knowledge_navigate
Submitted arguments
{
"node": 2731
}Native result and verdict
{
"does_not_license": {
"reading": "ANCHOR: node 2731 (node), resolving to 1 node(s).\n\nROLLUP for drg 428 (node 2731): everything the graph holds one hop away, every relation in both directions.\n rate_observed in (9 node(s)): payers that published a rate for 428; the rate itself is a quantity and lives in the rate table, never on the edge. Stored payer → procedure or DRG; from a DRG, step `in`\n 2700 payer highmark\n 2701 payer anthem\n 2702 payer bcbs-mn\n 2703 payer hcsc\n 2704 payer aetna\n 2705 payer cigna\n 2706 payer bcbs-north-carolina\n 2707 payer centene\n 20652 payer independence-blue-cross\n co_priced out (25 of 109 node(s) shown, most facilities first): codes some payer filed a rate for at the same facility in the same month as 428, per the compacted rate lake, each with the count of facilities and of payer-months it was seen at, most facilities first; the relation is symmetric, so this is also every code 428 is reached from, and it is a co-occurrence count and never a statement that the pair is billed together, which is the NCCI edit file's question and bundled_with's edge. Stored procedure or DRG → procedure or DRG, stored both ways; from a DRG, step `out`\n 2375 procedure 80076 n_facilities=7837 n_payer_months=9\n 2365 procedure 76705 n_facilities=7745 n_payer_months=9\n 2368 procedure 76981 n_facilities=6947 n_payer_months=9\n 2369 procedure 76982 n_facilities=6149 n_payer_months=9\n 2577 procedure 81517 n_facilities=6127 n_payer_months=9\n 2370 procedure 76983 n_facilities=5024 n_payer_months=9\n 2273 procedure 0003M n_facilities=4740 n_payer_months=9\n 2651 procedure 97161 n_facilities=4720 n_payer_months=3\n 2656 procedure 97162 n_facilities=4694 n_payer_months=3\n 2647 procedure 97116 n_facilities=4654 n_payer_months=3\n 2598 procedure 91200 n_facilities=4577 n_payer_months=9\n 2657 procedure 97163 n_facilities=4433 n_payer_months=3\n 2263 procedure 0002M n_facilities=4388 n_payer_months=9\n 2658 procedure 97164 n_facilities=4226 n_payer_months=3\n 2350 procedure 50200 n_facilities=3840 n_payer_months=6\n 2373 procedure 80061 n_facilities=3810 n_payer_months=2\n 2592 procedure 84443 n_facilities=3809 n_payer_months=2\n 2581 procedure 83718 n_facilities=3802 n_payer_months=2\n 2371 procedure 80048 n_facilities=3801 n_payer_months=2\n 2579 procedure 83036 n_facilities=3792 n_payer_months=2\n 2578 procedure 82043 n_facilities=3788 n_payer_months=2\n 2372 procedure 80053 n_facilities=3782 n_payer_months=2\n 2582 procedure 83880 n_facilities=3777 n_payer_months=2\n 2366 procedure 76770 n_facilities=3729 n_payer_months=2\n 2377 procedure 81479 n_facilities=3488 n_payer_months=5\n filed_charge in (25 of 539 node(s) shown, most rows first): hospitals that filed a negotiated standard charge for 428 under 45 CFR 180; the edge is stored hospital -> code, so from 428 it is taken `in`, and each hospital listed is a source of the edge. The most rows behind the edge first, cut at the top with the total stated; each carries the rows, filings and distinct payer strings behind it, its NPI or the rung that found none, and the name and state its filing carried. The amount is a quantity with a methodology beside it and stays in the hospital tier, never on the edge; the filed_charge