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Acuvance / Coker Group (DataRise) — Commercial (non-Medicare) contract reimbursement rates for physician-administered Part B drugs, resolved to health plan x provider type x drug x unit — i.e. the actual negotiated commercial allowed amount per milligram or unit for in-office infusion and injection drugs, across the major commercial carriers (UnitedHealthcare, Cigna, Aetna, Elevance, BCBS plans by state). This is the commercially-negotiated reimbursement side of the drug economy that is otherwise only visible through individual payer contracts. The underlying material is Transparency-in-Cover…
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Commercial (non-Medicare) contract reimbursement rates for physician-administered Part B drugs, resolved to health plan x provider type x drug x unit — i.e. the actual negotiated commercial allowed amount per milligram or unit for in-office infusion and injection drugs, across the major commercial carriers (UnitedHealthcare, Cigna, Aetna, Elevance, BCBS plans by state). This is the commercially-negotiated reimbursement side of the drug economy that is otherwise only visible through individual payer contracts. The underlying material is Transparency-in-Coverage machine-readable files, which are legally mandated to be published but are released as enormous, heterogeneous JSON that is impractical to parse — the vendor's product is the parsed, normalised, queryable version. Sold as custom queries with 24-72 hour turnaround and a private portal for result sets over 1 million rows; pricing is per unique health plan queried rather than per drug code.
From 4 yearsCoverage Health Care · FinancialsAsset class Equities
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Acuvance / Coker Group (DataRise) — Commercial (non-Medicare) contract reimbursement rates for physician-administered Part B drugs, resolved to health plan x provider type x drug x unit — i.e. the actual negotiated commercial allowed amount per milligram or unit for in-office infusion and injection drugs, across the major commercial carriers (UnitedHealthcare, Cigna, Aetna, Elevance, BCBS plans by state). This is the commercially-negotiated reimbursement side of the drug economy that is otherwise only visible through individual payer contracts. The underlying material is Transparency-in-Cover…
Cokergroup offers (Alternative, Fundamental, Reference) — Very large: the vendor states result sets exceeding 1 million rows are routine for a single order and pushes them to a private portal, and the underlying Transparency-in-Coverage files from UnitedHealthcare, Cigna, Aetna and Elevance are individually enormous. Plausible total panel is 10^8 or more plan-drug-provider-geography rate observations across all commercial plans, though what a given buyer sees is bounded by the plans they license..
Provider-side revenue-cycle and contract negotiation for infusion and ophthalmology practices (the page's own worked examples compute net margin per 30-minute infusion); PBM and payer benchmarking of commercial allowed amounts against Medicare Part B; training models that predict commercial allowed amount for a drug-plan-geography combination, which today has no public ground truth; identifying therapeutic substitution economics (Eylea versus Vabysmo reimbursement spread); site-of-care shift analysis between office, clinic and hospital; specialty-pharmacy and buy-and-bill economics; policy research into whether mandated transparency actually delivers comparable prices
The data is with 4 years of history.
Coverage spans US; Health Care Technology, Life and Health Insurance; alternative, fundamental, reference; equities.
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