[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"skill:01M6XGD5KQ2KA5H4F8VFP1SW94":3,"skill-same:01M6XGD5KQ2KA5H4F8VFP1SW94":107},{"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":18,"publishedAt":38,"linkOnly":39,"markdownContent":40,"markdownBody":41,"frontMatter":42,"refName":43,"commitSha":44,"skillDirectory":45,"forksCount":46,"repositoryHtmlUrl":47,"repositoryHomepageUrl":6,"ownerHtmlUrl":48,"ownerBlogUrl":6,"ownerDescription":49,"updatedAt":50,"install":51,"resources":64},"01M6XGD5KQ2KA5H4F8VFP1SW94","rxmembersim",null,"RxMemberSim generates realistic synthetic pharmacy data for testing PBM systems, claims adjudication, and drug utilization review. Use when user requests: (1) pharmacy claims or prescription data, (2) DUR alerts or drug interactions, (3) formulary or tier cohorts, (4) pharmacy prior authorization, (5) NCPDP formatted output.","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\u002Fskills\u002Frxmembersim\u002FSKILL.md",[],[5,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37],"prior authorization","NCPDP","when","pbm","for","claims","requests","drug utilization review","output","testing","drug interactions","synthetic","systems","alerts","use","utilization","authorization","data","review","2026-11-10 10:12:30",false,"---\nname: rxmembersim\ndescription: \"RxMemberSim generates realistic synthetic pharmacy data for testing PBM systems, claims adjudication, and drug utilization review. Use when user requests: (1) pharmacy claims or prescription data, (2) DUR alerts or drug interactions, (3) formulary or tier cohorts, (4) pharmacy prior authorization, (5) NCPDP formatted output.\"\n---\n\n# RxMemberSim - Pharmacy and PBM Data Generation\n\n## For Claude\n\nUse this skill when the user requests pharmacy data, prescription fills, or PBM cohorts. Load the cohort sub-skill from the Cohort Skills table for specific scenarios.\n\n**Triggers:** prescriptions, pharmacy claims, medication fills, DUR alerts, drug interactions, formulary\u002Ftier cohorts, NCPDP output, pharmacy prior authorization, step therapy\n\n**Capabilities:** pharmacy members (BIN\u002FPCN\u002FGroup), prescription fills with NDC codes, claim adjudication and pricing, DUR alerts, formulary\u002Ftier management, manufacturer copay programs, NCPDP D.0 output\n\n## Safety Guardrails\n\n- **All data is synthetic.** Every member, claim, NDC, NPI, and pricing value is fabricated. Never present output as real patient or pharmacy data.\n- **No clinical advice.** RxMemberSim models PBM workflows only. Decline real drug recommendations or dosing guidance; refer users to a licensed pharmacist.\n- **No real PHI.** Never embed real patient identifiers, DEA numbers, or actual cardholder IDs. Use realistic but fictional values.\n- **NDC codes are illustrative.** Example NDCs approximate real formats but may not map to FDA-registered products. Validate against the FDA NDC Directory for production use.\n- **Pricing is synthetic.** Ingredient costs, dispensing fees, and copay amounts do not reflect actual AWP, WAC, or MAC pricing.\n\n## Edge Cases and Validation\n\n- **Missing NDC or drug name:** Generate a plausible synthetic NDC (11-digit 5-4-2 format) and map to a fictional drug. Never leave NDC blank.\n- **Invalid BIN\u002FPCN\u002FGroup:** Flag as rejected with reject code 99 (\"Host Processing Error\") and include a corrective message.\n- **Partial member data:** Fill missing fields with realistic defaults (e.g., person_code \"01\", relationship_code \"1\" for subscriber). Note which fields were defaulted.\n- **Unknown RxNorm or GPI code:** Use a synthetic code in the correct format. Note that production systems should validate against the RxNorm API or GPI reference.\n- **Negative examples — do NOT generate:** real DEA numbers, actual AWP\u002FWAC pricing, clinical dosing recommendations, or data presented as non-synthetic.\n\n## Pharmacy Code Systems\n\n| System | Use | Example |\n|--------|-----|---------|\n| NDC | Drug product identifier (11-digit) | 00071015523 |\n| RxNorm | Standard drug concept (ingredient, dose form) | RxCUI 83367 |\n| GPI | Generic Product Identifier (drug class hierarchy) | 39400010100310 |\n| NCPDP | Pharmacy identifier and transaction standard | D.0 format |\n| NPI | Provider\u002Fpharmacy identifier | 1234567890 |\n| ICD-10-CM | Diagnosis code (required for PA submissions) | E11.9 |\n| HCPCS | Medical pharmacy \u002F buy-and-bill drugs | J0135 |\n\n## Quick Start\n\n### Simple Pharmacy Claim\n\n**Request:** \"Generate a pharmacy claim for atorvastatin\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000001\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"ndc\": \"00071015523\",\n    \"drug_name\": \"Atorvastatin 20mg\",\n    \"quantity\": 30,\n    \"days_supply\": 30,\n    \"pharmacy_npi\": \"1234567890\"\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost\": 12.50,\n    \"dispensing_fee\": 2.00,\n    \"copay\": 10.00,\n    \"plan_paid\": 4.50\n  }\n}\n```\n\n### DUR Alert Cohort\n\n**Request:** \"Generate a pharmacy claim that triggers a drug interaction alert\"\n\nClaude loads [dur-alerts.md](dur-alerts.md) and produces a claim with appropriate DUR response.