Data Dictionary
Detailed descriptions of field names from Payer Price Transparency Machine-Readable files.
For pricing information, please see https://payerset.com/pricing
There is an additional PLAN_MAP table that contains details about the Plans and Plan Types.
| Field Name | Description / Sample Values | Original Source |
|---|---|---|
ADDITIONAL_INFORMATION | Additional information relevant to rate | PAYER MRF |
BILLING_CLASS | Institutional or Professional | PAYER MRF |
BILLING_CODE | Billing code as-is in MRF | PAYER MRF |
BILLING_CODE_MODIFIER | Modifiers for different rates (22-99, P1) | PAYER MRF |
BILLING_CODE_NAME | Billing code name as-is in MRF | PAYER MRF |
BILLING_CODE_TYPE | HCPCS, CPT, MS-DRG, etc | PAYER MRF |
BILLING_CODE_TYPE_VERSION | Version of the billing code (2023, 2024) | PAYER MRF |
EXPIRATION_DATE | Expiration date of the rate (12/31/2024) | PAYER MRF |
NEGOTIATED_RATE | Negotiated Rate value | PAYER MRF |
NEGOTIATED_TYPE | Fee schedule, negotiated, percentage, per diem | PAYER MRF |
NEGOTIATION_ARRANGEMENT | Fee for service (ffs) or Bundle | PAYER MRF |
NPI | Provider ID | PAYER MRF |
SERVICE_CODES | Location of service (11, 21, 22, etc) | PAYER MRF |
TIN_TYPE | EIN or NPI | PAYER MRF |
TIN_VALUE | Value of associated EIN or NPI | PAYER MRF |
NPPES_CITY | City Name from NPPES | NPPES |
NPPES_STATE | State Name from NPPES | NPPES |
NPPES_ORGANIZATION_NAME | Organization Name from NPPES | NPPES |
NPPES_ORGFRIENDLYNAME | Org Name + DBA Name if present | ADDED BY PAYERSET |
NPPES_PRIMARY_TAXONOMY_CODE | Primary taxonomy derived using switches in NPPES file | ADDED BY PAYERSET |
NUCC_TAXONOMY_GROUPING | High-level taxonomy grouping (Allopathic, Hospitals, Hospital Units, etc) | NUCC |
NUCC_TAXONOMY_CLASSIFICATION | More granular taxonomy classification (Clinic/Center, Abmulance, Nursing Care, etc) | NUCC |
NUCC_TAXONOMY_SPECIALIZATION | Most granular taxonomy (Adult Mental Health, Oncology, Orthopedic Surgery, etc...) | NUCC |
PAYER | Payer column added for convenience | ADDED BY PAYERSET |
PAYERSET_BILLING_CODE_NAME | Payerset standardized name of 21k+ billing codes | ADDED BY PAYERSET |
PAYERSET_BILLING_CODE_CATEGORY | Payerset categorization of 21k+ billing codes | ADDED BY PAYERSET |
PAYERSET_BILLING_CODE_SUBCATEGORY | Payerset subcategorization of 21k+ billing codes | ADDED BY PAYERSET |
PAYERSET_BILLING_CODE_TYPE | Payerset categorization of billing code types | ADDED BY PAYERSET |
PLAN_ID | Payerset-created Plan ID that links back to original plan via PLAN_MAP table | ADDED BY PAYERSET |
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