[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"skill:01M6XG8WF7WVC8S954842QR3TZ":3,"skill-same:01M6XG8WF7WVC8S954842QR3TZ":247},{"skillNo":4,"name":5,"nameZh":6,"description":7,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":16,"categories":17,"keywords":23,"publishedAt":46,"linkOnly":47,"markdownContent":48,"markdownBody":49,"frontMatter":50,"refName":51,"commitSha":52,"skillDirectory":53,"forksCount":54,"repositoryHtmlUrl":55,"repositoryHomepageUrl":6,"ownerHtmlUrl":56,"ownerBlogUrl":6,"ownerDescription":57,"updatedAt":58,"install":59,"resources":72},"01M6XG8WF7WVC8S954842QR3TZ","healthsim-networksim",null,"NetworkSim provides provider network intelligence using real NPPES data (8.9M providers). Use this skill for ANY request involving: (1) provider search by specialty or location, (2) facility search (hospitals, nursing homes, clinics), (3) NPI validation, (4) network adequacy assessment against CMS\u002FNCQA standards, (5) healthcare desert identification, (6) provider density analysis, (7) network roster generation, (8) hospital or physician quality metrics, (9) cross-product provider assignment, (10) pharmacy network analysis.","FDU-INS\u002FInsurance-Skills","FDU-INS","https:\u002F\u002Favatars.githubusercontent.com\u002Fu\u002F167067594?v=4","01M6XEYMRS4CVJMZ834YWE66BV","FDU-Insurance","01M6XEYMXPDA34HFM0ZE6AY78G",82,"Apache-2.0","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim-2\u002Fnetworksim\u002FSKILL.md",[18],{"categoryNo":19,"categoryName":20,"taxonomyType":21,"taxonomyTypeDesc":22},"01JBSEEDCAT000000000000033","数据分析师","PROFESSION","适用职业",[24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45],"networksim","healthsim","healthsim networksim","healthcare","request","for","nursing","network analysis","intelligence","provider","standards","provider network","analysis","Providers","adequacy assessment","data","network","cms","search","metrics","product","assessment","2026-11-10 10:12:30",false,"---\nname: healthsim-networksim\ndescription: >\n  NetworkSim provides provider network intelligence using real NPPES data (8.9M providers).\n  Use this skill for ANY request involving: (1) provider search by specialty or location,\n  (2) facility search (hospitals, nursing homes, clinics), (3) NPI validation,\n  (4) network adequacy assessment against CMS\u002FNCQA standards, (5) healthcare desert\n  identification, (6) provider density analysis, (7) network roster generation,\n  (8) hospital or physician quality metrics, (9) cross-product provider assignment,\n  (10) pharmacy network analysis.\n---\n\n# NetworkSim - Provider Network Intelligence & Analytics\n\n## Overview\n\nNetworkSim queries **real NPPES provider data** (8.9M records), CMS facility data (60K+ facilities), and quality metrics. Unlike synthetic generation, it uses **actual registered providers** to enable:\n\n1. **Provider Discovery**: Search by specialty, location, credentials, quality\n2. **Network Analysis**: Assess adequacy against CMS MA, NCQA, Medicaid standards\n3. **Healthcare Access**: Identify deserts via access gaps, health needs, vulnerability\n4. **Cross-Product Integration**: Provide real providers for PatientSim, MemberSim, TrialSim\n\n## Quick Reference\n\n| I want to... | Use This Skill | Key Triggers |\n|--------------|----------------|--------------|\n| **Provider Search** | | |\n| Find providers by specialty | `query\u002Fprovider-search.md` | \"find cardiologists\", \"search for PCPs\", \"providers in\" |\n| Search hospitals\u002Ffacilities | `query\u002Ffacility-search.md` | \"hospitals in\", \"find nursing homes\", \"clinics near\" |\n| Find pharmacies | `query\u002Fpharmacy-search.md` | \"pharmacies in\", \"retail pharmacy\", \"specialty pharmacy\" |\n| **Validation & Roster** | | |\n| Validate an NPI | `query\u002Fnpi-validation.md` | \"is NPI valid\", \"validate NPI\", \"check NPI\" |\n| Generate network roster | `query\u002Fnetwork-roster.md` | \"create roster\", \"export providers\", \"network list\" |\n| **Density & Coverage** | | |\n| Calculate provider density | `query\u002Fprovider-density.md` | \"providers per 100K\", \"density analysis\", \"HRSA benchmark\" |\n| Assess network coverage | `query\u002Fcoverage-analysis.md` | \"network coverage\", \"geographic coverage\", \"specialty gaps\" |\n| **Quality