tool serves it. Stored hospital → procedure or DRG; from a DRG, step `in`\n 24827 hospital 1548393127 n_rows=1585 n_filings=1 n_payer_strings=85 npi=1548393127 npi_resolution=filed filed_name=\"University Medical Center of Southern Nevada\" filed_state=NV\n 24894 hospital 1598708513 n_rows=743 n_filings=1 n_payer_strings=22 npi=1598708513 npi_resolution=filed filed_name=\"JOHNSTON-WILLIS HOSPITAL\" filed_state=VA\n 24556 hospital 1396739165 n_rows=488 n_filings=1 n_payer_strings=14 npi=1396739165 npi_resolution=filed filed_name=\"PARKWEST MEDICAL CENTER\" filed_state=TN\n 24008 hospital 1063470763 n_rows=421 n_filings=1 n_payer_strings=22 npi=1063470763 npi_resolution=filed filed_name=\"BELTON REGIONAL MEDICAL CENTER\" filed_state=MO\n 25471 hospital 1942247044 n_rows=420 n_filings=1 n_payer_strings=21 npi=1942247044 npi_resolution=filed filed_name=\"CENTERPOINT MEDICAL CENTER\" filed_state=MO\n 24092 hospital 1124054978 n_rows=324 n_filings=1 n_payer_strings=33 npi=1124054978 npi_resolution=filed filed_name=\"LOS ROBLES HOSPITAL AND MEDICAL CENTER\" filed_state=CA\n 24095 hospital 1124074273 n_rows=313 n_filings=1 n_payer_strings=33 npi=1124074273 npi_resolution=filed filed_name=\"METHODIST HOSPITAL\" filed_state=TX\n 24518 hospital 1376071530 n_rows=297 n_filings=1 n_payer_strings=24 npi=1376071530 npi_resolution=ccn filed_name=\"METHODIST HOSPITAL ATASCOSA\" filed_state=TX\n 24086 hospital 1114971660 n_rows=273 n_filings=1 n_payer_strings=30 npi=1114971660 npi_resolution=filed filed_name=\"RIVERSIDE COMMUNITY HOSPITAL\" filed_state=CA\n 25513 hospital 1962412486 n_rows=264 n_filings=1 n_payer_strings=14 npi=1962412486 npi_resolution=filed filed_name=\"IHC Health Services, Inc,. DBA Intermountain Health Alta View Hospital\" filed_state=?\n 23938 hospital 1013514199 n_rows=177 n_filings=3 n_payer_strings=35 npi=1013514199 npi_resolution=declared filed_name=\"\" filed_state=?\n 25075 hospital 1700036696 n_rows=171 n_filings=1 n_payer_strings=14 npi=1700036696 npi_resolution=filed filed_name=\"ROANE COUNTY MEDICAL CENTER\" filed_state=TN\n 23960 hospital 1023593746 n_rows=164 n_filings=1 n_payer_strings=19 npi=1023593746 npi_resolution=filed filed_name=\"ANGEL MEDICAL CENTER\" filed_state=NC\n 24861 hospital 1578048294 n_rows=164 n_filings=1 n_payer_strings=19 npi=1578048294 npi_resolution=filed filed_name=\"BLUE RIDGE REGIONAL HOSPITAL\" filed_state=NC\n 24038 hospital 1083715841 n_rows=147 n_filings=1 n_payer_strings=6 npi=1083715841 npi_resolution=filed filed_name=\"LLC I, LLC\" filed_state=LA\n 25438 hospital 1912014358 n_rows=136 n_filings=1 n_payer_strings=14 npi=1912014358 npi_resolution=filed filed_name=\"IHC Health Services Inc., DBA Intermountain Health American Fork Hospital\" filed_state=?\n 24965 hospital 1639197395 n_rows=122 n_filings=1 n_payer_strings=112 npi=1639197395 npi_resolution=filed filed_name=\"Holy Cross Hospital-Ft. Lauderdale\" filed_state=?\n 25101 hospital 1710958228 n_rows=117 n_filings=1 n_payer_strings=36 npi=1710958228 npi_resolution=filed filed_name=\"WATSONVILLE COMMUNITY HOSPITAL\" filed_state=?\n 25539 hospital 1982621447 n_rows=116 n_filings=2 n_payer_strings=55 npi=1982621447 npi_resolution=declared filed_name=\"St. Charles Redmond\" filed_state=?