{
 "title": "Out-of-network psychiatry and therapy claim outcomes, NYC outpatient practice, 2019-2026 (de-identified, aggregated)",
 "generated": "2026-10-27",
 "source": "Real claims from an NYC outpatient psychiatry practice, 2019-2026, de-identified. Payer-to-practice remittances.",
 "suppression": "Cells with fewer than 3 distinct patients are omitted.",
 "notes": "Publishes plan payment as a share of the allowed amount only. Allowed-to-billed and paid-to-billed ratios are excluded per cell. No dollar amounts.",
 "rows": [
  {
   "payer": "Anthem BCBS",
   "cpt": "90833",
   "n_lines": 12,
   "plan_paid_pct_of_allowed_median": 50.0,
   "plan_paid_pct_of_allowed_iqr": "37.5-62.5",
   "member_coinsurance_pct_median": 40.0,
   "deductible_applied_pct_of_lines": 25,
   "denied_pct_of_lines": 0
  },
  {
   "payer": "Anthem BCBS",
   "cpt": "90836",
   "n_lines": 57,
   "plan_paid_pct_of_allowed_median": 80.0,
   "plan_paid_pct_of_allowed_iqr": "70.0-80.0",
   "member_coinsurance_pct_median": 20.0,
   "deductible_applied_pct_of_lines": 18,
   "denied_pct_of_lines": 0
  },
  {
   "payer": "Anthem BCBS",
   "cpt": "99213",
   "n_lines": 11,
   "plan_paid_pct_of_allowed_median": 50.0,
   "plan_paid_pct_of_allowed_iqr": "35.0-60.0",
   "member_coinsurance_pct_median": 50.0,
   "deductible_applied_pct_of_lines": 27,
   "denied_pct_of_lines": 0
  },
  {
   "payer": "Anthem BCBS",
   "cpt": "99214",
   "n_lines": 59,
   "plan_paid_pct_of_allowed_median": 80.0,
   "plan_paid_pct_of_allowed_iqr": "70.0-90.0",
   "member_coinsurance_pct_median": 20.0,
   "deductible_applied_pct_of_lines": 12,
   "denied_pct_of_lines": 2
  },
  {
   "payer": "UnitedHealthcare",
   "cpt": "90833",
   "n_lines": 9,
   "plan_paid_pct_of_allowed_median": 70.0,
   "plan_paid_pct_of_allowed_iqr": "70.0-80.0",
   "member_coinsurance_pct_median": 30.0,
   "deductible_applied_pct_of_lines": 11,
   "denied_pct_of_lines": 0
  },
  {
   "payer": "UnitedHealthcare",
   "cpt": "90836",
   "n_lines": 31,
   "plan_paid_pct_of_allowed_median": 60.0,
   "plan_paid_pct_of_allowed_iqr": "0.0-70.0",
   "member_coinsurance_pct_median": 30.0,
   "deductible_applied_pct_of_lines": 38,
   "denied_pct_of_lines": 6
  },
  {
   "payer": "UnitedHealthcare",
   "cpt": "99213",
   "n_lines": 11,
   "plan_paid_pct_of_allowed_median": 70.0,
   "plan_paid_pct_of_allowed_iqr": "70.0-75.0",
   "member_coinsurance_pct_median": 30.0,
   "deductible_applied_pct_of_lines": 9,
   "denied_pct_of_lines": 0
  },
  {
   "payer": "UnitedHealthcare",
   "cpt": "99214",
   "n_lines": 26,
   "plan_paid_pct_of_allowed_median": 60.0,
   "plan_paid_pct_of_allowed_iqr": "0.0-67.5",
   "member_coinsurance_pct_median": 40.0,
   "deductible_applied_pct_of_lines": 35,
   "denied_pct_of_lines": 0
  }
 ]
}