📄️ ada_cdt_lookup
American Dental Association (ADA) Current Dental Terminology (CDT) lookup table.
📄️ address_canonical
Canonical address information retrieved from smarty.com API. See address_seen for field details.
📄️ address_seen
Stores every address we've ever encountered from any source in the database.
📄️ api_metrics
Stores metrics for API calls.
📄️ claim
Information about a healthcare or prescription drug claim
📄️ claim_anesthesia_procedure
Provides information about the anesthesia HCPCS codes associated with a claim
📄️ claim_coordination_of_benefits
Information about other subscribers that may be responsible for payment during coordination of benefits. Some repricers also use the SBR/CAS segments to indicate the price for a primary payer, even if that is not technically spec compliant
📄️ claim_coordination_of_benefits_adjustment
Lists the adjustments that have been performed on a claim during the process of adjudication. Only used for Coordination of Benefits according to the EDI spec, but may be used for repricing with the primary payer (from 2320 loop)
📄️ claim_coverage
Provides information about member coverage for a specific plan during service dates
📄️ claim_diagnosis
Provides information about the ICD diagnosis codes associated with a claim
📄️ claim_drg
Provides information about the DRG code associated with an inpatient claim
📄️ claim_member
Member information for a claim. Includes subscriber and patient (when provided) information
📄️ claim_member_match_hash
Text hash used for finding matches between claims (claim_member) and eligibility (member_seen)
📄️ claim_member_to_member_seen_match
Describes matches between claims (claim_member) and eligibility (member_seen).
📄️ claim_note
Notes for a claim
📄️ claim_occurrence
Provides information about the NUBC occurrence and occurrence span codes associated with a claim
📄️ claim_paperwork
Describes a paper attachment following the claim
📄️ claim_pay_to_plan
Information about the subrogation demand payer
📄️ claim_procedure
Provides information about the ICD procedure codes associated with a claim
📄️ claim_provider
Connects a claim to one or more providers
📄️ claim_tooth
Provides information about the status of individual teeth
📄️ claim_value
Provides information about the NUBC value codes associated with a claim
📄️ coverage
A unique set of data associated with a member coverage.
📄️ coverage_coordination_of_benefits
Coordination of Benefits information for a member
📄️ coverage_group_or_plan
Pulls together all the information available to map a set of members into one or more groups and one or more plans
📄️ cpt_concept_description
CPT concept descriptions.
📄️ cpt_hcup_group
Links CPT code to the appropriate HCUP CCS Group. See https://hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp for more information.
📄️ cpt_hierarchy
Hierarchy for CPT codes.
📄️ cpt_hierarchy_crosswalk
Crosswalk between cpt and cpt hierarchy..
📄️ cpt_hierarchy_lookup
Lookup for CPT code hierarchy.
📄️ cpt_lookup
CPT codes and descriptions from the AMA data file
📄️ eligibility
A unique set of data associated with a member eligibility.
📄️ email
A unique list of every email address we've seen in claims and eligibility
📄️ fax
A unique list of fax numbers we've seen in claims and eligibility
📄️ group
Information about a group of employees for a plan sponsor of a health plan (e.g. Intel California). For a small employer, this will usually match the company name. Note that this is our group definition, and may not match with the group definition of a TPA or other trading partner.
📄️ group_match
Information used to match members received from a TPA, plan sponsor, or other trading partner to our definition of a group (in the group table).
📄️ hcpcs_hcup_group
Links HCPCS code to the appropriate HCUP CCS Group. See https://hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp for more information.
📄️ hcpcs_lookup
Information on HCPCS codes from CMS
📄️ hcup_diagnosis_crosswalk
HCUP diagnosis crosswalk. See icd_diagnosis_hcup_group for the linkage between icd_diagnosis_id and hcup_diagnosis_group_id.
📄️ hcup_diagnosis_group_lookup
Information about the HCUP CCS groups for diagnosis codes. See https://hcup-us.ahrq.gov/toolssoftware/ccs10/ccs10.jsp for more information.
📄️ hcup_hcpcs_crosswalk
HCUP HCPCS crosswalk. See hcpcs_hcup_group for the linkage between hcpcs_id and hcup_hcpcs_group_id.
📄️ hcup_hcpcs_group_lookup
Information about the HCUP CCS groups for HCPCS codes. See https://hcup-us.ahrq.gov/toolssoftware/ccs_svcsproc/ccssvcproc.jsp for more information.