\n 24910 hospital 1598868655 n_rows=115 n_filings=1 n_payer_strings=109 npi=1598868655 npi_resolution=declared filed_name=\"Genesis Healthcare System\" filed_state=?\n 25136 hospital 1740254143 n_rows=114 n_filings=1 n_payer_strings=103 npi=1740254143 npi_resolution=declared filed_name=\"Overlook Medical Center\" filed_state=?\n 25274 hospital 1811994809 n_rows=113 n_filings=1 n_payer_strings=102 npi=1811994809 npi_resolution=declared filed_name=\"Chilton Medical Center\" filed_state=?\n 24580 hospital 1407833486 n_rows=112 n_filings=1 n_payer_strings=106 npi=1407833486 npi_resolution=declared filed_name=\"Saint Francis Hospital and Medical Center\" filed_state=?\n 25561 hospital 1992759419 n_rows=106 n_filings=1 n_payer_strings=39 npi=1992759419 npi_resolution=filed filed_name=\"HCA FLORIDA BAYONET POINT HOSPITAL\" filed_state=FL\n 24834 hospital 1558365890 n_rows=105 n_filings=2 n_payer_strings=40 npi=1558365890 npi_resolution=filed filed_name=\"METHODIST LEBONHEUR GERMANTOWN HOSP\" filed_state=?\n\nVISITED 1 node(s):\n 2731 drg 428\n\nThis answer is stated against numbering e492637bb79c8fa9. A claim about any node id above is only true against that numbering, so name it.\n\nNO READING IS ATTACHED. These fields carry no interpretation, and this world does not supply one unasked. To obtain a reading, and to find out whether what you are about to write is supported, call judgement_check with receipt \"r5796\" and the claims you intend to make. A claim written without checking it is a claim this world did not license.\n\nIf you can write your claim as an expression over the figures above, for example {\"op\": \"<=\", \"left\": \"anchor.nodes[0]\", \"right\": 12, \"scope\": \"marginal\"}, call claim_check with the same receipt instead. It decides by entailment over those figures and never reads your sentence, so it answers the same way in any language. The two checks are alternatives and neither falls back to the other."
},
"kind": "served",
"licence": {
"coverage_database": "Contains information from the CMS Medicare Coverage Database.",
"cpt": "CPT is copyright the American Medical Association. Served under a distribution licence.",
"linkback": "https://hammer.ai/coverage-intelligence",
"terms": "https://hammer.ai/terms"
},
"payload": {
"anchor": {
"form": "node",
"nodes": [
2731
],
"stated": "node 2731"
},
"boundary_crossings": [],
"documents": [],
"numbering_digest": "e492637bb79c8fa9",
"receipt": "r5796",
"relations": [],
"rollups": [
{
"edges": [
{
"direction": "in",
"nodes": [
{
"key": "highmark",
"kind": "payer",
"node": 2700
},
{
"key": "anthem",
"kind": "payer",
"node": 2701
},
{
"key": "bcbs-mn",
"kind": "payer",
"node": 2702
},
{
"key": "hcsc",
"kind": "payer",
"node": 2703
},
{
"key": "aetna",
"kind": "payer",
"node": 2704
},
{
"key": "cigna",
"kind": "payer",
"node": 2705
},
{
"key": "bcbs-north-carolina",
"kind": "payer",
"node": 2706
},
{
"key": "centene",
"kind": "payer",
"node": 2707
},
{
"key": "independence-blue-cross",
"kind": "payer",
"node": 20652
}
],
"reads": "payers that published a rate for 428; the rate itself is a quantity and lives in the rate table, never on the edge. Stored payer → procedure or DRG; from a DRG, step `in`",
"relation": "rate_observed",
"total": 9
},
{
"direction": "out",
"nodes": [
{
"key": "80076",
"kind": "procedure",
"n_facilities": 7837,
"n_payer_months": 9,
"node": 2375
},
{
"key": "76705",
