This data contains a 1% sample of United Healthcare'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