Network Regions
CTNY
Inventory →Payers→Emblem Health
Emblem Health
Serif Health Team
Serif Health Team
GHI
HMO NY
Network Quality History
Historical health monitoring and validation metrics for provider network datasets.
GOOD QUALITY
CONCERNS
LIMITED DATA
POOR
April 2026
Some Data Quality Concerns
- Codes
- 19K
Number of unique codes
- Rows
- 1.9M 1%
Rows of data in the file
- Prices
- 21M
Count of prices after exploding NPIs
- NPIs
- 5.6K
Number of unique NPIs
- EINs
- 151
Number of unique EINs
Professional Fees
Data includes professional fees for either of the CPT / HCPCS code types
Institutional Fees
Data includes institutional fees for any of the *-DRG / CPT / HCPCS / APC / RC code types
Common Codes
Data includes fees across a set of highly utilized and/or queried billing codes (e.g., 871, 27447, 99203, 90837)
Common Taxonomies
NPIs included in the dataset cover all common taxonomies (e.g., Family Medicine, LCSW, Dermatologist, Physical Therapist, ASC, Hospital)
Priced Providers
Adequate number of providers have prices in the dataset (based on network region and size)
Low Ambiguous Rates
Data avoids posting multiple rates for the same ein/npi list, billing code, and billing detail
Methodology
In order to determine the overall status for a payer network posting for a given month, the above tests are applied and evaluated.
If all tests pass, status is green.
If 1 test fails, status turns yellow.
If 2 or more tests fail, status turns red.
Behavioral, RX, and other specialty networks may bypass grading as they may fail listed test criteria but still be complete, useful, and usable data.
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