Data dictionary · Cascadia Health Plan — Aesop Data Practice Portal

snapshot_membership_daily

2,100,000,000 rows · 6 fields · Membership · 1 DQ

snap_sk

id

member_id

id

plan_id

id

snapshot_date_sk

id

active_flag

boolean boundary over/undercount

lob_code

code

bridge_claim_diagnosis

1,100,000,000 rows · 5 fields · Claims

claim_id

id

diagnosis_sk

id

icd10_code

code PII

diagnosis_sequence

integer

poa_flag

code

fact_claim_line

920,000,000 rows · 11 fields · Claims · 1 DQ

claim_line_sk

id

claim_line_id

id

claim_id

id

member_id

id

provider_id

id

procedure_sk

id

service_date_sk

id

units

integer

allowed_amount

money

paid_amount

money

pos_code

code

fact_eob_remittance

680,000,000 rows · 7 fields · Claims

eob_sk

id

claim_id

id

claim_line_id

id

remit_date_sk

id

patient_responsibility

money

plan_paid

money

adjustment_reason_code

code

claim_status_history

380,000,000 rows · 7 fields · Claims

claim_id

id

status_seq

integer

from_status

code

to_status

code

feeds → First-Pass Resolution Rate

status_datetime

datetime

changed_by

id

reason_code

code

stg_claims_raw

380,000,000 rows · 7 fields · Claims · 1 DQ

stg_claim_id

id

claim_id

id

member_id

id

provider_id

id

load_datetime

datetime

source_system_code

code

raw_status

text

fact_claim

340,000,000 rows · 12 fields · Claims · 1 DQ

claim_sk

id

claim_id

id

member_id

id

provider_id

id

plan_id

id

service_date_sk

id

paid_date_sk

id

billed_amount

money

allowed_amount

money

paid_amount

money ~1.5% restated

claim_status_code

code

diagnosis_primary

code PII

adjudication_message

310,000,000 rows · 5 fields · Claims

adjudication_id

id

message_seq

integer

message_code

code

message_text

text

severity

code

gl_posting

240,000,000 rows · 9 fields · Finance · 1 DQ

posting_id

id

gl_account

code suspense postings ~1%

cost_center

code

fund_id

id

claim_id

id

debit_amount

money

credit_amount

money

accounting_period

code

posted_date

date

adjudication_result

225,000,000 rows · 11 fields · Claims

claim_line_id

id

claim_id

id

adjudication_id

id

benefit_plan_id

id

disposition

code

allowed_amount

money

paid_amount

money

pricing_method

code

adjudicated_datetime

datetime

adjudicator_id

id

auto_adjudicated_flag

boolean

feeds → Auto-Adjudication Rate

pricing_audit

225,000,000 rows · 7 fields · Claims

claim_line_id

id

pricing_audit_id

id

pricing_source

code

contract_id

id

fee_schedule_id

id

computed_allowed

money

priced_datetime

datetime

stg_pharmacy_raw

220,000,000 rows · 5 fields · Pharmacy

stg_rx_id

id

pharmacy_claim_id

id

member_id

id

ndc

code

load_datetime

datetime

claim_line

210,000,000 rows · 15 fields · Claims · 1 DQ

claim_line_id

id

feeds → Claims Denial Rate

claim_id

id

line_number

integer

revenue_code

code

procedure_code

code

units

decimal

charge_amount

money

allowed_amount

money

paid_amount

money

feeds → Medical Loss Ratio (MLR)feeds → Claims PMPMfeeds → Net Claims Costfeeds → Days in Claims Payable (DCP)feeds → Average Paid per Claimfeeds → Capitation as % of Medical Spend

cob_savings_amount

money populated only post-COB; feeds MLR, Net Claims Cost, and COB Recovery differently across reports

feeds → Medical Loss Ratio (MLR)feeds → Claims PMPMfeeds → Net Claims Costfeeds → COB Recovery Rate

copay_amount

money

coinsurance_amount

money

deductible_amount

money

line_status

code

service_date

date PII

billing_audit_log

210,000,000 rows · 8 fields · Reporting & BI

audit_id

id

entity_type

code

entity_id

id

action

code

changed_by

id PII

old_value

text

new_value

text

change_timestamp

datetime

fact_pharmacy_claim

210,000,000 rows · 11 fields · Pharmacy · 1 DQ

rx_sk

id

pharmacy_claim_id

id

member_id

id

ndc

code ~4% null

prescriber_npi

text

fill_date_sk

id

days_supply

integer

quantity

decimal

ingredient_cost

money

paid_amount

money

rebate_eligible_flag

boolean

eob_line_detail

205,000,000 rows · 7 fields · Claims

eob_id

id

claim_line_id

id

billed_amount

money

allowed_amount

money

paid_amount

money

member_liability

money

remark_code

code

remittance_line

195,000,000 rows · 6 fields · Claims

remittance_id

id

claim_line_id

id

paid_amount

money

adjustment_group_code

code

adjustment_reason_code

code

adjustment_amount

money

claim_line_payment_allocation

195,000,000 rows · 7 fields · Finance

claim_line_id

id

allocation_id

id

gl_account

code

cost_center

code

fund_id

id

allocated_amount

money

accounting_period

code

member_cost_share_detail

195,000,000 rows · 6 fields · Premium & Billing

claim_line_id

id

member_id

id PII

copay_applied

money

coinsurance_applied

money

deductible_applied

money

member_total_liability

money

claim_diagnosis

150,000,000 rows · 6 fields · Claims · 1 DQ

claim_id

id

diagnosis_seq

integer

icd10_code

code PII

diagnosis_type

code

present_on_admission

code

poa_exempt_flag

boolean

ar_transaction

120,000,000 rows · 9 fields · Finance

ar_txn_id

id

billing_account_id

id

invoice_id

id ~9% null (non-invoice adjustments)

txn_type

code

txn_date

date

amount

money

gl_account

code ~5% unmapped

cost_center

code

source_system

code

risk_adjustment_claim_extract

110,000,000 rows · 7 fields · Risk & Actuarial · 1 DQ

claim_id

id

member_id

id PII

icd10_code

code PII

hcc_code

code null ~7%

risk_score_id

id

service_year

integer

extract_date

date

claim_edit

95,000,000 rows · 7 fields · Claims · 1 DQ

claim_line_id

id

edit_id

id

feeds → Edit Override Rate

edit_code

code

edit_category

code

edit_disposition

code

fired_datetime

datetime

source_engine

code

stg_premium_raw

90,000,000 rows · 6 fields · Premium & Billing

stg_premium_id

id

premium_id

id

member_id

id

group_id

id

booked_amount

money

load_datetime

datetime

fact_premium

86,000,000 rows · 10 fields · Premium & Billing · 1 DQ

premium_sk

id

premium_id

id

member_id

id

group_id

id

plan_id

id

coverage_month_sk

id

billed_premium

money

collected_premium

money

subsidy_amount

money

member_months

decimal

claim_line_modifier

68,000,000 rows · 4 fields · Claims · 1 DQ

claim_line_id

id

modifier_seq

integer

modifier_code

code

modifier_source

code

claim_note

62,000,000 rows · 6 fields · Claims · 1 DQ

claim_id

id

note_id

id

note_text

text PII free text, possible PHI

note_type

code

authored_by

id

authored_datetime

datetime

invoice_line

62,000,000 rows · 11 fields · Premium & Billing

invoice_line_id

id

invoice_id

id

member_id

id ~1% orphaned member_id (termed members billed)

plan_id

id

benefit_plan_id

id

line_type

code

coverage_month

date

billed_amount

money

feeds → Total Premium Revenuefeeds → Premium Collection Rate

rate_amount

money

proration_factor

decimal

member_count

integer

encounter_submission

58,000,000 rows · 6 fields · Reporting & BI · 1 DQ

claim_id

id

encounter_id

id

submission_type

code

regulator

code

submission_status

code rejected, not resubmitted ~4%

submitted_date

date

um_audit_log

58,000,000 rows · 8 fields · Clinical & Care

audit_id

id

employee_id

id

member_id

id PII

object_type

code

object_id

id

action

code

event_datetime

datetime

source_ip

text PII

premium_calculation

58,000,000 rows · 9 fields · Premium & Billing · 1 DQ

premium_calc_id

id

member_id

id

plan_id

id

coverage_month

date

rate_schedule_id

id

gross_premium

money

aptc_amount

money

net_premium

money

calc_timestamp

datetime

crm_audit_log

58,000,000 rows · 7 fields · Reporting & BI

audit_id

id

entity_type

code

entity_id

id

action

code

changed_by

text

changed_at

datetime

field_changed

text null for bulk operations

duplicate_claim_check

52,000,000 rows · 6 fields · Claims

claim_id

id

suspect_claim_id

id

match_type

code

match_score

decimal

disposition

code

evaluated_datetime

datetime

stg_eligibility_raw

52,000,000 rows · 6 fields · Membership · 1 DQ

stg_elig_id

id

member_id

id

plan_id

id

coverage_status

text 5 casing variants

eff_date

date

load_datetime

datetime

edi_837_transaction

49,000,000 rows · 7 fields · Claims · 1 DQ

transaction_id

id

batch_id

id

claim_id

id ~2% unassociated

transaction_type

code

control_number

text

parse_status

code

received_datetime

datetime

claim_header

48,000,000 rows · 15 fields · Claims · 1 DQ

claim_id

id

member_id

id PII

provider_id

id

provider_npi

code

facility_id

id

plan_id

id

benefit_plan_id

id

claim_type

code institutional vs professional inferred from bill type when 837 indicator missing (~4%)

bill_type_code

code

total_charge_amount

money

received_date

date

statement_from_date

date PII

statement_thru_date

date PII

claim_status

code

adjustment_indicator

code

claim_geo_attribution

48,000,000 rows · 5 fields · Reporting & BI · 1 DQ

claim_id

id

service_state

code

service_county_fips

code

rural_urban_flag

code null ~8%

rating_area

code

timely_filing_check

48,000,000 rows · 5 fields · Claims

claim_id

id

filing_limit_days

integer

days_to_file

integer

within_limit_flag

boolean

exception_reason

code

broker_attribution

48,000,000 rows · 5 fields · Sales & Broker · 1 DQ

claim_id

id

member_id

id PII

broker_id

id null ~30%

group_id

id

attribution_date

date

claim_payment_summary

48,000,000 rows · 8 fields · Reporting & BI · 1 DQ

claim_id

id

member_id

id PII

total_billed

money

total_allowed

money

total_paid

money

total_cob_savings

money excludes late-COB lines

total_member_liability

money

snapshot_date

date

claim_sla_tracking

48,000,000 rows · 6 fields · Claims

claim_id

id

received_date

date

finalized_date

date

turnaround_days

integer

feeds → Clean Claim Turnaround Time

sla_target_days

integer

sla_met_flag

boolean

gl_posting

48,000,000 rows · 9 fields · Finance

gl_posting_id

id

ar_txn_id

id

gl_account

code

cost_center

code

fund_id

id ~8% null

debit_amount

money

credit_amount

money

posting_date

date

journal_batch_id

text

fact_quality_measure

48,000,000 rows · 7 fields · Quality & STARS

quality_sk

id

measure_id

id

member_id

id

measurement_year

integer

numerator_flag

boolean

denominator_flag

boolean

exclusion_flag

boolean

eob

46,000,000 rows · 10 fields · Claims

eob_id

id

claim_id

id

member_id

id PII

eob_date

date

total_billed

money

total_allowed

money

total_paid

money

member_responsibility

money

delivery_method

code

generated_datetime

datetime

pharmacy_claim_line

44,000,000 rows · 12 fields · Pharmacy · 1 DQ

claim_line_id

id

feeds → Generic Dispensing Rate (GDR)

pharmacy_claim_id

id

ndc

code

quantity_dispensed

decimal

days_supply

integer 4% report days_supply=0

ingredient_cost

money

dispensing_fee

money

sales_tax

money

total_amount_paid

money

feeds → Medical Loss Ratio (MLR)feeds → Net Claims Costfeeds → Rx PMPMfeeds → Specialty Spend Share

member_copay

money

daw_code

code

basis_of_cost_determination

code

pricing_adjudication_result

44,000,000 rows · 8 fields · Pharmacy

claim_line_id

id

pharmacy_claim_id

id

pricing_basis_used

code

feeds → MAC Effectiveness (MAC %)

mac_list_id

id

calculated_allowed

money

u_and_c_submitted

money

lower_of_logic_applied

code

adjudication_datetime

datetime

claim_procedure

42,000,000 rows · 5 fields · Claims

claim_id

id

procedure_seq

integer

icd10_pcs_code

code PII

procedure_date

date PII

principal_flag

boolean

audit_trail

42,000,000 rows · 9 fields · Membership

audit_id

id

entity_type

text

entity_key

text

member_id

id PII

action

code

changed_by

text

changed_at

datetime

old_value

text

new_value

text

pharmacy_claim_header

42,000,000 rows · 12 fields · Pharmacy · 1 DQ

pharmacy_claim_id

id

member_id

id PII

ndc

code

pharmacy_npi

code

prescriber_npi

code PII

date_of_service

date

date_filled

date

claim_status

code values 'P','R','D','C' plus 4 legacy lowercase variants

rx_number

text PII

compound_flag

boolean

transmission_datetime

datetime

plan_id

id

email_engagement

42,000,000 rows · 7 fields · Sales & Broker

engagement_id

id

campaign_member_id

id

member_id

id null for lead targets

event_type

code

event_at

datetime

device_type

code

link_url

text

fact_premium_billing

42,000,000 rows · 8 fields · Premium & Billing

billing_sk

id

invoice_id

id

group_id

id

premium_id

id

invoice_date_sk

id

invoice_amount

money

paid_amount

money

aging_bucket

code

fact_cob_detail

42,000,000 rows · 6 fields · Claims · 1 DQ

cob_sk

id

claim_id

id

member_id

id

other_payer_name

text

payer_order

code ~6% inconsistent

other_payer_paid

money

cob_detail

34,000,000 rows · 11 fields · Claims · 1 DQ

claim_line_id

id

cob_id

id

member_id

id PII

coordination_type

code

our_responsibility

code

primary_payer_id

code

primary_payer_paid

money

primary_payer_allowed

money

cob_savings_amount

money computed here, then copied to claim_line; recompute drift between the two tables ~3%

cob_method

code

cob_processed_date

date

cash_application

34,000,000 rows · 8 fields · Premium & Billing

cash_app_id

id

premium_id

id

invoice_id

id

invoice_line_id

id ~7% null (applied at header only)

applied_amount

money

feeds → Premium Collection Rate

application_date

date

application_type

code

auto_matched_flag

boolean

denied_claim

31,000,000 rows · 7 fields · Claims

claim_line_id

id

denial_id

id

feeds → Claims Denial Rate

denial_reason_code

code

denial_category

code

denied_amount

money

denial_datetime

datetime

appealable_flag

boolean

capitation_roster

28,000,000 rows · 8 fields · Provider · 1 DQ

roster_id

id

provider_id

id

member_id

id PII

capitation_period

code

plan_id

id

effective_date

date

termination_date

date

assignment_status

code

assessment_question

24,000,000 rows · 8 fields · Clinical & Care

assessment_question_id

id

assessment_id

id

member_id

id PII

question_code

code

question_text

text

response_value

text PII

response_score

integer

answered_datetime

datetime

billing_member_coverage

24,000,000 rows · 10 fields · Premium & Billing · 1 DQ

billing_coverage_id

id

member_id

id

feeds → Active Membership

billing_account_id

id

plan_id

id

benefit_plan_id

id

coverage_tier

code

billed_start_date

date

billed_end_date

date open-ended nulls ~20%

billing_status

code

subscriber_flag

boolean

authorization_link

22,000,000 rows · 6 fields · Clinical & Care · 1 DQ

claim_id

id

auth_id

id

auth_match_method

code

auth_status

code

units_authorized

decimal

units_used

decimal can exceed authorized

member_month_summary

21,600,000 rows · 8 fields · Membership · 1 DQ

member_id

id PII

coverage_month

date

benefit_plan_id

id

group_id

id

line_of_business

code

is_eligible_full_month

boolean

member_month_fraction

decimal

feeds → Member Monthsfeeds → Member Months Growth (YoY)

eligibility_span_id

id

member_month_actuarial

21,600,000 rows · 8 fields · Membership · 1 DQ

member_month_id

id

member_id

id PII

group_id

id

benefit_plan_id

id

coverage_month

date

line_of_business

code

is_dual_eligible

boolean

exposure_fraction

decimal ~2% duplicate spans

feeds → Member Months

rebate_accrual

21,000,000 rows · 10 fields · Finance · 1 DQ

accrual_id

id

pharmacy_claim_id

id

claim_line_id

id

ndc

code

rebate_contract_id

id

accrual_period

code

accrual_amount

money

feeds → Medical Loss Ratio (MLR)feeds → Net Claims Costfeeds → Rx PMPMfeeds → Rebate Capture Rate

gl_account

code

cost_center

code

accrued_date

date

accumulator_transaction

18,400,000 rows · 8 fields · Membership · 1 DQ

accumulator_txn_id

id

member_id

id PII

benefit_plan_id

id

claim_id

id

accumulator_type

code

applied_amount

money

transaction_date

date

reversal_flag

boolean

claim_lag_snapshot

18,400,000 rows · 9 fields · Claims · 1 DQ

claim_id

id

claim_line_id

id

member_id

id

incurred_date

date

paid_date

date

paid_amount

money

service_category

code

lag_days

integer

reserve_run_id

id

remittance_advice

18,000,000 rows · 8 fields · Claims

remittance_id

id

provider_id

id

provider_npi

code

check_eft_number

text

remit_date

date

total_paid_amount

money

payment_method

code

trace_number

text

apc_assignment

18,000,000 rows · 5 fields · Claims

claim_line_id

id

apc_code

code

status_indicator

code

relative_weight

decimal

packaged_flag

boolean

edi_835_transaction

18,000,000 rows · 5 fields · Claims

transaction_id

id

remittance_id

id

control_number

text

transmission_status

code

transmitted_datetime

datetime

ar_aging_snapshot

18,000,000 rows · 10 fields · Finance

aging_snapshot_id

id

billing_account_id

id

as_of_date

date

bucket_current

money

bucket_1_30

money

bucket_31_60

money

bucket_61_90

money

bucket_91_120

money

feeds → Premium AR Aging % > 90 days

bucket_over_120

money

feeds → Premium AR Aging % > 90 days

total_ar

money

feeds → Premium AR Aging % > 90 days

campaign_member

18,000,000 rows · 7 fields · Sales & Broker · 1 DQ

campaign_member_id

id

campaign_id

id

member_id

id null where targeting a lead

lead_id

id null where targeting a member

send_status

code

sent_at

datetime

responded

boolean

provider_payment

17,500,000 rows · 9 fields · Finance

payment_id

id

remittance_id

id

provider_id

id

gl_account

code

cost_center

code

payment_amount

money

feeds → Provider Payment Accuracy

payment_date

date

payment_status

code

void_flag

boolean

check_register

17,500,000 rows · 7 fields · Finance

check_number

text

payment_id

id

bank_account

code

check_amount

money

issue_date

date

cleared_flag

boolean

cleared_date

date

ar_balance

15,000,000 rows · 9 fields · Finance

ar_balance_id

id

billing_account_id

id

accounting_period

code

opening_balance

money

charges

money

payments

money

adjustments

money

closing_balance

money

feeds → Days Sales Outstanding (Premium DSO)

gl_account

code

claim_attachment

14,000,000 rows · 6 fields · Claims · 1 DQ

claim_id

id

attachment_id

id

attachment_type

code

document_uri

text dead pointers ~11%

received_date

date

reviewed_flag

boolean

group_billing_roster

14,000,000 rows · 9 fields · Premium & Billing · 1 DQ

roster_line_id

id

group_id

id

member_id

id ~4% mismatch vs enrollment

coverage_month

date

coverage_tier

code

group_reported_premium

money

plan_calculated_premium

money

variance_amount

money

reconciled_flag

boolean

fact_edit_override

14,000,000 rows · 6 fields · Claims

override_sk

id

claim_id

id

edit_code

code

override_reason

text

override_user

text PII

override_date_sk

id

clinical_note

12,500,000 rows · 10 fields · Clinical & Care

clinical_note_id

id

case_id

id

member_id

id PII

note_type

code

note_text

text PII

encounter_datetime

datetime

authored_by_employee_id

id

signed_datetime

datetime

addendum_flag

boolean

sensitivity_level

code

claim_adjustment

12,000,000 rows · 8 fields · Claims

claim_id

id

adjustment_id

id

adjustment_type

code

adjustment_reason

code

original_paid

money

adjusted_paid

money

net_adjustment

money

adjustment_date

date

fact_capitation

12,000,000 rows · 7 fields · Claims

cap_sk

id

provider_id

id

member_id

id

plan_id

id

cap_month_sk

id

cap_amount

money

member_count

integer

lockbox_transaction

11,000,000 rows · 8 fields · Premium & Billing · 1 DQ

lockbox_txn_id

id

bank_batch_id

text

remitter_name

text PII OCR variants

check_number

text

deposit_date

date

amount

money

matched_premium_id

id ~14% null (unmatched)

matched_flag

boolean

fee_schedule_rate

9,800,000 rows · 6 fields · Provider · 1 DQ

fee_schedule_id

id

procedure_code

code terminated codes

modifier_code

code

allowed_rate

money

rate_basis

code

effective_date

date

member_premium

9,800,000 rows · 9 fields · Premium & Billing · 1 DQ

premium_id

id

member_id

id PII

subscriber_id

id PII

benefit_plan_id

id

coverage_month

date

gross_premium

money

subsidy_amount

money

net_premium

money

feeds → Total Premium Revenue

premium_status

code

cms_pde_record

9,800,000 rows · 10 fields · Reporting & BI · 1 DQ

pde_id

id

pharmacy_claim_id

id

member_id

id PII

ndc

code

gross_drug_cost

money

patient_pay_amount

money

lics_amount

money

cms_submission_date

date

pde_status

code

reject_code

code

fact_authorization

9,800,000 rows · 9 fields · Clinical & Care

auth_sk

id

auth_id

id

member_id

id

provider_id

id

requested_date_sk

id

decision_date_sk

id

service_type_code

code

auth_status

code

units_approved

integer

auth_status_history

9,700,000 rows · 7 fields · Clinical & Care

status_history_id

id

auth_id

id

from_status

code

to_status

code

changed_datetime

datetime

changed_by_employee_id

id

reason_code

code

premium_revenue_recognition

9,600,000 rows · 8 fields · Finance · 1 DQ

rev_rec_id

id

plan_id

id

coverage_month

date

billed_premium

money

feeds → Total Premium Revenue

earned_premium

money

unearned_premium

money

gl_account

code

recognition_date

date

claim_resubmission

9,200,000 rows · 5 fields · Claims · 1 DQ

claim_id

id

original_claim_id

id null ~9%

frequency_code

code

resubmission_reason

code

resubmitted_date

date

premium_receipt

9,200,000 rows · 10 fields · Premium & Billing

premium_id

id

billing_account_id

id

receipt_number

text

payment_date

date

posted_date

date ~3% null (unposted lockbox items)