\n\n## Cohort Skills\n\nLoad the appropriate cohort based on user request:\n\n| Cohort | Trigger Phrases | File |\n|----------|-----------------|------|\n| **Retail Pharmacy** | prescription, fill, refill, copay, retail | [retail-pharmacy.md](retail-pharmacy.md) |\n| **Specialty Pharmacy** | specialty drug, biologics, limited distribution | [specialty-pharmacy.md](specialty-pharmacy.md) |\n| **DUR Alerts** | drug interaction, DUR, therapeutic dup, early refill | [dur-alerts.md](dur-alerts.md) |\n| **Formulary Management** | formulary, tier, coverage, preferred | [formulary-management.md](formulary-management.md) |\n| **Rx Enrollment** | rx enrollment, pharmacy member, BIN PCN, rx coverage | [rx-enrollment.md](rx-enrollment.md) |\n| **Rx Prior Auth** | rx prior auth, pharmacy PA, step therapy, formulary exception | [rx-prior-auth.md](rx-prior-auth.md) |\n| **Rx Accumulators** | rx accumulator, pharmacy deductible, rx OOP, TrOOP, Part D phase | [rx-accumulator.md](rx-accumulator.md) |\n| **Manufacturer Programs** | copay card, PAP, patient assistance, copay assistance, hub program | [manufacturer-programs.md](manufacturer-programs.md) |\n\n## Generation Parameters\n\n| Parameter | Type | Default | Description |\n|-----------|------|---------|-------------|\n| fill_type | string | new | new, refill |\n| drug_type | string | generic | generic, brand, specialty |\n| pharmacy_type | string | retail | retail, mail_order, specialty |\n| claim_status | string | paid | paid, rejected, reversed |\n| dur_outcome | string | none | none, warning, reject |\n\n## Output Entities\n\n### RxMember\nPharmacy member\u002Fcardholder information:\n- member_id, cardholder_id\n- bin, pcn, group_number, person_code\n- rx_plan_code, coverage_start\u002Fend\n- relationship_code, subscriber_id\n- mail_order_eligible, specialty_eligible\n\n### RxPlan\nPharmacy benefit plan configuration:\n- rx_plan_code, plan_name, plan_type\n- formulary_id, tier_structure\n- rx_deductible, rx_oop_max\n- specialty settings (coinsurance, per-fill max)\n- Part D phases (for Medicare plans)\n\n### RxAccumulator\nPharmacy benefit accumulators:\n- rx_deductible (applied, limit, remaining)\n- rx_oop_max (applied, limit, remaining)\n- specialty_oop, daw_brand_penalty\n- TrOOP (for Medicare Part D)\n- current_phase (for Part D)\n\n### Prescription\nWritten prescription details:\n- prescription_number, ndc, drug_name\n- quantity_prescribed, days_supply\n- refills_authorized, refills_remaining\n- prescriber_npi, prescriber_dea\n- written_date, expiration_date\n- daw_code, directions\n\n### PharmacyClaim\nNCPDP-style claim transaction:\n- claim_id, transaction_code (B1\u002FB2\u002FB3)\n- bin, pcn, group_number, cardholder_id\n- pharmacy_npi, prescriber_npi\n- ndc, quantity_dispensed, days_supply\n- pricing fields (ingredient cost, dispensing fee)\n- DUR fields (reason, service, result codes)\n\n### ClaimResponse\nAdjudication response:\n- transaction_response_status (A, R, P, D)\n- pricing (ingredient cost paid, dispensing fee, patient pay)\n- reject codes (if applicable)\n- DUR alerts (if applicable)\n- authorization number, accumulated amounts\n\n### PharmacyPriorAuth\nPharmacy PA request and decision:\n- pa_id, status, pa_type\n- request_date, decision_date\n- approval details (override_code, expiration)\n- denial details (reason, alternatives)\n- clinical information, urgency\n\n### DURAlert\nDrug utilization review alert:\n- dur_code, dur_type, clinical_significance\n- interacting_drugs, severity_level\n- override_code, outcome_code\n- pharmacist_message, recommendation\n\n### FormularyDrug\nDrug coverage information:\n- ndc, gpi, rxnorm_code, drug_name\n- tier, covered status\n- PA required, step therapy required\n- quantity limits, age\u002Fgender restrictions\n\n### CopayAssistance\nManufacturer copay programs:\n- program_id, program_type\n- ndc, program_name\n- annual_max_benefit, remaining_benefit\n- copay_covered, effective_dates\n\nSee [..\u002F..\u002Freferences\u002Fdata-models.md](..\u002F..\u002Freferences\u002Fdata-models.md) for complete schemas.\n\n## NCPDP Transaction Codes\n\n| Code | Description | Use Case |\n|------|-------------|----------|\n| B1 | Billing | New claim submission |\n| B2 | Reversal | Cancel previous claim |\n| B3 | Rebill | Correct and resubmit |\n| E1 | Eligibility | Check coverage |\n| P1 | Prior Auth Request | Submit PA |\n| P2 | Prior Auth Inquiry | Check PA status |\n| P4 | Prior Auth Cancel | Cancel PA request |\n\n## Common Reject Codes\n\n| Code | Description | Resolution |\n|------|-------------|------------|\n| 70 | Product\u002FService Not Covered | Check formulary, PA |\n| 75 | Prior Authorization Required | Submit PA request |\n| 76 | Plan Limitations Exceeded | Check quantity limits |\n| 79 | Refill Too Soon | Wait or override |\n| 80 | Prescriber Not Found | Verify NPI |\n| 83 | Duplicate Paid Claim | Check claim history |\n| 88 | DUR Reject | Clinical review needed |\n\n## DUR Alert Types\n\n| Code | Type | Description |\n|------|------|-------------|\n| DD | Drug-Drug | Interaction between medications |\n| TD | Therapeutic Duplication | Same drug class |\n| ER | Early Refill | Before 80% supply used |\n| HD | High Dose | Exceeds recommended dose |\n| LD | Low Dose | Below therapeutic dose |\n| DA | Drug-Age | Age precaution |\n| DG | Drug-Gender | Gender precaution |\n| DC | Drug-Disease | Contraindication |\n\n## Output Formats\n\n| Format | Request | Use Case |\n|--------|---------|----------|\n| JSON | default | API testing |\n| NCPDP D.0 | \"as NCPDP\", \"pharmacy claim format\" | Real-time claims |\n| CSV | \"as CSV\" | Analytics |\n\nSee [..\u002F..\u002Fformats\u002Fncpdp-d0.md](..\u002F..\u002Fformats\u002Fncpdp-d0.md) for transformation.