Synthetic data appearing in In-Network Rate MRF

[dgolden]

The Priority Health HMO In-Network Rate MRF has what looks to be “synthetic” price data for MS-DRG, but the professional service (CPT) data looks real. Can MRF production fail in this fashion, such that data for certain billing code types can be valid, while other types are invalid?

For the curious, here are screenshots of the analysis by keyark.com

The first hint of a problem was from a quick visual inspection of the data. Notice how the negotiated_rate “percentage” is decimal and out-of-range (I was expecting an integer in the range of 100 to 125):

And Counts on negotiated_rate show repetition of the same (unreal) values:

MRF is a 468MB GZ compressed file:
http://priorityhealthtransparencymrfs.s3-website-us-east-1.amazonaws.com/2022_09_01_priority_health_HMO_in-network-rates.zip