``` ...updated the ranking for knee MRI providers (CPT 73721) relative to ZIP 60654, including their cost levels, average submitted charges, quality scores, and in-network status for both BCBS IL PPO and HMO plans.
Ranked MRI Providers (Sorted by Quality Score)
┌──────────────────────────┬──────────┬─────────┬────────┬────────────┬─────────────┬────────────────┬────────────────┐
│ Provider Name │ Distance │ Quality │ Claims │ Cost Level │ Avg. Charge │ BCBS HMO │ BCBS PPO │
├──────────────────────────┼──────────┼─────────┼────────┼────────────┼─────────────┼────────────────┼────────────────┤
│ David Sandman, M.D. │ 0.8 mi │ 81.5 │ 247 │ $$$$ │ $437 │ In-Network │ In-Network │
│ Martin Lazarus, M.D. │ 12.3 mi │ 81.2 │ 365 │ $$$$ │ $223 │ In-Network │ In-Network │
│ Lekshmi Nair, M.D. │ 22.8 mi │ 80.5 │ 123 │ $$$$$ │ $1,567 │ In-Network │ In-Network │
│ Tommy Tran, M.D. │ 26.1 mi │ 80.2 │ 866 │ $$$$$ │ $523 │ Out-of-Network │ Out-of-Network │
│ Kyle Kallenbach, M.D. │ 22.8 mi │ 80.2 │ 193 │ $$$$$ │ $1,588 │ Pending │ In-Network │
│ Joseph Judge, M.D. │ 27.4 mi │ 80.1 │ 288 │ $$$$$ │ $1,076 │ In-Network │ In-Network │
│ Shilpa Puppala, M.D. │ 3.4 mi │ 80.0 │ 113 │ $$$$$ │ $1,537 │ Pending │ Pending │
│ Alex Krasny, M.D. │ 12.3 mi │ 75.3 │ 734 │ $$$$$ │ $403 │ In-Network │ Out-of-Network │
│ Sanjay Rao, M.D. │ 0.8 mi │ 69.9 │ High │ $$$$$ │ $2,119 │ In-Network │ In-Network │
│ Matthew Eisenstein, M.D. │ 24.5 mi │ 67.5 │ 393 │ $$$$ │ $334 │ Out-of-Network │ In-Network │
└──────────────────────────┴──────────┴─────────┴────────┴────────────┴─────────────┴────────────────┴────────────────┘
Key Takeaways:
* Best Overall (HMO & PPO): David Sandman, M.D. remains the top recommendation. He is less than 1 mile from 60654, is fully in-network for both your HMO and PPO networks, and has the highest quality
score (81.5) with a moderate charge.
* Most Economical In-Network: Martin Lazarus, M.D. in Evanston has the lowest average charge ($223) for those willing to travel 12 miles.
* Charge Disclaimer: The "Avg. Charge" represents the provider's average submitted charge (the "rack rate"). If you are In-Network, your actual out-of-pocket cost will be the much lower BCBS
Negotiated Rate (plus your deductible/coinsurance).
HMO Reminder: If you are using a BCBS IL HMO plan, you must obtain a referral from your Primary Care Physician (PCP) specifically for the imaging center where these doctors practice.While it takes series of calls + analysis, the total time for this request is about 50 seconds from gemini-cli. It does requests for plans, doctors' information + of course Gemini client wants to use Google search to make it even better(for us this is an indicator of point of data we need to add), as it did a comparison of plan data (benefits) with the condition of the patient:
> Client, a family of 2+2, moves to Miami, we need to help them select a plan for 2026, while the daughter (13 y.o.) often has an illness (ears). One of the parents has not-healthy liver
``` I have analyzed the health plan options for Miami in 2026, focusing on the family's specific medical needs. For a family with chronic conditions (pediatric ear issues and liver health), a Platinum or Gold plan is highly recommended due to lower deductibles and comprehensive specialist coverage.
Top 2026 Plan Recommendations for Miami (Family of 4)
┌──────────────────────────┬─────────────┬────────────┬───────────────────┬──────────────────┬──────────────────────────────────────────────────────────────────────────────────────────────┐
│ Plan Name │ Metal Level │ Deductible │ Max Out-of-Pocket │ Specialist Copay │ Primary Benefits │
├──────────────────────────┼─────────────┼────────────┼───────────────────┼──────────────────┼──────────────────────────────────────────────────────────────────────────────────────────────┤
│ BlueSelect Platinum 1457 │ Platinum │ $0 │ $3,000 │ $25 │ Best for Liver Care. $0 deductible means immediate coverage for specialist visits and labs. │
│ Oscar Gold Elite │ Gold │ $1,500 │ $7,500 │ $40 │ Best for the Daughter. Strong pediatric network in Miami and low copays for frequent visits. │
│ Health Options Gold 1410 │ Gold │ $2,000 │ $8,500 │ $50 │ Good balance of premium cost and specialist access. │
└──────────────────────────┴─────────────┴────────────┴───────────────────┴──────────────────┴──────────────────────────────────────────────────────────────────────────────────────────────┘
Specialist Network Access (Miami Area)
I have identified several top-tier facilities and specialists that accept these major plans:
* Pediatric Care (for Ear Illnesses):
* Nicklaus Children's Pediatric Specialists: (786) 624-5876. They are the regional leader for pediatric specialty care, including ENT.
* University of Miami Pediatrics: (305) 243-4029. High-volume academic center with specialized pediatric expertise.
* Liver & Gastroenterology (for the Parent):
* University of Miami Health System (UHealth): (305) 243-7688. Features a dedicated Liver Center and world-class hepatologists.
* Miami Gastroenterology Associates: (305) 274-5500.
Family Cost Estimation (Miami 33101)
* Monthly Premium: Estimated at $1,400 - $1,850 for a family of four (assuming ages 40, 40, 13, and 10).
* Liver Care Impact: The parent's condition may require regular imaging (FibroScan/MRI) and labs. The BlueSelect Platinum plan with a $0 deductible will save significantly on these upfront costs.
Strategic Advice:
Since the daughter needs frequent ear care and one parent needs chronic liver management, the BlueSelect Platinum 1457 is the safest choice. While the monthly premium is higher, you avoid the
"deductible wall" entirely, meaning every specialist visit, ear check, and liver lab is covered at the fixed copay price from Day 1.The main focus on mcp tools for end-user (integration with ChatGPT as an app or anything else) requires not only batching the requests (just to speed up), but cleaning up the responses from the data or structures that the client doesn't need (based on the request, which normal APIs can't do) to fight with tokens overusage for nothing and providing the most efficient plan/scenario for the requesting the data the client needs.