\n\n## Examples\n\n### Example 1: Generic Fill - Paid\n\n**Request:** \"Generate a paid pharmacy claim for lisinopril\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000001\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"bin\": \"610014\", \"pcn\": \"RXGROUP\", \"group_number\": \"CORP001\",\n    \"cardholder_id\": \"001234001\",\n    \"ndc\": \"00093505601\",\n    \"drug_name\": \"Lisinopril 10mg Tablet\",\n    \"quantity_dispensed\": 30,\n    \"days_supply\": 30,\n    \"pharmacy_npi\": \"9876543210\",\n    \"prescriber_npi\": \"1234567890\",\n    \"ingredient_cost_submitted\": 8.50,\n    \"dispensing_fee_submitted\": 2.00\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost_paid\": 8.50,\n    \"dispensing_fee_paid\": 1.75,\n    \"patient_pay_amount\": 10.00,\n    \"copay_amount\": 10.00,\n    \"authorization_number\": \"AUTH20250115001\"\n  }\n}\n```\n\n### Example 2: Brand Drug - Rejected (PA Required)\n\n**Request:** \"Generate a rejected claim for Eliquis requiring prior auth\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000002\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"ndc\": \"00003089421\",\n    \"drug_name\": \"Eliquis 5mg Tablet\",\n    \"quantity_dispensed\": 60,\n    \"days_supply\": 30\n  },\n  \"response\": {\n    \"status\": \"rejected\",\n    \"reject_code\": \"75\",\n    \"reject_message\": \"Prior Authorization Required\",\n    \"additional_message\": \"Submit PA with diagnosis and documentation of AFib or VTE\",\n    \"help_desk_phone\": \"1-800-555-0123\"\n  }\n}\n```\n\n### Example 3: Early Refill Warning\n\n**Request:** \"Generate a claim with early refill DUR alert\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000003\",\n    \"ndc\": \"00071015523\",\n    \"drug_name\": \"Atorvastatin 20mg\",\n    \"service_date\": \"2025-01-15\",\n    \"quantity_dispensed\": 30,\n    \"days_supply\": 30\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"dur_response\": {\n      \"alert_count\": 1,\n      \"alerts\": [\n        {\n          \"type\": \"ER\",\n          \"description\": \"Early Refill\",\n          \"severity\": \"warning\",\n          \"message\": \"Refill 8 days early (73% of supply used)\",\n          \"previous_fill_date\": \"2024-12-27\",\n          \"days_supply_previous\": 30,\n          \"percent_used\": 73,\n          \"professional_service_code\": \"M0\",\n          \"result_of_service_code\": \"1A\"\n        }\n      ]\n    },\n    \"patient_pay_amount\": 10.00\n  }\n}\n```\n\n### Example 4: Specialty Drug with Copay Assistance\n\n**Request:** \"Generate a specialty pharmacy claim with manufacturer copay card\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000004\",\n    \"ndc\": \"00074433906\",\n    \"drug_name\": \"Humira 40mg\u002F0.4mL Pen\",\n    \"quantity_dispensed\": 2,\n    \"days_supply\": 28,\n    \"pharmacy_type\": \"specialty\"\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost_paid\": 6500.00,\n    \"dispensing_fee_paid\": 0.00,\n    \"patient_pay_amount\": 500.00,\n    \"coinsurance_amount\": 500.00,\n    \"tier\": 5\n  },\n  \"copay_assistance\": {\n    \"program_name\": \"Humira Complete\",\n    \"program_bin\": \"004682\",\n    \"copay_card_applied\": true,\n    \"assistance_amount\": 495.00,\n    \"final_patient_pay\": 5.00,\n    \"annual_max_benefit\": 16000.00,\n    \"remaining_benefit\": 15505.00\n  }\n}\n```\n\n## Related Skills\n\n### Cross-Product: PatientSim (Clinical)\n\nRxMemberSim pharmacy claims correspond to PatientSim medication orders:\n\n| RxMemberSim Skill | PatientSim Cohorts | Integration |\n|-------------------|---------------------|-------------|\n| [retail-pharmacy.md](retail-pharmacy.md) | Chronic disease meds, discharge Rx | Fill date +0-3 days from order\u002Fdischarge |\n| [specialty-pharmacy.md](specialty-pharmacy.md) | Oncology, biologics | Limited distribution, PA often required |\n| [dur-alerts.md](dur-alerts.md) | Multi-drug regimens | DDI based on patient's med list |\n| [rx-prior-auth.md](rx-prior-auth.md) | High-cost drugs | Clinical criteria from PatientSim |\n\n**PatientSim Cohort Links:** [diabetes-management](..\u002Fpatientsim\u002Fdiabetes-management.md), [heart-failure](..\u002Fpatientsim\u002Fheart-failure.md), [chronic-kidney-disease](..\u002Fpatientsim\u002Fchronic-kidney-disease.md), [behavioral-health](..\u002Fpatientsim\u002Fbehavioral-health.md), [oncology](..\u002Fpatientsim\u002Foncology\u002F)\n\n> **Integration Pattern:** Generate medication orders in PatientSim, then model fills in RxMemberSim. Match NDCs, apply fill timing (retail: same day; specialty: +1-7 days), and PA rules.\n\n### Cross-Product: MemberSim (Claims)\n\nPharmacy and medical benefits coordinate:\n\n| RxMemberSim Skill | MemberSim Skill | Integration |\n|-------------------|-----------------|-------------|\n| [formulary-management.md](formulary-management.md) | [plan-benefits.md](..\u002Fmembersim\u002Fplan-benefits.md) | Coordinated benefit design |\n| [rx-accumulator.md](rx-accumulator.md) | [accumulator-tracking.md](..\u002Fmembersim\u002Faccumulator-tracking.md) | Combined deductible\u002FOOP |\n| [rx-prior-auth.md](rx-prior-auth.md) | [prior-authorization.md](..\u002Fmembersim\u002Fprior-authorization.md) | Pharmacy vs. medical PA |\n| [rx-enrollment.md](rx-enrollment.md) | [enrollment-eligibility.md](..\u002Fmembersim\u002Fenrollment-eligibility.md) | Synchronized coverage |\n\n> **Integration Pattern:** For integrated medical+Rx plans, pharmacy costs count toward combined OOP maximum. Ensure coverage dates and accumulator totals are synchronized.\n\n### Cross-Product: PopulationSim Integration\n\nWhen a geography is specified, RxMemberSim grounds prescribing patterns and adherence in PopulationSim's CDC PLACES, SVI, and ADI data. See [populationsim-integration.md](populationsim-integration.md) for the generation pattern and SDOH impact tables.\n\n### Cross-Product: NetworkSim (Pharmacy Networks)\n\nNetworkSim provides pharmacy entities and benefit structures for prescription claims:\n\n| RxMemberSim Need | NetworkSim Skill | Generated Entity |\n|------------------|------------------|------------------|\n| Dispensing pharmacy | [pharmacy-for-rx.md](..\u002Fnetworksim\u002Fintegration\u002Fpharmacy-for-rx.md) | Pharmacy with NCPDP, NPI |\n| Formulary context | [formulary-for-rx.md](..\u002Fnetworksim\u002Fintegration\u002Fformulary-for-rx.md) | Tier, PA requirements |\n| Pharmacy benefit | [synthetic-pharmacy-benefit.md](..\u002Fnetworksim\u002Fsynthetic\u002Fsynthetic-pharmacy-benefit.md) | Benefit design |\n| Specialty pharmacy | [specialty-pharmacy.md](..