"kind": "procedure",
"n_facilities": 7745,
"n_payer_months": 9,
"node": 2365
},
{
"key": "76981",
"kind": "procedure",
"n_facilities": 6947,
"n_payer_months": 9,
"node": 2368
},
{
"key": "76982",
"kind": "procedure",
"n_facilities": 6149,
"n_payer_months": 9,
"node": 2369
},
{
"key": "81517",
"kind": "procedure",
"n_facilities": 6127,
"n_payer_months": 9,
"node": 2577
},
{
"key": "76983",
"kind": "procedure",
"n_facilities": 5024,
"n_payer_months": 9,
"node": 2370
},
{
"key": "0003M",
"kind": "procedure",
"n_facilities": 4740,
"n_payer_months": 9,
"node": 2273
},
{
"key": "97161",
"kind": "procedure",
"n_facilities": 4720,
"n_payer_months": 3,
"node": 2651
},
{
"key": "97162",
"kind": "procedure",
"n_facilities": 4694,
"n_payer_months": 3,
"node": 2656
},
{
"key": "97116",
"kind": "procedure",
"n_facilities": 4654,
"n_payer_months": 3,
"node": 2647
},
{
"key": "91200",
"kind": "procedure",
"n_facilities": 4577,
"n_payer_months": 9,
"node": 2598
},
{
"key": "97163",
"kind": "procedure",
"n_facilities": 4433,
"n_payer_months": 3,
"node": 2657
},
{
"key": "0002M",
"kind": "procedure",
"n_facilities": 4388,
"n_payer_months": 9,
"node": 2263
},
{
"key": "97164",
"kind": "procedure",
"n_facilities": 4226,
"n_payer_months": 3,
"node": 2658
},
{
"key": "50200",
"kind": "procedure",
"n_facilities": 3840,
"n_payer_months": 6,
"node": 2350
},
{
"key": "80061",
"kind": "procedure",
"n_facilities": 3810,
"n_payer_months": 2,
"node": 2373
},
{
"key": "84443",
"kind": "procedure",
"n_facilities": 3809,
"n_payer_months": 2,
"node": 2592
},
{
"key": "83718",
"kind": "procedure",
"n_facilities": 3802,
"n_payer_months": 2,
"node": 2581
},
{
"key": "80048",
"kind": "procedure",
"n_facilities": 3801,
"n_payer_months": 2,
"node": 2371
},
{
"key": "83036",
"kind": "procedure",
"n_facilities": 3792,
"n_payer_months": 2,
"node": 2579
},
{
"key": "82043",
"kind": "procedure",
"n_facilities": 3788,
"n_payer_months": 2,
"node": 2578
},
{
"key": "80053",
"kind": "procedure",
"n_facilities": 3782,
"n_payer_months": 2,
"node": 2372
},
{
"key": "83880",
"kind": "procedure",
"n_facilities": 3777,
"n_payer_months": 2,
"node": 2582
},
{
"key": "76770",
"kind": "procedure",
"n_facilities": 3729,
"n_payer_months": 2,
"node": 2366
},
{
"key": "81479",
"kind": "procedure",
"n_facilities": 3488,
"n_payer_months": 5,
"node": 2377
}
],
"nodes_cut": true,
"reads": "codes some payer filed a rate for at the same facility in the same month as 428, per the compacted rate lake, each with the count of facilities and of payer-months it was seen at, most facilities first; the relation is symmetric, so this is also every code 428 is reached from, and it is a co-occurrence count and never a statement that the pair is billed together, which is the NCCI edit file's question and bundled_with's edge. Stored procedure or DRG → procedure or DRG, stored both ways; from a DRG, step `out`",
"relation": "co_priced",
"total": 109
},
{
"direction": "in",
"nodes": [
{
"filed_name": "University Medical Center of Southern Nevada",
"filed_state": "NV",
"key": "1548393127",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 85,
"n_rows": 1585,
"node": 24827,
"npi": "1548393127",
"npi_resolution": "filed"
},
{
"filed_name": "JOHNSTON-WILLIS HOSPITAL",
"filed_state": "VA",
"key": "1598708513",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 22,
