
        "description": {
          "type": "string",
          "minLength": 1
        },
        "negotiated_rates": {
          "type": "array",
          "items": {
            "$ref": "#/definitions/negotiated_rates"
          },
          "default": [],
          "minItems": 1
        },
        "covered_services": {
          "type": "array",
          "items": {
            "$ref": "#/definitions/contained_billing_code"
          },
          "default": [],
          "minItems": 1
        },
        "bundled_codes": {
          "type": "array",
          "items": {
            "$ref": "#/definitions/contained_billing_code"
          },
          "default": [],
          "minItems": 1
        }
      },
      "required": [
        "negotiation_arrangement",
        "name",
        "billing_code_type",
        "billing_code_type_version",
        "billing_code",
        "negotiated_rates",
        "description"
      ]
    },
    "contained_billing_code": {
      "type": "object",
      "properties": {
        "billing_code_type": {
          "$ref": "#/definitions/billing_code_types"
        },
        "billing_code_type_version": {
          "type": "string",
          "minLength": 1
        },
        "billing_code": {
          "type": "string",
          "minLength": 1
        },
        "description": {
          "type": "string",
          "minLength": 1
        }
      },
      "required": [
        "billing_code_type",
        "billing_code_type_version",
        "billing_code",
        "description"
      ]
    },
    "negotiated_rates": {
      "type": "object",
      "properties": {
        "negotiated_prices": {
          "type": "array",
          "items": {
            "$ref": "#/definitions/negotiated_price"
          },
          "uniqueItems": true,
          "default": [],
          "minItems": 1
        },
        "provider_references": {
          "type": "array",
          "items": {
            "type": "number"
          },
          "uniqueItems": true,
          "default": [],
          "minItems": 1
        }
      },
      "required": [
        "provider_references",
        "negotiated_prices"
      ]
    },
    "negotiated_price": {
      "type": "object",
      "properties": {
        "service_code": {
          "oneOf": [
            {
              "type": "array",
              "items": {
                "type": "string",
                "pattern": "^(0[1-9]|1[0-9]|2[0-7]|3[1-4]|4[1-2]|4[9]|5[0-8]|6[0-2]|6[5-6]|7[1-2]|81|99)$"
              },
              "uniqueItems": true
            },
            {
              "type": "array",
              "items": {
                "type": "string",
                "pattern": "^CSTM-00$"
              },
              "maxItems": 1
            }
          ]
        },
        "billing_class": {
          "enum": [
            "professional",
            "institutional",
            "both"
          ]
        },
        "setting": {
          "enum": [
            "inpatient",
            "outpatient",
            "both"
          ]
        },
        "negotiated_type": {
          "enum": [
            "negotiated",
            "derived",
            "fee schedule",
            "percentage",
            "per diem"
          ]
        },
        "billing_code_modifier": {
          "type": "array",
          "items": {
            "type": "string"
          },
          "uniqueItems": true,
          "default": [],
          "minItems": 1
        },
        "negotiated_rate": {
          "type": "number",
          "exclusiveMinimum": 0
        },
        "expiration_date": {
          "type": "string",
          "format": "date",
          "description": "This is a date format of YYYY-MM-DD",
          "minLength": 10,
          "maxLength": 10
        },
        "additional_information": {
          "type": "string",
          "description": "In situations in which alternative reimbursement arrangements can neither be expressed as a dollar amount nor as a percentage, this open text field can be used to provide information such as, a description of the formula, variables, methodology or other information necessary to understand the arrangement. The open text field may be utilized for reporting only if a plan or issuer cannot disclose its in-network rates as a dollar amount or a percentage.",
          "minLength": 1
        }
      },
      "required": [
        "negotiated_type",
        "billing_class",
        "negotiated_rate",
        "expiration_date",
        "setting"
      ],
      "if": {
        "properties": {
          "billing_class": {
            "const": "professional"
          }
        }
      },
      "then": {
        "required": [
          "service_code"
        ]
      }
    },