payment_amount

money

payment_method

code

payment_channel

code

unapplied_amount

money

feeds → Unapplied Cash Ratio

reversal_flag

boolean

eligibility_verification_log

8,900,000 rows · 8 fields · Membership · 1 DQ

inquiry_id

id

member_id

id PII

feeds → Eligibility Verification Match Rate

provider_npi

text

inquiry_datetime

datetime

response_code

code

feeds → Eligibility Verification Match Rate

service_type_code

code

trace_number

text

channel

code

member_contact_log

8,900,000 rows · 10 fields · Clinical & Care · 1 DQ

contact_log_id

id

case_id

id

member_id

id PII

contact_method

code

contact_direction

code

contact_datetime

datetime

outcome_code

code

phone_number

text PII 6% invalid format

duration_minutes

integer

employee_id

id

commission_line

8,900,000 rows · 10 fields · Sales & Broker · 1 DQ

commission_line_id

id

statement_id

id

broker_id

id

member_id

id orphaned rows ~2%

plan_id

id

premium_id

id null where reconstructed

earned_premium_basis

money 2% mismatch vs billing

feeds → Total Premium Revenue

commission_amount

money

feeds → Broker Commission Expense Ratio

comp_type

code

earned_month

date

queue_assignment

8,400,000 rows · 6 fields · Claims

pend_id

id

queue_code

code

examiner_id

id

assigned_datetime

datetime

completed_datetime

datetime

assignment_status

code

edit_override

7,800,000 rows · 8 fields · Claims · 1 DQ

edit_id

id

override_id

id

feeds → Edit Override Rate

claim_line_id

id

override_reason_code

code

override_reason_text

text free-text, inconsistent

overridden_by

id

override_datetime

datetime

supervisor_approval_flag

boolean

ncpdp_reject_code

7,800,000 rows · 5 fields · Pharmacy

reject_event_id

id

pharmacy_claim_id

id

ncpdp_reject_code

code

reject_description

text

reject_datetime

datetime

churn_prediction

7,600,000 rows · 7 fields · Membership · 1 DQ

churn_score_id

id

member_id

id

score_date

date

churn_probability

decimal

churn_band

code

feeds → Book-of-Business Retention Rate

top_driver

code

model_version

text null for backfilled

delinquency_status

7,400,000 rows · 8 fields · Premium & Billing

delinquency_id

id

billing_account_id

id

member_id

id null for group accounts

as_of_date

date

days_past_due

integer

feeds → Delinquency Rate

delinquency_level

code

past_due_amount

money

grace_period_flag

boolean

auth_note

7,300,000 rows · 8 fields · Clinical & Care

auth_note_id

id

auth_id

id

member_id

id PII

note_type

code

note_text

text PII

authored_by_employee_id

id

authored_datetime

datetime

is_phi_redacted

boolean

stars_gap_claim_flag

7,200,000 rows · 6 fields · Quality & STARS

claim_id

id

member_id

id PII

measure_id

code

gap_status

code

numerator_hit_flag

boolean

evaluated_date

date

enrollment_834_inbound

7,200,000 rows · 9 fields · Membership · 1 DQ

file_id

text

record_id

id

group_id

id

member_id

id PII

maintenance_type_code

code

benefit_begin_date

date

benefit_end_date

date

received_datetime

datetime

process_status

code

feeds → 834 Auto-Adjudication Rate

sold_membership_snapshot

7,200,000 rows · 9 fields · Membership · 1 DQ

snapshot_id

id

snapshot_month

date

member_id

id

broker_id

id

plan_id

id

group_id

id null for individual

sold_status

code includes 'pending_effectuation' which inflates active count

effective_date

date

is_active_sold

boolean

feeds → Active Membershipfeeds → Member Persistency Rate

fact_risk_score

7,200,000 rows · 7 fields · Risk & Actuarial · 1 DQ

risk_score_sk

id

risk_score_id

id

member_id

id

scoring_period_sk

id

raf_score

decimal mixed model version

hcc_count

integer

model_version

code

cms_payment_reconciliation

7,100,000 rows · 8 fields · Finance · 1 DQ

cms_recon_id

id

member_id

id

coverage_month

date

cms_expected_aptc

money

plan_reported_aptc

money

discrepancy_amount

money 15% unexplained

recon_status

code

gl_account

code

subsidy_aptc_detail

6,800,000 rows · 8 fields · Premium & Billing

aptc_detail_id

id

billing_account_id

id

member_id

id

coverage_month

date

aptc_amount

money

csr_variant

code

net_member_responsibility

money

cms_reconciled_flag

boolean

member_communication_log

6,400,000 rows · 7 fields · Membership

comm_id

id

member_id

id PII

comm_type

code

channel

code

sent_date

date

delivery_status

code

template_id

text

drg_assignment

6,200,000 rows · 6 fields · Claims

claim_id

id

drg_code

code

drg_version

code

relative_weight

decimal

grouper_outcome

code

outlier_flag

boolean

drg_pricing

6,200,000 rows · 6 fields · Claims

claim_id

id

base_rate

money

drg_payment

money

outlier_payment

money

capital_payment

money

total_drg_amount

money

awp_price_history

6,200,000 rows · 5 fields · Pharmacy · 1 DQ

ndc

code

awp_unit_price

money

wac_unit_price

money

effective_date

date

price_source

text

auth_line

6,100,000 rows · 11 fields · Clinical & Care

auth_line_id

id

auth_id

id

line_number

integer

service_code

code

service_code_type

code

requested_units

integer

approved_units

integer

unit_type

code

service_from_date

date

service_to_date

date

line_status

code

adjustment_transaction

5,800,000 rows · 9 fields · Premium & Billing

adjustment_id

id

invoice_id

id

billing_account_id

id

adjustment_type

code

adjustment_amount

money

reason_code

code

retro_period_start

date null in 40% of rows

created_by

id

created_at

datetime

member_interaction

5,800,000 rows · 9 fields · Membership · 1 DQ

interaction_id

id

member_id

id

crm_profile_id

id

channel

code free-text 11%

interaction_type

code

interaction_at

datetime

agent_employee_id

id

disposition

code

notes

text PII

enrollment_transaction

5,600,000 rows · 10 fields · Membership · 1 DQ

enrollment_txn_id

id

feeds → Retro Enrollment Rate

member_id

id PII

group_id

id

benefit_plan_id

id

transaction_type

code

transaction_reason_code

code

effective_date

date

received_date

date

processed_date

date

transaction_status

code

member_medication

5,400,000 rows · 10 fields · Pharmacy · 1 DQ

member_medication_id

id

member_id

id PII

case_id

id

ndc

code 14% null

drug_name

text PII

dosage

text PII

reconciliation_source

code

start_date

date

end_date

date

adherence_flag

code

flagged_claim_line

5,240,000 rows · 9 fields · Claims

claim_line_id

id

claim_id

id

procedure_code

code

modifier

code 24% null

diagnosis_code

code PII

units

integer

billed_amount

money

allowed_amount

money

place_of_service

code

auth_procedure

5,200,000 rows · 8 fields · Clinical & Care

auth_procedure_id

id

auth_id

id

procedure_code

code

procedure_code_system

code

modifier_1

code

modifier_2

code

requested_quantity

integer

tooth_or_site

code

invoice_delivery

4,900,000 rows · 7 fields · Premium & Billing

delivery_id

id

invoice_id

id

delivery_channel

code

delivery_address

text PII

sent_date

date

delivery_status

code bounced/returned not always captured

opened_flag

boolean

benefit_accumulator

4,800,000 rows · 9 fields · Membership · 1 DQ

member_id

id PII

benefit_plan_id

id

accumulator_type

code

benefit_year

integer

deductible_limit

money

deductible_met

money can exceed limit

oop_limit

money

oop_met

money

last_updated

datetime

auth_diagnosis

4,800,000 rows · 8 fields · Clinical & Care · 1 DQ

auth_diagnosis_id

id

auth_id

id

member_id

id PII

diagnosis_code

code PII

diagnosis_code_system

code

diagnosis_description

text PII

diagnosis_rank

integer

present_on_admission

code

invoice_header

4,800,000 rows · 12 fields · Premium & Billing

invoice_id

id

billing_account_id

id

group_id

id null for individual invoices

invoice_number

text

coverage_period_start

date

coverage_period_end

date

invoice_date

date

due_date

date

invoice_status

code 3 casing variants

total_premium_amount

money

feeds → Days Sales Outstanding (Premium DSO)

total_due_amount

money

currency_code

code

ref_fee_schedule

4,800,000 rows · 5 fields · Provider

fee_schedule_id

id

cpt_hcpcs_code

code

allowed_amount

money

effective_date

date

region

text

program_metric_result

4,600,000 rows · 8 fields · Clinical & Care · 1 DQ

metric_result_id

id

enrollment_id

id

member_id

id PII

metric_code

code

metric_value

decimal PII mixed units

unit_of_measure

code

reading_date

date

source

code

eligibility_history

4,200,000 rows · 8 fields · Membership

eligibility_id

id

member_id

id PII

change_type

code

prior_status

code

new_status

code

effective_date

date

changed_by

text

changed_at

datetime

um_work_queue_item

4,200,000 rows · 10 fields · Clinical & Care

work_item_id

id

queue_code

code

auth_id

id

case_id

id

member_id

id PII

priority

code

assigned_employee_id

id

sla_due_datetime

datetime

item_status

code

created_datetime

datetime

medication_adherence_metric

4,200,000 rows · 8 fields · Quality & STARS · 1 DQ

member_id

id PII

measure_id

code

gpi_class

code

measurement_period

code

pdc_numerator

integer

pdc_denominator

integer

pdc_score

decimal

feeds → Medication Adherence (PDC)

adherent_flag

boolean

feeds → Medication Adherence (PDC)

medicare_premium_billing

4,200,000 rows · 9 fields · Premium & Billing

mapd_billing_id

id

member_id

id

billing_account_id

id

coverage_month

date

plan_premium

money

lis_subsidy_amount

money

late_enrollment_penalty

money

withhold_method

code SSA-withhold vs direct-bill mismatch ~5%

net_member_premium

money

appeal_audit_log

4,200,000 rows · 8 fields · Appeals

audit_id

id

appeal_id

id

case_id

id

changed_field

text

old_value

text

new_value

text

changed_by

id

change_datetime

datetime

fact_er_visit

4,200,000 rows · 6 fields · Clinical & Care

er_sk

id

member_id

id

facility_id

id

visit_date_sk

id

acuity_level

code

avoidable_flag

boolean

rule_hit

4,120,000 rows · 9 fields · Fraud · 1 DQ

hit_id

id

rule_id

id

claim_id

id

claim_line_id

id

provider_id

id

member_id

id PII

hit_amount

money

hit_date

date

disposition

code

coordination_of_care_flag

4,100,000 rows · 6 fields · Clinical & Care

claim_id

id

member_id

id PII

care_program_code

code

case_id

id

flag_reason

code

flag_date

date

auth_attachment

4,100,000 rows · 8 fields · Clinical & Care · 1 DQ

attachment_id

id

auth_id

id

member_id

id PII

document_type

code

file_name

text PII

storage_uri

text

received_via

code

received_datetime

datetime

controlled_substance_log

4,100,000 rows · 9 fields · Fraud

cs_log_id

id

pharmacy_claim_id

id

member_id

id PII

prescriber_npi

code PII

ndc

code

dea_schedule

code

morphine_mg_equivalent

decimal

days_supply

integer

date_of_service

date

campaign_response

4,100,000 rows · 7 fields · Sales & Broker · 1 DQ

response_id

id

campaign_member_id

id

campaign_id

id

response_type

code

response_at

datetime

converted_opportunity_id

id null if no conversion

attributed_revenue

money double-counted across campaigns

feeds → Marketing Cost Per Acquisition (CPA)

fact_enrollment_span

4,100,000 rows · 9 fields · Membership · 1 DQ

enrollment_sk

id

member_id

id

plan_id

id

benefit_plan_id

id

group_id

id

span_start_date

date

span_end_date

date

coverage_status

code

disenroll_reason

code

referral_status_history

3,900,000 rows · 6 fields · Clinical & Care

referral_status_history_id

id

referral_id

id

from_status

code

to_status

code

changed_datetime

datetime

changed_by_employee_id

id

bridge_member_plan

3,900,000 rows · 5 fields · Membership

member_id

id

plan_id

id

benefit_plan_id

id

effective_date

date

expiration_date

date

pharmacy_crossover_claim

3,800,000 rows · 6 fields · Pharmacy · 1 DQ

pharmacy_claim_id

id

member_id

id PII

ndc

code ~5% null

medical_claim_id

id

crossover_reason

code

crossover_date

date

auth_claim_link

3,800,000 rows · 7 fields · Claims · 1 DQ

auth_claim_link_id

id

auth_id

id

claim_id

id

claim_line_id

id

match_method

code

match_confidence

decimal

linked_datetime

datetime

stg_gl_raw

3,800,000 rows · 6 fields · Finance

stg_gl_id

id

gl_account

code

cost_center

code

fund_id

id

amount

money

load_datetime

datetime

fact_care_gap

3,800,000 rows · 6 fields · Clinical & Care

gap_sk

id

member_id

id

measure_id

id

gap_type

code

identified_date_sk

id

closed_flag

boolean

pharmacy_benefit_accumulator

3,600,000 rows · 8 fields · Premium & Billing · 1 DQ

member_id

id PII

benefit_plan_id

id

accumulator_year

integer

deductible_met_amount

money

oop_met_amount

money

troop_amount

money

coverage_phase

code

last_updated

datetime

auth_determination

3,400,000 rows · 10 fields · Clinical & Care

determination_id

id

auth_id

id

determination_type

code

determination_outcome

code

feeds → Prior Auth Approval Rate

decided_datetime

datetime

decided_by_role

code

reviewer_employee_id

id

medical_necessity_met

boolean

feeds → Pre-Service Denial Rate

auto_approved

boolean

turnaround_hours

decimal negative values where decided before received timestamp

feeds → Authorization Turnaround Time (TAT)

sla_event

3,400,000 rows · 9 fields · Clinical & Care

sla_event_id

id

auth_id

id

sla_type

code

clock_start_datetime

datetime

clock_stop_datetime

datetime

pause_minutes

integer

regulatory_standard

code

met_flag

boolean

feeds → Authorization Turnaround Time (TAT)feeds → SLA Compliance Rate

breach_reason

code

feeds → SLA Compliance Rate

dunning_event

3,200,000 rows · 8 fields · Premium & Billing

dunning_id

id

billing_account_id

id

member_id

id

dunning_stage

code

notice_date

date

channel

code

amount_due

money

response_flag

boolean

document_attachment

3,200,000 rows · 7 fields · Sales & Broker · 1 DQ

attachment_id

id

entity_type

code

entity_id

id orphaned ~6%

file_name

text

document_type

code

uploaded_by

text

uploaded_at

datetime

appeal_link

3,100,000 rows · 6 fields · Appeals · 1 DQ

claim_line_id

id

appeal_id

id cross-app orphans ~10%

case_id

id

appeal_level

code

appeal_outcome

code

linked_date

date

medicaid_eligibility_feed

3,100,000 rows · 8 fields · Membership · 1 DQ

feed_record_id

id

member_id

id PII

medicaid_id

text PII

aid_category

code

eligibility_start_date

date

eligibility_end_date

date

redetermination_date

date

file_received_date

date

authorization_letter

3,100,000 rows · 9 fields · Clinical & Care

letter_id

id

auth_id

id

member_id

id PII

letter_type

code

recipient_type

code

generated_datetime

datetime

sent_datetime

datetime

delivery_method

code

template_code

code

dur_alert

3,100,000 rows · 10 fields · Clinical & Care · 1 DQ

dur_alert_id

id

pharmacy_claim_id

id

member_id

id PII

ndc

code

dur_type

code

severity

code

conflicting_ndc

code

alert_datetime

datetime

pharmacist_override_flag

boolean

override_reason

code

ssa_premium_withhold

3,100,000 rows · 7 fields · Premium & Billing · 1 DQ

ssa_withhold_id

id

member_id

id

coverage_month

date

requested_withhold

money

ssa_confirmed_withhold

money

withhold_status

code

trr_reason_code

code 6% mismatch

hcc_capture

3,100,000 rows · 9 fields · Risk & Actuarial · 1 DQ

hcc_capture_id

id

member_id

id PII

payment_year

integer

hcc_code

code PII

diagnosis_code

code PII

coefficient

decimal

capture_source

code

is_chart_confirmed

boolean ~6% suspect/unconfirmed

risk_score_id

id

score_feature

2,980,000 rows · 6 fields · Fraud

feature_id

id

risk_score_id

id

feature_name

text

feature_value

decimal

contribution_weight

decimal

z_score

decimal

capitation_eligibility_roster

2,900,000 rows · 7 fields · Membership · 1 DQ

roster_id

id

member_id

id PII

provider_id

id

provider_npi

text

cap_period

date

benefit_plan_id

id

roster_status

code

provider_audit_trail

2,900,000 rows · 8 fields · Reporting & BI

audit_id

id

provider_id

id

table_name

text

field_name

text

old_value

text

new_value

text

change_timestamp

datetime

changed_by

text

auth_request

2,900,000 rows · 13 fields · Clinical & Care · 1 DQ

auth_id

id

member_id

id PII

provider_id

id

provider_npi

code

facility_id

id

request_type

code

service_category

code

urgency

code

received_datetime

datetime 4% null on urgent

created_datetime

datetime

requested_units

integer

place_of_service

code

auth_status

code

cob_pharmacy_detail

2,900,000 rows · 7 fields · Claims · 1 DQ

cob_id

id

pharmacy_claim_id

id

member_id

id PII

other_payer_id

code

other_payer_bin

code

other_payer_amount

money

cob_sequence

integer

audit_log

2,840,000 rows · 8 fields · Fraud

log_id

id

employee_id

id

case_id

id

action

code

entity_accessed

text

member_id

id PII

accessed_at

datetime

ip_address

text PII

claim_intake_batch

2,800,000 rows · 6 fields · Claims

batch_id

id

intake_channel

code

clearinghouse_id

code

received_datetime

datetime

claim_count

integer

batch_status

code

mac_price_detail

2,800,000 rows · 6 fields · Pharmacy · 1 DQ

mac_list_id

id

gpi

code

ndc

code

mac_unit_price

money

effective_date

date

last_updated

date

bridge_member_pcp

2,800,000 rows · 5 fields · Provider · 1 DQ

member_id

id

provider_id

id

attribution_start

date

attribution_end

date

attribution_method

code

fax_inbound

2,700,000 rows · 8 fields · Clinical & Care · 1 DQ

fax_id

id

received_datetime

datetime

from_number

text PII

page_count

integer

classification

code 35% unclassified

auth_id

id

indexed_by_employee_id

id

storage_uri

text

cob_recovery

2,600,000 rows · 7 fields · Finance · 1 DQ

recovery_id

id

claim_line_id

id

recovery_type

code

cob_savings_amount

money sourced from claim_line; basis of recovery target

recovered_amount

money

feeds → COB Recovery Rate

recovery_status

code

recovery_date

date

capitation_payment

2,400,000 rows · 8 fields · Finance

cap_payment_id

id

provider_id

id

capitation_period

code

member_count

integer

pmpm_rate

money

total_cap_amount

money

feeds → Capitation as % of Medical Spend

gl_account

code

payment_date

date

cms_membership_reconciliation

2,400,000 rows · 8 fields · Membership · 1 DQ

mmr_record_id

id

member_id

id PII

mbi

text PII

contract_number

text

pbp_number

text

cms_payment_month

date

reconciliation_status

code

discrepancy_code

code

fee_schedule_line

2,400,000 rows · 9 fields · Provider · 1 DQ

fee_schedule_line_id

id

fee_schedule_id

id

procedure_code

code

modifier

code

allowed_amount

money 7% zero rate

feeds → Claims PMPMfeeds → Fee Schedule Load Completeness

unit_basis

code

rvu_value

decimal

effective_date

date

termination_date

date

auth_policy_link

2,400,000 rows · 5 fields · Clinical & Care

auth_policy_link_id

id

auth_id

id

policy_id

id

applied_datetime

datetime

policy_outcome

code

member_pharmacy_eligibility

2,400,000 rows · 9 fields · Membership · 1 DQ

member_id

id PII

feeds → Rx PMPM

group_id

id

benefit_plan_id

id

formulary_id

id

rx_bin

code

rx_pcn

code

rx_group

code

effective_date

date

termination_date

date

lead_activity

2,400,000 rows · 7 fields · Sales & Broker · 1 DQ

activity_id

id

lead_id

id

broker_id

id

activity_type

code free-text in legacy rows

activity_at

datetime

outcome

code

notes

text PII

fact_gl_balance

2,400,000 rows · 8 fields · Finance

gl_balance_sk

id

gl_account

code

cost_center

code

fund_id

id

period_sk

id

debit_amount

money

credit_amount

money

net_amount

money

fact_benefit_accumulator

2,400,000 rows · 7 fields · Membership

accum_sk

id

member_id

id

benefit_plan_id

id

plan_year

integer

accum_type

code

applied_amount

money

remaining_amount

money

care_plan_intervention

2,300,000 rows · 9 fields · Clinical & Care

intervention_id

id

goal_id

id

care_plan_id

id

intervention_code

code

intervention_description

text PII

due_date

date

completed_date

date

intervention_status

code

assigned_employee_id

id

member_condition

2,200,000 rows · 8 fields · Clinical & Care

member_condition_id

id

member_id

id PII

condition_code

code PII

feeds → Risk Adjustment Factor (RAF)

condition_category

code

identified_date

date

identification_method

code

confidence_level

code

active_flag

boolean

member_eligibility

2,100,000 rows · 8 fields · Membership · 1 DQ

member_id

id PII

group_id

id

plan_id

id

benefit_plan_id

id

eligibility_status

code

effective_date

date

termination_date

date retro changes lag

coverage_level

code

benefit_accumulator

2,100,000 rows · 9 fields · Membership · 1 DQ

member_id

id PII

benefit_plan_id

id

accumulator_type

code

plan_year

integer

accumulated_amount

money PII

feeds → Accumulator Reconciliation Variance

limit_amount

money

remaining_amount

money

network_tier

code

last_updated

datetime

auth_clinical_criteria

2,100,000 rows · 8 fields · Clinical & Care · 1 DQ

criteria_eval_id

id

auth_id

id

criteria_source

code

criteria_set_id

code

criteria_set_version

text 18% null pre-2024

criteria_met

boolean

guideline_title

text

evaluated_datetime

datetime

broker_commission_billing

2,100,000 rows · 8 fields · Sales & Broker

commission_billing_id

id

broker_id

id

group_id

id null for individual market

member_id

id

coverage_month

date

premium_base

money

commission_rate

decimal

commission_amount

money

application_status_history

2,100,000 rows · 6 fields · Sales & Broker

history_id

id

application_id

id

from_status

code

to_status

code

changed_at

datetime

changed_by

text

etl_load_audit

2,100,000 rows · 7 fields · Reporting & BI

audit_id

id

target_table

text

batch_id

id

load_datetime

datetime

insert_count

integer

update_count

integer

reject_count

integer

pended_claim

1,900,000 rows · 8 fields · Claims · 1 DQ

claim_id

id

pend_id

id

feeds → Days in Claims Payable (DCP)feeds → First-Pass Resolution Rate

pend_reason_code

code

pend_category

code

pended_datetime

datetime

pend_age_days

integer negative values

feeds → Pended Claim Aging

assigned_queue

code

assigned_examiner_id

id

benefit_coverage_rule

1,900,000 rows · 7 fields · Membership · 1 DQ

benefit_plan_id

id

service_category

code orphaned categories

covered_flag

boolean

copay_amount

money

coinsurance_pct

decimal

prior_auth_required

boolean

annual_limit_units

integer

concurrent_review

1,900,000 rows · 11 fields · Clinical & Care

concurrent_review_id

id

auth_id

id

member_id

id PII

facility_id

id

review_datetime

datetime

review_type

code

clinical_status

code PII

days_approved

integer

next_review_date

date

level_of_care

code

reviewer_employee_id

id

member_eligibility_snapshot

1,900,000 rows · 9 fields · Membership · 1 DQ

eligibility_snapshot_id

id

member_id

id PII

feeds → Active Membership

plan_id

id

benefit_plan_id

id

group_id

id

coverage_start_date

date

coverage_end_date

date overlapping spans 4%

feeds → Active Membership

line_of_business

code

as_of_datetime

datetime

membership_count_snapshot

1,900,000 rows · 7 fields · Premium & Billing · 1 DQ

count_snapshot_id

id

plan_id

id

coverage_month

date

market_segment

code

billed_member_count

integer

feeds → Active Membership

billed_subscriber_count

integer

snapshot_date

date

campaign_attribution

1,900,000 rows · 6 fields · Reporting & BI · 1 DQ

attribution_id

id

application_id

id

campaign_id

id

attribution_model

code pre/post model not reconciled

attribution_weight

decimal

feeds → Marketing Cost Per Acquisition (CPA)

