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{"sheet":"Instructions","index":0,"n_rows":15,"n_cols":3,"rows_kept":15,"cut":false,"hidden":false,"merged":[[0,0,0,2],[1,0,1,2]]}
["Virginia Network Adequacy Justification Form Instructions"]
["Please use the following guide for the data needed in each cell."]
["Field","Description","Example"]
["Carrier Name","Enter full legal name of Carrier","XYZ Insurance Company, Inc."]
["HIOS ID","Enter 5-digit HIOS ID",12345]
["Network ID","Enter Network ID","YourNetworkID"]
["Network Name","Enter Network Name","YourNetworkName1"]
["Product Type","Health or Dental","Health"]
["Questions 1","Enter any sources used","Source Name"]
["Question 2-3","Select from the provided drop down list","Monthly"]
["Question 3","Select from the provided drop down list","Yes"]
["Question 4","Enter a number",1234]
["Locality (Rows 13-100)","Select the appropriate locailty from the drop down list","49080 - Bath"]
["Unmet Specialty (Rows 13-100)","Select the appropriate specialty from the drop down list","Cardiac Catheterization Services"]
["Question 5","Select all that apply from the drop down list","No providers of this specialty type are currently practicing within the T&D standards of this county."]

{"sheet":"Network Adequacy Justification","index":1,"n_rows":100,"n_cols":9,"rows_kept":100,"cut":false,"hidden":false,"merged":[[2,1,2,7],[6,1,6,9],[5,0,5,9],[11,0,11,9],[8,0,8,3],[7,0,7,3],[12,7,12,9],[12,5,12,6],[10,0,10,3],[9,0,9,3],[12,3,12,4],[3,1,3,2],[4,1,4,2],[4,8,4,9],[4,4,4,5],[3,4,3,9],[7,4,7,9],[4,6,4,7],[8,5,10,9],[15,3,15,4],[15,5,15,6],[15,7,15,9],[16,3,16,4],[16,5,16,6],[16,7,16,9],[13,3,13,4],[13,5,13,6],[13,7,13,9],[14,3,14,4],[14,5,14,6],[14,7,14,9],[19,3,19,4],[19,5,19,6],[19,7,19,9],[20,3,20,4],[20,5,20,6],[20,7,20,9],[17,3,17,4],[17,5,17,6],[17,7,17,9],[18,3,18,4],[18,5,18,6],[18,7,18,9],[23,3,23,4],[23,5,23,6],[23,7,23,9],[24,3,24,4],[24,5,24,6],[24,7,24,9],[21,3,21,4],[21,5,21,6],[21,7,21,9],[22,3,22,4],[22,5,22,6],[22,7,22,9],[27,3,27,4],[27,5,27,6],[27,7,27,9],[28,3,28,4],[28,5,28,6],[28,7,28,9],[25,3,25,4],[25,5,25,6],[25,7,25,9],[26,3,26,4],[26,5,26,6],[26,7,26,9],[31,3,31,4],[31,5,31,6],[31,7,31,9],[32,3,32,4],[32,5,32,6],[32,7,32,9],[29,3,29,4],[29,5,29,6],[29,7,29,9],[30,3,30,4],[30,5,30,6],[30,7,30,9],[35,3,35,4],[35,5,35,6],[35,7,35,9],[36,3,36,4],[36,5,36,6],[36,7,36,9],[33,3,33,4],[33,5,33,6],[33,7,33,9],[34,3,34,4],[34,5,34,6],[34,7,34,9],[39,3,39,4],[39,5,39,6],[39,7,39,9],[40,3,40,4],[40,5,40,6],[40,7,40,9],[37,3,37,4],[37,5,37,6],[37,7,37,9],[38,3,38,4],[38,5,38,6],[38,7,38,9],[43,3,43,4],[43,5,43,6],[43,7,43,9],[44,3,44,4],[44,5,44,6],[44,7,44,9],[41,3,41,4],[41,5,41,6],[41,7,41,9],[42,3,42,4],[42,5,42,6],[42,7,42,9],[47,3,47,4],[47,5,47,6],[47,7,47,9],[48,3,48,4],[48,5,48,6],[48,7,48,9],[45,3,45,4],[45,5,45,6],[45,7,45,9],[46,3,46,4],[46,5,46,6],[46,7,46,9],[51,3,51,4],[51,5,51,6],[51,7,51,9],[52,3,52,4],[52,5,52,6],[52,7,52,9],[49,3,49,4],[49,5,49,6],[49,7,49,9],[50,3,50,4],[50,5,50,6],[50,7,50,9],[55,3,55,4],[55,5,55,6],[55,7,55,9],[56,3,56,4],[56,5,56,6],[56,7,56,9],[53,3,53,4],[53,5,53,6],[53,7,53,9],[54,3,54,4],[54,5,54,6],[54,7,54,9],[59,3,59,4],[59,5,59,6],[59,7,59,9],[60,3,60,4],[60,5,60,6],[60,7,60,9],[57,3,57,4],[57,5,57,6],[57,7,57,9],[58,3,58,4],[58,5,58,6],[58,7,58,9],[63,3,63,4],[63,5,63,6],[63,7,63,9],[64,3,