Metrics** | | |\n| Filter by hospital quality | `query\u002Fhospital-quality-search.md` | \"4-star hospitals\", \"high quality\", \"CMS ratings\" |\n| Filter by physician credentials | `query\u002Fphysician-quality-search.md` | \"MD only\", \"board certified\", \"credentials\" |\n| **Advanced Analytics** | | |\n| Assess network adequacy | `analytics\u002Fnetwork-adequacy-analysis.md` | \"adequacy assessment\", \"CMS standards\", \"NCQA requirements\" |\n| Identify healthcare deserts | `analytics\u002Fhealthcare-deserts.md` | \"healthcare deserts\", \"underserved areas\", \"access gaps\" |\n| **Synthetic Generation** | | |\n| Generate synthetic provider | `synthetic\u002Fsynthetic-provider.md` | \"generate a provider\", \"create physician\" |\n| Generate synthetic facility | `synthetic\u002Fsynthetic-facility.md` | \"generate hospital\", \"create facility\" |\n| Generate synthetic pharmacy | `synthetic\u002Fsynthetic-pharmacy.md` | \"generate pharmacy\", \"create pharmacy\" |\n| Generate synthetic network | `synthetic\u002Fsynthetic-network.md` | \"generate network\", \"create provider network\" |\n| Generate synthetic plan | `synthetic\u002Fsynthetic-plan.md` | \"generate plan\", \"create health plan\" |\n| **Integration** | | |\n| Assign provider to encounter | `integration\u002Fprovider-for-encounter.md` | \"provider for patient\", \"attending physician\" |\n| Determine network status | `integration\u002Fnetwork-for-member.md` | \"in-network check\", \"network status\" |\n| Route prescription | `integration\u002Fpharmacy-for-rx.md` | \"pharmacy for prescription\", \"dispense at\" |\n\n## Trigger Phrases\n\n- **Provider\u002FFacility**: \"find [specialty] in [location]\", \"hospitals in [state]\", \"nursing homes near\", \"pharmacies in\"\n- **Validation\u002FRoster**: \"validate NPI\", \"is NPI valid\", \"create roster\", \"export providers\"\n- **Density\u002FCoverage**: \"providers per 100K\", \"density in [county]\", \"HRSA benchmark\"\n- **Quality**: \"4-star hospitals\", \"MD\u002FDO only\", \"board certified\"\n- **Adequacy**: \"CMS adequacy standards\", \"NCQA coverage\", \"provider ratio\", \"time\u002Fdistance\"\n- **Deserts\u002FAccess**: \"healthcare deserts\", \"underserved counties\", \"access gaps\", \"shortage areas\"\n\n## Skill Inventory\n\n### Query Skills (9 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Provider Search | `query\u002Fprovider-search.md` | 450 | Search 8.9M providers by specialty, location |\n| Facility Search | `query\u002Ffacility-search.md` | 380 | Search hospitals, nursing homes, clinics |\n| Pharmacy Search | `query\u002Fpharmacy-search.md` | 320 | Search retail, specialty, mail pharmacies |\n| NPI Validation | `query\u002Fnpi-validation.md` | 280 | Validate NPIs with Luhn checksums |\n| Network Roster | `query\u002Fnetwork-roster.md` | 350 | Generate rosters in CSV\u002FJSON\u002FExcel |\n| Provider Density | `query\u002Fprovider-density.md` | 400 | Calculate density vs HRSA benchmarks |\n| Coverage Analysis | `query\u002Fcoverage-analysis.md` | 380 | Assess geographic\u002Fspecialty coverage |\n| Hospital Quality | `query\u002Fhospital-quality-search.md` | 320 | Filter by CMS star ratings |\n| Physician Quality | `query\u002Fphysician-quality-search.md` | 290 | Filter by credentials (MD\u002FDO\u002FNP\u002FPA) |\n\n### Analytics Skills (2 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Network Adequacy | `analytics\u002Fnetwork-adequacy-analysis.md` | 653 | CMS\u002FNCQA regulatory compliance |\n| Healthcare Deserts | `analytics\u002Fhealthcare-deserts.md` | 757 | Access + health needs + vulnerability |\n\n### Synthetic Skills (6 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Synthetic Provider | `synthetic\u002Fsynthetic-provider.md` | 400 | Generate providers with valid NPI format |\n| Synthetic Facility | `synthetic\u002Fsynthetic-facility.md` | 350 | Generate hospitals, ASCs, clinics |\n| Synthetic Pharmacy | `synthetic\u002Fsynthetic-pharmacy.md` | 320 | Generate pharmacies with NCPDP IDs |\n| Synthetic Network | `synthetic\u002Fsynthetic-network.md` | 450 | Generate complete network configurations |\n| Synthetic Plan | `synthetic\u002Fsynthetic-plan.md` | 380 | Generate health plan structures |\n| Synthetic Pharmacy Benefit | `synthetic\u002Fsynthetic-pharmacy-benefit.md` | 