attributed_at

datetime

fact_admission

1,900,000 rows · 8 fields · Clinical & Care

admission_sk

id

member_id

id

facility_id

id

admit_date_sk

id

discharge_date_sk

id

drg_code

code PII

length_of_stay

integer

readmit_flag

boolean

flagged_claim

1,860,000 rows · 12 fields · Claims · 1 DQ

claim_id

id

claim_line_id

id

member_id

id PII

provider_id

id

provider_npi

text

facility_id

id

billed_amount

money

paid_amount

money

flag_reason_code

code

review_status

code

service_date

date

edit_override_id

id 18% null

case_note

1,840,000 rows · 8 fields · Appeals · 1 DQ

note_id

id

appeal_id

id

case_id

id

note_text

text PII

note_type

code

authored_by

id

authored_datetime

datetime

internal_only_flag

boolean

overpayment_recovery

1,800,000 rows · 7 fields · Finance

overpayment_id

id

claim_line_id

id

provider_id

id

overpaid_amount

money

feeds → Provider Payment Accuracy

recovery_method

code

recovered_amount

money

feeds → Net Claims Cost

identified_date

date

referral

1,700,000 rows · 11 fields · Clinical & Care · 1 DQ

referral_id

id

member_id

id PII

case_id

id

referring_provider_id

id

referred_to_provider_id

id orphaned rows

referral_type

code

specialty_code

code

diagnosis_code

code PII

referral_status

code

created_date

date

expiration_date

date

eligibility

1,620,000 rows · 12 fields · Membership · 1 DQ

eligibility_id

id

member_id

id PII

plan_id

id

benefit_plan_id

id

eligibility_start_date

date

feeds → Member Months

eligibility_end_date

date

feeds → Active Membership

eligibility_status

code

feeds → Active Membershipfeeds → Termination Rate (Annualized)

coverage_level

code

medicaid_aid_category

code

medicare_status_code

code

determination_date

date

source_system

text

dir_fee

1,600,000 rows · 8 fields · Finance

dir_fee_id

id

pharmacy_claim_id

id

pharmacy_npi

code

network_id

id

dir_amount

money

feeds → Net Claims Cost

fee_basis

code

accrual_period

code

gl_account

code

quote_line

1,600,000 rows · 7 fields · Sales & Broker

quote_line_id

id

quote_id

id

relationship

code

date_of_birth

date PII

tobacco_use

boolean PII

rated_premium

money

rating_area

code

enrollment_span

1,480,000 rows · 11 fields · Membership · 1 DQ

enrollment_span_id

id

member_id

id PII

group_id

id

plan_id

id

benefit_plan_id

id

span_start_date

date

feeds → Average Coverage Tenure (months)

span_end_date

date open-ended nulls treated inconsistently downstream

feeds → Average Coverage Tenure (months)

enrollment_reason_code

code

coverage_tier

code

span_status

code

created_at

datetime

member_xref

1,480,000 rows · 6 fields · Membership · 1 DQ

member_id

id PII

source_system

text

source_member_key

text PII

match_confidence

decimal

match_method

code

created_at

datetime

premium_rate_schedule

1,450,000 rows · 9 fields · Premium & Billing

rate_schedule_id

id

plan_id

id

benefit_plan_id

id

rating_area

code

age_band

code

coverage_tier

code

base_rate

money

effective_date

date

end_date

date 12% null (open-ended rates never closed)

dim_member

1,450,000 rows · 12 fields · Membership · 1 DQ

member_sk

id

member_id

id

first_name

text PII

last_name

text PII

date_of_birth

date PII

gender_code

code

ssn

text PII ~6% null or masked inconsistently

address_zip

text PII

effective_date

date

expiration_date

date

current_flag

boolean

source_system_code

code

interest_payment

1,400,000 rows · 7 fields · Finance

claim_id

id

interest_id

id

interest_amount

money

days_late

integer

interest_rate

decimal

gl_account

code

accrued_date

date

care_plan_goal

1,400,000 rows · 8 fields · Clinical & Care

goal_id

id

care_plan_id

id

member_id

id PII

goal_category

code

goal_description

text PII

target_date

date

goal_status

code

priority

code

formulary_drug

1,400,000 rows · 9 fields · Pharmacy · 1 DQ

formulary_id

id

ndc

code

gpi

code

tier

integer

on_formulary_flag

boolean

prior_auth_required

boolean

step_therapy_required

boolean

quantity_limit_flag

boolean

effective_date

date

member_address

1,340,000 rows · 11 fields · Membership · 1 DQ

member_id

id PII

address_type

code

address_line_1

text PII

address_line_2

text PII

city

text PII

state_code

code

zip_code

text PII

county_code

code

effective_date

date

end_date

date

is_primary

boolean

id_card_print_queue

1,340,000 rows · 7 fields · Membership

print_request_id

id

card_id

id

member_id

id PII

request_date

date

fulfillment_status

code

vendor_batch_id

text

mailed_date

date

risk_score

1,240,000 rows · 9 fields · Risk & Actuarial

risk_score_id

id

member_id

id PII

model_version

code

payment_year

integer

raf_score

decimal

demographic_score

decimal

disease_score

decimal

normalized_raf

decimal

feeds → Risk Adjustment Factor (RAF)

score_status

code

eligibility_response_cache

1,200,000 rows · 6 fields · Membership · 1 DQ

cache_id

id

member_id

id PII

benefit_plan_id

id

cached_response

text PII

as_of_date

date

expires_at

datetime

bridge_provider_network

1,200,000 rows · 5 fields · Provider · 1 DQ

provider_id

id

network_id

id

plan_id

id

effective_date

date

par_status

code

fact_pharmacy_rebate

1,200,000 rows · 6 fields · Pharmacy · 1 DQ

rebate_sk

id

ndc

code

manufacturer

text

quarter_sk

id

accrued_rebate

money 2-quarter lag

received_rebate

money

id_card

1,180,000 rows · 10 fields · Membership · 1 DQ

card_id

id

member_id

id PII

benefit_plan_id

id

card_number

text PII

rx_bin

text

rx_pcn

text

rx_group

text

issue_date

date

card_status

code

is_digital

boolean

assessment

1,100,000 rows · 11 fields · Clinical & Care · 1 DQ

assessment_id

id

case_id

id

member_id

id PII

assessment_type

code

instrument_code

code

started_datetime

datetime

completed_datetime

datetime 9% null

total_score

integer PII

risk_tier

code

administered_by_employee_id

id

modality

code

member_contact

980,000 rows · 7 fields · Membership · 1 DQ

member_id

id PII

contact_type

code

phone_number

text PII

email_address

text PII

is_verified

boolean

opt_in_sms

boolean

updated_at

datetime

raf_reconciliation

960,000 rows · 7 fields · Risk & Actuarial · 1 DQ

reconciliation_id

id

member_id

id PII

payment_year

integer

internal_raf

decimal

feeds → Risk Adjustment Factor (RAF)

cms_returned_raf

decimal ~11% null pending return files

raf_variance

decimal

reconciliation_status

code

edit_override

920,000 rows · 6 fields · Pharmacy

override_id

id

pharmacy_claim_id

id

edit_type

code

override_code

code

override_by

text

override_datetime

datetime

case_document

920,000 rows · 8 fields · Appeals

document_id

id

appeal_id

id

case_id

id

document_type

code

file_name

text

contains_phi_flag

boolean

uploaded_datetime

datetime

storage_uri

text

care_plan_barrier

890,000 rows · 8 fields · Clinical & Care

barrier_id

id

care_plan_id

id

member_id

id PII

barrier_category

code

barrier_description

text PII

identified_date

date

resolved_date

date

sdoh_domain

code

grace_period_tracking

890,000 rows · 10 fields · Premium & Billing

grace_period_id

id

billing_account_id

id

member_id

id

grace_type

code

grace_start_date

date

grace_end_date

date

month_1_paid_flag

boolean

month_2_paid_flag

boolean

month_3_paid_flag

boolean

claims_pend_flag

boolean

data_quality_log

890,000 rows · 6 fields · Reporting & BI · 1 DQ

dq_log_id

id

rule_name

text

target_table

text

eval_datetime

datetime

fail_count

integer

severity

code mostly warn-only

broker_performance_snapshot

840,000 rows · 8 fields · Reporting & BI · 1 DQ

perf_snapshot_id

id

broker_id

id

snapshot_month

date

sold_lives

integer CRM basis, diverges from enrollment

feeds → Active Membership

new_apps

integer

retained_lives

integer

earned_premium

money

feeds → Total Premium Revenue

persistency_rate

decimal

feeds → Member Persistency Rate

mart_provider_performance

840,000 rows · 7 fields · Provider

perf_sk

id

provider_id

id

quarter_sk

id

total_paid

money

claim_count

integer

attributed_members

integer

feeds → Provider Network Adequacy %

quality_score

decimal

pharmacy_remittance

820,000 rows · 8 fields · Finance

remittance_id

id

pharmacy_npi

code

provider_id

id

payment_cycle

code

total_paid

money

total_clawback

money

check_eft_number

text

remit_date

date

nps_survey

820,000 rows · 7 fields · Quality & STARS

survey_id

id

member_id

id

campaign_id

id null for transactional surveys

survey_type

code

sent_at

datetime

channel

code

status

code

flagged_pharmacy_claim

742,000 rows · 10 fields · Pharmacy · 1 DQ

pharmacy_claim_id

id

member_id

id PII

ndc

code

prescriber_npi

text

pharmacy_npi

text casing/format variants

days_supply

integer

quantity

decimal

paid_amount

money

flag_reason_code

code

fill_date

date

termination

740,000 rows · 9 fields · Membership · 1 DQ

termination_id

id

feeds → Termination Rate (Annualized)

member_id

id PII

enrollment_span_id

id

group_id

id

termination_date

date

termination_reason_code

code

is_voluntary

boolean

reinstatement_eligible

boolean

processed_date

date

reviewer_caseload

740,000 rows · 8 fields · Workforce

caseload_id

id

employee_id

id

snapshot_date

date

queue_code

code

assigned_count

integer

completed_count

integer

avg_turnaround_hours

decimal

feeds → Authorization Turnaround Time (TAT)

role

code

prior_auth_request

680,000 rows · 12 fields · Pharmacy · 1 DQ

auth_id

id

feeds → Prior Auth Approval Rate

member_id

id PII

ndc

code

gpi

code

prescriber_npi

code PII

diagnosis_code

code PII

request_datetime

datetime

decision_status

code

feeds → Prior Auth Approval Rate

decision_reason

text

approved_quantity

decimal

effective_date

date

expiration_date

date

chart_review_finding

680,000 rows · 8 fields · Risk & Actuarial

finding_id

id

member_id

id PII

payment_year

integer

hcc_code

code PII

finding_type

code

reviewer_id

id

chart_date

date PII

provider_npi

id

fact_appeal

680,000 rows · 8 fields · Appeals

appeal_sk

id

appeal_id

id

member_id

id

claim_id

id

received_date_sk

id

resolved_date_sk

id

appeal_type

code

outcome_code

code

member_demographic_snapshot

640,000 rows · 7 fields · Membership · 1 DQ

member_id

id PII

first_name

text PII casing variants

last_name

text PII

date_of_birth

date PII ~0.5% null

gender_code

code PII

ssn

text PII

zip_code

code PII

member_claim_history_index

640,000 rows · 5 fields · Reporting & BI

member_id

id PII

first_claim_date

date

last_claim_date

date

lifetime_paid

money

claim_count

integer

coverage_tier_assignment

640,000 rows · 6 fields · Membership

subscriber_id

id PII

benefit_plan_id

id

coverage_tier

code

covered_member_count

integer

effective_date

date

end_date

date

inpatient_stay

640,000 rows · 12 fields · Clinical & Care · 1 DQ

stay_id

id

member_id

id PII

facility_id

id

auth_id

id

admit_datetime

datetime

discharge_datetime

datetime 7% null

feeds → 30-Day Readmission Rate

admit_type

code

admit_source

code

discharge_disposition

code

drg_code

code

primary_diagnosis_code

code PII

observed_los_days

decimal

feeds → Average Length of Stay (ALOS)

case_assignment

640,000 rows · 7 fields · Clinical & Care · 1 DQ

assignment_id

id

case_id

id

employee_id

id

role_label

text 5 casing variants

assigned_date

date

unassigned_date

date

is_primary

boolean

readmission_risk_score

640,000 rows · 7 fields · Risk & Actuarial · 1 DQ

risk_score_id

id

member_id

id PII

stay_id

id

score_value

decimal PII

risk_band

code

model_version

text null on legacy

scored_date

date

vaccine_administration

640,000 rows · 7 fields · Pharmacy

vaccine_event_id

id

pharmacy_claim_id

id

member_id

id PII

ndc

code

cvx_code

code

administration_fee

money

date_of_service

date

write_off

640,000 rows · 9 fields · Finance · 1 DQ

write_off_id

id

billing_account_id

id

invoice_id

id ~30% null

write_off_amount

money

feeds → Write-off Rate

reason_code

code 22% free-text instead of coded

approved_by

id PII

write_off_date

date

gl_account

code

recoverable_flag

boolean

book_of_business

640,000 rows · 9 fields · Sales & Broker · 1 DQ

bob_id

id

broker_id

id

member_id

id

group_id

id null for individual market

plan_id

id

bor_effective_date

date

bor_term_date

date null for active book

acquisition_channel

code

is_active

boolean

feeds → Active Membershipfeeds → Book-of-Business Retention Rate

member_crm_profile

640,000 rows · 11 fields · Membership · 1 DQ

crm_profile_id

id

member_id

id

first_name

text PII

last_name

text PII

date_of_birth

date PII

email

text PII 18% null

phone

text PII

mailing_address

text PII casing variants

preferred_language

code

broker_id

id

lifecycle_stage

code

member_consent

640,000 rows · 7 fields · Membership · 1 DQ

consent_id

id

member_id

id

consent_type

code

opt_in

boolean

channel

code

consent_date

date null for migrated records

source

code

program_enrollment

620,000 rows · 9 fields · Clinical & Care · 1 DQ

enrollment_id

id

program_id

id

member_id

id PII

case_id

id

enrollment_status

code

feeds → Case Management Engagement Rate

enrolled_date

date

disenrolled_date

date

disenroll_reason

code

engagement_level

code

feeds → Case Management Engagement Rate

member_master

612,000 rows · 11 fields · Membership · 1 DQ

member_id

id PII

subscriber_id

id PII

first_name

text PII

last_name

text PII

date_of_birth

date PII

ssn

text PII 11% null (Medicaid members)

gender_code

code

relationship_code

code

member_status

code

created_at

datetime

source_system

text 3 casing variants (FACETS/Facets/facets)

member_demographic

612,000 rows · 8 fields · Membership · 1 DQ

member_id

id PII

race_code

code PII

ethnicity_code

code PII

primary_language

code PII

marital_status

code PII

preferred_contact_method

code

effective_date

date

updated_at

datetime

member_segment

612,000 rows · 6 fields · Membership

member_id

id PII

segment_code

code

risk_band

code

chronic_condition_flag

boolean PII

effective_date

date

assigned_by

text

member_demographic

604,000 rows · 9 fields · Membership · 1 DQ

member_id

id PII

feeds → Active Membership

group_id

id

plan_id

id

member_first_name

text PII

member_last_name

text PII

date_of_birth

date PII

member_address

text PII 1.2% mismatch vs source

language_preference

code

phone

text PII

member_demographic_snapshot

600,000 rows · 11 fields · Membership · 1 DQ

member_id

id PII

first_name

text PII

last_name

text PII

date_of_birth

date PII 0.3% null

gender

code PII

preferred_language

code PII

phone

text PII

address_line

text PII ~9% stale

plan_id

id

group_id

id

snapshot_date

date

fact_member_demographic

600,000 rows · 6 fields · Membership · 1 DQ

demo_sk

id

member_id

id

race_code

code PII ~3% null

ethnicity_code

code PII

primary_language

code PII

snapshot_date_sk

id

transition_of_care

560,000 rows · 10 fields · Clinical & Care

toc_id

id

member_id

id PII

case_id

id

stay_id

id

discharge_date

date

followup_due_date

date

followup_completed_date

date completed within 7 days on only 62%

followup_type

code

readmission_30d_flag

boolean

feeds → 30-Day Readmission Rate

assigned_employee_id

id

examiner_productivity

540,000 rows · 6 fields · Workforce

examiner_id

id

work_date

date

claims_worked

integer

claims_finalized

integer

avg_handle_seconds

integer

quality_score

decimal

claim_lag_triangle

540,000 rows · 5 fields · Risk & Actuarial

service_month

code

paid_month

code

product_line

code

paid_amount

money

claim_count

integer

member_consent

540,000 rows · 7 fields · Membership

member_id

id PII

consent_type

code PII

consent_status

code

effective_date

date

expiration_date

date

captured_by

text

captured_at

datetime

pharmacy_network_affiliation

540,000 rows · 7 fields · Provider · 1 DQ

network_id

id

pharmacy_npi

code

provider_id

id

effective_date

date

termination_date

date

preferred_flag

boolean

reimbursement_tier

code

application

540,000 rows · 12 fields · Sales & Broker · 1 DQ

application_id

id

quote_id

id

broker_id

id

member_id

id null until effectuated (~30%)

group_id

id null for individual

plan_id

id

benefit_plan_id

id

applicant_name

text PII

applicant_ssn

code PII masked in 100%; raw in legacy 0.5%

application_status

code

feeds → Lead Conversion Rate

submitted_at

datetime

effective_date

date

network_affiliation

520,000 rows · 5 fields · Provider · 1 DQ

provider_id

id

network_id

code

affiliation_status

code

effective_date

date

termination_date

date duplicate active spans

pcp_assignment

520,000 rows · 8 fields · Membership · 1 DQ

member_id

id PII

provider_id

id

provider_npi

text

benefit_plan_id

id

assignment_type

code

effective_date

date

end_date

date

is_auto_assigned

boolean

denial_rationale

520,000 rows · 7 fields · Clinical & Care

rationale_id

id

denial_id

id

member_id

id PII

rationale_text

text PII

guideline_cited

text

authored_by_employee_id

id

authored_datetime

datetime

case_episode

520,000 rows · 7 fields · Clinical & Care

episode_id

id

case_id

id

member_id

id PII

episode_type

code

start_date

date

end_date

date

episode_status

code

reserve_run_detail

520,000 rows · 9 fields · Risk & Actuarial · 1 DQ

reserve_run_id

id

incurred_month

date

service_category

code

paid_to_date

money

completion_factor

decimal null for 2 most recent incurred months

feeds → Completion Factor

ultimate_incurred

money

ibnr_amount

money

feeds → IBNR Reserve Balance

member_months

integer

pmpm_ultimate

decimal

feeds → Claims PMPM

commission_statement

520,000 rows · 9 fields · Sales & Broker

statement_id

id

broker_id

id

agency_id

id

cycle_month

date

gross_commission

money

chargeback_amount

money

net_commission

money

feeds → Broker Commission Expense Ratio

payment_status

code

paid_date

date null until paid

mart_membership_monthly

520,000 rows · 8 fields · Membership · 1 DQ

mart_sk

id

plan_id

id

lob_code

code

snapshot_month_sk

id

active_members

integer point-in-time vs avg differs

feeds → Active Membership

member_months

decimal

feeds → Member Months

new_members

integer

termed_members

integer

fact_credentialing

520,000 rows · 6 fields · Provider · 1 DQ

cred_sk

id

provider_id

id

provider_npi

text

cred_status

code ~10% stale active

approved_date_sk

id

recred_due_date_sk

id

compound_ingredient

510,000 rows · 6 fields · Pharmacy

compound_ingredient_id

id

pharmacy_claim_id

id

ndc

code

ingredient_quantity

decimal

ingredient_cost

money

ingredient_sequence

integer

aberrancy_score

486,000 rows · 9 fields · Fraud

risk_score_id

id

provider_id

id

provider_npi

text

model_id

id

scoring_period

text

aberrancy_score

decimal

percentile_rank

decimal

peer_group

code

computed_at

datetime

enrollment_application

480,000 rows · 9 fields · Membership

application_id

id

member_id

id PII

group_id

id

plan_id

id

application_channel

code

submitted_date

date

application_status

code

effective_date_requested

date

broker_id

id

medicare_fee_reference

480,000 rows · 7 fields · Provider

reference_id

id

procedure_code

code

modifier

code

locality_code

code

medicare_allowed

money

feeds → Average Contracted Rate vs Medicare

total_rvu

decimal

effective_year

integer

health_risk_assessment

480,000 rows · 9 fields · Clinical & Care · 1 DQ

hra_id

id

member_id

id PII

plan_id

id

outreach_method

code

sent_date

date

completed_date

date 24% null

hra_status

code

composite_risk_score

decimal PII

chronic_condition_flag

boolean PII

feeds → Risk Adjustment Factor (RAF)

quote

480,000 rows · 10 fields · Sales & Broker · 1 DQ

quote_id

id

opportunity_id

id

lead_id

id

broker_id

id

plan_id

id

benefit_plan_id

id

quoted_premium

money

effective_date

date

quote_status

code

created_at

datetime

broker_payment

480,000 rows · 9 fields · Finance · 1 DQ

payment_id

id

statement_id

id

broker_id

id

agency_id

id

payment_amount

money

payment_method

code

gl_account

code null pre-2024

cost_center

code

payment_date

date

mart_claims_pmpm

480,000 rows · 7 fields · Claims

pmpm_sk

id

plan_id

id

service_month_sk

id

total_paid

money

member_months

decimal

feeds → Member Months

pmpm_amount

money

feeds → Claims PMPM

utilization_per_1000

decimal

etl_job_run

480,000 rows · 7 fields · Reporting & BI

job_run_id

id

job_name

text

start_datetime

datetime

end_datetime

datetime

status

code

rows_processed

integer

error_message

text

payment_void_reissue

420,000 rows · 6 fields · Finance · 1 DQ

void_id

id

original_payment_id

id orphaned ~8%

reissue_payment_id

id

void_reason_code

code

void_date

date

void_amount

money

family_accumulator_link

420,000 rows · 6 fields · Membership

family_unit_id

id

subscriber_id

id PII

member_id

id PII

benefit_plan_id

id

plan_year

integer

contributes_to_family

boolean

dur_interaction_master

420,000 rows · 6 fields · Clinical & Care

interaction_id

id

gpi_a

code

gpi_b

code

severity_level

code

clinical_effect

text

source

text

binder_payment

420,000 rows · 9 fields · Premium & Billing

binder_id

id

billing_account_id

id

member_id

id

plan_id

id

binder_due_date

date

binder_received_date

date 11% null (never paid)

