_schema>http://json-schema.org/draft-07/schema#
object
ffs
bundle
capitation
percentage
per diem
string
CPT
HCPCS
ICD
MS-DRG
R-DRG
S-DRG
APS-DRG
AP-DRG
APR-DRG
APC
NDC
HIPPS
LOCAL
EAPG
CDT
RC
CSTM-ALL
string
string
string
array
<_ref>#/definitions/negotiated_rates
array
<_ref>#/definitions/covered_services
array
<_ref>#/definitions/bundled_codes
negotiation_arrangement
name
billing_code_type
billing_code_type_version
billing_code
negotiated_rates
description
object
CPT
HCPCS
ICD
MS-DRG
R-DRG
S-DRG
APS-DRG
AP-DRG
APR-DRG
APC
NDC
HIPPS
LOCAL
EAPG
CDT
RC
CSTM-ALL
string
string
string
billing_code_type
billing_code_type_version
billing_code
description
object
CPT
HCPCS
ICD
MS-DRG
R-DRG
S-DRG
APS-DRG
AP-DRG
APR-DRG
APC
NDC
HIPPS
LOCAL
EAPG
CDT
RC
CSTM-ALL
string
string
string
billing_code_type
billing_code_type_version
billing_code
description
object
number
array
<_ref>#/definitions/providers
true
provider_group_id
provider_groups
object
array
number
true
object
string
ein
npi
string
type
value
npi
tin
object
array
<_ref>#/definitions/negotiated_price
true
array
<_ref>#/definitions/providers
true
array
<_ref>#/definitions/provider_references/properties/provider_group_id
true
provider_references
provider_groups
negotiated_prices
object
array
string
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true
professional
institutional
both
negotiated
derived
fee schedule
array
string
true
number
string
This is a date format of YYYY-MM-DD
string
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.
negotiated_type
billing_class
negotiated_rate
expiration_date
professional
service_code
object
string
string
string
string
string
group
individual
string
This is a date format of YYYY-MM-DD
string
array
<_ref>#/definitions/provider_references
array
<_ref>#/definitions/in_network
reporting_entity_name
reporting_entity_type
last_updated_on
in_network
version
plan_id_type
plan_id
plan_market_type
plan_name
plan_id
plan_market_type
plan_name
plan_id_type
plan_market_type
plan_name
plan_id_type
plan_id