\u002Fnetworksim\u002Freference\u002Fspecialty-pharmacy.md) | Limited distribution, hub model |\n\n> **Integration Pattern:** Generate claims in RxMemberSim first, then use NetworkSim to add pharmacy entities with NCPDP IDs and formulary context.\n\n### Output Formats\n- [..\u002F..\u002Fformats\u002Fncpdp-d0.md](..\u002F..\u002Fformats\u002Fncpdp-d0.md) - NCPDP D.0 format\n- [..\u002F..\u002Fformats\u002Fcsv.md](..\u002F..\u002Fformats\u002Fcsv.md) - CSV export\n- [..\u002F..\u002Fformats\u002Fsql.md](..\u002F..\u002Fformats\u002Fsql.md) - SQL export\n\n### Reference Data\n- [..\u002F..\u002Freferences\u002Fdata-models.md](..\u002F..\u002Freferences\u002Fdata-models.md) - Entity schemas\n- [..\u002F..\u002Freferences\u002Fcode-systems.md](..\u002F..\u002Freferences\u002Fcode-systems.md) - NDC, RxNorm, GPI, NCPDP codes\n\n---\n\n## Generative Framework Integration\n\nRxMemberSim integrates with the [Generative Framework](..\u002Fgeneration\u002FSKILL.md) for specification-driven generation at scale.\n\n- **Profile-Driven:** `\"Generate 200 pharmacy members from the Medicare diabetic profile\"` — samples demographics, assigns Rx coverage, links to formulary\u002Fnetwork.\n- **Journey-Driven:** `\"Add diabetic first-year journey with fills\"` — generates Rx, refills, DUR alerts, and accumulator impacts (TrOOP for Part D).\n- **Cross-Domain Sync:** RxMember → MemberSim Member, Fill → PatientSim Prescription, Pharmacy\u002FPrescriber → NetworkSim. See [cross-domain-sync.md](..\u002Fgeneration\u002Fexecutors\u002Fcross-domain-sync.md).\n","# RxMemberSim - Pharmacy and PBM Data Generation\n\n## For Claude\n\nUse this skill when the user requests pharmacy data, prescription fills, or PBM cohorts. Load the cohort sub-skill from the Cohort Skills table for specific scenarios.\n\n**Triggers:** prescriptions, pharmacy claims, medication fills, DUR alerts, drug interactions, formulary\u002Ftier cohorts, NCPDP output, pharmacy prior authorization, step therapy\n\n**Capabilities:** pharmacy members (BIN\u002FPCN\u002FGroup), prescription fills with NDC codes, claim adjudication and pricing, DUR alerts, formulary\u002Ftier management, manufacturer copay programs, NCPDP D.0 output\n\n## Safety Guardrails\n\n- **All data is synthetic.** Every member, claim, NDC, NPI, and pricing value is fabricated. Never present output as real patient or pharmacy data.\n- **No clinical advice.** RxMemberSim models PBM workflows only. Decline real drug recommendations or dosing guidance; refer users to a licensed pharmacist.\n- **No real PHI.** Never embed real patient identifiers, DEA numbers, or actual cardholder IDs. Use realistic but fictional values.\n- **NDC codes are illustrative.** Example NDCs approximate real formats but may not map to FDA-registered products. Validate against the FDA NDC Directory for production use.\n- **Pricing is synthetic.** Ingredient costs, dispensing fees, and copay amounts do not reflect actual AWP, WAC, or MAC pricing.\n\n## Edge Cases and Validation\n\n- **Missing NDC or drug name:** Generate a plausible synthetic NDC (11-digit 5-4-2 format) and map to a fictional drug. Never leave NDC blank.\n- **Invalid BIN\u002FPCN\u002FGroup:** Flag as rejected with reject code 99 (\"Host Processing Error\") and include a corrective message.\n- **Partial member data:** Fill missing fields with realistic defaults (e.g., person_code \"01\", relationship_code \"1\" for subscriber). Note which fields were defaulted.\n- **Unknown RxNorm or GPI code:** Use a synthetic code in the correct format. Note that production systems should validate against the RxNorm API or GPI reference.\n- **Negative examples — do NOT generate:** real DEA numbers, actual AWP\u002FWAC pricing, clinical dosing recommendations, or data presented as non-synthetic.\n\n## Pharmacy Code Systems\n\n| System | Use | Example |\n|--------|-----|---------|\n| NDC | Drug product identifier (11-digit) | 00071015523 |\n| RxNorm | Standard drug concept (ingredient, dose form) | RxCUI 83367 |\n| GPI | Generic Product Identifier (drug class hierarchy) | 39400010100310 |\n| NCPDP | Pharmacy identifier and transaction standard | D.0 format |\n| NPI | Provider\u002Fpharmacy identifier | 1234567890 |\n| ICD-10-CM | Diagnosis code (required for PA submissions) | E11.9 |\n| HCPCS | Medical pharmacy \u002F buy-and-bill drugs | J0135 |\n\n## Quick Start\n\n### Simple Pharmacy Claim\n\n**Request:** \"Generate a pharmacy claim for atorvastatin\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000001\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"ndc\": \"00071015523\",\n    \"drug_name\": \"Atorvastatin 20mg\",\n    \"quantity\": 30,\n    \"days_supply\": 30,\n    \"pharmacy_npi\": \"1234567890\"\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost\": 12.50,\n    \"dispensing_fee\": 2.00,\n    \"copay\": 10.00,\n    \"plan_paid\": 4.50\n  }\n}\n```\n\n### DUR Alert Cohort\n\n**Request:** \"Generate a pharmacy claim that triggers a drug interaction alert\"\n\nClaude loads [dur-alerts.md](dur-alerts.md) and produces a claim with appropriate DUR response.