350 | Generate PBM configurations |\n\n### Integration Skills (5 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Provider for Encounter | `integration\u002Fprovider-for-encounter.md` | 280 | Assign providers to PatientSim |\n| Network for Member | `integration\u002Fnetwork-for-member.md` | 300 | Network status for MemberSim |\n| Pharmacy for Rx | `integration\u002Fpharmacy-for-rx.md` | 260 | Pharmacy routing for RxMemberSim |\n| Formulary for Rx | `integration\u002Fformulary-for-rx.md` | 290 | Formulary checks for RxMemberSim |\n| Benefit for Claim | `integration\u002Fbenefit-for-claim.md` | 270 | Benefit lookup for MemberSim |\n\n### Reference Skills (7 skills)\n\n| Skill | File | Purpose |\n|-------|------|---------|\n| Network Types | `reference\u002Fnetwork-types.md` | HMO, PPO, EPO, POS structures |\n| Plan Structures | `reference\u002Fplan-structures.md` | Cost sharing, benefit design |\n| Pharmacy Benefits | `reference\u002Fpharmacy-benefit-concepts.md` | PBM, formulary, tiers |\n| Network Adequacy | `reference\u002Fnetwork-adequacy.md` | CMS\u002FNCQA standards |\n| PBM Operations | `reference\u002Fpbm-operations.md` | Claims processing, rebates |\n| Specialty Pharmacy | `reference\u002Fspecialty-pharmacy.md` | Limited distribution, hubs |\n| Utilization Management | `reference\u002Futilization-management.md` | PA, step therapy, QL |\n\n### Pattern Skills (5 skills)\n\n| Skill | File | Purpose |\n|-------|------|---------|\n| HMO Network | `patterns\u002Fhmo-network-pattern.md` | Closed network, gatekeeper model |\n| PPO Network | `patterns\u002Fppo-network-pattern.md` | Open access, tiered cost sharing |\n| Tiered Network | `patterns\u002Ftiered-network-pattern.md` | Quality-based tier assignment |\n| Specialty Distribution | `patterns\u002Fspecialty-distribution-pattern.md` | Specialty mix by geography |\n| Pharmacy Benefit | `patterns\u002Fpharmacy-benefit-patterns.md` | PBM network configurations |\n\n---\n\n## Output Types\n\n### ProviderSearchResult\n\nProvider records from NPPES database:\n\n```json\n{\n  \"npi\": \"1234567890\",\n  \"entity_type\": \"individual\",\n  \"name\": {\n    \"last\": \"Johnson\",\n    \"first\": \"Sarah\",\n    \"credential\": \"MD, FACC\"\n  },\n  \"taxonomy\": {\n    \"code\": \"207RC0000X\",\n    \"classification\": \"Internal Medicine\",\n    \"specialization\": \"Cardiovascular Disease\"\n  },\n  \"practice_location\": {\n    \"address\": \"123 Medical Center Dr\",\n    \"city\": \"Houston\",\n    \"state\": \"TX\",\n    \"zip\": \"77030\",\n    \"county_fips\": \"48201\"\n  },\n  \"enumeration_date\": \"2015-03-15\",\n  \"last_update\": \"2024-11-01\"\n}\n```\n\n### AdequacyAssessment\n\nKey fields: `geography` (type, code, name), `standard` (CMS_MA\u002FNCQA), `metrics.pcp_ratio` (actual, required, status), `metrics.specialist_coverage` (13 specialties), `overall_status` (COMPLIANT\u002FNON_COMPLIANT).\n\n### HealthcareDesert\n\nKey fields: `geography` (fips, county, state), `desert_type`, `severity` (critical\u002Fhigh\u002Fmoderate), `scores` (access_gap, health_burden, social_vulnerability, composite 0-1), `intervention_priority` (1=highest).\n\n### NetworkRoster\n\nKey fields: `roster_id`, `criteria` (specialty, geography, quality_filter), `summary` (total_providers, by_taxonomy), `export_formats` (csv, json, xlsx).\n\n---\n\n## Data Sources\n\n### Provider Data (network.providers)\n\n| Attribute | Value |\n|-----------|-------|\n| Source | NPPES (National Plan and Provider Enumeration System) |\n| Records | 8,925,672 |\n| Update Frequency | Monthly CMS releases |\n| Coverage | All active US healthcare providers with NPIs |\n| County FIPS | 97.77% coverage (3,213 of 3,286 counties) |\n\n**Key Columns**: npi, entity_type_code, last_name, first_name, credential, taxonomy_1-4, practice_state, practice_city, practice_zip, county_fips\n\n### Additional Tables\n\n| Table | Source | Records | Key Content |\n|-------|--------|---------|-------------|\n| `network.facilities` | CMS POS file | 77,302 | Hospitals (01), SNFs (05), HHAs (07), Hospice (13) |\n| `network.hospital_quality` | CMS Hospital Compare | 5,421 | Star ratings (1-5), mortality, readmission, safety |\n| `network.physician_quality` | CMS Physician Compare | 1,478,309 | Quality measures, Medicare participation |\n| `network.ahrf_county` | HRSA AHRF | 3,235 | Provider counts, hospital beds, health workforce |\n\n---\n\n## Regulatory Standards\n\nSee `reference\u002Fnetwork-adequacy.md` for full CMS MA ratios, time\u002Fdistance tables, NCQA 13 essential specialties, ECP requirements, and HPSA\u002FMUA definitions.