binder_amount

money

effectuation_status

code

feeds → Binder Payment Effectuation Rate

effectuation_date

date

self_bill_reconciliation

420,000 rows · 8 fields · Premium & Billing

self_bill_recon_id

id

group_id

id

billing_cycle

code

amount_billed

money

amount_remitted

money

variance_amount

money

variance_reason

code null in 35%

recon_completed_date

date

raf_gap_opportunity

420,000 rows · 8 fields · Risk & Actuarial

gap_id

id

member_id

id PII

payment_year

integer

suspected_hcc

code PII

suspect_source

code

estimated_raf_lift

decimal

gap_status

code

provider_id

id

fact_care_management

420,000 rows · 7 fields · Clinical & Care

cm_sk

id

case_id

id

member_id

id

program_type

code

enrolled_date_sk

id

risk_stratification

code PII

case_status

code

network_link_analysis

412,000 rows · 9 fields · Fraud · 1 DQ

link_id

id

entity_a_type

code

entity_a_id

id

entity_b_type

code

entity_b_id

id

link_type

code

link_strength

decimal

shared_address

text PII

detected_date

date

denial

410,000 rows · 11 fields · Clinical & Care

denial_id

id

feeds → Pre-Service Denial Rate

auth_id

id

member_id

id PII

denial_type

code

denial_reason_code

code

denial_category

code

denied_datetime

datetime

denied_by_employee_id

id

physician_reviewer_npi

code

notice_sent_datetime

datetime

overturned_on_appeal

boolean

feeds → Denial Overturn Rate

medication_reconciliation

410,000 rows · 8 fields · Pharmacy

med_rec_id

id

member_id

id PII

case_id

id

stay_id

id

performed_date

date

performed_by_employee_id

id

discrepancy_count

integer

reconciliation_status

code

payment_plan_installment

410,000 rows · 7 fields · Premium & Billing

installment_id

id

payment_plan_id

id

due_date

date

scheduled_amount

money

paid_amount

money

paid_date

date null where unpaid (~28%)

status

code

pmpm_actual

410,000 rows · 8 fields · Risk & Actuarial

pmpm_id

id

line_of_business

code

benefit_plan_id

id

incurred_month

date

service_category

code

allowed_pmpm

decimal

paid_pmpm

decimal

feeds → Claims PMPM

member_months

integer

feeds → Member Months

override_commission

410,000 rows · 7 fields · Sales & Broker · 1 DQ

override_id

id

agency_id

id

downline_broker_id

id

commission_line_id

id

override_pct

decimal

override_amount

money

feeds → Broker Commission Expense Ratio

earned_month

date

renewal

410,000 rows · 9 fields · Premium & Billing · 1 DQ

renewal_id

id

member_id

id null for group-level renewals

group_id

id null for individual

plan_id

id

renewal_plan_year

integer

prior_premium

money

renewal_premium

money 25% null until rated

renewal_status

code

feeds → Member Persistency Rate

renewal_effective_date

date

member_portal_account

380,000 rows · 6 fields · Membership · 1 DQ

member_id

id PII

username

text PII

account_status

code

registration_date

date

last_login

datetime

mfa_enabled

boolean

contract_rate_schedule

380,000 rows · 8 fields · Provider · 1 DQ

rate_schedule_id

id

contract_id

id

procedure_code

code

modifier

code

contracted_rate

money

feeds → Net Claims Costfeeds → Average Contracted Rate vs Medicare

rate_basis

code

effective_date

date

termination_date

date 6% orphaned

copay_card_offset

380,000 rows · 7 fields · Pharmacy

offset_id

id

pharmacy_claim_id

id

member_id

id PII

ndc

code

manufacturer_program

text

offset_amount

money

accumulator_applies

boolean

high_dollar_claim_review

340,000 rows · 6 fields · Claims

claim_id

id

review_id

id

billed_threshold

money

review_outcome

code

reviewer_id

id

reviewed_date

date

provider_credentialing_status_history

340,000 rows · 7 fields · Provider

status_history_id

id

credentialing_id

id

provider_id

id

prior_status

code

new_status

code

change_date

datetime

changed_by

text

autopay_enrollment

340,000 rows · 9 fields · Premium & Billing

autopay_id

id

billing_account_id

id

member_id

id

payment_token

text PII

funding_type

code

draft_day_of_month

integer

enrolled_date

date

status

code

last_draft_status

code

completion_factor_triangle

340,000 rows · 8 fields · Risk & Actuarial · 1 DQ

triangle_id

id

line_of_business

code

incurred_month

date

lag_month

integer

cumulative_paid

money

incremental_paid

money

age_to_age_factor

decimal

selected_factor

decimal

fact_provider_contract

340,000 rows · 7 fields · Provider

contract_sk

id

provider_id

id

contract_id

id

fee_schedule_id

id

reimbursement_type

code

effective_date

date

term_date

date

mart_utilization_summary

340,000 rows · 7 fields · Claims

util_sk

id

plan_id

id

service_category

code

month_sk

id

visit_count

integer

per_1000

decimal

avg_paid

money

dependent

325,000 rows · 8 fields · Membership · 1 DQ

member_id

id PII

feeds → Dependent Coverage Ratio

subscriber_id

id PII

dependent_relationship_code

code

date_of_birth

date PII

disabled_dependent_flag

boolean PII

student_status

code

age_off_date

date

verification_status

code

lead

320,000 rows · 12 fields · Sales & Broker · 1 DQ

lead_id

id

first_name

text PII

last_name

text PII

email

text PII 12% null

phone

text PII

date_of_birth

date PII 15% null

zip_code

code

lead_source

code

assigned_broker_id

id null for unassigned (~22%)

lead_status

code

feeds → Lead Conversion Rate

created_at

datetime

product_interest

code

prepay_edit

318,000 rows · 8 fields · Claims

prepay_edit_id

id

provider_id

id

claim_id

id

edit_code

code

action

code

held_amount

money

released_amount

money

applied_date

date

directory_verification_log

310,000 rows · 7 fields · Provider

verification_id

id

directory_id

id

provider_id

id

verification_method

code

verification_outcome

code

verified_date

date

verified_by

text

care_plan

310,000 rows · 9 fields · Clinical & Care

care_plan_id

id

case_id

id

member_id

id PII

plan_template_code

code

created_date

date

last_reviewed_date

date

next_review_due_date

date overdue by >90 days on 31% of open plans

feeds → Care Plan Currency Rate

plan_status

code

feeds → Care Plan Currency Rate

authored_by_employee_id

id

ndc_drug_master

310,000 rows · 13 fields · Pharmacy · 1 DQ

ndc

code

label_name

text

generic_name

text

gpi

code

manufacturer_name

text 3 casing variants for same labeler

labeler_code

code

dosage_form

code

route_of_administration

code

strength

text

package_size

decimal

brand_generic_indicator

code

feeds → Generic Dispensing Rate (GDR)

obsolete_date

date

dea_schedule

code

termination_for_nonpayment

310,000 rows · 8 fields · Premium & Billing

term_npn_id

id

billing_account_id

id

member_id

id

term_effective_date

date

last_paid_through_date

date

outstanding_balance

money

reinstatement_eligible_flag

boolean

notice_sent_date

date ~6% null

complaint_intake

310,000 rows · 10 fields · Appeals · 1 DQ

intake_id

id

member_id

id PII

case_id

id

intake_channel

code 4 casing variants

intake_datetime

datetime

contact_name

text PII

contact_phone

text PII

summary_text

text PII

routed_to_queue

code

triaged_flag

boolean

payment_token_vault

300,000 rows · 7 fields · Premium & Billing · 1 DQ

payment_token

text PII

member_id

id

instrument_type

code

last4

text PII

expiration_month

integer

expiration_year

integer

vault_status

code 3% expired flagged active

enrollment_834_error

290,000 rows · 8 fields · Membership

error_id

id

feeds → 834 Auto-Adjudication Rate

record_id

id

group_id

id

error_code

code

error_description

text

error_severity

code

resolution_status

code

created_at

datetime

ibnr_by_provider

290,000 rows · 6 fields · Provider · 1 DQ

ibnr_provider_id

id

provider_id

id ~3% orphaned/terminated

incurred_month

date

paid_to_date

money

ibnr_allocated

money

service_category

code

subscriber

287,000 rows · 8 fields · Membership

subscriber_id

id PII

feeds → Dependent Coverage Ratio

member_id

id PII

group_id

id

contract_number

text PII

subscriber_ssn

text PII

hire_date

date

cobra_indicator

boolean

created_at

datetime

case

280,000 rows · 11 fields · Clinical & Care

case_id

id

member_id

id PII

case_type

code

program_code

code

acuity_level

code

opened_date

date

closed_date

date

case_status

code

primary_condition_code

code PII

assigned_cm_employee_id

id

referral_source

code

refund_transaction

280,000 rows · 9 fields · Premium & Billing

refund_id

id

billing_account_id

id

member_id

id

refund_amount

money

refund_reason

code

refund_method

code

issued_date

date

gl_account

code

escheat_flag

boolean

suspense_account

280,000 rows · 8 fields · Finance · 1 DQ

suspense_id

id

received_date

date

amount

money

feeds → Unapplied Cash Ratio

source_reference

text

probable_billing_account_id

id null in 60%

resolution_status

code

resolved_date

date

gl_account

code

case_assignment

276,000 rows · 8 fields · Appeals

assignment_id

id

appeal_id

id

case_id

id

employee_id

id

queue_code

code

assigned_datetime

datetime

reassigned_flag

boolean

sla_priority

code

billing_pattern_profile

262,000 rows · 10 fields · Provider

profile_id

id

provider_id

id

provider_npi

text

period

text

total_billed

money

total_paid

money

claim_count

integer

unique_members

integer

high_level_em_pct

decimal

avg_units_per_visit

decimal

stg_provider_roster

260,000 rows · 5 fields · Provider · 1 DQ

stg_provider_id

id

provider_id

id

provider_npi

text ~5% missing

provider_name

text PII

load_datetime

datetime

timeliness_clock

244,000 rows · 11 fields · Appeals · 1 DQ

clock_id

id

appeal_id

id

case_id

id

clock_type

code

regulatory_threshold_hours

integer

clock_start_datetime

datetime

clock_due_datetime

datetime

clock_stop_datetime

datetime

clock_pause_total_hours

decimal 0.3% negative

met_threshold_flag

boolean

feeds → Appeals Timeliness Ratefeeds → Grievance Timeliness Ratefeeds → Expedited Appeal Compliance Rate

days_remaining

integer

cms_universe_export

244,000 rows · 8 fields · Reporting & BI

export_id

id

appeal_id

id

case_id

id

universe_type

code

reporting_period

text

export_datetime

datetime

validation_status

code

submitted_to_cms_flag

boolean

fact_grievance

240,000 rows · 6 fields · Appeals

grievance_sk

id

case_id

id

member_id

id

category_code

code

received_date_sk

id

resolution_days

integer

acknowledgement_letter

231,000 rows · 9 fields · Appeals · 1 DQ

letter_id

id

appeal_id

id

case_id

id

letter_type

code

generated_date

date

due_date

date

sent_date

date 5% late vs due

feeds → Acknowledgement Letter Timeliness

delivery_method

code

language_code

code

dim_drug

215,000 rows · 7 fields · Pharmacy · 1 DQ

drug_sk

id

ndc

code ~9% format inconsistency

drug_name

text

gpi_code

code

therapeutic_class

text

brand_generic_flag

code

specialty_drug_flag

boolean

appeal_level_history

214,000 rows · 7 fields · Appeals

level_history_id

id

appeal_id

id

from_level

code

to_level

code

escalation_reason

code

transition_datetime

datetime

transitioned_by

id

subrogation_case

210,000 rows · 7 fields · Finance

subro_case_id

id

member_id

id PII

claim_id

id

liability_type

code

estimated_recovery

money

recovered_amount

money

case_status

code

special_enrollment_event

210,000 rows · 8 fields · Membership · 1 DQ

sep_id

id

member_id

id PII

qle_type

code

event_date

date

reported_date

date

verification_status

code

enrollment_deadline

date

documentation_received

boolean

cob_coverage

210,000 rows · 9 fields · Membership · 1 DQ

cob_id

id

member_id

id PII

other_carrier_name

text

other_policy_number

text PII

coverage_type

code

primacy_order

code

effective_date

date

termination_date

date

verified_date

date

dependent_verification

210,000 rows · 7 fields · Membership · 1 DQ

verification_id

id

member_id

id PII

subscriber_id

id PII

document_type

code PII

verification_outcome

code

reviewed_date

date

reviewer

text

provider_par_status

210,000 rows · 6 fields · Provider · 1 DQ

par_status_id

id

provider_id

id

network_id

id

par_indicator

code conflicts with network_affiliation

effective_date

date

termination_date

date

primary_source_verification

210,000 rows · 7 fields · Provider

psv_id

id

credentialing_id

id

provider_id

id

verification_element

code

source_name

text

verification_status

code

verified_date

date

provider_reference

210,000 rows · 7 fields · Provider · 1 DQ

provider_id

id

provider_npi

code 2% null

provider_name

text

specialty_code

code

network_status

code

par_flag

boolean

facility_id

id

prescriber_master

210,000 rows · 7 fields · Provider · 1 DQ

prescriber_npi

code PII

provider_id

id

prescriber_name

text PII

specialty

text

dea_number

code PII

state_license

code

npi_active_flag

boolean

billing_account

210,000 rows · 12 fields · Premium & Billing · 1 DQ

billing_account_id

id

group_id

id

member_id

id null for group-level accounts

account_type

code

account_status

code 3 casing variants (ACTIVE/Active/active)

billing_cycle_code

code

bill_to_name

text PII

bill_to_address

text PII

effective_date

date

term_date

date 18% null for active accounts

cost_center

code ~2% null

created_at

datetime

capitation_actuarial

210,000 rows · 8 fields · Provider

cap_actuarial_id

id

provider_id

id

benefit_plan_id

id

cap_month

date

capitated_member_months

integer

cap_pmpm

decimal

risk_adjusted_cap_pmpm

decimal

cap_paid

money

opportunity

210,000 rows · 10 fields · Sales & Broker · 1 DQ

opportunity_id

id

lead_id

id

broker_id

id

group_id

id null for individual market

product_line

code

stage

code inconsistent stage labels

feeds → Lead Conversion Rate

estimated_lives

integer

estimated_annual_premium

money

expected_close_date

date

created_at

datetime

dim_provider

210,000 rows · 10 fields · Provider · 1 DQ

provider_sk

id

provider_id

id

provider_npi

text

provider_name

text PII 3 casing variants

specialty_code

code

provider_type

code

network_status

code

effective_date

date

expiration_date

date

current_flag

boolean

resolution_letter

205,000 rows · 10 fields · Appeals

resolution_letter_id

id

appeal_id

id

determination_id

id

member_id

id PII

letter_template_code

code

outcome_summary

text PII

generated_date

date

sent_date

date

language_code

code

appeal_rights_included_flag

boolean

sanction_screening

196,000 rows · 8 fields · Provider

screening_id

id

provider_id

id

provider_npi

text

screening_date

date

list_checked

code

match_result

code

match_score

decimal

reviewed

boolean

appeal_claim_link

192,000 rows · 6 fields · Appeals · 1 DQ

link_id

id

appeal_id

id

claim_id

id 2.1% orphaned

claim_line_id

id

disputed_amount

money

link_reason

code

other_insurance_coverage

190,000 rows · 7 fields · Claims · 1 DQ

member_id

id PII

coverage_seq

integer

carrier_name

text

carrier_policy_number

text PII

coverage_priority

code

effective_date

date

termination_date

date stale

appeal_link

190,000 rows · 6 fields · Appeals

appeal_link_id

id

denial_id

id

appeal_id

id

feeds → Denial Overturn Rate

member_id

id PII

appeal_level

code

linked_datetime

datetime

opioid_risk_score

190,000 rows · 8 fields · Risk & Actuarial

risk_score_id

id

member_id

id PII

scoring_period

code

total_mme

decimal

prescriber_count

integer

pharmacy_count

integer

opioid_risk_tier

code

computed_date

date

nsf_returned_payment

190,000 rows · 8 fields · Premium & Billing

nsf_id

id

premium_id

id

billing_account_id

id

return_reason_code

code

return_date

date

returned_amount

money

nsf_fee_amount

money

reversal_posted_flag

boolean

nps_response

190,000 rows · 7 fields · Quality & STARS · 1 DQ

nps_response_id

id

survey_id

id

member_id

id

nps_score

integer 8% out of 0-10 range

feeds → Net Promoter Score (NPS)

nps_category

code

feeds → Net Promoter Score (NPS)

verbatim

text PII uncoded free-text

responded_at

datetime

provider_quality_score

188,000 rows · 8 fields · Quality & STARS · 1 DQ

quality_score_id

id

provider_id

id

measure_id

id

measurement_period

code

numerator

integer

denominator

integer 8% null attribution

rate

decimal

benchmark_percentile

integer

provider_master

185,000 rows · 8 fields · Provider · 1 DQ

provider_id

id

provider_npi

code ~7% null

provider_name

text PII

provider_type

code

specialty_code

code

tax_id

text PII

par_status

code

effective_date

date

individual_billing_account

182,000 rows · 9 fields · Premium & Billing · 1 DQ

billing_account_id

id

member_id

id

subscriber_name

text PII

subscriber_dob

date PII

subscriber_ssn_last4

text PII ~9% null

market_segment

code

aptc_eligible_flag

boolean

autopay_enrolled_flag

boolean

paperless_flag

boolean

adjudication_config_audit

180,000 rows · 7 fields · Claims

config_change_id

id

config_domain

code

changed_object

text

old_value

text

new_value

text

changed_by

id

change_datetime

datetime

aptc_subsidy

180,000 rows · 7 fields · Premium & Billing

member_id

id PII

benefit_plan_id

id

plan_year

integer

aptc_monthly_amount

money PII

csr_variant

code

household_income_fpl

decimal PII

effective_date

date

network_affiliation

156,000 rows · 8 fields · Provider · 1 DQ

affiliation_id

id

provider_id

id

feeds → Active Network Providersfeeds → Provider Sanction Exposure

network_id

id

plan_id

id

par_status

code

feeds → PAR Provider Ratio

tier_level

code

effective_date

date

termination_date

date duplicate spans

determination

151,000 rows · 10 fields · Appeals

determination_id

id

appeal_id

id

appeal_level

code

decision_code

code

overturn_flag

boolean

feeds → Overturn Rate

partial_overturn_flag

boolean

decision_date

date

decision_rationale

text PII

reviewer_id

id

financial_impact

money

case_note

148,000 rows · 7 fields · Fraud · 1 DQ

note_id

id

case_id

id

author_employee_id

id

note_type

code

note_text

text PII free-text PII leakage

created_at

datetime

is_privileged

boolean

appeal_case

148,000 rows · 12 fields · Appeals · 1 DQ

appeal_id

id

feeds → Active Membership

member_id

id PII

plan_id

id

benefit_plan_id

id

case_id

id

line_of_business

code

appeal_type

code

appeal_level

code

received_date

date

original_decision_date

date 2% null

current_status

code

expedited_flag

boolean

feeds → Expedited Appeal Compliance Rate

appeal_classification

148,000 rows · 8 fields · Appeals

appeal_id

id

cms_category_code

code

part_c_or_d

code

service_category

code

clinical_vs_administrative

code

classified_by

id

classified_datetime

datetime

reclassified_flag

boolean

medicare_entitlement

142,000 rows · 8 fields · Membership

member_id

id PII

mbi

text PII

part_a_start_date

date

part_b_start_date

date

esrd_indicator

boolean PII

hospice_indicator

boolean PII

lis_level

code

updated_at

datetime

contract_line_item

142,000 rows · 8 fields · Provider · 1 DQ

contract_line_id

id

contract_id

id

service_category

code

reimbursement_methodology

code

reimbursement_pct

decimal 4% null

fee_schedule_id

id

effective_date

date

termination_date

date

provider_outreach

140,000 rows · 7 fields · Provider

outreach_id

id

provider_id

id

outreach_type

code

outreach_channel

code

outreach_date

date

outreach_outcome

code

employee_id

id

collections_case

140,000 rows · 8 fields · Finance

collections_case_id

id

billing_account_id

id

placed_date

date

agency_id

id null for internal (~55%)

placement_balance

money

recovered_amount

money

case_status

code

closed_date

date

commission_chargeback

140,000 rows · 7 fields · Sales & Broker · 1 DQ

chargeback_id

id

commission_line_id

id

broker_id

id

member_id

id

chargeback_reason

code 20% null

chargeback_amount

money

chargeback_date

date

appeal_provider_link

138,000 rows · 6 fields · Appeals · 1 DQ

link_id

id

appeal_id

id

provider_id

id

provider_npi

id 11% null

provider_role

code

facility_id

id

recovery_transaction

134,500 rows · 9 fields · Finance · 1 DQ

txn_id

id

recovery_id

id

claim_id

id

txn_type

code

amount

money

posted_date

date

gl_account

code

fund_id

id

reversal_flag

boolean

pharmacy_claim_audit

120,000 rows · 8 fields · Fraud

audit_id

id

pharmacy_claim_id

id

pharmacy_npi

code

audit_type

code

discrepancy_amount

money

audit_finding

code

recovered_amount

money

audit_date

date

invoice_dispute

120,000 rows · 8 fields · Premium & Billing

dispute_id

id

invoice_id

id

billing_account_id

id

dispute_reason

code

disputed_amount

money

opened_date

date

resolution

code null while open (~18%)