\n\n## Cohort Skills\n\nLoad the appropriate cohort based on user request:\n\n| Cohort | Trigger Phrases | File |\n|----------|-----------------|------|\n| **Retail Pharmacy** | prescription, fill, refill, copay, retail | [retail-pharmacy.md](retail-pharmacy.md) |\n| **Specialty Pharmacy** | specialty drug, biologics, limited distribution | [specialty-pharmacy.md](specialty-pharmacy.md) |\n| **DUR Alerts** | drug interaction, DUR, therapeutic dup, early refill | [dur-alerts.md](dur-alerts.md) |\n| **Formulary Management** | formulary, tier, coverage, preferred | [formulary-management.md](formulary-management.md) |\n| **Rx Enrollment** | rx enrollment, pharmacy member, BIN PCN, rx coverage | [rx-enrollment.md](rx-enrollment.md) |\n| **Rx Prior Auth** | rx prior auth, pharmacy PA, step therapy, formulary exception | [rx-prior-auth.md](rx-prior-auth.md) |\n| **Rx Accumulators** | rx accumulator, pharmacy deductible, rx OOP, TrOOP, Part D phase | [rx-accumulator.md](rx-accumulator.md) |\n| **Manufacturer Programs** | copay card, PAP, patient assistance, copay assistance, hub program | [manufacturer-programs.md](manufacturer-programs.md) |\n\n## Generation Parameters\n\n| Parameter | Type | Default | Description |\n|-----------|------|---------|-------------|\n| fill_type | string | new | new, refill |\n| drug_type | string | generic | generic, brand, specialty |\n| pharmacy_type | string | retail | retail, mail_order, specialty |\n| claim_status | string | paid | paid, rejected, reversed |\n| dur_outcome | string | none | none, warning, reject |\n\n## Output Entities\n\n### RxMember\nPharmacy member\u002Fcardholder information:\n- member_id, cardholder_id\n- bin, pcn, group_number, person_code\n- rx_plan_code, coverage_start\u002Fend\n- relationship_code, subscriber_id\n- mail_order_eligible, specialty_eligible\n\n### RxPlan\nPharmacy benefit plan configuration:\n- rx_plan_code, plan_name, plan_type\n- formulary_id, tier_structure\n- rx_deductible, rx_oop_max\n- specialty settings (coinsurance, per-fill max)\n- Part D phases (for Medicare plans)\n\n### RxAccumulator\nPharmacy benefit accumulators:\n- rx_deductible (applied, limit, remaining)\n- rx_oop_max (applied, limit, remaining)\n- specialty_oop, daw_brand_penalty\n- TrOOP (for Medicare Part D)\n- current_phase (for Part D)\n\n### Prescription\nWritten prescription details:\n- prescription_number, ndc, drug_name\n- quantity_prescribed, days_supply\n- refills_authorized, refills_remaining\n- prescriber_npi, prescriber_dea\n- written_date, expiration_date\n- daw_code, directions\n\n### PharmacyClaim\nNCPDP-style claim transaction:\n- claim_id, transaction_code (B1\u002FB2\u002FB3)\n- bin, pcn, group_number, cardholder_id\n- pharmacy_npi, prescriber_npi\n- ndc, quantity_dispensed, days_supply\n- pricing fields (ingredient cost, dispensing fee)\n- DUR fields (reason, service, result codes)\n\n### ClaimResponse\nAdjudication response:\n- transaction_response_status (A, R, P, D)\n- pricing (ingredient cost paid, dispensing fee, patient pay)\n- reject codes (if applicable)\n- DUR alerts (if applicable)\n- authorization number, accumulated amounts\n\n### PharmacyPriorAuth\nPharmacy PA request and decision:\n- pa_id, status, pa_type\n- request_date, decision_date\n- approval details (override_code, expiration)\n- denial details (reason, alternatives)\n- clinical information, urgency\n\n### DURAlert\nDrug utilization review alert:\n- dur_code, dur_type, clinical_significance\n- interacting_drugs, severity_level\n- override_code, outcome_code\n- pharmacist_message, recommendation\n\n### FormularyDrug\nDrug coverage information:\n- ndc, gpi, rxnorm_code, drug_name\n- tier, covered status\n- PA required, step therapy required\n- quantity limits, age\u002Fgender restrictions\n\n### CopayAssistance\nManufacturer copay programs:\n- program_id, program_type\n- ndc, program_name\n- annual_max_benefit, remaining_benefit\n- copay_covered, effective_dates\n\nSee [..\u002F..\u002Freferences\u002Fdata-models.md](..\u002F..\u002Freferences\u002Fdata-models.md) for complete schemas.\n\n## NCPDP Transaction Codes\n\n| Code | Description | Use Case |\n|------|-------------|----------|\n| B1 | Billing | New claim submission |\n| B2 | Reversal | Cancel previous claim |\n| B3 | Rebill | Correct and resubmit |\n| E1 | Eligibility | Check coverage |\n| P1 | Prior Auth Request | Submit PA |\n| P2 | Prior Auth Inquiry | Check PA status |\n| P4 | Prior Auth Cancel | Cancel PA request |\n\n## Common Reject Codes\n\n| Code | Description | Resolution |\n|------|-------------|------------|\n| 70 | Product\u002FService Not Covered | Check formulary, PA |\n| 75 | Prior Authorization Required | Submit PA request |\n| 76 | Plan Limitations Exceeded | Check quantity limits |\n| 79 | Refill Too Soon | Wait or override |\n| 80 | Prescriber Not Found | Verify NPI |\n| 83 | Duplicate Paid Claim | Check claim history |\n| 88 | DUR Reject | Clinical review needed |\n\n## DUR Alert Types\n\n| Code | Type | Description |\n|------|------|-------------|\n| DD | Drug-Drug | Interaction between medications |\n| TD | Therapeutic Duplication | Same drug class |\n| ER | Early Refill | Before 80% supply used |\n| HD | High Dose | Exceeds recommended dose |\n| LD | Low Dose | Below therapeutic dose |\n| DA | Drug-Age | Age precaution |\n| DG | Drug-Gender | Gender precaution |\n| DC | Drug-Disease | Contraindication |\n\n## Output Formats\n\n| Format | Request | Use Case |\n|--------|---------|----------|\n| JSON | default | API testing |\n| NCPDP D.0 | \"as NCPDP\", \"pharmacy claim format\" | Real-time claims |\n| CSV | \"as CSV\" | Analytics |\n\nSee [..\u002F..\u002Fformats\u002Fncpdp-d0.md](..\u002F..\u002Fformats\u002Fncpdp-d0.md) for transformation.\n\n## Examples\n\n### Example 1: Generic Fill - Paid\n\n**Request:** \"Generate a paid pharmacy claim for lisinopril\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000001\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"bin\": \"610014\", \"pcn\": \"RXGROUP\", \"group_number\": \"CORP001\",\n    \"cardholder_id\": \"001234001\",\n    \"ndc\": \"00093505601\",\n    \"drug_name\": \"Lisinopril 10mg Tablet\",\n    \"quantity_dispensed\": 30,\n    \"days_supply\": 30,\n    \"pharmacy_npi\": \"9876543210\",\n    \"prescriber_npi\": \"1234567890\",\n    \"ingredient_cost_submitted\": 8.50,\n    \"dispensing_fee_submitted\": 2.00\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost_paid\": 8.50,\n    \"dispensing_fee_paid\": 1.75,\n    \"patient_pay_amount\": 10.00,\n    \"copay_amount\": 10.00,\n    \"authorization_number\": \"AUTH20250115001\"\n  }\n}\n```\n\n### Example 2: Brand Drug - Rejected (PA