\n\n**Quick reference**:\n- CMS MA PCP ratio: 1:1,200 enrollees\n- HRSA HPSA threshold: \u003C60 PCPs per 100K\n- NCQA requires coverage across 13 specialties\n- Time\u002Fdistance varies by urban\u002Fsuburban\u002Frural designation\n\n**Database**: healthsim.duckdb (1.7 GB), indexed on county_fips, taxonomy_1, practice_state\n\n---\n\n## Cross-Product Integration\n\n### NetworkSim → PatientSim\n\nAssign providers to clinical encounters:\n\n```sql\n-- Find cardiologist for heart failure patient\nSELECT npi, first_name, last_name, credential\nFROM network.providers\nWHERE taxonomy_1 LIKE '207RC%'  -- Cardiovascular\n  AND practice_state = 'TX'\n  AND county_fips = '48201'     -- Harris County\nLIMIT 1;\n```\n\n### NetworkSim → MemberSim\n\nDetermine network status for claims:\n\n```sql\n-- Check if provider is in network\nSELECT \n  CASE WHEN p.npi IS NOT NULL THEN 'IN_NETWORK' \n       ELSE 'OUT_OF_NETWORK' END as network_status\nFROM network.providers p\nWHERE p.npi = '1234567890';\n```\n\n### NetworkSim + PopulationSim\n\nEquity analysis combining provider access with vulnerability:\n\n```sql\n-- Provider access in vulnerable communities\nSELECT \n    sv.county,\n    sv.rpl_themes as svi_percentile,\n    COUNT(DISTINCT p.npi) as provider_count,\n    sv.e_totpop as population,\n    ROUND(COUNT(DISTINCT p.npi) * 100000.0 \u002F sv.e_totpop, 1) as per_100k\nFROM population.svi_county sv\nLEFT JOIN network.providers p ON sv.stcnty = p.county_fips\nWHERE sv.rpl_themes > 0.75  -- Most vulnerable quartile\nGROUP BY sv.county, sv.rpl_themes, sv.e_totpop\nORDER BY per_100k ASC;\n```\n\n---\n\n## Safety Guardrails\n\n### Real Data Disclaimer\nNetworkSim queries **real NPPES registry data** (public CMS data, non-PHI). Every NPI is a real registered provider. Results reflect registry status only -- not accepting-patients, insurance participation, or clinical competence.\n\n### What NetworkSim Does NOT Do\n- **No clinical advice**: Never suggest a provider is \"best\" for a condition\n- **No insurance verification**: Network status is simulated, not real-time eligibility\n- **No appointment scheduling**: Registry data is not a booking system\n- **No synthetic NPIs in real queries**: Use `synthetic\u002F` skills only for test data\n\n### Code System References\n| System | Used For | Example |\n|--------|----------|---------|\n| NUCC Taxonomy | Provider specialty classification | `207RC0000X` = Cardiovascular Disease |\n| NPI | Provider identification (Luhn-validated) | `1234567890` |\n| County FIPS | Geographic scoping | `48201` = Harris County, TX |\n| CMS Certification Number | Facility identification | POS file facility IDs |\n| CBSA | Urban\u002Frural classification | Metro, micro, rural designations |\n| HCPCS | Provider service codes | Level I (CPT) and Level II codes |\n\n**Cross-product code systems** (via PatientSim\u002FMemberSim\u002FRxMemberSim integration): ICD-10 (diagnoses), CPT (procedures), LOINC (labs), SNOMED (clinical terms), RxNorm\u002FNDC (medications). These are real standard codes -- linked patient data is synthetic\u002Ffictional.\n\n### Edge Cases\n- **Missing county_fips**: ~2.2% of records lack county FIPS; filter with `WHERE county_fips IS NOT NULL` for geographic queries\n- **Deactivated NPIs**: Check `npi_deactivation_date IS NULL` for active providers\n- **Multi-taxonomy providers**: Up to 15 taxonomies; `taxonomy_1` is primary but check `taxonomy_2`-`taxonomy_4` for dual-specialty searches\n- **Organization vs Individual**: `entity_type_code = 1` (individual) vs `2` (organization); filter appropriately\n\n### Negative Examples (What NOT to Do)\n\n**Never give clinical advice based on provider data:**\n- WRONG: \"I recommend Dr. Smith for your heart condition\" or \"The patient needs a cardiologist\"\n- RIGHT: \"Here are cardiologists registered in Harris County per NPPES data. This is simulated test data for analytics, not a referral.