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Smita Ramanadham previously told the Daily Mail

As we had indicated in prior rulemaking (88 FR 82100 through 82101), EDI 835 ERA transaction data, the electronic transaction data that provides claim payment information that hospitals use to track and analyze their claims and reimbursement patterns, including any adjustments made to the claim such as denials, reductions or increases to the amount charged, and expected patient co-payments, co-insurance, or secondary coverage, would meet the requirement to calculate an allowed amount

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Both require a licensed provider's prescription

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