resolved_date

date

clinical_review

119,000 rows · 10 fields · Appeals

clinical_review_id

id

appeal_id

id

reviewer_id

id

review_type

code

primary_diagnosis_code

code PII

procedure_code

code

clinical_finding

text PII

medical_necessity_met_flag

boolean

review_datetime

datetime

guideline_cited

text

retro_enrollment

118,000 rows · 11 fields · Membership · 1 DQ

retro_id

id

feeds → Retro Enrollment Rate

member_id

id PII

enrollment_span_id

id

adjustment_type

code

original_effective_date

date

new_effective_date

date

retro_days

integer

premium_impact

money

claims_reprocess_required

boolean

approved_by

text

processed_date

date

network_tier_assignment

118,000 rows · 6 fields · Provider

tier_assignment_id

id

provider_id

id

network_id

id

tier_level

code

tier_rationale

code

effective_date

date

appeal_auth_link

104,000 rows · 6 fields · Appeals

link_id

id

appeal_id

id

auth_id

id

denial_reason_code

code

service_requested

code

link_datetime

datetime

case_evidence

98,300 rows · 8 fields · Fraud

evidence_id

id

case_id

id

evidence_type

code

file_reference

text

chain_of_custody

text

uploaded_by_employee_id

id

uploaded_at

datetime

is_phi

boolean PII

facility_provider_link

98,000 rows · 6 fields · Provider

link_id

id

facility_id

id

provider_id

id

privilege_type

code

admitting_privileges

boolean

effective_date

date

pharmacy_trend_actuarial

96,000 rows · 8 fields · Pharmacy

rx_trend_id

id

therapeutic_class

code

trend_month

date

ndc

code

gross_pmpm

decimal

net_pmpm_post_rebate

decimal

rebate_pmpm

decimal

utilization_per_1000

decimal

grievance_case

96,000 rows · 12 fields · Appeals · 1 DQ

case_id

id

feeds → Active Membership

member_id

id PII

plan_id

id

line_of_business

code

grievance_category

code 9% free-text variants

grievance_subcategory

code

received_date

date

received_channel

code

oral_or_written

code

quality_of_care_flag

boolean

resolution_date

date

feeds → Grievance Timeliness Rate

current_status

code

mart_pharmacy_summary

96,000 rows · 7 fields · Pharmacy

rx_summary_sk

id

therapeutic_class

text

month_sk

id

script_count

integer

gross_cost

money

rebate_amount

money

net_cost

money

feeds → Pharmacy Net Cost PMPM

enrollment_workqueue

94,000 rows · 8 fields · Membership

workitem_id

id

member_id

id PII

queue_type

code

priority

code

assigned_analyst

text

status

code

created_at

datetime

resolved_at

datetime

formulary_change_log

94,000 rows · 8 fields · Pharmacy

change_id

id

formulary_id

id

ndc

code

change_type

code

old_tier

integer

new_tier

integer

pt_committee_date

date

effective_date

date

retention_case

94,000 rows · 9 fields · Membership · 1 DQ

retention_case_id

id

member_id

id

broker_id

id

risk_reason

code

case_status

code

save_reason

code inconsistent taxonomy

opened_at

datetime

closed_at

datetime

outcome

code

feeds → Book-of-Business Retention Rate

case_status_history

92,500 rows · 7 fields · Fraud

history_id

id

case_id

id

from_status

code

to_status

code

changed_by_employee_id

id

changed_at

datetime

reason_code

code

procedure_code_reference

92,000 rows · 6 fields · Provider

procedure_code

code

code_system

code

short_description

text

service_category

code

is_active

boolean

effective_date

date

provider_efficiency_metric

92,000 rows · 7 fields · Risk & Actuarial

efficiency_id

id

provider_id

id

measurement_period

code

observed_cost

money

expected_cost

money

efficiency_ratio

decimal

risk_score_id

id

provider_data_change_request

89,000 rows · 7 fields · Provider

change_request_id

id

provider_id

id

change_type

code

requested_value

text

request_status

code

submitted_date

date

processed_date

date

timeliness_pause

88,000 rows · 7 fields · Appeals

pause_id

id

clock_id

id

pause_reason_code

code

pause_start_datetime

datetime

pause_end_datetime

datetime

member_extension_flag

boolean

info_requested_text

text

ibnr_estimate

86,000 rows · 7 fields · Risk & Actuarial

ibnr_id

id

service_period

code

product_line

code

paid_to_date

money

estimated_unpaid

money

completion_factor

decimal

estimate_date

date

premium_rate_table

86,000 rows · 8 fields · Premium & Billing

rate_id

id

benefit_plan_id

id

coverage_tier

code

rating_region

code

age_band

code

plan_year

integer

monthly_premium

money

effective_date

date

eligibility_extract_audit

86,000 rows · 7 fields · Reporting & BI

extract_id

id

target_system

text

extract_date

date

record_count

integer

as_of_date

date

extract_status

code

checksum

text

peer_to_peer_review

86,000 rows · 8 fields · Clinical & Care · 1 DQ

p2p_id

id

auth_id

id

denial_id

id

requesting_provider_npi

code

medical_director_employee_id

id

scheduled_datetime

datetime

completed_datetime

datetime

outcome

code 11% null

quantity_limit_rule

86,000 rows · 7 fields · Pharmacy

ql_rule_id

id

formulary_id

id

gpi

code

max_quantity

decimal

per_days

integer

rule_type

code

effective_date

date

premium_tax_assessment

86,000 rows · 8 fields · Finance

premium_tax_id

id

state_code

code

assessment_period

code

taxable_premium

money

tax_rate

decimal

assessed_amount

money

gl_account

code

paid_flag

boolean

reserve_development

86,000 rows · 8 fields · Risk & Actuarial

development_id

id

original_reserve_run_id

id

restated_valuation_date

date

original_estimate

money

restated_estimate

money

development_amount

money

redundancy_deficiency_pct

decimal

feeds → Reserve Redundancy/Deficiency

line_of_business

code

loss_ratio_summary

86,000 rows · 10 fields · Finance

loss_ratio_id

id

line_of_business

code

benefit_plan_id

id

period

code

earned_premium

money

paid_claims

money

ibnr_reserve

money

feeds → IBNR Reserve Balance

incurred_claims

money

actuarial_mlr

decimal

feeds → Medical Loss Ratio (MLR)

reserve_run_id

id

underwriting_audit_log

86,000 rows · 8 fields · Sales & Broker

audit_id

id

uw_case_id

id

action_type

code

override_reason

code

actor_id

id

action_datetime

datetime

old_value

text

new_value

text

ref_formulary

86,000 rows · 5 fields · Pharmacy

formulary_id

id

ndc

code

tier

code

prior_auth_required

boolean

step_therapy_flag

boolean

fact_fund_balance

86,000 rows · 7 fields · Finance

fund_balance_sk

id

fund_id

id

period_sk

id

opening_balance

money

inflows

money

outflows

money

closing_balance

money

fraud_referral

85,000 rows · 7 fields · Fraud

referral_id

id

claim_id

id

provider_id

id

referral_reason

code

flag_score

decimal

siu_case_id

id

referral_date

date

reinstatement

78,000 rows · 7 fields · Premium & Billing

reinstatement_id

id

term_npn_id

id

member_id

id

reinstatement_date

date

catch_up_amount

money

approved_by

id

reinstatement_reason

code

sla_tracking

76,400 rows · 7 fields · Reporting & BI

sla_id

id

case_id

id

sla_type

code

target_days

integer

elapsed_days

integer

breached

boolean

breach_date

date null when not breached

provider_contract_term

76,000 rows · 7 fields · Provider

term_id

id

contract_id

id

term_category

code

term_value

text

timely_filing_days

integer

appeal_window_days

integer

effective_date

date

mart_broker_commission

76,000 rows · 6 fields · Sales & Broker

comm_sk

id

broker_id

id

month_sk

id

new_groups

integer

covered_lives

integer

commission_amount

money

provider_specialty

74,000 rows · 7 fields · Provider

provider_id

id

specialty_code

code

specialty_description

text

taxonomy_code

code

is_primary_specialty

boolean

board_certified

boolean

effective_date

date

dim_diagnosis

72,000 rows · 6 fields · Clinical & Care

diagnosis_sk

id

icd10_code

code PII

diagnosis_desc

text PII

diagnosis_category

text

hcc_flag

boolean

chronic_flag

boolean

recovery

71,800 rows · 11 fields · Finance · 1 DQ

recovery_id

id

overpayment_id

id

case_id

id

provider_id

id

recovery_method

code casing variants (offset/Offset/OFFSET)

recovery_amount

money

recovered_amount

money

recovery_status

code

gl_account

code

cost_center

code

recovery_date

date 22% null (pending)

provider_education

71,000 rows · 7 fields · Provider · 1 DQ

education_id

id

provider_id

id

degree_type

code

school_name

text multiple casing variants

graduation_year

integer

residency_program

text

fellowship_program

text

broker_of_record

68,000 rows · 7 fields · Sales & Broker

bor_id

id

group_id

id

broker_id

id

member_id

id PII

effective_date

date

termination_date

date

commission_eligible

boolean

pharmacy_master

68,000 rows · 12 fields · Provider · 1 DQ

pharmacy_npi

code

provider_id

id

pharmacy_name

text

chain_code

code

dea_number

code PII

address_line

text

city

text

state

code

zip

code

pharmacy_type

code

is_mail_order

boolean

is_specialty

boolean

overpayment

67,300 rows · 10 fields · Finance · 1 DQ

overpayment_id

id

case_id

id

claim_id

id

provider_id

id

member_id

id PII

overpaid_amount

money

identified_date

date

identification_method

code

gl_account

code

status

code

provider_license

67,000 rows · 8 fields · Provider · 1 DQ

license_id

id

provider_id

id

license_number

text PII

license_type

code

license_state

code

license_issue_date

date

license_expiration_date

date 9% expired

license_status

code

provider_tin_link

63,000 rows · 6 fields · Provider · 1 DQ

tin_link_id

id

provider_id

id

tax_id

text PII duplicate under multiple TINs

billing_npi

code

effective_date

date

termination_date

date

reinstatement

62,000 rows · 7 fields · Membership

reinstatement_id

id

member_id

id PII

termination_id

id

reinstatement_date

date

reinstatement_reason

code

gap_days

integer

processed_by

text

provider_location

62,000 rows · 12 fields · Provider · 1 DQ

location_id

id

provider_id

id

facility_id

id

address_line_1

text PII

address_line_2

text

city

text

state

code

zip_code

text

county_fips

code

location_type

code

is_primary

boolean

accepts_new_patients

boolean stale; 18% not refreshed in 12mo

provider_geo_coordinate

62,000 rows · 7 fields · Provider · 1 DQ

geo_id

id

location_id

id

provider_id

id

latitude

decimal

longitude

decimal

geocode_precision

code 11% default centroid

county_fips

code

actuarial_gl_bridge

62,000 rows · 7 fields · Finance · 1 DQ

bridge_id

id

reserve_run_id

id

gl_account

code ~5% orphaned

cost_center

code

posting_amount

money

posting_period

code

posting_type

code

ref_code_mapping

62,000 rows · 5 fields · Reporting & BI · 1 DQ

mapping_id

id

code_type

text

source_code

code

conformed_code

code ~8% UNK

source_system_code

code

benefit_plan_cost_share

61,000 rows · 7 fields · Membership

benefit_plan_id

id

service_category_code

code

copay_amount

money

coinsurance_pct

decimal

network_tier

code

requires_auth

boolean

effective_date

date

credentialing_committee_review

61,000 rows · 7 fields · Provider

review_id

id

credentialing_id

id

committee_name

text

review_date

date

decision_code

code

reviewer_employee_id

id

notes

text

overturn_reason

61,000 rows · 7 fields · Appeals · 1 DQ

overturn_reason_id

id

determination_id

id 1.4% orphaned

reason_code

code

root_cause_category

code

feeds → Overturn Rate

responsible_department

code

preventable_flag

boolean

reason_notes

text

medical_record_request

58,700 rows · 9 fields · Fraud · 1 DQ

request_id

id

case_id

id

provider_id

id

member_id

id PII

claim_id

id

requested_date

date

due_date

date

received_date

date 35% null

status

code

provider_credentialing

58,000 rows · 9 fields · Provider · 1 DQ

credentialing_id

id

provider_id

id

provider_npi

code

credentialing_status

code

initial_cred_date

date

feeds → Credentialing Cycle Time

recred_due_date

date 6% past due

feeds → Recredentialing Compliance Rate

committee_decision

code

committee_decision_date

date

feeds → Credentialing Cycle Timefeeds → Recredentialing Compliance Rate

credentialing_cycle

code

provider_group_membership

58,000 rows · 6 fields · Provider

membership_id

id

provider_id

id

group_id

id

role_in_group

code

effective_date

date

termination_date

date

provider_directory

58,000 rows · 10 fields · Provider · 1 DQ

directory_id

id

provider_id

id

provider_npi

code

display_name

text PII

display_specialty

text

display_address

text PII 23% mismatch vs provider_location

feeds → Provider Directory Accuracy

display_phone

text PII

accepts_new_patients

boolean

languages_spoken

text

last_verified_date

date 30% over 90 days old

feeds → Provider Directory Accuracy

reserve_variance_analysis

58,000 rows · 8 fields · Risk & Actuarial

variance_id

id

period

code

service_category

code

expected_incurred

money

actual_incurred

money

variance_amount

money

variance_pct

decimal

explanation_code

code

rate_card

58,000 rows · 8 fields · Sales & Broker · 1 DQ

rate_card_id

id

plan_id

id

benefit_plan_id

id

rating_area

code

age_band

code

plan_year

integer

base_rate

money

tobacco_load_factor

decimal 3% null

fraud_waste_abuse_flag

56,000 rows · 8 fields · Fraud · 1 DQ

fwa_flag_id

id

member_id

id PII

prescriber_npi

code PII

pharmacy_npi

code

flag_type

code

risk_score

decimal

flagged_date

date

disposition

code

sales_goal

56,000 rows · 7 fields · Sales & Broker

goal_id

id

broker_id

id null for agency-level goals

agency_id

id

product_line

code

period

text

target_lives

integer

target_premium

money

prior_auth_appeal

54,000 rows · 9 fields · Appeals

appeal_id

id

auth_id

id

member_id

id PII

case_id

id

appeal_level

code

received_date

date

resolved_date

date

outcome

code

overturn_flag

boolean

membership_projection

54,000 rows · 7 fields · Membership

projection_id

id

line_of_business

code

benefit_plan_id

id

projection_month

date

projected_members

integer

projected_member_months

integer

scenario

code

recoupment_letter

52,600 rows · 8 fields · Finance

letter_id

id

overpayment_id

id

provider_id

id

letter_type

code

amount_demanded

money

sent_date

date

response_due_date

date

response_status

code 28% null

payment_plan

52,000 rows · 9 fields · Premium & Billing

payment_plan_id

id

billing_account_id

id

member_id

id

original_balance

money

installment_count

integer

installment_amount

money

start_date

date

plan_status

code

default_flag

boolean

member_representative

52,000 rows · 8 fields · Appeals · 1 DQ

representative_id

id

appeal_id

id

member_id

id PII

rep_name

text PII

rep_relationship

code

rep_phone

text PII

aor_received_date

date

aor_valid_flag

boolean 7% null

provider_npi_registry

51,000 rows · 8 fields · Provider · 1 DQ

provider_npi

code

provider_id

id

npi_type

code

enumeration_date

date

deactivation_date

date

nppes_last_updated

date

taxonomy_code

code

is_sole_proprietor

boolean

vendor_recovery_assignment

48,900 rows · 8 fields · Finance · 1 DQ

assignment_id

id

overpayment_id

id

vendor_id

id

assigned_amount

money

recovered_by_vendor

money

contingency_fee

money

assigned_date

date

status

code

provider_master

48,000 rows · 12 fields · Provider · 1 DQ

provider_id

id

provider_npi

code

provider_type

code

entity_type_code

code

provider_first_name

text PII

provider_last_name

text PII 3 casing variants

organization_name

text

tax_id

text PII

primary_specialty_code

code

status

code

feeds → Active Network Providers

effective_date

date

termination_date

date

provider_demographic

48,000 rows · 8 fields · Provider · 1 DQ

provider_id

id

date_of_birth

date PII 12% null

gender_code

code PII

ssn

text PII

email_address

text PII

phone_number

text PII

preferred_language

code

ethnicity_code

code PII

benefit_authorization_rule

48,000 rows · 8 fields · Membership

rule_id

id

benefit_plan_id

id

service_category

code

procedure_code

code

auth_required_flag

boolean

medical_necessity_required

boolean

effective_date

date

termination_date

date

rebate_contract_term

48,000 rows · 8 fields · Finance · 1 DQ

rebate_term_id

id

rebate_contract_id

id

gpi

code

ndc

code

base_rebate_pct

decimal

market_share_tier

code

price_protection_cap_pct

decimal

formulary_id

id

specialty_drug_case

48,000 rows · 9 fields · Clinical & Care

case_id

id

member_id

id PII

ndc

code

gpi

code

diagnosis_code

code PII

specialty_pharmacy_npi

code

enrollment_date

date

adherence_status

code

care_manager

text

medical_underwriting_assessment

48,000 rows · 8 fields · Sales & Broker

assessment_id

id

uw_case_id

id

member_id

id PII

member_name

text PII

date_of_birth

date PII

disclosed_conditions

text PII

load_factor

decimal

assessment_status

code

mart_risk_adjustment

48,000 rows · 6 fields · Risk & Actuarial · 1 DQ

raf_sk

id

plan_id

id

period_sk

id

avg_raf

decimal V24/V28 blend

feeds → Risk Adjustment Factor (RAF)

member_months

decimal

normalized_raf

decimal

group_benefit_offering

47,000 rows · 7 fields · Membership

group_id

id

benefit_plan_id

id

plan_year

integer

offering_effective_date

date

offering_end_date

date

employer_contribution_pct

decimal

is_default_plan

boolean

provider_caqh_profile

47,000 rows · 6 fields · Provider · 1 DQ

caqh_id

id

provider_id

id

caqh_number

text PII

attestation_date

date 19% stale

profile_status

code

last_sync_date

datetime

appeal_pharmacy_link

47,000 rows · 7 fields · Appeals

link_id

id

appeal_id

id

pharmacy_claim_id

id

ndc

code

formulary_id

id

coverage_determination_type

code

tier_requested

code

provider_malpractice_insurance

46,000 rows · 8 fields · Provider

coverage_id

id

provider_id

id

carrier_name

text

policy_number

text PII

coverage_amount_per_claim

money

coverage_amount_aggregate

money

coverage_effective_date

date

coverage_expiration_date

date

premium_holiday

46,000 rows · 8 fields · Premium & Billing

premium_holiday_id

id

billing_account_id

id

group_id

id

waiver_months

integer

waiver_amount

money

reason_code

code

approved_by

id

effective_month

date

chart_review

44,100 rows · 9 fields · Clinical & Care

review_id

id

request_id

id

case_id

id

reviewer_employee_id

id

reviewed_claim_id

id

clinical_determination

code

recoupable_amount

money

diagnosis_supported

boolean

reviewed_at

datetime

provider_board_certification

44,000 rows · 7 fields · Provider

certification_id

id

provider_id

id

board_name

text

certification_specialty

code

certification_date

date

recertification_date

date

certification_status

code

provider_contract

42,000 rows · 7 fields · Provider · 1 DQ

contract_id

id

provider_id

id

contract_type

code

reimbursement_method

code

effective_date

date overlapping spans

termination_date

date

fee_schedule_id

id

rating_factor

42,000 rows · 6 fields · Premium & Billing

rating_factor_id

id

rating_table_id

id

factor_type

code

factor_key

text

factor_value

decimal

is_capped

boolean

actuarial_data_load_log

42,000 rows · 7 fields · Reporting & BI · 1 DQ

load_id

id

source_system

code

extract_date

date

load_status

code ~8% false SUCCESS

row_count

integer

reject_count

integer

load_datetime

datetime

dim_geography

42,000 rows · 6 fields · Reporting & BI

geography_sk

id

zip_code

text

county_name

text

state_code

code

rating_area

code

region

text

fact_workforce_headcount

42,000 rows · 6 fields · Workforce

hc_sk

id

cost_center

code

month_sk

id

employee_id

id

fte_count

decimal

labor_cost

money

fact_sales_pipeline

42,000 rows · 6 fields · Sales & Broker

pipeline_sk

id

group_id

id

broker_id

id

stage_code

code

expected_lives

integer

close_date_sk

id

investigation_finding

41,200 rows · 7 fields · Fraud

finding_id

id

investigation_id

id

finding_type

code

description

text

substantiated

boolean

exposure_amount

money

recorded_at

datetime

provider_remittance_config

41,000 rows · 7 fields · Premium & Billing · 1 DQ

remit_config_id

id

provider_id

id

payment_method

code

bank_routing_number

text PII 5% missing

bank_account_number

text PII

remittance_address

text PII

era_enrolled

boolean

provider_dea_registration

39,000 rows · 7 fields · Provider

dea_id

id

provider_id

id

dea_number

text PII

dea_schedule

code

dea_state

code

dea_expiration_date

date

dea_status

code

controlled_substance_pattern

38,400 rows · 9 fields · Pharmacy

pattern_id

id

member_id

id PII

ndc

code

morphine_equiv_daily

decimal

prescriber_count

integer

pharmacy_count

integer

overlap_days

integer

period

text

risk_tier

code

provider_risk_pool

38,000 rows · 8 fields · Provider

risk_pool_id

id

provider_id

id

pool_period

code

target_budget

money

actual_claims

money

surplus_deficit

money

shared_savings_pct

decimal

settlement_amount

money

group_contact

38,000 rows · 7 fields · Membership · 1 DQ

contact_id

id

group_id

id

contact_name

text PII

role

code

email

text PII

phone

text PII

is_primary

boolean

dim_date

36,500 rows · 8 fields · Reporting & BI

date_sk

id

calendar_date

date

day_of_week

text

month_number

integer

fiscal_period

code

fiscal_year

integer

quarter

code

is_holiday

boolean

referral

34,800 rows · 10 fields · Fraud · 1 DQ

referral_id

id

case_id

id 45% null (unconverted referrals)

referral_source

code

referral_channel

code

subject_provider_id

id

subject_member_id

id PII

reporter_name

text PII 11% null

received_date

date

triage_status

code

allegation_summary

text

provider_network_adequacy

34,000 rows · 8 fields · Provider

adequacy_id

id

network_id

id

county_fips

code

specialty_code

code

provider_count

integer

avg_distance_miles

decimal

meets_standard

boolean

feeds → Network Adequacy Pass Rate

measurement_date

date

mart_stars_summary

32,000 rows · 7 fields · Quality & STARS

stars_sk

id

contract_id

text

measure_id

id

measurement_year

integer

measure_rate

decimal

star_value

decimal

feeds → Star Rating

weight

decimal

case_allegation

31,200 rows · 7 fields · Fraud · 1 DQ

allegation_id

id

case_id

id

scheme_code

code 3 casing variants

scheme_description

text

alleged_amount

money

detection_source

code

created_at

datetime

gold_carding_status

31,000 rows · 7 fields · Provider

gold_card_id

id

provider_npi

code

service_category

code

gold_card_status

code

approval_rate_trailing

decimal

effective_date

date

review_due_date

date

dim_facility

31,000 rows · 6 fields · Provider · 1 DQ

facility_sk

id

facility_id

id

facility_name

text

facility_type

code

facility_npi

text

state_code

code

savings_estimate

29,400 rows · 9 fields · Finance · 1 DQ

savings_id

id

case_id

id

savings_type

code

savings_category

code

estimated_savings

money double-counted vs recovery

realized_savings

money

calculation_basis

text

period

text

validated

boolean

case_assignment

26,800 rows · 7 fields · Fraud

assignment_id

id

case_id

id

employee_id

id

role_on_case

code

assigned_at

datetime

unassigned_at

datetime 38% null

is_primary

boolean

siu_subject

24,100 rows · 8 fields · Fraud · 1 DQ

subject_id

id

case_id

id

subject_role

code

member_id

id PII

provider_id

id

provider_npi

text

subject_name

text PII

added_date

date

bad_debt_reserve

24,000 rows · 7 fields · Finance

reserve_id

id

accounting_period

code

market_segment

code

ar_basis_amount

money

reserve_rate

decimal

reserve_amount

money

gl_account

code

fact_fraud_case

24,000 rows · 8 fields · Fraud

fraud_sk

id

case_id

id

provider_id

id

member_id

id

open_date_sk

id

flagged_amount

money

recovered_amount

money

case_status

code

broker_credentialing

22,400 rows · 7 fields · Sales & Broker · 1 DQ

credential_id

id

broker_id

id

certification_type

code

plan_year

integer free-text in 9% of rows

completion_date

date

score

decimal null where pass/fail only

status

code

provider_master

21,800 rows · 8 fields · Provider · 1 DQ

provider_id

id

provider_npi

text

provider_name

text PII

tin

text PII

specialty_code

code 12% null

provider_type

code

network_status

code

par_status

code

provider_peer_group

21,800 rows · 7 fields · Provider · 1 DQ

peer_assignment_id

id

provider_id

id

provider_npi

text

peer_group_code

code

specialty_code

code stale specialty mapping

region

code

effective_date

date

hotline_tip

21,600 rows · 7 fields · Fraud

tip_id

id

referral_id

id

call_date

datetime

caller_anonymous

boolean

caller_phone

text PII 68% null (anonymous)