\"\n\n**Always distinguish real reference data from synthetic\u002Ffictional entities:**\n- WRONG: \"Here is the patient's real provider\" (implies real clinical relationship)\n- RIGHT: \"NPI data is from the real NPPES registry (public CMS data). Patient\u002Fencounter data is synthetic\u002Ffictional -- not real patient information.\"\n\n**Never mix synthetic and real data without labeling:**\n- WRONG: Return synthetic NPIs alongside real NPPES query results\n- RIGHT: Label synthetic providers (from `synthetic\u002F` skills) vs real providers (from `network.providers`)\n\n## Validation Rules\n\n### NPI: 10 digits, Luhn checksum, prefix 1 (individual) or 2 (organization), active in NPPES\n### Taxonomy: Valid NUCC codes, primary taxonomy switch indicator\n### Geography: 2-letter state, 5-digit county FIPS, 5- or 9-digit ZIP\n\n---\n\n## Related Documentation\n\n- **Examples**: [hello-healthsim\u002Fexamples\u002Fnetworksim-examples.md](..\u002F..\u002Fhello-healthsim\u002Fexamples\u002Fnetworksim-examples.md)\n- **Developer Guide**: [developer-guide.md](developer-guide.md)\n- **Prompt Guide**: [prompt-guide.md](prompt-guide.md)\n- **Data Architecture**: [docs\u002Fhealthsim-duckdb-schema.md](..\u002F..\u002Fdocs\u002Fhealthsim-duckdb-schema.md)\n- **Master SKILL.md**: [SKILL.md](..\u002F..\u002FSKILL.md)\n\n---\n\n*Last Updated: December 28, 2025*\n*Version: 2.0.0*\n*Status: Active (Phase 3)*\n","# NetworkSim - Provider Network Intelligence & Analytics\n\n## Overview\n\nNetworkSim queries **real NPPES provider data** (8.9M records), CMS facility data (60K+ facilities), and quality metrics. Unlike synthetic generation, it uses **actual registered providers** to enable:\n\n1. **Provider Discovery**: Search by specialty, location, credentials, quality\n2. **Network Analysis**: Assess adequacy against CMS MA, NCQA, Medicaid standards\n3. **Healthcare Access**: Identify deserts via access gaps, health needs, vulnerability\n4. **Cross-Product Integration**: Provide real providers for PatientSim, MemberSim, TrialSim\n\n## Quick Reference\n\n| I want to... | Use This Skill | Key Triggers |\n|--------------|----------------|--------------|\n| **Provider Search** | | |\n| Find providers by specialty | `query\u002Fprovider-search.md` | \"find cardiologists\", \"search for PCPs\", \"providers in\" |\n| Search hospitals\u002Ffacilities | `query\u002Ffacility-search.md` | \"hospitals in\", \"find nursing homes\", \"clinics near\" |\n| Find pharmacies | `query\u002Fpharmacy-search.md` | \"pharmacies in\", \"retail pharmacy\", \"specialty pharmacy\" |\n| **Validation & Roster** | | |\n| Validate an NPI | `query\u002Fnpi-validation.md` | \"is NPI valid\", \"validate NPI\", \"check NPI\" |\n| Generate network roster | `query\u002Fnetwork-roster.md` | \"create roster\", \"export providers\", \"network list\" |\n| **Density & Coverage** | | |\n| Calculate provider density | `query\u002Fprovider-density.md` | \"providers per 100K\", \"density analysis\", \"HRSA benchmark\" |\n| Assess network coverage | `query\u002Fcoverage-analysis.md` | \"network coverage\", \"geographic coverage\", \"specialty gaps\" |\n| **Quality Metrics** | | |\n| Filter by hospital quality | `query\u002Fhospital-quality-search.md` | \"4-star hospitals\", \"high quality\", \"CMS ratings\" |\n| Filter by physician credentials | `query\u002Fphysician-quality-search.md` | \"MD only\", \"board certified\", \"credentials\" |\n| **Advanced Analytics** | | |\n| Assess network adequacy | `analytics\u002Fnetwork-adequacy-analysis.md` | \"adequacy assessment\", \"CMS standards\", \"NCQA requirements\" |\n| Identify healthcare deserts | `analytics\u002Fhealthcare-deserts.md` | \"healthcare deserts\", \"underserved areas\", \"access gaps\" |\n| **Synthetic Generation** | | |\n| Generate synthetic provider | `synthetic\u002Fsynthetic-provider.md` | \"generate a provider\", \"create physician\" |\n| Generate synthetic facility | `synthetic\u002Fsynthetic-facility.md` | \"generate hospital\", \"create facility\" |\n| Generate synthetic pharmacy | `synthetic\u002Fsynthetic-pharmacy.md` | \"generate pharmacy\", \"create pharmacy\" |\n| Generate synthetic network | `synthetic\u002Fsynthetic-network.md` | \"generate network\", \"create provider network\" |\n| Generate synthetic plan | `synthetic\u002Fsynthetic-plan.md` | \"generate plan\", \"create