payer_manual_claims/2026-09-16/fields

Source: data/payer_manual_claims/2026-09-16/fields.parquet. Source vintage: Package vintage 2026-10-01; source path partition 2026-09-16; inspect record and rule clocks separately. Grain: Packaged source record; inspect schema and linked world method before aggregation. Snapshot: 7a53af6a9beb58928d4a64dc92db09c9db65433f9909f1a10d16e302adaf86ba.

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Source records. NULL means missing; empty text is labelled separately.
claim_id
Utf8
position
Int32
name
Utf8
value
Utf8
span
Utf8
page
Int32
__row_id
Int64
001a1412d8854eb45fcb335d
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0
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who may perform
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Provider offices are prohibited from providing client access
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Provider offices are prohibited from providing client access to the Client Enrollment Services Enrollment Portal to make an online enrollment choice within any provider setting.15
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0
001ea6f3642209d6c5a548ff
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0
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disposition
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payable-with-criteria
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Use HCPCS codes A0428 and A0426 (nonemergency transportation services) and HCPCS code A0425 (relative mileage) when the person has one of the following conditions: • Altered mental status (e.g. Alzheimer's, dementia – excludes involuntary and voluntary behavioral health services). • Bariatric • Bedbound (not able to stand or bear weight unassisted) • Continuous cardiac monitoring • Hospital to hospital transfer (i.e. services are not available at sending facility, or there are no beds available at sending facility, and the client requires admission and the ambulance transportation is medically necessary) • Intravenous (IV) infusion monitoring23
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1
001ede89c87fe42a5ff19ced
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0
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effective date
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October 1, 2025
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Effective October 1, 2025
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4
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2
0022a8ba146cb7c13de959a4
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0
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disposition
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payable
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as well as for psychiatric services provided in the psychiatric distinct part unit (APR-DRG 750 – 760)
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14
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3
002498b94fbe19d58d469a19
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0
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supervision level
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under the Kaiser Permanente contracted provider's supervision.
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under the Kaiser Permanente contracted provider's supervision.
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10
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4
0029cbacb58812f34e3250be
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0
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who may perform
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visiting nurses
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visiting nurses
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8
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5
003dc7c70be8af80505c6c56
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0
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accreditation required
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Accreditation based on a survey by a CMS- approved Medicare accreditation program of a national accrediting organization may be used by CMS to “deem” a provider or supplier as complying with the applicable regulatory standards.Accreditation based on a survey by a CMS- approved Medicare accreditation program of a national accrediting organization may be used by CMS to “deem” a provider or supplier as complying with the applicable regulatory standards.24
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6
003eb9042ed1626bc49f8e67
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0
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disposition
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prior-authorization-required
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with prior authorization
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17
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7
003f15a8ee9c25582b6b7424
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0
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who may perform
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select individuals at AHCCCS and the SMI Vendor
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only select individuals at AHCCCS and the SMI Vendor are permitted to reopen a case.
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16
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8
0047632a68cd5e552ee4467d
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0
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supervision level
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under the direction of a qualified school psychologist
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under the direction of a qualified school psychologist
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28
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9

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Evidence receipt r1485

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