tip_category

code

transcript

text PII

group_renewal

21,000 rows · 7 fields · Sales & Broker

renewal_id

id

group_id

id

plan_year

integer

renewal_status

code

rate_action_pct

decimal

renewal_decision_date

date

broker_id

id

contract_amendment

21,000 rows · 7 fields · Provider

amendment_id

id

contract_id

id

amendment_number

integer

amendment_type

code

amendment_reason

text

effective_date

date

executed_date

date

dim_procedure

18,900 rows · 5 fields · Claims

procedure_sk

id

cpt_hcpcs_code

code

procedure_desc

text

procedure_category

text

rbcs_category

code

group_structure

18,600 rows · 7 fields · Membership · 1 DQ

sub_group_id

id

group_id

id

division_name

text

class_code

code

effective_date

date

termination_date

date

billing_division

code

manual_rate

18,600 rows · 9 fields · Premium & Billing

manual_rate_id

id

benefit_plan_id

id

rating_period

code

claims_pmpm

decimal

admin_load

decimal

risk_margin

decimal

trend_load

decimal

feeds → Loss Ratio Trend

manual_premium_pmpm

decimal

rating_table_id

id

dim_group

18,500 rows · 7 fields · Sales & Broker · 1 DQ

group_sk

id

group_id

id

group_name

text

sic_code

code

group_size_band

code

broker_id

id

effective_date

date

siu_case

18,400 rows · 12 fields · Fraud

case_id

id

case_number

text

case_type

code

subject_type

code

member_id

id PII

provider_id

id

opened_date

date

closed_date

date 22% null (open cases) plus stale never-closed rows

status

code

priority

code

assigned_investigator_id

id

estimated_exposure

money

gpi_therapeutic_class

18,000 rows · 6 fields · Pharmacy

gpi

code

gpi_2_group

text

gpi_4_class

text

gpi_6_subclass

text

therapeutic_category

text

is_specialty

boolean

feeds → Specialty Spend Share

retro_adjustment_batch

18,000 rows · 7 fields · Premium & Billing · 1 DQ

retro_batch_id

id

batch_run_date

datetime

trigger_reason

code

member_count

integer

total_adjustment_amount

money

batch_status

code

posted_flag

boolean

high_cost_claimant

18,000 rows · 8 fields · Claims

hcc_claimant_id

id

member_id

id PII

period

code

paid_to_date

money

projected_annual

money

primary_condition

code PII

stop_loss_attachment

money

case_id

id

fact_ibnr_reserve

18,000 rows · 7 fields · Risk & Actuarial · 1 DQ

ibnr_sk

id

lob_code

code

period_sk

id

paid_to_date

money

completion_factor

decimal

ibnr_estimate

money

incurred_estimate

money

dim_employee

18,000 rows · 7 fields · Workforce

employee_sk

id

employee_id

id

employee_name

text PII

department

text

cost_center

code

hire_date

date

current_flag

boolean

mart_finance_pnl

18,000 rows · 7 fields · Finance · 1 DQ

pnl_sk

id

lob_code

code

period_sk

id

premium_revenue

money

feeds → Total Premium Revenue

medical_expense

money

feeds → Net Claims Cost

admin_expense

money

underwriting_margin

money pre-adjustment

feeds → Underwriting Margin %

investigation

15,900 rows · 8 fields · Fraud

investigation_id

id

case_id

id

investigation_type

code

lead_investigator_id

id

opened_date

date

closed_date

date open investigations null

finding

code

confidence_level

code

category_ii_complaint_link

15,400 rows · 7 fields · Appeals · 1 DQ

ctm_link_id

id

case_id

id

ctm_id

text 22% null

ctm_category

code

immediate_need_flag

boolean

ctm_received_date

date

ctm_resolution_date

date

broker_license

14,800 rows · 8 fields · Sales & Broker · 1 DQ

license_id

id

broker_id

id

state_code

code

line_of_authority

code

license_number

code PII

issue_date

date

expiration_date

date

status

code

member_demographic_flagged

14,600 rows · 8 fields · Membership · 1 DQ

member_id

id PII

member_name

text PII

dob

date PII

ssn_last4

text PII

group_id

id

plan_id

id

address_snapshot

text PII snapshot drift

snapshot_date

date

underwriting_decision

14,200 rows · 8 fields · Sales & Broker

uw_decision_id

id

uw_case_id

id

decision_code

code

quoted_premium_pmpm

decimal

rate_adjustment_pct

decimal

decline_reason

code

decision_datetime

datetime

underwriter_id

id

meta_table_lineage

14,000 rows · 5 fields · Reporting & BI · 1 DQ

lineage_id

id

source_table

text

target_table

text

transform_job

text

last_verified_date

date often stale

group_eligibility_rule

12,800 rows · 7 fields · Membership

rule_id

id

group_id

id

rule_type

code

waiting_period_days

integer

min_hours_per_week

integer

dependent_age_limit

integer

effective_date

date

sla_breach_event

12,700 rows · 8 fields · Appeals

breach_id

id

clock_id

id

appeal_id

id

breach_type

code

feeds → Appeals Timeliness Rate

breach_datetime

datetime

hours_over_threshold

decimal

root_cause_code

code

self_reported_to_cms_flag

boolean

experience_rate

12,400 rows · 8 fields · Premium & Billing · 1 DQ

experience_rate_id

id

group_id

id

rating_period

code

incurred_claims_pmpm

decimal

credibility_pct

decimal ~7% null for small groups

manual_blend_pmpm

decimal

blended_premium_pmpm

decimal

pooling_point

money

group_account

12,400 rows · 9 fields · Membership · 1 DQ

group_id

id

group_name

text

broker_id

id

industry_code

code 22% null

employee_count

integer

funding_type

code

effective_date

date

renewal_month

integer

account_status

code

facility_master

12,000 rows · 5 fields · Provider

facility_id

id

facility_name

text

facility_type

code

facility_npi

code

par_status

code

provider_roster_load

12,000 rows · 7 fields · Provider · 1 DQ

roster_load_id

id

group_id

id

source_system

text

load_date

datetime

records_received

integer

records_accepted

integer

records_rejected

integer 15% reject rate

step_therapy_protocol

12,000 rows · 6 fields · Pharmacy

protocol_id

id

formulary_id

id

step_number

integer

required_gpi

code

target_gpi

code

min_trial_days

integer

large_claim_pooling

11,400 rows · 8 fields · Claims

pooling_id

id

claim_id

id

member_id

id PII

group_id

id

total_claim

money

pooling_point

money

pooled_amount

money

incurred_year

integer

provider_termination

9,800 rows · 8 fields · Provider

termination_id

id

provider_id

id

contract_id

id

termination_reason

code

termination_type

code

notice_date

date

effective_termination_date

date

member_notification_required

boolean

underwriting_case

9,800 rows · 10 fields · Sales & Broker

uw_case_id

id

group_id

id

broker_id

id

case_type

code

effective_date

date

requested_lives

integer

uw_status

code

underwriter_id

id

decision_date

date

sic_code

code

dim_benefit_plan

9,800 rows · 8 fields · Membership · 1 DQ

benefit_plan_sk

id

benefit_plan_id

id

plan_id

id

deductible_amount

money

oop_max_amount

money

copay_pcp

money

coinsurance_pct

decimal

effective_date

date

broker_appointment

9,600 rows · 7 fields · Sales & Broker

appointment_id

id

broker_id

id

product_line

code

state_code

code

appointment_status

code

appointed_date

date

renewal_due_date

date 7% null

mart_mlr_summary

9,600 rows · 7 fields · Finance · 1 DQ

mlr_sk

id

lob_code

code

period_sk

id

earned_premium

money

incurred_claims

money

quality_improvement_exp

money

mlr_ratio

decimal basis varies by report

feeds → Medical Loss Ratio (MLR)

prior_auth_criteria

9,400 rows · 8 fields · Pharmacy

criteria_id

id

gpi

code

formulary_id

id

criterion_text

text

required_diagnosis_code

code

max_age

integer

min_age

integer

auto_approve_eligible

boolean

open_enrollment_period

9,200 rows · 7 fields · Membership

oe_period_id

id

group_id

id

plan_year

integer

oe_start_date

date

oe_end_date

date

market_segment

code

is_active

boolean

reopening_request

9,100 rows · 7 fields · Appeals

reopening_id

id

appeal_id

id

reopening_reason

code

requested_date

date

good_cause_flag

boolean

reopening_outcome

code

reopened_date

date

provider_contract

8,900 rows · 11 fields · Provider

contract_id

id

provider_id

id

contract_number

text

contract_type

code

reimbursement_methodology

code

effective_date

date

termination_date

date

renewal_date

date

par_status

code

contract_status

code

fee_schedule_id

id

watchlist

8,900 rows · 8 fields · Fraud · 1 DQ

watchlist_id

id

list_source

code

entity_type

code

provider_npi

text 9% unmatched

member_id

id PII

exclusion_reason

code

exclusion_date

date

active

boolean

plan_benefit_year

8,600 rows · 6 fields · Membership

benefit_plan_id

id

plan_year

integer

accumulator_reset_month

integer

renewal_type

code

grace_period_days

integer

effective_date

date

hcc_model_coefficient

8,600 rows · 6 fields · Risk & Actuarial

coefficient_id

id

model_version

code

factor_code

code

factor_description

text

coefficient

decimal

segment

code

billing_group_master

8,400 rows · 10 fields · Premium & Billing

group_id

id

group_name

text PII

group_tax_id

text PII 4% null

billing_arrangement

code

remittance_method

code

broker_id

id orphaned broker_id rows (~6%)

sic_code

code

group_effective_date

date

group_status

code

self_billed_flag

boolean

iro_referral

8,400 rows · 8 fields · Appeals · 1 DQ

iro_referral_id

id

appeal_id

id

iro_name

text

referral_date

date

referral_reason

code

iro_decision_code

code

iro_decision_date

date 18% null on open

iro_upheld_plan_flag

boolean

broker_territory_assignment

7,800 rows · 5 fields · Sales & Broker · 1 DQ

assignment_id

id

broker_id

id

territory_id

id

effective_date

date

term_date

date

quality_of_care_referral

7,800 rows · 8 fields · Quality & STARS

qoc_referral_id

id

case_id

id

member_id

id PII

provider_id

id

severity_level

code

referred_to_dept

code

referral_date

date

peer_review_required_flag

boolean

provider_appeal

7,600 rows · 7 fields · Appeals

appeal_id

id

provider_id

id

appeal_type

code

appeal_reason

code

submitted_date

date

resolution_status

code

resolution_date

date

rebate_dispute

7,600 rows · 8 fields · Finance

dispute_id

id

invoice_id

id

rebate_contract_id

id

disputed_amount

money

dispute_reason

code

opened_date

date

resolved_date

date

resolution

code

trend_study

7,400 rows · 8 fields · Risk & Actuarial · 1 DQ

study_id

id

study_period_start

date

study_period_end

date

service_category

code 3 casing variants

observed_unit_cost_trend

decimal

observed_util_trend

decimal

normalized_trend

decimal

credibility_weight

decimal

stop_loss_recoverable

7,200 rows · 8 fields · Finance

recoverable_id

id

member_id

id PII

contract_year

integer

attachment_point

money

claims_above_attachment

money

coinsurance_pct

decimal

estimated_recoverable

money

fund_id

id

mart_revenue_monthly

7,200 rows · 7 fields · Premium & Billing · 1 DQ

rev_sk

id

lob_code

code

revenue_month_sk

id

billed_premium

money

collected_premium

money

earned_premium

money earned basis ambiguous

feeds → Total Premium Revenue

capitation_revenue

money

dim_broker

6,400 rows · 6 fields · Sales & Broker

broker_sk

id

broker_id

id

broker_name

text PII

agency_name

text

license_state

code

active_flag

boolean

state_complaint_referral

6,300 rows · 8 fields · Appeals · 1 DQ

referral_id

id

case_id

id

member_id

id PII

state_agency_code

code

state_case_number

text inconsistent format

referral_received_date

date

response_due_date

date

response_sent_date

date

allowed_amount_rule

5,600 rows · 9 fields · Provider · 1 DQ

rule_id

id

contract_id

id

fee_schedule_id

id

service_category

code

pricing_logic

code

percent_of_medicare

decimal

feeds → Claims PMPMfeeds → Net Claims Cost

lesser_of_billed_flag

boolean

priority_order

integer overlapping ranges

effective_date

date

provider_complaint

5,400 rows · 7 fields · Provider

complaint_id

id

provider_id

id

complaint_source

code

complaint_category

code

complaint_date

date

severity

code

resolution_status

code

broker_agency_affiliation

5,100 rows · 7 fields · Sales & Broker · 1 DQ

affiliation_id

id

broker_id

id

agency_id

id

role

code

effective_date

date

term_date

date

is_primary

boolean

fee_schedule_load_audit

4,800 rows · 7 fields · Reporting & BI

load_audit_id

id

fee_schedule_id

id

load_date

datetime

source_file

text

rows_loaded

integer

rows_failed

integer

load_status

code

rebate_payment

4,800 rows · 7 fields · Finance · 1 DQ

payment_id

id

invoice_id

id

rebate_contract_id

id

paid_amount

money

feeds → Rebate Capture Rate

received_date

date

variance_amount

money

gl_account

code

rx_rebate_accrual

4,800 rows · 7 fields · Pharmacy · 1 DQ

rebate_accrual_id

id

formulary_id

id

accrual_quarter

code

gross_rx_spend

money

rebate_pct

decimal ~9% null

accrued_rebate

money

received_rebate

money

mart_appeals_summary

4,800 rows · 6 fields · Appeals

appeals_summary_sk

id

appeal_type

code

month_sk

id

received_count

integer

overturned_count

integer

feeds → Appeal Overturn Rate

avg_turnaround_days

decimal

edit_definition

4,200 rows · 8 fields · Claims

edit_code

code

edit_name

text

edit_category

code

default_disposition

code

clinical_rationale

text

effective_date

date

termination_date

date

active_flag

boolean

employer_group

4,200 rows · 10 fields · Membership · 1 DQ

group_id

id

group_name

text

group_tax_id

text PII

sic_code

code

funding_arrangement

code

situs_state

code

group_status

code

effective_date

date

termination_date

date

account_manager

text

reserve_run_header

4,200 rows · 10 fields · Risk & Actuarial

reserve_run_id

id

valuation_date

date

incurred_period_start

date

incurred_period_end

date

line_of_business

code

method

code

run_status

code

run_by

id

run_datetime

datetime

is_locked

boolean

reserve_signoff

4,200 rows · 7 fields · Risk & Actuarial

signoff_id

id

reserve_run_id

id

signing_actuary_id

id

opinion_type

code

signoff_date

date

materiality_threshold

money

comments

text

broker_master

4,200 rows · 10 fields · Sales & Broker · 1 DQ

broker_id

id

broker_name

text PII

broker_npn

code 4% null (National Producer Number)

agency_id

id

email

text PII

phone

text PII

channel_type

code

status

code

appointment_date

date

termination_date

date null for active; 11% stale terminations not backfilled

employee_master

4,200 rows · 12 fields · Workforce · 1 DQ

employee_id

id

feeds → Benefits Participation Rate

legal_first_name

text PII

legal_last_name

text PII

preferred_name

text PII 3 casing variants

date_of_birth

date PII

ssn

text PII

hire_date

date

employment_status

code

feeds → Total Headcount

position_id

id

cost_center

code

manager_employee_id

id

worker_type

code

dim_plan

4,200 rows · 8 fields · Membership

plan_sk

id

plan_id

id

plan_name

text

line_of_business

code

metal_tier

code

hmo_ppo_flag

code

effective_date

date

current_flag

boolean

facility_accreditation

4,100 rows · 6 fields · Provider

accreditation_id

id

facility_id

id

accrediting_body

code

accreditation_status

code

survey_date

date

expiration_date

date

provider_flag

3,920 rows · 9 fields · Provider · 1 DQ

flag_id

id

provider_id

id orphaned rows

provider_npi

text

flag_type

code

flag_reason

text

flag_status

code

flagged_date

date

flagged_by_employee_id

id

prepay_review

boolean

mart_executive_kpi

3,600 rows · 7 fields · Reporting & BI · 1 DQ

exec_sk

id

kpi_name

text

period_sk

id

kpi_value

decimal manually overwritten

feeds → Medical Loss Ratio (MLR)

target_value

decimal

variance_pct

decimal

source_note

text

reason_code_master

3,400 rows · 5 fields · Claims · 1 DQ

reason_code

code

code_set

code

description

text

member_facing_text

text

active_flag

boolean

benefit_plan

3,400 rows · 11 fields · Membership

benefit_plan_id

id

plan_id

id

benefit_plan_name

text

plan_year

integer

network_id

id

individual_deductible

money

family_deductible

money

individual_oop_max

money

family_oop_max

money

hsa_eligible

boolean

effective_date

date

drug_recall_event

3,400 rows · 6 fields · Clinical & Care

recall_id

id

ndc

code

recall_class

code

recall_reason

text

recall_date

date

member_outreach_flag

boolean

commission_schedule

3,400 rows · 9 fields · Sales & Broker · 1 DQ

schedule_id

id

product_line

code

channel_type

code

plan_year

integer

comp_basis

code

rate_pct

decimal

flat_amount

money null where pct-based

effective_date

date

term_date

date overlapping ranges

benefit_plan_config

3,200 rows · 6 fields · Membership

benefit_plan_id

id

plan_id

id

plan_name

text

product_line

code

metal_tier

code

effective_date

date

provider_group

3,200 rows · 6 fields · Provider

group_id

id

group_name

text

group_type

code

group_tax_id

text PII

parent_org_id

id

is_active

boolean

medical_policy

3,200 rows · 7 fields · Clinical & Care

policy_id

id

policy_number

code

policy_title

text

policy_version

text

effective_date

date

retired_date

date

approved_by_employee_id

id

pharmacy_contract

3,200 rows · 9 fields · Provider

contract_id

id

network_id

id

chain_code

code

reimbursement_basis

code

brand_discount_pct

decimal

generic_discount_pct

decimal

dispensing_fee_amount

money

effective_date

date

termination_date

date

experience_study

3,200 rows · 8 fields · Risk & Actuarial

experience_study_id

id

study_type

code

cohort_key

text

study_period_start

date

study_period_end

date

actual_rate

decimal

expected_rate

decimal

a_to_e_ratio

decimal

campaign

3,200 rows · 9 fields · Sales & Broker

campaign_id

id

campaign_name

text

channel

code

product_line

code

budget

money

feeds → Marketing Cost Per Acquisition (CPA)

start_date

date

end_date

date

status

code

cost_center

code null in 14% of rows

dim_gl_account

3,200 rows · 5 fields · Finance

gl_account_sk

id

gl_account

code

account_name

text

account_type

code

statutory_line

code

rebate_invoice

3,100 rows · 8 fields · Finance

invoice_id

id

rebate_contract_id

id

manufacturer_name

text

invoice_period

code

invoiced_amount

money

invoice_date

date

due_date

date

status

code

completion_factor_selection

2,800 rows · 8 fields · Risk & Actuarial

selection_id

id

line_of_business

code

service_category

code

lag_bucket

code

selected_cdf

decimal

feeds → Completion Factor

selection_basis

code

effective_valuation_date

date

analyst_id

id

facility_master

2,600 rows · 8 fields · Provider · 1 DQ

facility_id

id

facility_name

text

facility_npi

code

facility_type

code

facility_tax_id

text PII

bed_count

integer

ownership_type

code

is_active

boolean

length_of_stay_benchmark

2,400 rows · 7 fields · Clinical & Care

benchmark_id

id

drg_code

code

condition_category

code

geometric_mean_los

decimal

arithmetic_mean_los

decimal

benchmark_source

code

effective_date

date

billing_cycle_calendar

2,400 rows · 7 fields · Premium & Billing

billing_cycle_id

id

cycle_code

code

coverage_month

date

bill_generation_date

date

due_date

date

grace_cutoff_date

date

close_date

date

actuarial_scenario

2,400 rows · 6 fields · Risk & Actuarial

scenario_id

id

assumption_set_id

id

scenario_type

code

trend_shock_pct

decimal

morbidity_shock_pct

decimal

projected_loss_ratio

decimal

fact_dcp_calc

2,400 rows · 6 fields · Finance · 1 DQ

dcp_sk

id

period_sk

id

claims_payable

money basis varies

claims_paid_period

money

days_in_period

integer

dcp_days

decimal

feeds → Days in Claims Payable (DCP)

seasonality_factor

2,200 rows · 6 fields · Risk & Actuarial

seasonality_id

id

line_of_business

code

service_category

code

calendar_month

integer

seasonality_index

decimal

basis_period

code

member_flag

2,140 rows · 7 fields · Membership

flag_id

id

member_id

id PII

flag_type

code

flag_reason

text

flag_status

code

flagged_date

date

flagged_by_employee_id

id

specialty_taxonomy_crosswalk

2,100 rows · 5 fields · Provider · 1 DQ

crosswalk_id

id

specialty_code

code

taxonomy_code

code many-to-many ambiguity

source_system

code

confidence_level

code

trend_assumption

1,900 rows · 9 fields · Risk & Actuarial

trend_id

id

line_of_business

code

service_category

code

projection_year

integer

unit_cost_trend

decimal

utilization_trend

decimal

composite_trend

decimal

feeds → Loss Ratio Trend

trend_basis

code

approved_by

id

alj_hearing

1,900 rows · 7 fields · Appeals

alj_id

id

appeal_id

id

docket_number

text

hearing_date

date

hearing_outcome

code

plan_represented_flag

boolean

decision_received_date

date

data_mining_query

1,840 rows · 8 fields · Fraud

query_id

id

query_name

text

target_scheme

code

author_employee_id

id

last_run_at

datetime

records_returned

integer

dollars_identified

money

active

boolean

plan_pharmacy_benefit_config

1,800 rows · 8 fields · Premium & Billing

benefit_plan_id

id

plan_id

id

formulary_id

id

network_id

id

deductible_amount

money

oop_max_amount

money

mail_order_incentive_flag

boolean

plan_year

integer

billing_plan_ref

1,800 rows · 8 fields · Premium & Billing · 1 DQ

plan_id

id

benefit_plan_id

id

plan_name

text 7% drift from plan master

line_of_business

code

metal_tier

code

market_segment

code

hios_id

text

active_flag

boolean

benefit_actuarial_value

1,800 rows · 7 fields · Premium & Billing

av_id

id

benefit_plan_id

id

plan_id

id

metal_tier

code

av_pct

decimal

av_calculator_version

code

cost_sharing_summary

text

morbidity_factor

1,600 rows · 7 fields · Risk & Actuarial

morbidity_id

id

line_of_business

code

rating_area

code

benefit_year

integer

morbidity_factor

decimal

induced_demand_factor

decimal

source

code

meta_report_catalog

1,400 rows · 6 fields · Reporting & BI · 1 DQ

report_catalog_id

id

report_name

text

tool

text

owner_employee_id

id ~60% null

last_refresh_datetime

datetime

source_tables

text

external_referral

1,280 rows · 8 fields · Fraud

external_referral_id

id

case_id

id

agency

code

agency_contact

text PII

referral_date

date

referral_amount

money

outcome

code 52% null (pending/unknown outcome)