64,4],[64,5,64,6],[64,7,64,9],[61,3,61,4],[61,5,61,6],[61,7,61,9],[62,3,62,4],[62,5,62,6],[62,7,62,9],[67,3,67,4],[67,5,67,6],[67,7,67,9],[68,3,68,4],[68,5,68,6],[68,7,68,9],[65,3,65,4],[65,5,65,6],[65,7,65,9],[66,3,66,4],[66,5,66,6],[66,7,66,9],[71,3,71,4],[71,5,71,6],[71,7,71,9],[72,3,72,4],[72,5,72,6],[72,7,72,9],[69,3,69,4],[69,5,69,6],[69,7,69,9],[70,3,70,4],[70,5,70,6],[70,7,70,9],[75,3,75,4],[75,5,75,6],[75,7,75,9],[76,3,76,4],[76,5,76,6],[76,7,76,9],[73,3,73,4],[73,5,73,6],[73,7,73,9],[74,3,74,4],[74,5,74,6],[74,7,74,9],[79,3,79,4],[79,5,79,6],[79,7,79,9],[80,3,80,4],[80,5,80,6],[80,7,80,9],[77,3,77,4],[77,5,77,6],[77,7,77,9],[78,3,78,4],[78,5,78,6],[78,7,78,9],[83,3,83,4],[83,5,83,6],[83,7,83,9],[84,3,84,4],[84,5,84,6],[84,7,84,9],[81,3,81,4],[81,5,81,6],[81,7,81,9],[82,3,82,4],[82,5,82,6],[82,7,82,9],[87,3,87,4],[87,5,87,6],[87,7,87,9],[88,3,88,4],[88,5,88,6],[88,7,88,9],[85,3,85,4],[85,5,85,6],[85,7,85,9],[86,3,86,4],[86,5,86,6],[86,7,86,9],[91,7,91,9],[92,3,92,4],[92,5,92,6],[92,7,92,9],[89,3,89,4],[89,5,89,6],[89,7,89,9],[90,3,90,4],[90,5,90,6],[90,7,90,9],[99,3,99,4],[99,5,99,6],[99,7,99,9],[0,0,0,9],[97,3,97,4],[97,5,97,6],[97,7,97,9],[98,3,98,4],[98,5,98,6],[98,7,98,9],[95,3,95,4],[95,5,95,6],[95,7,95,9],[96,3,96,4],[96,5,96,6],[96,7,96,9],[93,3,93,4],[93,5,93,6],[93,7,93,9],[94,3,94,4],[94,5,94,6],[94,7,94,9],[91,3,91,4],[91,5,91,6]]}
["Virginia Network Adequacy Justification Form"]
[]
["Carrier Name:",null,null,null,null,null,null,null,"HIOS ID:"]
["Network ID:",null,null,"Network Name:"]
["Plan Year:",null,null,"Product Type:",null,null,"Form Completion Date:"]
[]
["INSTRUCTIONS: ","Carriers applying to offer qualified health plans (QHPs) or qualified dental plans (QDPs) on the Virginia Insurance Marketplace must submit a completed Network Adequacy Justification Form addressing each unmet network adequacy standard.  For each unmet network adequacy standard, respond to the following questions."]
["1. What sources are used to monitor new providers entering the service area?"]
["2. How often do you monitor your sources for new providers entering the service area? ",null,null,null,"Please Select"]
["3. Do you hold QHP/QDP enrollees of this plan responsible for only in-network cost sharing for out-of-network care received when you do not meet the network adequacy standards for network/county/specialty combinations? ",null,null,null,"Please Select"]
["4. What is the number of QHP/QDP enrollee complaints received regarding network adequacy during the prior Plan Year? "]
[]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]
["Locality:","Please Select","Unmet Specialty:","Please Select",null,"5. The primary reason(s) for not meeting each network adequacy standard for the respective correction finding. "]

{"sheet":"Recruitment Activity","index":2,"n_rows":106,"n_cols":12,"rows_kept":106,"cut":false,"hidden":false,"merged":[[3,0,3,11],[1,0,1,11],[0,0,0,11],[2,2,2,11],[2,0,2,1]]}
["Virginia Carrier Recruitment Activity"]
[]
["Instructions:",null,"Please enter all current recruitment activity aimed at resolving outstanding Network Adequacy corrections. You should include information on this tab for any providers with whom you cannot contract or any providers with whom you are continuing to pursue a contract for the upcoming plan year that has not yet been fully executed."]