    "providers": {
      "type": "object",
      "properties": {
        "npi": {
          "oneOf": [
            {
              "type": "array",
              "items": {
                "type": "number",
                "minimum": 1000000000,
                "maximum": 9999999999
              },
              "uniqueItems": true,
              "minItems": 1
            },
            {
              "type": "array",
              "items": {
                "type": "number",
                "minimum": 0,
                "maximum": 0
              },
              "minItems": 1,
              "maxItems": 1
            }
          ]
        },
        "tin": {
          "type": "object",
          "properties": {
            "type": {
              "type": "string"
            },
            "value": {
              "type": "string"
            },
            "business_name": {
              "type": "string",
              "minLength": 1
            }
          },
          "oneOf": [
            {
              "properties": {
                "type": {
                  "pattern": "^ein$"
                },
                "value": {
                  "pattern": "^[0-9]{2}-?[0-9]{7}$"
                }
              },
              "required": ["type", "value", "business_name"]
            },
            {
              "properties": {
                "type": {
                  "pattern": "^npi$"
                },
                "value": {
                  "pattern": "^[1-9][0-9]{9}$"
                }
              },
              "required": ["type", "value"]
            }
          ]
        }
      },
      "required": [
        "npi",
        "tin"
      ]
    },
    "billing_code_types": {
      "enum": [
        "CPT",
        "HCPCS",
        "ICD",
        "MS-DRG",
        "R-DRG",
        "S-DRG",
        "APS-DRG",
        "AP-DRG",
        "APR-DRG",
        "APC",
        "NDC",
        "HIPPS",
        "LOCAL",
        "EAPG",
        "CDT",
        "RC",
        "CSTM-ALL"
      ]
    }
  },
  "type": "object",
  "properties": {
    "reporting_entity_name": {
      "type": "string",
      "minLength": 1
    },
    "reporting_entity_type": {
      "type": "string",
      "minLength": 1
    },
    "plan_name": {
      "type": "string",
      "minLength": 1
    },
    "issuer_name": {
      "type": "string",
      "minLength": 1
    },
    "plan_sponsor_name": {
      "type": "string",
      "minLength": 1
    },
    "plan_id_type": {
      "enum": [
        "ein",
        "hios"
      ]
    },
    "plan_id": {
      "type": "string",
      "minLength": 1
    },
    "plan_market_type": {
      "enum": [
        "group",
        "individual"
      ]
    },
    "last_updated_on": {
      "type": "string",
      "format": "date",
      "description": "This is a date format of YYYY-MM-DD",
      "minLength": 10,
      "maxLength": 10
    },
    "version": {
      "type": "string",
      "minLength": 1
    },
    "provider_references": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "provider_group_id": {
            "type": "integer"
          },
          "provider_groups": {
            "type": "array",
            "items": {
              "$ref": "#/definitions/providers"
            },
            "default": [],
            "minItems": 1
          },
          "network_name": {
            "type": "array",
            "items": {
              "type": "string",
              "minLength": 1
            }
          }
        },
        "required": [
          "provider_group_id",
          "provider_groups",
          "network_name"
        ]
      },
      "minLength": 1
    },
    "in_network": {
      "type": "array",
      "items": {
        "$ref": "#/definitions/in_network"
      },
      "default": [],
      "minItems": 1
    }
  },
  "if": {
    "properties": {
      "plan_id_type": {
        "enum": [
          "ein"
        ]
      }
    },
    "required": [
      "plan_id_type"
    ]
  },
  "then": {
    "required": [
      "plan_sponsor_name"
    ]
  },
  "required": [
    "reporting_entity_name",
    "reporting_entity_type",
    "last_updated_on",
    "in_network",
    "version"
  ],
  "dependencies": {
    "plan_name": [
      "plan_id_type",
      "plan_id",
      "plan_market_type",
      "issuer_name"
    ],
    "plan_id_type": [
      "plan_name",
      "plan_id",
      "plan_market_type",
      "issuer_name"
    ],
    "plan_id": [
      "plan_name",
      "plan_id_type",
      "plan_market_type",
      "issuer_name"
    ],
    "plan_market_type": [
      "plan_name",
      "plan_id_type",
      "plan_id",
      "issuer_name"
    ],
    "issuer_name": [
      "plan_name",
      "plan_id_type",
      "plan_market_type",
      "plan_id"
    ]
  }
}