Required)\n\n**Request:** \"Generate a rejected claim for Eliquis requiring prior auth\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000002\",\n    \"transaction_code\": \"B1\",\n    \"service_date\": \"2025-01-15\",\n    \"ndc\": \"00003089421\",\n    \"drug_name\": \"Eliquis 5mg Tablet\",\n    \"quantity_dispensed\": 60,\n    \"days_supply\": 30\n  },\n  \"response\": {\n    \"status\": \"rejected\",\n    \"reject_code\": \"75\",\n    \"reject_message\": \"Prior Authorization Required\",\n    \"additional_message\": \"Submit PA with diagnosis and documentation of AFib or VTE\",\n    \"help_desk_phone\": \"1-800-555-0123\"\n  }\n}\n```\n\n### Example 3: Early Refill Warning\n\n**Request:** \"Generate a claim with early refill DUR alert\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000003\",\n    \"ndc\": \"00071015523\",\n    \"drug_name\": \"Atorvastatin 20mg\",\n    \"service_date\": \"2025-01-15\",\n    \"quantity_dispensed\": 30,\n    \"days_supply\": 30\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"dur_response\": {\n      \"alert_count\": 1,\n      \"alerts\": [\n        {\n          \"type\": \"ER\",\n          \"description\": \"Early Refill\",\n          \"severity\": \"warning\",\n          \"message\": \"Refill 8 days early (73% of supply used)\",\n          \"previous_fill_date\": \"2024-12-27\",\n          \"days_supply_previous\": 30,\n          \"percent_used\": 73,\n          \"professional_service_code\": \"M0\",\n          \"result_of_service_code\": \"1A\"\n        }\n      ]\n    },\n    \"patient_pay_amount\": 10.00\n  }\n}\n```\n\n### Example 4: Specialty Drug with Copay Assistance\n\n**Request:** \"Generate a specialty pharmacy claim with manufacturer copay card\"\n\n```json\n{\n  \"claim\": {\n    \"claim_id\": \"RX20250115000004\",\n    \"ndc\": \"00074433906\",\n    \"drug_name\": \"Humira 40mg\u002F0.4mL Pen\",\n    \"quantity_dispensed\": 2,\n    \"days_supply\": 28,\n    \"pharmacy_type\": \"specialty\"\n  },\n  \"response\": {\n    \"status\": \"paid\",\n    \"ingredient_cost_paid\": 6500.00,\n    \"dispensing_fee_paid\": 0.00,\n    \"patient_pay_amount\": 500.00,\n    \"coinsurance_amount\": 500.00,\n    \"tier\": 5\n  },\n  \"copay_assistance\": {\n    \"program_name\": \"Humira Complete\",\n    \"program_bin\": \"004682\",\n    \"copay_card_applied\": true,\n    \"assistance_amount\": 495.00,\n    \"final_patient_pay\": 5.00,\n    \"annual_max_benefit\": 16000.00,\n    \"remaining_benefit\": 15505.00\n  }\n}\n```\n\n## Related Skills\n\n### Cross-Product: PatientSim (Clinical)\n\nRxMemberSim pharmacy claims correspond to PatientSim medication orders:\n\n| RxMemberSim Skill | PatientSim Cohorts | Integration |\n|-------------------|---------------------|-------------|\n| [retail-pharmacy.md](retail-pharmacy.md) | Chronic disease meds, discharge Rx | Fill date +0-3 days from order\u002Fdischarge |\n| [specialty-pharmacy.md](specialty-pharmacy.md) | Oncology, biologics | Limited distribution, PA often required |\n| [dur-alerts.md](dur-alerts.md) | Multi-drug regimens | DDI based on patient's med list |\n| [rx-prior-auth.md](rx-prior-auth.md) | High-cost drugs | Clinical criteria from PatientSim |\n\n**PatientSim Cohort Links:** [diabetes-management](..\u002Fpatientsim\u002Fdiabetes-management.md), [heart-failure](..\u002Fpatientsim\u002Fheart-failure.md), [chronic-kidney-disease](..\u002Fpatientsim\u002Fchronic-kidney-disease.md), [behavioral-health](..\u002Fpatientsim\u002Fbehavioral-health.md), [oncology](..\u002Fpatientsim\u002Foncology\u002F)\n\n> **Integration Pattern:** Generate medication orders in PatientSim, then model fills in RxMemberSim. Match NDCs, apply fill timing (retail: same day; specialty: +1-7 days), and PA rules.\n\n### Cross-Product: MemberSim (Claims)\n\nPharmacy and medical benefits coordinate:\n\n| RxMemberSim Skill | MemberSim Skill | Integration |\n|-------------------|-----------------|-------------|\n| [formulary-management.md](formulary-management.md) | [plan-benefits.md](..\u002Fmembersim\u002Fplan-benefits.md) | Coordinated benefit design |\n| [rx-accumulator.md](rx-accumulator.md) | [accumulator-tracking.md](..\u002Fmembersim\u002Faccumulator-tracking.md) | Combined deductible\u002FOOP |\n| [rx-prior-auth.md](rx-prior-auth.md) | [prior-authorization.md](..\u002Fmembersim\u002Fprior-authorization.md) | Pharmacy vs. medical PA |\n| [rx-enrollment.md](rx-enrollment.md) | [enrollment-eligibility.md](..\u002Fmembersim\u002Fenrollment-eligibility.md) | Synchronized coverage |\n\n> **Integration Pattern:** For integrated medical+Rx plans, pharmacy costs count toward combined OOP maximum. Ensure coverage dates and accumulator totals are synchronized.\n\n### Cross-Product: PopulationSim Integration\n\nWhen a geography is specified, RxMemberSim grounds prescribing patterns and adherence in PopulationSim's CDC PLACES, SVI, and ADI data. See [populationsim-integration.md](populationsim-integration.md) for the generation pattern and SDOH impact tables.\n\n### Cross-Product: NetworkSim (Pharmacy Networks)\n\nNetworkSim provides pharmacy entities and benefit structures for prescription claims:\n\n| RxMemberSim Need | NetworkSim Skill | Generated Entity |\n|------------------|------------------|------------------|\n| Dispensing pharmacy | [pharmacy-for-rx.md](..\u002Fnetworksim\u002Fintegration\u002Fpharmacy-for-rx.md) | Pharmacy with NCPDP, NPI |\n| Formulary context | [formulary-for-rx.md](..\u002Fnetworksim\u002Fintegration\u002Fformulary-for-rx.md) | Tier, PA requirements |\n| Pharmacy benefit | [synthetic-pharmacy-benefit.md](..\u002Fnetworksim\u002Fsynthetic\u002Fsynthetic-pharmacy-benefit.md) | Benefit design |\n| Specialty pharmacy | [specialty-pharmacy.md](..\u002Fnetworksim\u002Freference\u002Fspecialty-pharmacy.md) | Limited distribution, hub model |\n\n> **Integration Pattern:** Generate claims in RxMemberSim first, then use NetworkSim to add pharmacy entities with NCPDP IDs and formulary context.