"n_rows": 743,
"node": 24894,
"npi": "1598708513",
"npi_resolution": "filed"
},
{
"filed_name": "PARKWEST MEDICAL CENTER",
"filed_state": "TN",
"key": "1396739165",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 14,
"n_rows": 488,
"node": 24556,
"npi": "1396739165",
"npi_resolution": "filed"
},
{
"filed_name": "BELTON REGIONAL MEDICAL CENTER",
"filed_state": "MO",
"key": "1063470763",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 22,
"n_rows": 421,
"node": 24008,
"npi": "1063470763",
"npi_resolution": "filed"
},
{
"filed_name": "CENTERPOINT MEDICAL CENTER",
"filed_state": "MO",
"key": "1942247044",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 21,
"n_rows": 420,
"node": 25471,
"npi": "1942247044",
"npi_resolution": "filed"
},
{
"filed_name": "LOS ROBLES HOSPITAL AND MEDICAL CENTER",
"filed_state": "CA",
"key": "1124054978",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 33,
"n_rows": 324,
"node": 24092,
"npi": "1124054978",
"npi_resolution": "filed"
},
{
"filed_name": "METHODIST HOSPITAL",
"filed_state": "TX",
"key": "1124074273",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 33,
"n_rows": 313,
"node": 24095,
"npi": "1124074273",
"npi_resolution": "filed"
},
{
"filed_name": "METHODIST HOSPITAL ATASCOSA",
"filed_state": "TX",
"key": "1376071530",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 24,
"n_rows": 297,
"node": 24518,
"npi": "1376071530",
"npi_resolution": "ccn"
},
{
"filed_name": "RIVERSIDE COMMUNITY HOSPITAL",
"filed_state": "CA",
"key": "1114971660",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 30,
"n_rows": 273,
"node": 24086,
"npi": "1114971660",
"npi_resolution": "filed"
},
{
"filed_name": "IHC Health Services, Inc,. DBA Intermountain Health Alta View Hospital",
"filed_state": "",
"key": "1962412486",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 14,
"n_rows": 264,
"node": 25513,
"npi": "1962412486",
"npi_resolution": "filed"
},
{
"filed_name": "",
"filed_state": "",
"key": "1013514199",
"kind": "hospital",
"n_filings": 3,
"n_partitions": 3,
"n_payer_strings": 35,
"n_rows": 177,
"node": 23938,
"npi": "1013514199",
"npi_resolution": "declared"
},
{
"filed_name": "ROANE COUNTY MEDICAL CENTER",
"filed_state": "TN",
"key": "1700036696",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 14,
"n_rows": 171,
"node": 25075,
"npi": "1700036696",
"npi_resolution": "filed"
},
{
"filed_name": "ANGEL MEDICAL CENTER",
"filed_state": "NC",
"key": "1023593746",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 19,
"n_rows": 164,
"node": 23960,
"npi": "1023593746",
"npi_resolution": "filed"
},
{
"filed_name": "BLUE RIDGE REGIONAL HOSPITAL",
"filed_state": "NC",
"key": "1578048294",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 19,
"n_rows": 164,
"node": 24861,
"npi": "1578048294",
"npi_resolution": "filed"
},
{
"filed_name": "LLC I, LLC",
"filed_state": "LA",
"key": "1083715841",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 6,
"n_rows": 147,
"node": 24038,
"npi": "1083715841",
"npi_resolution": "filed"
},
{
"filed_name": "IHC Health Services Inc., DBA Intermountain Health American Fork Hospital",
"filed_state": "",
"key": "1912014358",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 14,
"n_rows": 136,
"node": 25438,
"npi": "1912014358",
"npi_resolution": "filed"
},
{
