{
    "meta": {
        "total": 4,
        "page": 1,
        "per_page": 50,
        "pages": 1,
        "sort": "rate",
        "direction": "desc",
        "reporting_year": "CY2025",
        "rule": "CMS-0057-F",
        "note": "Rates are computed from published counts. null means the payer published no value; it never means zero."
    },
    "filings": [
        {
            "filing_id": "f0129",
            "parent_org": "Centene",
            "plan_name": "Ambetter Health Florida / Celtic (49004)",
            "contract_id": "49004",
            "coverage_type": "Marketplace QHP",
            "state": "FL",
            "reporting_period": "CY2025",
            "std_total": 419452,
            "std_approved": 331373,
            "std_denied": 88079,
            "std_denial_rate": 21,
            "std_denial_rate_printed": null,
            "std_appeals_total": 3670,
            "std_appeals_overturned": 2137,
            "std_appeal_overturn_rate": 58.23,
            "exp_total": 30415,
            "exp_approved": 24217,
            "exp_denied": 6198,
            "exp_denial_rate": 20.38,
            "ext_review_approved": 92,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 0,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 24,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.ambetterhealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/FL_MKT_AH_49004_MetricsSummary_R.pdf",
            "source_segment": "wave2",
            "extraction_note": "contract_id is the HIOS issuer ID. Largest marketplace filing by volume.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:FL:49004",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0128",
            "parent_org": "Centene",
            "plan_name": "Ambetter Health Florida (86382)",
            "contract_id": "86382",
            "coverage_type": "Marketplace QHP",
            "state": "FL",
            "reporting_period": "CY2025",
            "std_total": 6402,
            "std_approved": 5232,
            "std_denied": 1170,
            "std_denial_rate": 18.28,
            "std_denial_rate_printed": null,
            "std_appeals_total": 53,
            "std_appeals_overturned": 34,
            "std_appeal_overturn_rate": 64.15,
            "exp_total": 559,
            "exp_approved": 442,
            "exp_denied": 117,
            "exp_denial_rate": 20.93,
            "ext_review_approved": 3,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 0,
            "exp_tat_mean_hours": 24,
            "exp_tat_median_hours": 24,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.ambetterhealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/FL_MKT_AH_86382_MetricsSummary_R.pdf",
            "source_segment": "wave2",
            "extraction_note": "contract_id is the HIOS issuer ID.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:FL:86382",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0247",
            "parent_org": "GuideWell / Florida Blue",
            "plan_name": "BlueOptions (PPO) / BlueSelect (EPO)",
            "contract_id": "16842",
            "coverage_type": "Marketplace QHP",
            "state": "FL",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 5,
            "std_denial_rate_printed": 5,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 28,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 4,
            "ext_review_approved": 0,
            "std_tat_mean_days": 0.99,
            "std_tat_median_days": null,
            "exp_tat_mean_hours": 0.29,
            "exp_tat_median_hours": 0,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.floridablue.com/members/tools-resources/prior-authorization-medical-services/metrics",
            "source_segment": "blues",
            "extraction_note": "Percentages only - no raw counts published. One reporting row covers several marketed plan names under a single contract/issuer ID; row emitted once per reported ID. Median standard decision time not published. Extended review reported as 0% received / 0% approved, recorded as 0.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:FL:56503",
            "filing_unit": "qhp_issuer"
        },
        {
            "filing_id": "f0248",
            "parent_org": "GuideWell / Florida Blue",
            "plan_name": "myBlue (HMO) / BlueCare (HMO-POS)",
            "contract_id": "30252",
            "coverage_type": "Marketplace QHP",
            "state": "FL",
            "reporting_period": "CY2025",
            "std_total": null,
            "std_approved": null,
            "std_denied": null,
            "std_denial_rate": 1,
            "std_denial_rate_printed": 1,
            "std_appeals_total": null,
            "std_appeals_overturned": null,
            "std_appeal_overturn_rate": 30,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": 2,
            "ext_review_approved": 0,
            "std_tat_mean_days": 0.2,
            "std_tat_median_days": null,
            "exp_tat_mean_hours": 0.17,
            "exp_tat_median_hours": 0,
            "reports_counts": false,
            "quality_flags": "info:appeals_not_reported; info:percentages_only",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.floridablue.com/members/tools-resources/prior-authorization-medical-services/metrics",
            "source_segment": "blues",
            "extraction_note": "Percentages only - no raw counts published. One reporting row covers several marketed plan names under a single contract/issuer ID; row emitted once per reported ID. Median standard decision time not published. Extended review reported as 0% received / 0% approved, recorded as 0.",
            "source_sha256": null,
            "service_list_url": null,
            "service_list_items": null,
            "entity_id": "qhp:FL:56503",
            "filing_unit": "qhp_issuer"
        }
    ]
}