# Hospital Transparency Additional metadata for the hospital address can be made available but is not part of our standard offering. | Field Name | Description / Sample Values | Original Source | | -------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------ | | **ADDITIONAL\_PAYER\_NOTES** | Free-text notes hospitals sometimes include for a payer or plan. *e.g., “Only applicable to self-pay patients seen in ER,” “BCBS rates exclude lab fees”* | HOSPITAL MRF | | **BILLING\_CLASS** | Claim classification. *“Institutional”, “Professional”* | HOSPITAL MRF | | **BILLING\_CODE\_CATEGORY** | Broad clinical grouping of the billing code. *“Imaging”, “Surgery–Outpatient”, “Lab & Pathology”* | ADDED BY PAYERSET | | **CODE** | Billing code exactly as published. *“99213”, “0274”, “J9206”, “30145”* | HOSPITAL MRF | | **CODE\_TYPE** | Coding system. *“CPT”, “HCPCS”, “MS-DRG”, “APC”, “NDC”* | HOSPITAL MRF | | **DESCRIPTION** | Description from file (often truncated/abbreviated). *“Office/outpatient visit est low-level”, “Knee arthroscopy w/ meniscus repair”* | HOSPITAL MRF | | **DISCOUNTED\_CASH** | Hospital’s cash price offered to self-pay patients. | HOSPITAL MRF | | **DRUG\_CATEGORY** | Therapeutic class if row represents a drug. *“Antineoplastic Agents”, “Analgesics”* | HOSPITAL MRF | | **DRUG\_TYPE** | Brand / generic / biosimilar flag. *“Brand”, “Generic”, “Biosimilar”* | HOSPITAL MRF | | **DRUG\_UNIT** | Unit of measure for drug price. *“mg”, “mL”, “tablet”* | HOSPITAL MRF | | **GROSS** | Hospital’s standard (chargemaster) price. | HOSPITAL MRF | | **HOSPITAL** | Facility name from file header. *“Mayo Clinic Hospital – Rochester”* | HOSPITAL MRF | | **HOSPITAL\_ID** | Payerset stable hash / surrogate key for the facility. | ADDED BY PAYERSET | | **MAXIMUM** | Highest negotiated rate among all payers/plans for this code. | HOSPITAL MRF | | **METHODOLOGY** | Hospital’s narrative on how standard charges were derived. *“Cost-to-charge ratio”, “Rate-setting committee approved”* | HOSPITAL MRF | | **MINIMUM** | Lowest negotiated rate among all payers/plans for this code. | HOSPITAL MRF | | **PAYER\_NAME** | Payer name as listed by hospital. *“UnitedHealthcare”, “BCBS MN”, “Medicare FFS”* | HOSPITAL MRF | | **PLAN\_NAME** | Plan or network label from hospital. *“UMR PPO”, “Horizon Omnia Tier 1”* | HOSPITAL MRF | | **PS\_PAYER** | Payerset-standardized payer name (mapped across hospitals). | ADDED BY PAYERSET | | **PS\_PLAN** | Payerset-standardized plan/network name. | ADDED BY PAYERSET | | **SETTING** | Care setting or place of service (hospital-reported). *“Inpatient”, “Outpatient”, “Emergency Dept”, “Ambulatory Surgery”* | HOSPITAL MRF | | **STANDARD\_CHARGE\_ALGORITHM** | Text describing how **STANDARD\_CHARGE\_PERCENTAGE** or **STANDARD\_CHARGE\_DOLLAR** was calculated. *“Gross × 25%”, “Average of top 3 commercial contracts”* | HOSPITAL MRF | | **STANDARD\_CHARGE\_DOLLAR** | A flat-dollar “standard charge” (CMS-defined). | HOSPITAL MRF | | **STANDARD\_CHARGE\_PERCENTAGE** | Percent-based standard charge, if reported. *“150% of Medicare OPPS”* | HOSPITAL MRF | | **SYSTEM** | Parent health-system / IDN, if hospital provided or we inferred it. *“HCA Healthcare”, “Sutter Health”* | ADDED BY PAYERSET (fallback to MRF when present) | --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. Perform an HTTP GET request on the current page URL with the `ask` query parameter: ``` GET https://docs.payerset.com/data-lake/data-dictionary/hospital-transparency.md?ask= ``` The question should be specific, self-contained, and written in natural language. The response will contain a direct answer to the question and relevant excerpts and sources from the documentation. Use this mechanism when the answer is not explicitly present in the current page, you need clarification or additional context, or you want to retrieve related documentation sections.