"filed_name": "Holy Cross Hospital-Ft. Lauderdale",
"filed_state": "",
"key": "1639197395",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 112,
"n_rows": 122,
"node": 24965,
"npi": "1639197395",
"npi_resolution": "filed"
},
{
"filed_name": "WATSONVILLE COMMUNITY HOSPITAL",
"filed_state": "",
"key": "1710958228",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 36,
"n_rows": 117,
"node": 25101,
"npi": "1710958228",
"npi_resolution": "filed"
},
{
"filed_name": "St. Charles Redmond",
"filed_state": "",
"key": "1982621447",
"kind": "hospital",
"n_filings": 2,
"n_partitions": 2,
"n_payer_strings": 55,
"n_rows": 116,
"node": 25539,
"npi": "1982621447",
"npi_resolution": "declared"
},
{
"filed_name": "Genesis Healthcare System",
"filed_state": "",
"key": "1598868655",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 109,
"n_rows": 115,
"node": 24910,
"npi": "1598868655",
"npi_resolution": "declared"
},
{
"filed_name": "Overlook Medical Center",
"filed_state": "",
"key": "1740254143",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 103,
"n_rows": 114,
"node": 25136,
"npi": "1740254143",
"npi_resolution": "declared"
},
{
"filed_name": "Chilton Medical Center",
"filed_state": "",
"key": "1811994809",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 102,
"n_rows": 113,
"node": 25274,
"npi": "1811994809",
"npi_resolution": "declared"
},
{
"filed_name": "Saint Francis Hospital and Medical Center",
"filed_state": "",
"key": "1407833486",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 106,
"n_rows": 112,
"node": 24580,
"npi": "1407833486",
"npi_resolution": "declared"
},
{
"filed_name": "HCA FLORIDA BAYONET POINT HOSPITAL",
"filed_state": "FL",
"key": "1992759419",
"kind": "hospital",
"n_filings": 1,
"n_partitions": 1,
"n_payer_strings": 39,
"n_rows": 106,
"node": 25561,
"npi": "1992759419",
"npi_resolution": "filed"
},
{
"filed_name": "METHODIST LEBONHEUR GERMANTOWN HOSP",
"filed_state": "",
"key": "1558365890",
"kind": "hospital",
"n_filings": 2,
"n_partitions": 2,
"n_payer_strings": 40,
"n_rows": 105,
"node": 24834,
"npi": "1558365890",
"npi_resolution": "filed"
}
],
"nodes_cut": true,
"reads": "hospitals that filed a negotiated standard charge for 428 under 45 CFR 180; the edge is stored hospital -> code, so from 428 it is taken `in`, and each hospital listed is a source of the edge. The most rows behind the edge first, cut at the top with the total stated; each carries the rows, filings and distinct payer strings behind it, its NPI or the rung that found none, and the name and state its filing carried. The amount is a quantity with a methodology beside it and stays in the hospital tier, never on the edge; the filed_charge tool serves it. Stored hospital → procedure or DRG; from a DRG, step `in`",
"relation": "filed_charge",
"total": 539
}
],
"key": "428",
"kind": "drg",
"node": 2731
}
],
"rows": [],
"visited": [
{
"key": "428",
"kind": "drg",
"node": 2731,
"step": 0
}
]
},
"receipt": "r5796",
"session": "49ec6090f32b112cd7fc2d39a72e0974",
"tool": "knowledge_navigate",
"world": {
"build": 2,
"description": "What payers publish that they pay, code by code, and what may be said with it.",
"name": "hammer-coverage-intelligence",
"vintage": "2026-10-01"
}
}Permanent saved result
Read this evidence receipt
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