Anthem / Elevance - Payer Price Transparency

This data contains a 0.1% sample of Anthem's (Elevance's) price transparency machine-readable files that have been normalized into easy-to-use tables. This dataset contains data from thousands of health plans and is comprised of billions of records for negotiated rates by billing code and provider. Provider data maps directly to NPIs and additional NPI Enrichment data, such as NPPES and Hospital Enrollments from CMS.gov are available in the full datasets so you can easily perform rollups, crosswalks, and mappings. Tables: BILLING_CODES NEGOTIATED_RATES PROVIDER_MAP Fields Include all CMS-mandated fields as well as optional fields as-available within the dataset. The primary fields include: Billing Code (27447) Billing Code Name (ARTHROSCOPIC KNEE SURGERY) Billing Code Type (CPT/HCPCS) Negotiation Arrangement (FFS) Negotiated Rate ($15,000) Billing Class (PROFESSIONAL/INSTITUTIONAL) NPI (1184610297) TIN Type (EIN/NPI) TIN Number (89-3910301) Many other payers are available as well, full documentation is available on our website at https://docs.payerset.com

搜集汇总

背景与挑战

背景概述

该数据集是Anthem/Elevance价格透明度文件的0.1%样本，已标准化为易用表格，涵盖数千个健康计划的数十亿条协商费率记录，按计费代码和提供者分类。它包含三个核心表格和关键字段，如计费代码、协商费率和NPI，完整数据集还提供额外的NPI丰富数据以支持分析。