\n\n### Output Formats\n- [..\u002F..\u002Fformats\u002Fncpdp-d0.md](..\u002F..\u002Fformats\u002Fncpdp-d0.md) - NCPDP D.0 format\n- [..\u002F..\u002Fformats\u002Fcsv.md](..\u002F..\u002Fformats\u002Fcsv.md) - CSV export\n- [..\u002F..\u002Fformats\u002Fsql.md](..\u002F..\u002Fformats\u002Fsql.md) - SQL export\n\n### Reference Data\n- [..\u002F..\u002Freferences\u002Fdata-models.md](..\u002F..\u002Freferences\u002Fdata-models.md) - Entity schemas\n- [..\u002F..\u002Freferences\u002Fcode-systems.md](..\u002F..\u002Freferences\u002Fcode-systems.md) - NDC, RxNorm, GPI, NCPDP codes\n\n---\n\n## Generative Framework Integration\n\nRxMemberSim integrates with the [Generative Framework](..\u002Fgeneration\u002FSKILL.md) for specification-driven generation at scale.\n\n- **Profile-Driven:** `\"Generate 200 pharmacy members from the Medicare diabetic profile\"` — samples demographics, assigns Rx coverage, links to formulary\u002Fnetwork.\n- **Journey-Driven:** `\"Add diabetic first-year journey with fills\"` — generates Rx, refills, DUR alerts, and accumulator impacts (TrOOP for Part D).\n- **Cross-Domain Sync:** RxMember → MemberSim Member, Fill → PatientSim Prescription, Pharmacy\u002FPrescriber → NetworkSim. See [cross-domain-sync.md](..\u002Fgeneration\u002Fexecutors\u002Fcross-domain-sync.md).\n",{"name":5,"description":7},"main","b22eca2e974f918ce591c5b2bd829fb7510e0191","Skills\u002Fhealthsim\u002Fskills\u002Frxmembersim",18,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills","https:\u002F\u002Fgithub.com\u002FFDU-INS","Fudan University Department of Risk Management and Insurance","2026-07-12 12:54:34",{"source":8,"skillName":5,"commands":52,"prompt":62,"zipAvailable":63},[53,56,59],{"tool":54,"command":55},"npx","npx skills add FDU-INS\u002FInsurance-Skills --skill rxmembersim",{"tool":57,"command":58},"bunx","bunx skills add FDU-INS\u002FInsurance-Skills --skill rxmembersim",{"tool":60,"command":61},"pnpm","pnpm dlx skills add FDU-INS\u002FInsurance-Skills --skill rxmembersim","安装技能，技能地址：https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002FSKILL.md",true,[65,71,75,79,83,87,91,95,99,103],{"path":66,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":69,"sourceHtmlUrl":70},"dur-alerts.md","REFERENCE","参考文档",19068,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fdur-alerts.md",{"path":72,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":73,"sourceHtmlUrl":74},"formulary-management.md",18533,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fformulary-management.md",{"path":76,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":77,"sourceHtmlUrl":78},"manufacturer-programs.md",26054,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fmanufacturer-programs.md",{"path":80,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":81,"sourceHtmlUrl":82},"populationsim-integration.md",4261,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fpopulationsim-integration.md",{"path":84,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":85,"sourceHtmlUrl":86},"README.md",5135,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002FREADME.md",{"path":88,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":89,"sourceHtmlUrl":90},"retail-pharmacy.md",17107,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fretail-pharmacy.md",{"path":92,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":93,"sourceHtmlUrl":94},"rx-accumulator.md",20073,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Frx-accumulator.md",{"path":96,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":97,"sourceHtmlUrl":98},"rx-enrollment.md",16415,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Frx-enrollment.md",{"path":100,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":101,"sourceHtmlUrl":102},"rx-prior-auth.md",25267,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Frx-prior-auth.md",{"path":104,"resourceType":67,"resourceTypeDesc":68,"sizeBytes":105,"sourceHtmlUrl":106},"specialty-pharmacy.md",16001,"https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fhealthsim\u002Fskills\u002Frxmembersim\u002Fspecialty-pharmacy.md",[108,137,160,191,212,244],{"skillNo":109,"name":110,"nameZh":6,"description":111,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":112,"categories":113,"keywords":119,"publishedAt":38},"01M713QW6EGEG0YAD75440GSD0","로인장 (Roinjiang)","Activates when the user needs legal advice, contract review, insurance law consultation, startup legal support, or any legal\u002Fregulatory matter. She is a top-tier in-house lawyer with absolute loyalty to the CEO, specializing in insurance law, financial consumer protection, privacy, contracts, labor law, family law, civil and criminal matters.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002F로인장 (Roinjiang)\u002FSKILL.md",[114],{"categoryNo":115,"categoryName":116,"taxonomyType":117,"taxonomyTypeDesc":118},"01JBSEEDCAT000000000000037","律师与法务","PROFESSION","适用职业",[110,120,121,122,123,124,21,37,125,126,127,128,129,130,131,132,133,134,135,136],"insurance law","insurance","civil","contract","family","loyalty","with","top","contract review","ceo","support","advice","consultation","regulatory","privacy","protection","startup",{"skillNo":138,"name":139,"nameZh":6,"description":140,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":141,"categories":142,"keywords":143,"publishedAt":38},"01M713QRN8VFMA9VKS6R4DJ2WS","zocdoc-doctor-finder","Use when a user needs to find a doctor, dentist, specialist, therapist, or healthcare provider — especially when they mention insurance, in-network, availability, location, appointments, or booking. Also use for browsing provider reviews, comparing doctors by specialty, or checking if a provider takes their insurance.