health plan\" |\n| **Integration** | | |\n| Assign provider to encounter | `integration\u002Fprovider-for-encounter.md` | \"provider for patient\", \"attending physician\" |\n| Determine network status | `integration\u002Fnetwork-for-member.md` | \"in-network check\", \"network status\" |\n| Route prescription | `integration\u002Fpharmacy-for-rx.md` | \"pharmacy for prescription\", \"dispense at\" |\n\n## Trigger Phrases\n\n- **Provider\u002FFacility**: \"find [specialty] in [location]\", \"hospitals in [state]\", \"nursing homes near\", \"pharmacies in\"\n- **Validation\u002FRoster**: \"validate NPI\", \"is NPI valid\", \"create roster\", \"export providers\"\n- **Density\u002FCoverage**: \"providers per 100K\", \"density in [county]\", \"HRSA benchmark\"\n- **Quality**: \"4-star hospitals\", \"MD\u002FDO only\", \"board certified\"\n- **Adequacy**: \"CMS adequacy standards\", \"NCQA coverage\", \"provider ratio\", \"time\u002Fdistance\"\n- **Deserts\u002FAccess**: \"healthcare deserts\", \"underserved counties\", \"access gaps\", \"shortage areas\"\n\n## Skill Inventory\n\n### Query Skills (9 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Provider Search | `query\u002Fprovider-search.md` | 450 | Search 8.9M providers by specialty, location |\n| Facility Search | `query\u002Ffacility-search.md` | 380 | Search hospitals, nursing homes, clinics |\n| Pharmacy Search | `query\u002Fpharmacy-search.md` | 320 | Search retail, specialty, mail pharmacies |\n| NPI Validation | `query\u002Fnpi-validation.md` | 280 | Validate NPIs with Luhn checksums |\n| Network Roster | `query\u002Fnetwork-roster.md` | 350 | Generate rosters in CSV\u002FJSON\u002FExcel |\n| Provider Density | `query\u002Fprovider-density.md` | 400 | Calculate density vs HRSA benchmarks |\n| Coverage Analysis | `query\u002Fcoverage-analysis.md` | 380 | Assess geographic\u002Fspecialty coverage |\n| Hospital Quality | `query\u002Fhospital-quality-search.md` | 320 | Filter by CMS star ratings |\n| Physician Quality | `query\u002Fphysician-quality-search.md` | 290 | Filter by credentials (MD\u002FDO\u002FNP\u002FPA) |\n\n### Analytics Skills (2 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Network Adequacy | `analytics\u002Fnetwork-adequacy-analysis.md` | 653 | CMS\u002FNCQA regulatory compliance |\n| Healthcare Deserts | `analytics\u002Fhealthcare-deserts.md` | 757 | Access + health needs + vulnerability |\n\n### Synthetic Skills (6 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Synthetic Provider | `synthetic\u002Fsynthetic-provider.md` | 400 | Generate providers with valid NPI format |\n| Synthetic Facility | `synthetic\u002Fsynthetic-facility.md` | 350 | Generate hospitals, ASCs, clinics |\n| Synthetic Pharmacy | `synthetic\u002Fsynthetic-pharmacy.md` | 320 | Generate pharmacies with NCPDP IDs |\n| Synthetic Network | `synthetic\u002Fsynthetic-network.md` | 450 | Generate complete network configurations |\n| Synthetic Plan | `synthetic\u002Fsynthetic-plan.md` | 380 | Generate health plan structures |\n| Synthetic Pharmacy Benefit | `synthetic\u002Fsynthetic-pharmacy-benefit.md` | 350 | Generate PBM configurations |\n\n### Integration Skills (5 skills)\n\n| Skill | File | Lines | Purpose |\n|-------|------|-------|---------|\n| Provider for Encounter | `integration\u002Fprovider-for-encounter.md` | 280 | Assign providers to PatientSim |\n| Network for Member | `integration\u002Fnetwork-for-member.md` | 300 | Network status for MemberSim |\n| Pharmacy for Rx | `integration\u002Fpharmacy-for-rx.md` | 260 | Pharmacy routing for RxMemberSim |\n| Formulary for Rx | `integration\u002Fformulary-for-rx.md` | 290 | Formulary checks for RxMemberSim |\n| Benefit for Claim | `integration\u002Fbenefit-for-claim.md` | 270 | Benefit lookup for MemberSim |\n\n### Reference Skills (7 skills)\n\n| Skill | File | Purpose |\n|-------|------|---------|\n| Network Types | `reference\u002Fnetwork-types.md` | HMO, PPO, EPO, POS structures |\n| Plan Structures | `reference\u002Fplan-structures.md` | Cost sharing, benefit design |\n| Pharmacy Benefits | `reference\u002Fpharmacy-benefit-concepts.md` | PBM, formulary, tiers |\n| Network Adequacy | `reference\u002Fnetwork-adequacy.md` | CMS\u002FNCQA standards |\n| PBM Operations | `reference\u002Fpbm-operations.md` | Claims