[]
["#","Locality","Specialty Type","NPI","Provider/Facility Name","Street Address","City","State","Zip Code","Point of Contact\nPhone Number","Status of Recruitment Efforts","Comments"]
["X","51009 - Amherst","Cardiac Surgery Program",1234567890,"Provider Last, First ","1234 Somewhere Place","Chesterfield","VA",23831,9999999999,"Provider has entered into an exclusivity contract with another organization prohibiting the provider from contracting with you.","Provider not interested."]
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{"sheet":"Seletion Lists","index":3,"n_rows":134,"n_cols":5,"rows_kept":134,"cut":false,"hidden":true,"merged":[]}
["Primary Reason(s) for Unmet Standard -- Select all that apply",null,"Please Select",null,"Please Select"]
["*No providers of this Specialty type are currently practicing within the T&D standards of this county.",null,"51001 - Accomack",null,"Allergy and Immunology"]
["*Insufficient number of providers/facilities of this specialty type are currently practicing withing the T&D standards of this county.",null,"51003 - Albemarle",null,"Acute Inpatient Hospitals (Must have Emergency services available 24/7)"]
["*No providers/facilities of this specialty type within the T&D standards of this county are licensed, accredited, or certified by the state.",null,"51510 - Alexandria City",null,"Cardiac Catheterization Services"]
["*Insufficient number of providers/facilities of this specialty type within the T&D standards of this county are licensed, accredited, or certified by the state.",null,"51005 - Alleghany",null,"Cardiology"]
["*Topographic barriers that are unpassable (e.g., bodies of water or mountainous areas) are completely obstructing consumer access to otherwise available providers within the T&D standards of this county.",null,"51007 - Amelia",null,"Cardiac Surgery Program"]
["*Topographic barriers that are unpassable (e.g., bodies of water or mountainous areas) are partially obstructing consumer access to otherwise available providers within the T&D standards of this county.",null,"51009 - Amherst",null,"Cardiothoracic Surgery"]
["*No providers/facilities of this specialty type are available within the T&D standards of this county due to the provider(s) being in an exclusivity contract with another organization.",null,"51011 - Appomattox",null,"Chiropractor"]
["*Insufficient number of providers/facilities of this specialty type are available within the T&D standards of this county due to the provider(s) being in an exclusivity contract with another organization.",null,"51013 - Arlington",null,"Critical Care Services - Intensive Care Units (ICU)"]
["*The issuer's provider network is under development.",null,"51015 - Augusta",null,"Diagnostic Radiology (Free-standing; hospital outpatient; ambulatory health facilities with Dx Radiology)"]
[null,null,"51017 - Bath",null,"Dental"]
[null,null,"51019 - Bedford",null,"Inpatient or Residential Behavioral Health Facility Services"]
[null,null,"51021 - Bland",null,"Dermatology"]
[null,null,"51023 - Botetourt",null,"Emergency Medicine"]
["Please Select",null,"51520 - Bristol City",null,"Mammography"]
["Weekly",null,"51025 - Brunswick",null,"Endocrinology"]
["Monthly",null,"51027 - Buchanan",null,"Outpatient Infusion/Chemotherapy"]
["Quarterly",null,"51029 - Buckingham",null,"Skilled Nursing Facilities"]
["Yearly",null,"51530 - Buena Vista City",null,"ENT/Otolaryngology"]
[null,null,"51031 - Campbell",null,"Surgical Services (Ambulatory Surgical Centers and Outpatient Hospital)"]
["Please Select",null,"51033 - Caroline",null,"Gastroenterology"]
["Yes",null,"51035 - Carroll",null,"General Surgery"]
["No",null,"51036 - Charles City",null,"Gynecology (OB/GYN)"]
[null,null,"51037 - Charlotte",null,"Infectious Diseases"]
[null,null,"51540 - Charlottesville City",null,"Nephrology"]
["Please Select",null,"51550 - Chesapeake City",null,"Neurology"]
["Provider rejected good faith offer",null,"51041 - Chesterfield",null,"Urgent Care"]
["Provider has entered into an exclusivity contract with another organization prohibiting the provider from contracting with you.",null,"51043 - Clarke",null,"Neurosurgery"]