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fzocdoc-doctor-finder\u002FSKILL.md",[],[144,145,146,147,121,148,149,21,150,151,152,153,154,155,156,23,157,158,33,159],"zocdoc doctor finder","doctor","healthcare","reviews","browser automation","access","browsing","browser","booking","network","therapist","computer","availability","provider","tool","automation",{"skillNo":161,"name":162,"nameZh":6,"description":163,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":164,"categories":165,"keywords":171,"publishedAt":38},"01M713QKGV3FTX7EEYWKDM8ENZ","zenmux-context","Answers any question about ZenMux by reading the latest official documentation. Use this skill whenever the user asks about ZenMux product features, API usage, configuration, integration, pricing, models, providers, routing, fallback, streaming, multimodal, structured output, tool calling, reasoning, prompt caching, image generation, video generation, web search, long context, observability, logs, cost tracking, usage analytics, insurance, subscription, pay-as-you-go, invoices, best practices for tools like Claude Code, Cursor, Cline, CodeX, Gemini CLI, opencode, Cherry Studio, Obsidian, Sider, Open-WebUI, Dify, Neovate, GitHub Copilot, OpenClaw, CC-Switch, Immersive Translate, Studio Chat, architecture, benchmarks, FAQ, contact, privacy, terms of service, compliance, or any other ZenMux-related topic. Also trigger when the user writes in Chinese about ZenMux: 文档, 使用指南, 快速开始, API 参考, 最佳实践, 模型路由, 供应商路由, 订阅, 按量计费, 可观测性, 帮助, 常见问题, 接入指南, 配置. Trigger on phrases like \"how to use ZenMux\", \"ZenMux docs\", \"ZenMux API\", \"ZenMux integration\", \"ZenMux 怎么用\", \"ZenMux 接入\", \"ZenMux 配置\". Even if the user doesn't say \"ZenMux\" explicitly but asks about LLM API aggregation, model routing, provider fallback in a context where ZenMux is the project being worked on, this skill should activate.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fzenmux-context\u002FSKILL.md",[166],{"categoryNo":167,"categoryName":168,"taxonomyType":169,"taxonomyTypeDesc":170},"01JBSEEDCAT000000000000016","图像与多媒体","SCENARIO","使用场景",[172,173,174,175,121,176,177,178,179,180,181,182,183,184,185,186,187,188,189,190],"context","zenmux context","Video","chinese","project","web search","translate","search","open","question","pay","image","you","activate","architecture","logs","streaming","cherry studio","how",{"skillNo":192,"name":193,"nameZh":6,"description":194,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":195,"categories":196,"keywords":197,"publishedAt":38},"01M713QHWTBG634BCBV7NBJME1","workers-comp-guide","Guide workers compensation compliance and claims management.\nTRIGGERS - Use when user needs help with workers-comp-guide related tasks.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fworkers-comp-guide\u002FSKILL.md",[],[198,199,200,201,202,121,203,204,33,21,205,126,206,24,207,208,209,210,211],"workers","comp","workers comp","workers comp guide","guide","triggers","workers-comp","tasks","claims management","compliance","help","compensation","management","user",{"skillNo":213,"name":214,"nameZh":6,"description":215,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":216,"categories":217,"keywords":227,"publishedAt":38},"01M713QF45VMV1685AFNF1GPMA","weekly-kpi-report","Generate McKinsey-style board presentation PPTs from weekly auto insurance data. Automatically calculates 16+ KPIs, creates executive-level slides with actionable insights, and supports week-over-week comparisons. Use when user uploads insurance cost data (Excel\u002FCSV) and requests board report, weekly presentation, executive briefing, or mentions keywords like 董事会汇报, 周报PPT, 经营分析演示, McKinsey-style reports.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fweekly-kpi-report\u002FSKILL.md",[218,221,224],{"categoryNo":219,"categoryName":220,"taxonomyType":169,"taxonomyTypeDesc":170},"01JBSEEDCAT000000000000003","演示文稿",{"categoryNo":222,"categoryName":223,"taxonomyType":169,"taxonomyTypeDesc":170},"01JBSEEDCAT000000000000004","电子表格",{"categoryNo":225,"categoryName":226,"taxonomyType":117,"taxonomyTypeDesc":118},"01JBSEEDCAT000000000000034","行政与办公人员",[228,229,230,231,232,121,233,234,235,236,21,237,238,239,240,36,241,242,33,243],"weekly","weekly kpi report","kpi","report","xlsx","actionable","insights","briefing","auto","board report","reports","generate","演示","presentation","slides","uploads",{"skillNo":245,"name":246,"nameZh":6,"description":247,"descriptionZh":6,"repositoryFullName":8,"ownerLogin":9,"ownerAvatarUrl":10,"ownerAccountNo":11,"ownerDisplayName":12,"repositoryNo":13,"starsCount":14,"licenseSpdxId":15,"licenseFileUrl":6,"sourceHtmlUrl":248,"categories":249,"keywords":253,"publishedAt":38},"01M713QA9WJDHMNVTTY1ENRKVB","wealth-advisory","Wealth management and financial planning for HNW and UHNW clients. Activate when the user\nmentions wealth management, financial planning, retirement, estate planning, tax planning,\nGRAT, IDGT, trust, asset allocation, withdrawal rate, Monte Carlo simulation, goals-based\ninvesting, tax-loss harvesting, Roth conversion, insurance, annuity, mortgage strategy,\nconcentrated stock, family office, direct indexing, 529 plan, charitable giving, donor-advised\nfund, private foundation, or asks about personal finance strategy, inheritance, long-term\nfinancial planning, or UHNW advisory.","https:\u002F\u002Fgithub.com\u002FFDU-INS\u002FInsurance-Skills\u002Fblob\u002Fmain\u002FSkills\u002Fwealth-advisory\u002FSKILL.md",[250],{"categoryNo":251,"categoryName":252,"taxonomyType":117,"taxonomyTypeDesc":118},"01JBSEEDCAT000000000000040","财务",[254,255,121,256,257,21,185,258,259,260,261,262,263,264,265,266,267,268,269,270],"wealth advisory","advisory","stock","inheritance","conversion","indexing","plan","simulation","personal finance","rate","allocation","asset","direct","personal","investing","trust","planning"]