processing, rebates |\n| Specialty Pharmacy | `reference\u002Fspecialty-pharmacy.md` | Limited distribution, hubs |\n| Utilization Management | `reference\u002Futilization-management.md` | PA, step therapy, QL |\n\n### Pattern Skills (5 skills)\n\n| Skill | File | Purpose |\n|-------|------|---------|\n| HMO Network | `patterns\u002Fhmo-network-pattern.md` | Closed network, gatekeeper model |\n| PPO Network | `patterns\u002Fppo-network-pattern.md` | Open access, tiered cost sharing |\n| Tiered Network | `patterns\u002Ftiered-network-pattern.md` | Quality-based tier assignment |\n| Specialty Distribution | `patterns\u002Fspecialty-distribution-pattern.md` | Specialty mix by geography |\n| Pharmacy Benefit | `patterns\u002Fpharmacy-benefit-patterns.md` | PBM network configurations |\n\n---\n\n## Output Types\n\n### ProviderSearchResult\n\nProvider records from NPPES database:\n\n```json\n{\n  \"npi\": \"1234567890\",\n  \"entity_type\": \"individual\",\n  \"name\": {\n    \"last\": \"Johnson\",\n    \"first\": \"Sarah\",\n    \"credential\": \"MD, FACC\"\n  },\n  \"taxonomy\": {\n    \"code\": \"207RC0000X\",\n    \"classification\": \"Internal Medicine\",\n    \"specialization\": \"Cardiovascular Disease\"\n  },\n  \"practice_location\": {\n    \"address\": \"123 Medical Center Dr\",\n    \"city\": \"Houston\",\n    \"state\": \"TX\",\n    \"zip\": \"77030\",\n    \"county_fips\": \"48201\"\n  },\n  \"enumeration_date\": \"2015-03-15\",\n  \"last_update\": \"2024-11-01\"\n}\n```\n\n### AdequacyAssessment\n\nKey fields: `geography` (type, code, name), `standard` (CMS_MA\u002FNCQA), `metrics.pcp_ratio` (actual, required, status), `metrics.specialist_coverage` (13 specialties), `overall_status` (COMPLIANT\u002FNON_COMPLIANT).\n\n### HealthcareDesert\n\nKey fields: `geography` (fips, county, state), `desert_type`, `severity` (critical\u002Fhigh\u002Fmoderate), `scores` (access_gap, health_burden, social_vulnerability, composite 0-1), `intervention_priority` (1=highest).\n\n### NetworkRoster\n\nKey fields: `roster_id`, `criteria` (specialty, geography, quality_filter), `summary` (total_providers, by_taxonomy), `export_formats` (csv, json, xlsx).\n\n---\n\n## Data Sources\n\n### Provider Data (network.providers)\n\n| Attribute | Value |\n|-----------|-------|\n| Source | NPPES (National Plan and Provider Enumeration System) |\n| Records | 8,925,672 |\n| Update Frequency | Monthly CMS releases |\n| Coverage | All active US healthcare providers with NPIs |\n| County FIPS | 97.77% coverage (3,213 of 3,286 counties) |\n\n**Key Columns**: npi, entity_type_code, last_name, first_name, credential, taxonomy_1-4, practice_state, practice_city, practice_zip, county_fips\n\n### Additional Tables\n\n| Table | Source | Records | Key Content |\n|-------|--------|---------|-------------|\n| `network.facilities` | CMS POS file | 77,302 | Hospitals (01), SNFs (05), HHAs (07), Hospice (13) |\n| `network.hospital_quality` | CMS Hospital Compare | 5,421 | Star ratings (1-5), mortality, readmission, safety |\n| `network.physician_quality` | CMS Physician Compare | 1,478,309 | Quality measures, Medicare participation |\n| `network.ahrf_county` | HRSA AHRF | 3,235 | Provider counts, hospital beds, health workforce |\n\n---\n\n## Regulatory Standards\n\nSee `reference\u002Fnetwork-adequacy.md` for full CMS MA ratios, time\u002Fdistance tables, NCQA 13 essential specialties, ECP requirements, and HPSA\u002FMUA definitions.\n\n**Quick reference**:\n- CMS MA PCP ratio: 1:1,200 enrollees\n- HRSA HPSA threshold: \u003C60 PCPs per 100K\n- NCQA requires coverage across 13 specialties\n- Time\u002Fdistance varies by urban\u002Fsuburban\u002Frural designation\n\n**Database**: healthsim.duckdb (1.7 GB), indexed on county_fips, taxonomy_1, practice_state\n\n---\n\n## Cross-Product Integration\n\n### NetworkSim → PatientSim\n\nAssign providers to clinical encounters:\n\n```sql\n-- Find cardiologist for heart failure patient\nSELECT npi, first_name, last_name, credential\nFROM network.providers\nWHERE taxonomy_1 LIKE '207RC%'  -- Cardiovascular\n  AND practice_state = 'TX'\n  AND county_fips = '48201'     -- Harris County\nLIMIT 1;\n```\n\n### NetworkSim → MemberSim\n\nDetermine network status for claims:\n\n```sql\n-- Check if provider is in network\nSELECT \n  CASE