mfcu_case_number

text

provider_sanction

1,200 rows · 8 fields · Provider · 1 DQ

sanction_id

id

provider_id

id

provider_npi

code

sanction_source

code

sanction_type

code

sanction_date

date

reinstatement_date

date

is_active

boolean

feeds → Provider Sanction Exposure

mart_fraud_recovery

1,200 rows · 6 fields · Fraud

fraud_recovery_sk

id

quarter_sk

id

cases_opened

integer

flagged_amount

money

recovered_amount

money

recovery_rate

decimal

feeds → Fraud Recovery Rate

risk_adjustment_transfer

1,100 rows · 8 fields · Risk & Actuarial

transfer_id

id

line_of_business

code

rating_area

code

benefit_year

integer

plan_liability_risk_score

decimal

state_avg_premium

money

transfer_amount_pmpm

decimal

transfer_direction

code

plan_master

860 rows · 9 fields · Membership

plan_id

id

plan_name

text

line_of_business

code

product_type

code

metal_tier

code

hios_id

text

effective_date

date

termination_date

date

is_active

boolean

specialty_reference

860 rows · 5 fields · Provider

specialty_code

code

specialty_description

text

taxonomy_code

code

specialty_grouping

code

is_pcp_eligible

boolean

dim_cost_center

850 rows · 5 fields · Finance

cost_center_sk

id

cost_center

code

cost_center_name

text

department

text

owner_employee_id

id

fee_schedule

680 rows · 5 fields · Provider

fee_schedule_id

id

fee_schedule_name

text

effective_date

date

termination_date

date

pricing_basis

code

agency_master

680 rows · 8 fields · Sales & Broker · 1 DQ

agency_id

id

agency_name

text

tax_id

code PII 2% null

parent_agency_id

id orphaned parent references

region_code

code

tier

code

status

code

onboarded_date

date

network_plan_map

640 rows · 5 fields · Provider

network_id

id

plan_id

id

benefit_plan_id

id

effective_date

date

termination_date

date

rating_table

640 rows · 8 fields · Premium & Billing

rating_table_id

id

line_of_business

code

rating_area

code

effective_date

date

expiration_date

date

base_rate

money

filing_status

code

serff_filing_number

text

sales_employee

640 rows · 7 fields · Workforce · 1 DQ

employee_id

id

employee_name

text PII

role

code

manager_employee_id

id self-reference loops

cost_center

code

hire_date

date

status

code

actuarial_assumption_set

620 rows · 8 fields · Risk & Actuarial

assumption_set_id

id

assumption_set_name

text

version

code

effective_date

date

discount_rate

decimal

margin_pct

decimal

approved_by

id

is_active

boolean

detection_rule

612 rows · 8 fields · Fraud · 1 DQ

rule_id

id

rule_code

code

rule_name

text

rule_category

code 4 casing variants

logic_expression

text

severity

code

active

boolean

false_positive_rate

decimal 30% null (unmeasured rules)

mlr_rebate_calc

480 rows · 9 fields · Finance

rebate_calc_id

id

line_of_business

code

market_segment

code

mlr_reporting_year

integer

numerator_claims

money

quality_improvement_exp

money

denominator_premium

money

federal_mlr

decimal

feeds → Medical Loss Ratio (MLR)

rebate_owed

money

credibility_table

480 rows · 6 fields · Risk & Actuarial

credibility_id

id

line_of_business

code

size_band

code

full_credibility_life_years

integer

credibility_factor

decimal

method

code

dim_provider_specialty

480 rows · 5 fields · Provider

specialty_sk

id

specialty_code

code

specialty_desc

text

taxonomy_code

code

specialty_category

text

examiner

420 rows · 6 fields · Workforce

examiner_id

id

employee_id

id PII

examiner_name

text PII

team_code

code

skill_level

code

active_flag

boolean

capitation_arrangement

420 rows · 8 fields · Provider

cap_arrangement_id

id

contract_id

id

provider_id

id

cap_rate_pmpm

money

covered_service_category

code

member_panel_basis

code

effective_date

date

termination_date

date

territory

420 rows · 6 fields · Sales & Broker

territory_id

id

territory_name

text

region_code

code

zip_ranges

text

manager_employee_id

id

is_active

boolean

regulatory_threshold_ref

420 rows · 9 fields · Appeals

threshold_id

id

line_of_business

code

case_type

code

appeal_level

code

standard_threshold_hours

integer

expedited_threshold_hours

integer

regulatory_authority

code

citation

text

effective_date

date

rate_filing

410 rows · 9 fields · Premium & Billing

filing_id

id

serff_tracking_number

text

line_of_business

code

state

code

filing_year

integer

requested_rate_change_pct

decimal

approved_rate_change_pct

decimal

filing_status

code

disposition_date

date

enrollment_reason_codeset

340 rows · 5 fields · Membership

reason_code

code

reason_category

code

reason_description

text

is_active

boolean

effective_date

date

fee_schedule

340 rows · 8 fields · Provider

fee_schedule_id

id

fee_schedule_name

text

fee_schedule_type

code

base_source

code

region_code

code

effective_date

date

termination_date

date

conversion_factor

decimal

premium_deficiency_reserve

340 rows · 8 fields · Finance

pdr_id

id

line_of_business

code

contract_group

code

valuation_date

date

future_premium

money

future_claims

money

future_expense

money

pdr_amount

money

formulary_tier_definition

260 rows · 6 fields · Pharmacy

formulary_id

id

tier

integer

tier_label

text

copay_amount

money

coinsurance_pct

decimal

applies_to_deductible

boolean

rebate_contract

260 rows · 7 fields · Finance

rebate_contract_id

id

manufacturer_name

text

contract_start

date

contract_end

date

line_of_business

code

admin_fee_pct

decimal

gpo_name

text

ag_analyst

210 rows · 7 fields · Workforce

employee_id

id

analyst_name

text PII

team_code

code

line_of_business_focus

code

hire_date

date

active_flag

boolean

certification_level

code

value_based_arrangement

180 rows · 8 fields · Provider

vba_id

id

contract_id

id

provider_id

id

arrangement_model

code

risk_level

code

quality_gate_threshold

decimal

shared_savings_pct

decimal

performance_period

140 rows · 7 fields · Appeals

cms_category_code

code

category_name

text

part

code

reportable_universe

code

effective_date

date

retired_date

85 rows · 5 fields · Appeals

outcome_code

code

outcome_name

text

favorable_to_member_flag

boolean

counts_as_overturn_flag

boolean

active_flag

boolean

investigator

47 rows · 7 fields · Fraud

employee_id

id

investigator_name

text PII

unit

code

certification

code

caseload_target

integer

active

boolean

hire_date

date

disease_program

42 rows · 6 fields · Clinical & Care

program_id

id

program_code

code

program_name

text

condition_category

code

is_active

boolean

effective_date

date

formulary_master

42 rows · 7 fields · Pharmacy

formulary_id

id

formulary_name

text

line_of_business

code

effective_date

date

termination_date

date

cms_formulary_id

code

plan_year

integer

recovery_vendor

42 rows · 7 fields · Finance

vendor_id

id

vendor_name

text

vendor_type

code

contingency_rate

decimal

contract_start

date

contract_end

date

active

boolean

medical_director_reviewer

42 rows · 7 fields · Appeals

reviewer_id

id

reviewer_name

text PII

npi

id

specialty

code

reviewer_type

code

active_flag

boolean

credential_expiry_date

date

dim_claim_status

40 rows · 5 fields · Claims

claim_status_sk

id

status_code

code

status_desc

text

paid_flag

boolean

denied_flag

boolean

scoring_model

34 rows · 8 fields · Fraud

model_id

id

model_name

text

model_version

text

model_type

code

target_scheme

code

threshold

decimal

active

boolean

deployed_date

date

mac_price_list

24 rows · 5 fields · Pharmacy

mac_list_id

id

mac_list_name

text

network_id

id

effective_date

date

source_vendor

text

dim_line_of_business

12 rows · 5 fields · Reporting & BI

lob_sk

id

lob_code

code

lob_name

text

regulated_flag

boolean

mlr_threshold

decimal

gl_chart_of_accounts

0 rows · 10 fields · Finance · 1 DQ

gl_account

code

account_description

text 3 casing variants

account_type

code

financial_category

code

natural_account

code

parent_account

code

is_statutory

boolean

enabled_flag

boolean

effective_start_date

date

effective_end_date

date

gl_cost_center_master

0 rows · 7 fields · Finance

cost_center

code

cost_center_name

text

department_code

code

responsible_employee_id

id

line_of_business

code

is_active

boolean

created_date

date

gl_segment_values

0 rows · 6 fields · Finance · 1 DQ

segment_value_id

id

segment_name

code

segment_value

code

value_description

text

enabled_flag

boolean disabled values still posted to

summary_flag

boolean

gl_code_combinations

0 rows · 8 fields · Finance · 1 DQ

code_combination_id

id

gl_account

code

cost_center

code orphaned rows

fund_id

code

line_of_business

code

product_segment

code

intercompany_segment

code

enabled_flag

boolean

gl_ledger_definition

0 rows · 7 fields · Finance

ledger_id

id

ledger_name

text

ledger_category

code

currency_code

code

accounting_method

code

chart_of_accounts_id

id

is_statutory_ledger

boolean

gl_journal_header

0 rows · 10 fields · Finance

journal_header_id

id

journal_batch_name

text

ledger_id

id

source_code

code

category_code

code

accounting_period

code

posting_status

code

created_by_employee_id

id

posted_date

datetime

reversal_flag

boolean

gl_journal_line

0 rows · 11 fields · Finance · 1 DQ

journal_line_id

id

journal_header_id

id

line_number

integer

code_combination_id

id

gl_account

code

cost_center

code 2% null

entered_debit

money

entered_credit

money

accounted_debit

money

accounted_credit

money

line_description

text

gl_balances

0 rows · 10 fields · Finance

gl_balance_id

id

ledger_id

id

code_combination_id

id

gl_account

code

accounting_period

code

period_net_dr

money

period_net_cr

money

begin_balance

money

end_balance

money

ytd_balance

money

feeds → Administrative Expense Ratio

gl_accounting_periods

0 rows · 7 fields · Finance

accounting_period

code

period_name

text

fiscal_year

integer

period_start_date

date

period_end_date

date

period_status

code

close_date

datetime

gl_daily_rates

0 rows · 6 fields · Finance

daily_rate_id

id

from_currency

code

to_currency

code

conversion_date

date

conversion_rate

decimal

rate_type

code

gl_journal_import_interface

0 rows · 8 fields · Finance · 1 DQ

interface_row_id

id

source_code

code

group_id

id

gl_account

code

cost_center

code

entered_amount

money

status

code 14% rejected, never reprocessed

import_date

datetime

gl_allocation_rules

0 rows · 7 fields · Finance

allocation_rule_id

id

rule_name

text

allocation_basis

code

source_account_range

text

target_cost_center

code

driver_metric

code

is_active

boolean

gl_allocation_runs

0 rows · 7 fields · Finance

allocation_run_id

id

allocation_rule_id

id

accounting_period

code

total_allocated_amount

money

run_status

code

run_datetime

datetime

generated_journal_header_id

id

fund_master

0 rows · 6 fields · Finance

fund_id

code

fund_name

text

fund_type

code

regulatory_basis

code

line_of_business

code

is_restricted

boolean

ap_supplier_master

0 rows · 8 fields · Finance · 1 DQ

supplier_id

id

supplier_name

text duplicate variants

tax_id

text PII

supplier_type

code

provider_id

id

payment_terms

code

hold_flag

boolean

created_date

date

ap_supplier_site

0 rows · 8 fields · Finance

supplier_site_id

id

supplier_id

id

site_use

code

address_line

text PII

city

text

state

code

zip_code

code

bank_account_number

text PII

ap_invoice_header

0 rows · 10 fields · Finance

invoice_id

id

supplier_id

id

supplier_site_id

id

invoice_number

text

invoice_date

date

invoice_amount

money

invoice_currency

code

invoice_type

code

approval_status

code

accounting_period

code

ap_invoice_line

0 rows · 8 fields · Finance

invoice_line_id

id

invoice_id

id

line_number

integer

gl_account

code

cost_center

code

line_amount

money

tax_amount

money

line_description

text

ap_payment

0 rows · 8 fields · Finance

payment_id

id

supplier_id

id

payment_method

code

payment_amount

money

payment_date

date

bank_account_id

id

cleared_flag

boolean

void_flag

boolean

ap_payment_application

0 rows · 6 fields · Finance

payment_application_id

id

payment_id

id

invoice_id

id

applied_amount

money

discount_taken

money

application_date

date

ap_claims_disbursement_feed

0 rows · 9 fields · Finance · 1 DQ

disbursement_batch_id

id

claim_id

id

provider_id

id

paid_amount

money

check_eft_date

date

gl_account

code

cost_center

code

accounting_period

code period straddle at cutoff

posted_flag

boolean

ap_hold

0 rows · 6 fields · Finance

hold_id

id

invoice_id

id

hold_reason_code

code

hold_status

code

placed_date

date

released_date

date

ap_1099_detail

0 rows · 6 fields · Finance

form_1099_id

id

supplier_id

id

tax_id

text PII

tax_year

integer

income_type

code

reportable_amount

money

ar_cash_receipt

0 rows · 8 fields · Finance

cash_receipt_id

id

receipt_number

text

receipt_amount

money

receipt_date

date

receipt_source

code

group_id

code

bank_account_id

id

gl_account

code

ar_premium_receipt_application

0 rows · 7 fields · Premium & Billing · 1 DQ

receipt_application_id

id

cash_receipt_id

id

premium_id

id

invoice_id

id

applied_amount

money

unapplied_amount

money suspense 60+ days

feeds → Unapplied Cash

application_date

date

gl_premium_revenue_recognition

0 rows · 10 fields · Premium & Billing · 1 DQ

rev_rec_id

id

group_id

code

benefit_plan_id

code

plan_id

code

accounting_period

code

billed_premium

money

earned_premium

money retro restatements

feeds → Medical Loss Ratio (MLR)feeds → Total Premium Revenue

unearned_premium

money

member_months

integer

feeds → Member Months

gl_account

code

gl_premium_deficiency_reserve

0 rows · 7 fields · Finance

pdr_id

id

line_of_business

code

accounting_period

code

expected_losses

money

expected_premium

money

pdr_amount

money

gl_account

code

gl_ibnr_reserve_posting

0 rows · 9 fields · Risk & Actuarial · 1 DQ

ibnr_posting_id

id

line_of_business

code

accounting_period

code

ibnr_reserve_amount

money rounding variance vs actuarial

feeds → Days in Claims Payable (DCP)feeds → IBNR Reserve Balance

prior_period_reserve

money

reserve_change

money

actuarial_source_ref

id

gl_account

code

journal_header_id

id

gl_claims_incurred_accrual

0 rows · 8 fields · Finance

incurred_accrual_id

id

line_of_business

code

accounting_period

code

paid_claims

money

ibnr_change

money

incurred_claims

money

feeds → Medical Loss Ratio (MLR)feeds → Net Claims Costfeeds → Days in Claims Payable (DCP)

gl_account

code

journal_header_id

id

gl_capitation_expense

0 rows · 7 fields · Finance

cap_expense_id

id

provider_id

id

accounting_period

code

cap_member_months

integer

cap_amount

money

gl_account

code

cost_center

code

gl_reinsurance_recoverable

0 rows · 7 fields · Finance

reinsurance_recoverable_id

id

treaty_id

id

accounting_period

code

ceded_premium

money

ceded_losses

money

recoverable_amount

money

feeds → Net Claims Cost

gl_account

code

gl_rebate_accrual_mlr

0 rows · 8 fields · Finance · 1 DQ

mlr_rebate_id

id

line_of_business

code

benefit_year

integer

statutory_mlr_numerator

money differs from board MLR basis

statutory_mlr_denominator

money

statutory_mlr_pct

decimal

feeds → MLR Rebate Accrual

rebate_accrual_amount

money

feeds → MLR Rebate Accrual

gl_account

code

fa_asset_master

0 rows · 8 fields · Finance

asset_id

id

asset_number

text

asset_description

text

asset_category

code

cost_center

code

in_service_date

date

original_cost

money

asset_status

code

fa_asset_book

0 rows · 7 fields · Finance

asset_book_id

id

asset_id

id

book_type

code

depreciation_method

code

life_in_months

integer

salvage_value

money

date_placed_in_service

date

fa_depreciation_detail

0 rows · 7 fields · Finance

depreciation_id

id

asset_id

id

book_type

code

accounting_period

code

period_depreciation

money

accumulated_depreciation

money

net_book_value

money

fa_asset_retirement

0 rows · 6 fields · Finance

retirement_id

id

asset_id

id

retirement_date

date

proceeds_of_sale

money

gain_loss_amount

money

retirement_type

code

ce_bank_account

0 rows · 7 fields · Finance

bank_account_id

id

bank_name

text

account_number_masked

text PII

routing_number

text PII

account_purpose

code

gl_cash_account

code

currency_code

code

ce_bank_statement_line

0 rows · 7 fields · Finance · 1 DQ

statement_line_id

id

bank_account_id

id

statement_date

date

transaction_amount

money

transaction_type

code

match_status

code 5% unmatched

matched_gl_line_id

id

ce_reconciliation

0 rows · 7 fields · Finance

reconciliation_id

id

bank_account_id

id

accounting_period

code

book_balance

money

bank_balance

money

reconciling_difference

money

reconciled_flag

boolean

close_task_master

0 rows · 6 fields · Finance

close_task_id

id

task_name

text

close_phase

code

responsible_employee_id

id

depends_on_task_id

id

sla_day_of_close

integer

close_task_status

0 rows · 7 fields · Finance

close_status_id

id

close_task_id

id

accounting_period

code

status

code

completed_by_employee_id

id

completed_datetime

datetime

days_to_close

integer

feeds → Days to Close

manual_journal_approval

0 rows · 6 fields · Finance

approval_id

id

journal_header_id

id

submitted_by_employee_id

id

approver_employee_id

id

approval_status

code

approval_datetime

datetime

intercompany_transaction

0 rows · 7 fields · Finance · 1 DQ

intercompany_txn_id

id

from_entity

code

to_entity

code

gl_account

code

transaction_amount

money out-of-balance pairs

accounting_period

code

elimination_flag

boolean

budget_version

0 rows · 6 fields · Finance

budget_version_id

id

version_name

text

fiscal_year

integer

budget_type

code

status

code

created_date

date

budget_line

0 rows · 6 fields · Finance

budget_line_id

id

budget_version_id

id

gl_account

code

cost_center

code

accounting_period

code

budget_amount

money

stat_filing_master

0 rows · 7 fields · Finance

filing_id

id

filing_type

code

filing_period

code

regulator

code

due_date

date

filed_date

date

filing_status

code

stat_exhibit_line

0 rows · 6 fields · Finance

exhibit_line_id

id

filing_id

id

exhibit_code

code

line_label

text

gl_account_mapping

code

reported_amount

money

rbc_calculation

0 rows · 7 fields · Risk & Actuarial

rbc_id

id

filing_period

code

rbc_component

code

component_charge

money

total_adjusted_capital

money

authorized_control_level

money

rbc_ratio

decimal

feeds → Risk-Based Capital (RBC) Ratio

gl_account_mapping_xref

0 rows · 6 fields · Reporting & BI · 1 DQ

mapping_id

id

source_system

code

source_account_code

code

gl_account

code 23% map to suspense

mapping_effective_date

date

is_default_mapping

boolean

mlr_calc_worksheet

0 rows · 10 fields · Finance · 1 DQ

mlr_worksheet_id

id

line_of_business

code

accounting_period

code

incurred_claims_gl

money

quality_improvement_expense

money applied inconsistently

earned_premium_gl

money

taxes_fees_adjustment

money

mlr_ratio_gl

decimal

feeds → Medical Loss Ratio (MLR)feeds → Combined Ratio

gl_account_numerator

code

gl_account_denominator

code

cost_center_hierarchy

0 rows · 5 fields · Finance · 1 DQ

hierarchy_id

id

cost_center

code

parent_cost_center

code duplicate parentage

hierarchy_version

code

rollup_level

integer

gl_recurring_journal

0 rows · 6 fields · Finance

recurring_journal_id

id

template_name

text

ledger_id

id

frequency

code

auto_post_flag

boolean

last_generated_period

code

expense_report

0 rows · 7 fields · Finance

expense_report_id

id

employee_id

id

report_total

money

submission_date

date

approval_status

code

cost_center

code

reimbursed_date

date

expense_report_line

0 rows · 7 fields · Finance

expense_line_id

id

expense_report_id

id

expense_category

code

expense_date

date

line_amount

money

gl_account

code

receipt_attached_flag

boolean

po_purchase_order

0 rows · 7 fields · Finance

purchase_order_id

id

supplier_id

id

po_number

text

po_date

date

po_total

money

po_status

code

buyer_employee_id

id

po_purchase_order_line

0 rows · 8 fields · Finance

po_line_id

id

purchase_order_id

id

line_number

integer

item_description

text

quantity

decimal

unit_price

money

gl_account

code

cost_center

code

accrual_reversal_register

0 rows · 6 fields · Finance · 1 DQ

accrual_id

id

journal_header_id

id

accrual_amount

money

accrual_period

code

reversal_period

code

reversal_posted_flag

boolean stale accruals

gl_audit_adjustment

0 rows · 7 fields · Finance

audit_adjustment_id

id

fiscal_year

integer

adjustment_reason

text

gl_account

code

adjustment_amount

money

journal_header_id

id

audit_firm

text

tax_provision_detail

0 rows · 7 fields · Finance

tax_provision_id

id

legal_entity

code

accounting_period

code

pretax_income

money

current_tax_expense

money

deferred_tax_expense

money

effective_tax_rate

decimal

premium_tax_assessment

0 rows · 7 fields · Finance

premium_tax_id

id

state

code

accounting_period

code

taxable_premium

money

tax_rate

decimal

assessed_amount

money

gl_account

code

gl_security_assignment

0 rows · 6 fields · Finance

security_assignment_id

id

employee_id

id

ledger_id

id

cost_center_range

text

access_level

code

granted_date

date

trial_balance_snapshot

0 rows · 7 fields · Reporting & BI

trial_balance_id

id

ledger_id

id

gl_account

code

accounting_period

code

debit_balance

money

credit_balance

money

snapshot_datetime

datetime

financial_statement_line

0 rows · 6 fields · Reporting & BI

fsg_line_id

id

statement_type

code

line_label

text

account_range

text

line_sequence

integer

sign_convention

code

employee_demographic

0 rows · 7 fields · Workforce · 1 DQ

employee_id

id

gender

code PII

self_identified_ethnicity

code PII 22% null

veteran_status

code PII

disability_status

code PII

marital_status

code PII

primary_language

code

employee_contact

0 rows · 6 fields · Workforce · 1 DQ

contact_id

id

employee_id

id

contact_type

code

email_address

text PII

phone_number

text PII

is_primary

boolean

employee_address

0 rows · 10 fields · Workforce · 1 DQ

address_id

id

employee_id

id

address_type

code

street_line_1

text PII

street_line_2

text PII

city

text PII

state

code

postal_code

text PII

effective_date

date

end_date

date

emergency_contact

0 rows · 6 fields · Workforce

emergency_contact_id

id

employee_id

id

contact_name

text PII

relationship

code

phone_number

text PII

priority_order

integer

employment_event

0 rows · 9 fields · Workforce · 1 DQ

event_id

id

employee_id

id

event_type

code

reason_code

code 4% null

effective_date

date

prior_position_id

id

new_position_id

id

entered_by

text

entered_datetime

datetime

termination

0 rows · 7 fields · Workforce · 1 DQ

termination_id

id

employee_id

id

termination_date

date

termination_type

code ~6% mislabeled

feeds → Voluntary Turnover Rate

termination_reason

code

rehire_eligible

boolean

last_worked_date

date

position

0 rows · 8 fields · Workforce · 1 DQ

position_id

id

position_title

text

job_code

code 3% null

cost_center

code

fte_value

decimal

feeds → Full-Time Equivalent (FTE)

