{
    "meta": {
        "total": 3,
        "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": "f0111",
            "parent_org": "California DHCS",
            "plan_name": "Medi-Cal Dental Fee-for-Service",
            "contract_id": null,
            "coverage_type": "Medicaid FFS",
            "state": "CA",
            "reporting_period": "CY2025",
            "std_total": 3138788,
            "std_approved": 2212669,
            "std_denied": 926119,
            "std_denial_rate": 29.51,
            "std_denial_rate_printed": null,
            "std_appeals_total": 2430,
            "std_appeals_overturned": 1623,
            "std_appeal_overturn_rate": 66.79,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": null,
            "ext_review_approved": 188,
            "std_tat_mean_days": 4.8,
            "std_tat_median_days": 5,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/Medi-Cal-Dental-2025-Prior-Auth-Metrics.pdf",
            "source_segment": "states",
            "extraction_note": "Expedited not separately available. Median (5 days) exceeds mean (4.8). Of 24,230 extensions, only 188 approved and 24,042 denied."
        },
        {
            "filing_id": "f0112",
            "parent_org": "California DHCS",
            "plan_name": "Medi-Cal Fee-for-Service (medical and behavioral health)",
            "contract_id": null,
            "coverage_type": "Medicaid FFS",
            "state": "CA",
            "reporting_period": "CY2025",
            "std_total": 78987,
            "std_approved": 55741,
            "std_denied": 22404,
            "std_denial_rate": 28.36,
            "std_denial_rate_printed": null,
            "std_appeals_total": 43,
            "std_appeals_overturned": 3,
            "std_appeal_overturn_rate": 6.98,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": null,
            "ext_review_approved": 774,
            "std_tat_mean_days": 4,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "warn:std_headline_excludes_extended",
            "error_count": 0,
            "warn_count": 1,
            "source_url": "https://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/Medi-Cal-2025-Prior-Auth-Metrics.pdf",
            "source_segment": "states",
            "extraction_note": "Expedited data explicitly not available; standard and expedited reported together. Third outcome category 'Modified' = 842. CONTRADICTION: prints 3 of 43 appeals approved but labels it 14%; 3/43 is 7%. Also reports 9,439 auto-denied after extension."
        },
        {
            "filing_id": "ca-ccs-2025",
            "parent_org": "California DHCS",
            "plan_name": "California Children's Services (CCS)",
            "contract_id": null,
            "coverage_type": "Medicaid FFS",
            "state": "CA",
            "reporting_period": "CY2025",
            "std_total": 755850,
            "std_approved": 555301,
            "std_denied": 200549,
            "std_denial_rate": 26.53,
            "std_denial_rate_printed": null,
            "std_appeals_total": 15,
            "std_appeals_overturned": 1,
            "std_appeal_overturn_rate": 6.67,
            "exp_total": null,
            "exp_approved": null,
            "exp_denied": null,
            "exp_denial_rate": null,
            "ext_review_approved": 304799,
            "std_tat_mean_days": 9,
            "std_tat_median_days": 2,
            "exp_tat_mean_hours": null,
            "exp_tat_median_hours": null,
            "reports_counts": true,
            "quality_flags": "clean",
            "error_count": 0,
            "warn_count": 0,
            "source_url": "https://www.dhcs.ca.gov/vi/provgovpart/Documents/Interoperability-Prior-Auth-Metrics-Reports/CCS-2025-Prior-Auth-Metrics.pdf",
            "source_segment": "filings_2025",
            "extraction_note": "Document states all prior authorizations (standard and expedited) are reported together, so the denominator is combined. Headline figures are 555,301 approved / 200,549 denied of 755,850 (73%/27%); the 442,990 / 139,846 pair printed alongside is the within-7-days subset, not the total. Two independent extraction passes disagreed on which pair was the headline; resolved to the document total."
        }
    ]
}