WHEN p.npi IS NOT NULL THEN 'IN_NETWORK' \n       ELSE 'OUT_OF_NETWORK' END as network_status\nFROM network.providers p\nWHERE p.npi = '1234567890';\n```\n\n### NetworkSim + PopulationSim\n\nEquity analysis combining provider access with vulnerability:\n\n```sql\n-- Provider access in vulnerable communities\nSELECT \n    sv.county,\n    sv.rpl_themes as svi_percentile,\n    COUNT(DISTINCT p.npi) as provider_count,\n    sv.e_totpop as population,\n    ROUND(COUNT(DISTINCT p.npi) * 100000.0 \u002F sv.e_totpop, 1) as per_100k\nFROM population.svi_county sv\nLEFT JOIN network.providers p ON sv.stcnty = p.county_fips\nWHERE sv.rpl_themes > 0.75  -- Most vulnerable quartile\nGROUP BY sv.county, sv.rpl_themes, sv.e_totpop\nORDER BY per_100k ASC;\n```\n\n---\n\n## Safety Guardrails\n\n### Real Data Disclaimer\nNetworkSim queries **real NPPES registry data** (public CMS data, non-PHI). Every NPI is a real registered provider. Results reflect registry status only -- not accepting-patients, insurance participation, or clinical competence.\n\n### What NetworkSim Does NOT Do\n- **No clinical advice**: Never suggest a provider is \"best\" for a condition\n- **No insurance verification**: Network status is simulated, not real-time eligibility\n- **No appointment scheduling**: Registry data is not a booking system\n- **No synthetic NPIs in real queries**: Use `synthetic\u002F` skills only for test data\n\n### Code System References\n| System | Used For | Example |\n|--------|----------|---------|\n| NUCC Taxonomy | Provider specialty classification | `207RC0000X` = Cardiovascular Disease |\n| NPI | Provider identification (Luhn-validated) | `1234567890` |\n| County FIPS | Geographic scoping | `48201` = Harris County, TX |\n| CMS Certification Number | Facility identification | POS file facility IDs |\n| CBSA | Urban\u002Frural classification | Metro, micro, rural designations |\n| HCPCS | Provider service codes | Level I (CPT) and Level II codes |\n\n**Cross-product code systems** (via PatientSim\u002FMemberSim\u002FRxMemberSim integration): ICD-10 (diagnoses), CPT (procedures), LOINC (labs), SNOMED (clinical terms), RxNorm\u002FNDC (medications). These are real standard codes -- linked patient data is synthetic\u002Ffictional.\n\n### Edge Cases\n- **Missing county_fips**: ~2.2% of records lack county FIPS; filter with `WHERE county_fips IS NOT NULL` for geographic queries\n- **Deactivated NPIs**: Check `npi_deactivation_date IS NULL` for active providers\n- **Multi-taxonomy providers**: Up to 15 taxonomies; `taxonomy_1` is primary but check `taxonomy_2`-`taxonomy_4` for dual-specialty searches\n- **Organization vs Individual**: `entity_type_code = 1` (individual) vs `2` (organization); filter appropriately\n\n### Negative Examples (What NOT to Do)\n\n**Never give clinical advice based on provider data:**\n- WRONG: \"I recommend Dr. Smith for your heart condition\" or \"The patient needs a cardiologist\"\n- RIGHT: \"Here are cardiologists registered in Harris County per NPPES data. This is simulated test data for analytics, not a referral.\"\n\n**Always distinguish real reference data from synthetic\u002Ffictional entities:**\n- WRONG: \"Here is the patient's real provider\" (implies real clinical relationship)\n- RIGHT: \"NPI data is from the real NPPES registry (public CMS data). Patient\u002Fencounter data is synthetic\u002Ffictional -- not real patient information.\"\n\n**Never mix synthetic and real data without labeling:**\n- WRONG: Return synthetic NPIs alongside real NPPES query results\n- RIGHT: Label synthetic providers (from `synthetic\u002F` skills) vs real providers (from `network.providers`)\n\n## Validation Rules\n\n### NPI: 10 digits, Luhn checksum, prefix 1 (individual) or 2 (organization), active in NPPES\n### Taxonomy: Valid NUCC codes, primary taxonomy switch indicator\n### Geography: 2-letter state, 5-digit county FIPS, 5- or 9-digit ZIP\n\n---\n\n## Related Documentation\n\n- **Examples**: [hello-healthsim\u002Fexamples\u002Fnetworksim-examples.md](..\u002F..\u002Fhello-healthsim\u002Fexamples\u002Fnetworksim-examples.md)\n- **Developer Guide**: [developer-guide.md](developer-guide.md)\n- **Prompt Guide**: [prompt-guide.md](prompt-guide.md)\n- **Data Architecture**: 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