["Provider not licensed, accredited, or certified by the state.",null,"51570 - Colonial Heights City",null,"Occupational Therapy"]
["Provider moved, retired or facility closed.",null,"51580 - Covington City",null,"Oncology - Medical & Surgical"]
["Provider does not contract with any commercial insurance organizations. ",null,"51045 - Craig",null,"Oncology - Radiation"]
["Contract negotiations being conducted.",null,"51047 - Culpeper",null,"Ophthalmology"]
[null,null,"51049 - Cumberland",null,"Orthopedic Surgery"]
[null,null,"51590 - Danville City",null,"Outpatient Clinical Behavioral Health (Licensed, accredited, or certified professionals)"]
[null,null,"51051 - Dickenson",null,"Physical Medicine & Rehabilitation"]
[null,null,"51053 - Dinwiddie",null,"Physical Therapy"]
[null,null,"51595 - Emporia City",null,"Plastic Surgery"]
[null,null,"51057 - Essex",null,"Podiatry"]
[null,null,"51059 - Fairfax",null,"Primary Care - Adult"]
[null,null,"51600 - Fairfax City",null,"Primary Care - Pediatric"]
[null,null,"51610 - Falls Church City",null,"Psychiatry"]
[null,null,"51061 - Fauquier",null,"Pulmonology"]
[null,null,"51063 - Floyd",null,"Rheumatology"]
[null,null,"51065 - Fluvanna",null,"Speech Therapy"]
[null,null,"51067 - Franklin",null,"Urology"]
[null,null,"51620 - Franklin City",null,"Vascular Surgery"]
[null,null,"51069 - Frederick"]
[null,null,"51630 - Fredericksburg City"]
[null,null,"51640 - Galax City"]
[null,null,"51071 - Giles"]
[null,null,"51073 - Gloucester"]
[null,null,"51075 - Goochland"]
[null,null,"51077 - Grayson"]
[null,null,"51079 - Greene"]
[null,null,"51081 - Greensville"]
[null,null,"51083 - Halifax"]
[null,null,"51650 - Hampton City"]
[null,null,"51085 - Hanover"]
[null,null,"51660 - Harrisonburg City"]
[null,null,"51087 - Henrico"]
[null,null,"51089 - Henry"]
[null,null,"51091 - Highland"]
[null,null,"51670 - Hopewell City"]
[null,null,"51093 - Isle of Wight"]
[null,null,"51095 - James City"]
[null,null,"51097 - King and Queen"]
[null,null,"51099 - King George"]
[null,null,"51101 - King William"]
[null,null,"51103 - Lancaster"]
[null,null,"51105 - Lee"]
[null,null,"51678 - Lexington City"]
[null,null,"51107 - Loudoun"]
[null,null,"51109 - Louisa"]
[null,null,"51111 - Lunenburg"]
[null,null,"51680 - Lynchburg City"]
[null,null,"51113 - Madison"]
[null,null,"51683 - Manassas City"]
[null,null,"51685 - Manassas Park City"]
[null,null,"51690 - Martinsville City"]
[null,null,"51115 - Mathews"]
[null,null,"51117 - Mecklenburg"]
[null,null,"51119 - Middlesex"]
[null,null,"51121 - Montgomery"]
[null,null,"51125 - Nelson"]
[null,null,"51127 - New Kent"]
[null,null,"51700 - Newport News City"]
[null,null,"51710 - Norfolk City"]
[null,null,"51131 - Northampton"]
[null,null,"51133 - Northumberland"]
[null,null,"51720 - Norton City"]
[null,null,"51135 - Nottoway"]
[null,null,"51137 - Orange"]
[null,null,"51139 - Page"]
[null,null,"51141 - Patrick"]
[null,null,"51730 - Petersburg City"]
[null,null,"51143 - Pittsylvania"]
[null,null,"51735 - Poquoson City"]
[null,null,"51740 - Portsmouth City"]
[null,null,"51145 - Powhatan"]
[null,null,"51147 - Prince Edward"]
[null,null,"51149 - Prince George"]
[null,null,"51153 - Prince William"]
[null,null,"51155 - Pulaski"]
[null,null,"51750 - Radford"]
[null,null,"51157 - Rappahannock"]
[null,null,"51159 - Richmond"]
[null,null,"51760 - Richmond City"]
[null,null,"51161 - Roanoke"]
[null,null,"51770 - Roanoke City"]
[null,null,"51163 - Rockbridge"]
[null,null,"51165 - Rockingham"]
[null,null,"51167 - Russell"]
[null,null,"51775 - Salem"]
[null,null,"51169 - Scott"]
[null,null,"51171 - Shenandoah"]
[null,null,"51173 - Smyth"]
[null,null,"51175 - Southampton"]
[null,null,"51177 - Spotsylvania"]
[null,null,"51179 - Stafford"]
[null,null,"51790 - Staunton City"]
[null,null,"51800 - Suffolk City"]
[null,null,"51181 - Surry"]
[null,null,"51183 - Sussex"]
[null,null,"51185 - Tazewell"]
[null,null,"51810 - Virginia Beach City"]
[null,null,"51187 - Warren"]
[null,null,"51191 - Washington"]
[null,null,"51820 - Waynesboro City"]
[null,null,"51193 - Westmoreland"]
[null,null,"51830 - Williamsburg City"]
[null,null,"51840 - Winchester City"]
[null,null,"51195 - Wise"]
[null,null,"51197 - Wythe"]
[null,null,"51199 - York"]