{
  "state": "CA",
  "state_name": "California",
  "status": "published",
  "release_date": "2026-05-08",
  "generated_at": "2026-05-09T00:17:38+00:00",
  "methodology_version": "0.2.0",
  "commit_sha": "bebebde",
  "denominators": {
    "practitioner": 901602,
    "organization": 314249,
    "location": 151084
  },
  "findings": [
    {
      "slug": "npi-taxonomy-correctness",
      "hypotheses": [
        "H9",
        "H10",
        "H11",
        "H12",
        "H13"
      ],
      "title": "NPI and taxonomy correctness",
      "state_computable": true,
      "state_numerator": 893079,
      "state_denominator": 901602,
      "state_pct": 99.0547,
      "national_pct": null,
      "state_headline": "893,079 of 901,602 CA practitioner NPIs (99.0547%) match NPPES; 29,170 are flagged deactivated in NPPES while still active in the federal NDH.",
      "not_computable_reason": null
    },
    {
      "slug": "duplicate-detection",
      "hypotheses": [
        "H14",
        "H15"
      ],
      "title": "Duplicate detection",
      "state_computable": true,
      "state_numerator": 130576,
      "state_denominator": 314249,
      "state_pct": 41.5518,
      "national_pct": 13.5464,
      "state_headline": "CA has 314,249 Organization resources covering 183,673 unique NPIs \u2014 130,576 excess resources (41.5518%) appear duplicated.",
      "not_computable_reason": null
    },
    {
      "slug": "temporal-staleness",
      "hypotheses": [
        "H18"
      ],
      "title": "Temporal staleness",
      "state_computable": true,
      "state_numerator": 0,
      "state_denominator": 1366935,
      "state_pct": 0.0,
      "national_pct": 0.0,
      "state_headline": "0 of 1,366,935 CA-resident resources carry a meta.lastUpdated on the 2026-05-08 release day. As at the national level, meta.lastUpdated is a release-time stamp; state-scoping does not change this finding.",
      "not_computable_reason": null
    },
    {
      "slug": "endpoint-liveness",
      "hypotheses": [
        "H1",
        "H2",
        "H3",
        "H4",
        "H5"
      ],
      "title": "Endpoint liveness",
      "state_computable": false,
      "state_numerator": null,
      "state_denominator": null,
      "state_pct": null,
      "national_pct": 85.3732,
      "state_headline": null,
      "not_computable_reason": "FHIR Endpoints in NDH do not carry a state field. State scoping requires joining Endpoint.managingOrganization to Organization._state. Approximately 97% of NDH Endpoints have no populated managingOrganization back-reference (see /findings/referential-integrity), so a state-scoped endpoint-liveness number would only cover the 3% with a resolvable back-reference. The national rate is the defensible reference."
    },
    {
      "slug": "referential-integrity",
      "hypotheses": [
        "H6",
        "H7",
        "H8"
      ],
      "title": "Referential integrity",
      "state_computable": false,
      "state_numerator": null,
      "state_denominator": null,
      "state_pct": null,
      "national_pct": 0.0,
      "state_headline": null,
      "not_computable_reason": "Cross-resource references in NDH are graph-level. State filtering on the source side (PractitionerRole.practitioner) is straightforward, but the target side (Organization, Location) may be in a different state, so a per-state integrity rate conflates two distinct populations. The national rate is the defensible reference."
    },
    {
      "slug": "network-adequacy-gauge",
      "hypotheses": [
        "H22"
      ],
      "title": "Network adequacy gauge",
      "state_computable": false,
      "state_numerator": null,
      "state_denominator": null,
      "state_pct": null,
      "national_pct": 90.3497,
      "state_headline": null,
      "not_computable_reason": "Same constraint as endpoint-liveness: FHIR Endpoints lack a state field, and the indirect join via managingOrganization covers only ~3% of Endpoints. The 85% Medicare Advantage network-adequacy implied ceiling is itself a national reference, so a state-scoped recomputation here would not be meaningful for state Medicaid PR strategy."
    }
  ],
  "verify_samples": [
    {
      "npi": "1417805078",
      "display_name": "MAPILE, SEAN",
      "flagged_by": "npi-taxonomy-correctness",
      "flag_reason": "Not present in NPPES npi_raw",
      "nppes_lookup_url": "https://npiregistry.cms.hhs.gov/provider-view/1417805078"
    },
    {
      "npi": "1851249213",
      "display_name": "CLARK, RAMON",
      "flagged_by": "npi-taxonomy-correctness",
      "flag_reason": "Not present in NPPES npi_raw",
      "nppes_lookup_url": "https://npiregistry.cms.hhs.gov/provider-view/1851249213"
    },
    {
      "npi": "1356297782",
      "display_name": "HOOVER, MARY",
      "flagged_by": "npi-taxonomy-correctness",
      "flag_reason": "Not present in NPPES npi_raw",
      "nppes_lookup_url": "https://npiregistry.cms.hhs.gov/provider-view/1356297782"
    },
    {
      "npi": "1245183920",
      "display_name": "HILL, BETH",
      "flagged_by": "npi-taxonomy-correctness",
      "flag_reason": "Not present in NPPES npi_raw",
      "nppes_lookup_url": "https://npiregistry.cms.hhs.gov/provider-view/1245183920"
    },
    {
      "npi": "1801741400",
      "display_name": "MENDOZA, SHEYLA",
      "flagged_by": "npi-taxonomy-correctness",
      "flag_reason": "Not present in NPPES npi_raw",
      "nppes_lookup_url": "https://npiregistry.cms.hhs.gov/provider-view/1801741400"
    }
  ],
  "notes": "State-scoped re-run of cleanly state-filterable AINPI findings against the 2026-05-08 NPD release. NPI/taxonomy correctness here measures only H10 (NPPES match); the full H11/H13 specialty-agreement re-run requires the CMS Medicare/NUCC crosswalk and is scheduled for a methodology v0.3 update. Verify samples are five CA-resident NPIs not present in NPPES \u2014 the actionable cohort the state PI team can revalidate first."
}