Inventory -> Payers

Oxford Health Plan

Network Regions NJ

Oxford Health Plan HMO Primary Advantage

HMO

August 2025

Poor, Use With Caution

Codes: 2.1K 86%

Rows

Prices: 69M 98%

NPIs: 20K

EINs: 20K

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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Inventory -> Payers

Oxford Health Plan