is_filled

boolean

reports_to_position_id

id

location_id

id

job_code

0 rows · 6 fields · Workforce

job_code

code

job_title

text

job_family_id

id

flsa_status

code

eeo_category

code

is_active

boolean

job_family

0 rows · 4 fields · Workforce

job_family_id

id

job_family_name

text

job_function

code

career_track

code

department

0 rows · 6 fields · Workforce · 1 DQ

cost_center

code misaligned to GL

department_name

text

parent_cost_center

code

department_head_employee_id

id

gl_account

code

division_code

code

org_unit

0 rows · 5 fields · Workforce · 1 DQ

org_unit_id

id

org_unit_name

text

parent_org_unit_id

id

org_level

integer

cost_center

code

location

0 rows · 8 fields · Workforce

location_id

id

location_name

text

address_line

text

city

text

state

code

postal_code

text

location_type

code

is_remote_eligible

boolean

supervisory_org

0 rows · 5 fields · Workforce

sup_org_id

id

sup_org_name

text

manager_employee_id

id

parent_sup_org_id

id

headcount

integer

compensation

0 rows · 8 fields · Workforce · 1 DQ

comp_id

id

employee_id

id

base_salary

money PII 7% unit inconsistency

feeds → Average Base Salary

pay_frequency

code

hourly_rate

decimal PII

feeds → Average Base Salary

pay_grade_id

id

currency_code

code

effective_date

date

compensation_history

0 rows · 7 fields · Workforce

comp_history_id

id

employee_id

id

prior_base_salary

money PII

new_base_salary

money PII

change_pct

decimal

change_reason

code

effective_date

date

pay_grade

0 rows · 6 fields · Workforce

pay_grade_id

id

grade_code

code

min_salary

money

mid_salary

money

max_salary

money

currency_code

code

salary_survey_market

0 rows · 6 fields · Workforce · 1 DQ

survey_id

id

job_code

code

survey_vendor

text

market_p50

money

market_p75

money

survey_year

integer mixed years

bonus_plan

0 rows · 6 fields · Workforce

bonus_plan_id

id

plan_name

text

plan_type

code

target_pct

decimal

eligibility_rule

text

plan_year

integer

bonus_award

0 rows · 6 fields · Workforce · 1 DQ

award_id

id

employee_id

id

bonus_plan_id

id

target_amount

money PII

actual_amount

money PII

payout_date

date 4% null

payroll_run

0 rows · 7 fields · Workforce

payroll_run_id

id

pay_period_start

date

pay_period_end

date

check_date

date

run_status

code

gross_total

money

net_total

money

payroll_detail

0 rows · 8 fields · Workforce · 1 DQ

payroll_detail_id

id

payroll_run_id

id

employee_id

id

gross_pay

money PII

feeds → Total Labor Cost

net_pay

money PII

hours_paid

decimal

cost_center

code

gl_account

code

payroll_earning

0 rows · 6 fields · Workforce

earning_id

id

payroll_detail_id

id

earning_code

code

earning_amount

money PII

hours

decimal

rate

0 rows · 8 fields · Workforce · 1 DQ

enrollment_id

id

employee_id

id

feeds → Benefits Participation Rate

benefit_offering_id

id orphans

coverage_tier

code

employee_cost

money PII

employer_cost

money

feeds → Total Labor Cost

effective_date

date

end_date

date

benefit_dependent

0 rows · 6 fields · Workforce · 1 DQ

dependent_id

id

employee_id

id

dependent_name

text PII

relationship

code PII

dependent_dob

date PII 9% null

is_covered

boolean

retirement_plan

0 rows · 7 fields · Workforce

retirement_account_id

id

employee_id

id

plan_type

code

contribution_pct

decimal PII

employer_match_pct

decimal

vesting_pct

decimal

enrollment_date

date

leave_of_absence

0 rows · 8 fields · Workforce · 1 DQ

loa_id

id

employee_id

id

leave_type

code PII

leave_reason

code PII

start_date

date

expected_return_date

date

actual_return_date

date stale on closed leaves

is_paid

boolean

time_entry

0 rows · 8 fields · Workforce · 1 DQ

time_entry_id

id

employee_id

id

work_date

date

clock_in

datetime

clock_out

datetime 3% missing

hours_worked

decimal

cost_center

code

approval_status

code

timesheet

0 rows · 8 fields · Workforce · 1 DQ

timesheet_id

id

employee_id

id

period_start

date

period_end

date

total_hours

decimal

feeds → Overtime Hours Ratio

overtime_hours

decimal

feeds → Overtime Hours Ratio

approved_by_employee_id

id

submission_status

code

pto_balance

0 rows · 7 fields · Workforce · 1 DQ

pto_balance_id

id

employee_id

id

leave_bank_code

code

accrued_hours

decimal

used_hours

decimal

available_hours

decimal negative legacy values

as_of_date

date

pto_request

0 rows · 7 fields · Workforce

pto_request_id

id

employee_id

id

leave_bank_code

code

start_date

date

end_date

date

requested_hours

decimal

request_status

code

schedule_shift

0 rows · 7 fields · Workforce

shift_id

id

employee_id

id

shift_date

date

shift_start

datetime

shift_end

datetime

location_id

id

shift_type

code

requisition

0 rows · 9 fields · Workforce · 1 DQ

requisition_id

id

job_code

code

requisition_title

text

hiring_manager_employee_id

id 11% null

cost_center

code

open_date

date

feeds → Time to Fill

target_fill_date

date

req_status

code

openings_count

integer

candidate

0 rows · 6 fields · Workforce · 1 DQ

candidate_id

id

first_name

text PII

last_name

text PII

email_address

text PII duplicates

phone_number

text PII

source_channel

code

application

0 rows · 7 fields · Workforce · 1 DQ

application_id

id

candidate_id

id

requisition_id

id

application_date

date

current_stage

code

disposition

code

disposition_date

date out-of-order timestamps

interview

0 rows · 6 fields · Workforce

interview_id

id

application_id

id

interviewer_employee_id

id

interview_date

datetime

interview_type

code

recommendation

code

offer

0 rows · 7 fields · Workforce

offer_id

id

application_id

id

offered_salary

money PII

offered_job_code

code

offer_date

date

offer_status

code

feeds → Offer Acceptance Rate

accepted_date

date

feeds → Time to Fillfeeds → Offer Acceptance Rate

onboarding_task

0 rows · 7 fields · Workforce · 1 DQ

onboarding_task_id

id

employee_id

id

task_name

text

task_category

code

is_complete

boolean flag/date mismatch

due_date

date

completed_date

date

performance_review

0 rows · 7 fields · Workforce · 1 DQ

review_id

id

employee_id

id

reviewer_employee_id

id

review_cycle

text

overall_rating

code scale changed 2024

calibrated_rating

code

review_date

date

performance_goal

0 rows · 7 fields · Workforce

goal_id

id

employee_id

id

review_cycle

text

goal_description

text

weight_pct

decimal

achievement_pct

decimal

goal_status

code

succession_plan

0 rows · 5 fields · Workforce · 1 DQ

succession_id

id

position_id

id

successor_employee_id

id points to terminated

readiness_level

code

risk_of_loss

code

training_course

0 rows · 5 fields · Workforce

course_id

id

course_name

text

course_category

code

is_mandatory

boolean

feeds → Mandatory Training Compliance

recurrence_months

integer

training_completion

0 rows · 7 fields · Workforce · 1 DQ

completion_id

id

employee_id

id

course_id

id

assigned_date

date

completion_date

date 15% null

completion_status

code

feeds → Mandatory Training Compliance

score

decimal

license_certification

0 rows · 7 fields · Workforce · 1 DQ

license_id

id

employee_id

id

license_type

code PII

license_number

text PII

issuing_state

code

issue_date

date

expiration_date

date 8% lapsed unflagged

hr_case

0 rows · 7 fields · Workforce

hr_case_id

id

employee_id

id

case_type

code PII

case_status

code

opened_date

date

closed_date

date

assigned_hr_employee_id

id

headcount_snapshot

0 rows · 7 fields · Reporting & BI · 1 DQ

snapshot_id

id

snapshot_date

date missing month-ends

employee_id

id

feeds → Total Headcountfeeds → Voluntary Turnover Rate

cost_center

code

job_code

code

fte_value

decimal

feeds → Full-Time Equivalent (FTE)

employment_status

code

labor_cost_allocation

0 rows · 7 fields · Finance · 1 DQ

allocation_id

id

employee_id

id

cost_center

code

gl_account

code

allocation_pct

decimal 3% not summing to 100

period_month

date

allocated_cost

money

feeds → Total Labor Cost

contingent_worker

0 rows · 8 fields · Workforce · 1 DQ

contingent_worker_id

id

worker_name

text PII

vendor_name

text

employee_id

id ~40% null

cost_center

code

bill_rate

money

start_date

date

end_date

date

badge_access

0 rows · 6 fields · Workforce · 1 DQ

badge_id

id

employee_id

id active for terminated

badge_number

text PII

access_level

code

granted_date

date

revoked_date

date

measure_master

0 rows · 10 fields · Quality & STARS

measure_id

id

measure_code

code

measure_name

text

measure_steward

text

domain_category

code

measurement_year

integer

weight_part_c_d

decimal

is_star_measure

boolean

reporting_methodology

code

higher_is_better

boolean

measure_version_history

0 rows · 7 fields · Quality & STARS

measure_version_id

id

measure_id

id

spec_version

text

effective_date

date

retired_date

date

change_summary

text

ncqa_release

code

value_set

0 rows · 5 fields · Quality & STARS

value_set_id

id

value_set_oid

code

value_set_name

text

code_system

code

measurement_year

integer

value_set_code

0 rows · 5 fields · Quality & STARS · 1 DQ

value_set_code_id

id

value_set_id

id

code

code_system

code

code_description

text

measure_eligible_population

0 rows · 10 fields · Quality & STARS · 1 DQ

elig_pop_id

id

measure_id

id

member_id

id PII

measurement_year

integer

plan_id

id

benefit_plan_id

id

product_line

code

continuous_enrollment_met

boolean

anchor_date_met

boolean

age_as_of_anchor

integer PII

measure_denominator

0 rows · 9 fields · Quality & STARS · 1 DQ

denominator_id

id

measure_id

id

member_id

id PII

measurement_year

integer

in_denominator

boolean

required_exclusion_applied

boolean

optional_exclusion_applied

boolean

hospice_excluded

boolean

member_months_contributed

decimal

feeds → Member Months

measure_numerator

0 rows · 9 fields · Quality & STARS

numerator_id

id

measure_id

id

member_id

id PII

measurement_year

integer

numerator_compliant

boolean

compliant_date

date

compliance_source

code

claim_id

id

supplemental_data_id

id

measure_exclusion

0 rows · 7 fields · Quality & STARS · 1 DQ

exclusion_id

id

measure_id

id

member_id

id PII

exclusion_type

code

exclusion_reason_code

code

exclusion_date

date

evidence_source

code

measure_rate_result

0 rows · 10 fields · Quality & STARS

rate_result_id

id

measure_id

id

plan_id

id

measurement_year

integer

numerator_count

integer

denominator_count

integer

exclusion_count

integer

rate

decimal

feeds → HEDIS Measure Rate

rate_inverse

decimal

run_timestamp

datetime

hybrid_sample

0 rows · 8 fields · Quality & STARS · 1 DQ

hybrid_sample_id

id

measure_id

id

member_id

id PII

measurement_year

integer

sample_rank

integer

in_initial_sample

boolean

oversample_flag

boolean

exclusion_replaced

boolean

medical_record_review

0 rows · 10 fields · Clinical & Care

mrr_id

id

hybrid_sample_id

id

member_id

id PII

measure_id

id

abstractor_id

id

numerator_found

boolean

service_date

date PII

clinical_value

text PII

abstraction_status

code

review_datetime

datetime

chart_chase

0 rows · 9 fields · Clinical & Care · 1 DQ

chase_id

id

member_id

id PII

provider_id

id

provider_npi

code

measure_id

id

chase_status

code

requested_date

date

received_date

date

retrieval_vendor

text

supplemental_data_source

0 rows · 6 fields · Quality & STARS

supplemental_source_id

id

source_name

text

source_type

code

is_standard_supplemental

boolean

data_steward_contact

text

primary_source_verified

boolean

supplemental_data_record

0 rows · 10 fields · Quality & STARS · 1 DQ

supplemental_data_id

id

supplemental_source_id

id

member_id

id PII

measure_id

id

code

code_system

code

service_date

date PII

result_value

text PII

provider_npi

code

load_date

date

lab_result_feed

0 rows · 8 fields · Clinical & Care · 1 DQ

lab_result_id

id

member_id

id PII

loinc_code

code

result_value

decimal PII

result_unit

text

collection_date

date PII

ordering_provider_npi

code

abnormal_flag

code

gap_in_care

0 rows · 10 fields · Clinical & Care

gap_id

id

member_id

id PII

measure_id

id

measurement_year

integer

gap_status

code

feeds → Open Gaps in Care

gap_opened_date

date

gap_closed_date

date

closure_source

code

priority_score

decimal

attributed_provider_id

id

gap_closure_activity

0 rows · 8 fields · Clinical & Care

closure_activity_id

id

gap_id

id

member_id

id PII

activity_type

code

activity_channel

code

activity_date

datetime

outcome_code

code

performed_by

text

member_gap_summary

0 rows · 6 fields · Clinical & Care · 1 DQ

member_gap_summary_id

id

member_id

id PII

open_gap_count

integer

feeds → Open Gaps in Care

closed_gap_count

integer

highest_priority_measure_id

id

last_refreshed

datetime

provider_measure_attribution

0 rows · 8 fields · Provider · 1 DQ

attribution_id

id

member_id

id PII

provider_id

id

provider_npi

code

measure_id

id

attribution_method

code

attribution_period_start

date

attribution_period_end

date

provider_quality_scorecard

0 rows · 9 fields · Provider

scorecard_id

id

provider_id

id

provider_npi

code

measure_id

id

measurement_year

integer

numerator_count

integer

denominator_count

integer

provider_rate

decimal

peer_percentile

decimal

star_cut_point

0 rows · 7 fields · Quality & STARS

cut_point_id

id

measure_id

id

measurement_year

integer

star_level

integer

threshold_min

decimal

threshold_max

decimal

is_predicted

boolean

measure_star_assignment

0 rows · 8 fields · Quality & STARS

measure_star_id

id

measure_id

id

contract_id

code

plan_id

id

measurement_year

integer

measure_rate

decimal

star_value

decimal

feeds → Star Rating

weight

decimal

contract_star_rating

0 rows · 9 fields · Quality & STARS

contract_star_id

id

contract_id

code

measurement_year

integer

part_c_summary

decimal

part_d_summary

decimal

overall_star_rating

decimal

feeds → Star Rating

reward_factor_applied

decimal

cai_adjustment

decimal

run_timestamp

datetime

improvement_measure_calc

0 rows · 7 fields · Quality & STARS

improvement_calc_id

id

measure_id

id

contract_id

code

prior_year_star

decimal

current_year_star

decimal

net_change

decimal

significant_change_flag

boolean

star_what_if_scenario

0 rows · 8 fields · Quality & STARS

scenario_id

id

scenario_name

text

contract_id

code

measurement_year

integer

assumptions_json

text

projected_overall_star

decimal

created_by

text

created_at

datetime

cahps_survey

0 rows · 7 fields · Quality & STARS

cahps_survey_id

id

measurement_year

integer

contract_id

code

vendor_name

text

fielding_start

date

fielding_end

date

sample_size

integer

cahps_response

0 rows · 7 fields · Quality & STARS · 1 DQ

cahps_response_id

id

cahps_survey_id

id

member_id

id PII

response_mode

code

response_date

date

completed_flag

boolean

proxy_completed

boolean

cahps_item_score

0 rows · 6 fields · Quality & STARS

cahps_item_id

id

cahps_response_id

id

composite_code

code

item_code

code

raw_response

integer PII

top_box_flag

boolean

cahps_composite_result

0 rows · 7 fields · Quality & STARS

composite_result_id

id

cahps_survey_id

id

contract_id

code

composite_code

code

case_mix_adjusted_score

decimal

feeds → CAHPS Composite Score

star_value

decimal

feeds → CAHPS Composite Score

reliability_flag

code

hos_survey_result

0 rows · 9 fields · Quality & STARS · 1 DQ

hos_result_id

id

member_id

id PII

contract_id

code

cohort_year

integer

physical_component_score

decimal PII

mental_component_score

decimal PII

fall_risk_managed

boolean

bladder_control_addressed

boolean

physical_activity_discussed

boolean

regulatory_submission

0 rows · 9 fields · Reporting & BI

submission_id

id

submission_type

code

regulator

code

measurement_year

integer

contract_id

code

due_date

date

submitted_date

date

submission_status

code

submitted_by

text

idss_audit_result

0 rows · 7 fields · Reporting & BI

audit_result_id

id

submission_id

id

measure_id

id

audit_designation

code

auditor_org

text

auditor_finding

text

audit_date

date

submission_validation_error

0 rows · 7 fields · Reporting & BI · 1 DQ

validation_error_id

id

submission_id

id

measure_id

id

severity

code

error_code

code

error_message

text

resolved_flag

boolean

qrs_marketplace_result

0 rows · 6 fields · Quality & STARS

qrs_result_id

id

measure_id

id

qhp_id

code

measurement_year

integer

rate

decimal

global_rating

integer

member_risk_segment

0 rows · 8 fields · Clinical & Care · 1 DQ

risk_segment_id

id

member_id

id PII

measurement_year

integer

risk_score_id

id

feeds → Risk Adjustment Factor (RAF)

lis_dual_flag

boolean PII

disability_flag

boolean PII

sdoh_segment

code PII

stratification_group

code

measure_run_batch

0 rows · 8 fields · Reporting & BI

run_batch_id

id

measurement_year

integer

engine_version

text

run_type

code

run_start

datetime

run_end

datetime

record_count

integer

run_status

code

measure_data_lineage

0 rows · 7 fields · Reporting & BI

lineage_id

id

run_batch_id

id

source_system

code

feed_name

text

as_of_date

date

row_count

integer

feed_received_at

datetime

intervention_campaign

0 rows · 8 fields · Clinical & Care

campaign_id

id

campaign_name

text

target_measure_id

id

measurement_year

integer

channel

code

start_date

date

end_date

date

target_member_count

integer

campaign_member_enrollment

0 rows · 7 fields · Clinical & Care · 1 DQ

campaign_enrollment_id

id

campaign_id

id

member_id

id PII

gap_id

id

contact_status

code

last_contact_date

date

responded_flag

boolean

provider_incentive_payment

0 rows · 9 fields · Provider

incentive_payment_id

id

provider_id

id

provider_npi

code

measurement_year

integer

measure_id

id

earned_amount

money

gl_account

code

cost_center

code

payment_status

code

measurement_year_config

0 rows · 6 fields · Quality & STARS

my_config_id

id

measurement_year

integer

ncqa_volume_release

text

cms_star_year

integer

lock_date

date

is_locked

boolean

member_measure_eligibility_xref

0 rows · 9 fields · Membership · 1 DQ

elig_xref_id

id

member_id

id PII

plan_id

id

benefit_plan_id

id

group_id

id

span_start

date

feeds → Member Months

span_end

date

product_line

code

enrollment_gap_days

integer

claim_measure_event

0 rows · 9 fields · Claims · 1 DQ

claim_measure_event_id

id

claim_id

id

claim_line_id

id

member_id

id PII

measure_id

id

service_date

date PII

value_set_id

id

event_role

code

provider_npi

code

pharmacy_measure_event

0 rows · 9 fields · Pharmacy

pharmacy_measure_event_id

id

pharmacy_claim_id

id

member_id

id PII

ndc

code

measure_id

id

fill_date

date PII

days_supply

integer

pdc_numerator_days

integer

feeds → Medication Adherence (PDC ≥80%)

is_adherence_measure

boolean

measure_benchmark

0 rows · 7 fields · Quality & STARS

benchmark_id

id

measure_id

id

measurement_year

integer

benchmark_source

code

percentile_50

decimal

percentile_75

decimal

percentile_90

decimal

data_quality_finding

0 rows · 8 fields · Reporting & BI

dq_finding_id

id

run_batch_id

id

source_table

text

finding_type

code

affected_member_id

id PII

measure_id

id

severity

code

detected_at

datetime

Every field, profiled and connected

snapshot_membership_daily

bridge_claim_diagnosis

fact_claim_line

fact_eob_remittance

claim_status_history

stg_claims_raw

fact_claim

adjudication_message

gl_posting

adjudication_result

pricing_audit

stg_pharmacy_raw

claim_line

billing_audit_log

fact_pharmacy_claim

eob_line_detail

remittance_line

claim_line_payment_allocation

member_cost_share_detail

claim_diagnosis

ar_transaction

risk_adjustment_claim_extract

claim_edit

stg_premium_raw

fact_premium

claim_line_modifier

claim_note

invoice_line

encounter_submission

um_audit_log

premium_calculation

crm_audit_log

duplicate_claim_check

stg_eligibility_raw

edi_837_transaction

claim_header

claim_geo_attribution

timely_filing_check

broker_attribution

claim_payment_summary

claim_sla_tracking

gl_posting

fact_quality_measure

eob

pharmacy_claim_line

pricing_adjudication_result

claim_procedure

audit_trail

pharmacy_claim_header

email_engagement

fact_premium_billing

fact_cob_detail

cob_detail

cash_application

denied_claim

capitation_roster

assessment_question

billing_member_coverage

authorization_link

member_month_summary

member_month_actuarial

rebate_accrual

accumulator_transaction

claim_lag_snapshot

remittance_advice

apc_assignment

edi_835_transaction

ar_aging_snapshot

campaign_member

provider_payment

check_register

ar_balance

claim_attachment

group_billing_roster

fact_edit_override

clinical_note

claim_adjustment

fact_capitation

lockbox_transaction