📄️ hcup_procedure_crosswalk
HCUP procedure crosswalk. See icd_procedure_hcup_group for the linkage between icd_procedure_id and hcup_procedure_group_id.
📄️ hcup_procedure_group_lookup
Information about the HCUP CCS groups for HCPCS codes. See https://hcup-us.ahrq.gov/toolssoftware/procedureicd10/procedure_icd10.jsp for more information.
📄️ icd_diagnosis_hcup_group
Links ICD Diagnosis code to the appropriate HCUP CCS Group. See https://hcup-us.ahrq.gov/toolssoftware/ccs10/ccs10.jsp for more information.
📄️ icd_diagnosis_hierarchy
ICD diagnosis code hierarchy.
📄️ icd_diagnosis_hierarchy_level1_lookup
ICD diagnosis code hierarchy level 1 lookup.
📄️ icd_diagnosis_hierarchy_level2_lookup
ICD diagnosis code hierarchy level 2 lookup.
📄️ icd_diagnosis_hierarchy_level3_lookup
ICD diagnosis code hierarchy level 3 lookup.
📄️ icd_diagnosis_hierarchy_level4_lookup
ICD diagnosis code hierarchy level 4 lookup.
📄️ icd_diagnosis_horizon_blue_cross_case_management_lookup
Complex case management trigger diagnosis codes (Horizon Blue Cross Blue Shield).
📄️ icd_diagnosis_lookup
List of ICD Diagnosis codes from CMS
📄️ icd_diagnosis_stop_loss_trigger
List of ICD Diagnosis stop loss trigger codes
📄️ icd_procedure_hcup_group
Links ICD Procedure code to the appropriate HCUP CCS Group. See https://hcup-us.ahrq.gov/toolssoftware/procedureicd10/procedure_icd10.jsp for more information.
📄️ icd_procedure_hierarchy
Crosswalk between ICD procedure code and the hierarchy lookups.
📄️ icd_procedure_hierarchy1_lookup
ICD procedure code hierarchy level 1 lookup.
📄️ icd_procedure_hierarchy2_lookup
ICD procedure code hierarchy level 2 lookup.
📄️ icd_procedure_hierarchy3_lookup
ICD procedure code hierarchy level 3 lookup.
📄️ icd_procedure_hierarchy4_lookup
ICD procedure code hierarchy level 4 lookup.
📄️ icd_procedure_hierarchy5_lookup
ICD procedure code hierarchy level 5 lookup.
📄️ icd_procedure_hierarchy_title_lookup
Stores the titles for each of the hierarchy levels, which vary depending on the section code (hierarchy level 1).
📄️ icd_procedure_lookup
List of ICD Procedure codes from CMS
📄️ insurer_payer
Identifies the insurer / network / carrier or other entity responsible for paying the claim on behalf of the employer
📄️ line_item
Information about a line item for a health, dental, prescription drug, etc. claim
📄️ line_item_adjudication
Describes the adjudication performed for a line item on behalf of the payer. According to the EDI specification, this is only used for Coordination of Benefits, but some reprices also use it for claims repricing
📄️ line_item_adjustment
A log of all adjustments made to a line item by a Coordination of Benefits payer. Sometimes used by repricing organizations to show pricing adjustments
📄️ line_item_form_response
Responses to a codified questionnaire
📄️ line_item_measurement
Measurement details for a line item
📄️ line_item_note
Notes for a line item
📄️ line_item_paperwork
Describes a paper attachment following the line_item
📄️ line_item_provider
Connects a line item to a provider
📄️ line_item_tooth
Provides information about the status of individual teeth
📄️ login
Information about application logins
📄️ member_canonical
The canonical member table. Other tables have foreign keys to this table.
📄️ member_coverage
Keeps track of each load of an enrolled member's coverage
📄️ member_coverage_coordination_of_benefits
Coordination of Benefits information for a specific enrolled member
📄️ member_coverage_provider
Member provider selections for primary care, capitated physicians, pharmacy, etc.
📄️ member_eligibility
Keeps track of member eligibility information
📄️ member_eligibility_person_or_org
Links a member_eligibility to employer, custodial parent, school, etc. person_or_org records
📄️ member_eligibility_race_or_ethnicity
Identifies one or more race or ethnicity categories for a member.
📄️ member_seen
Contains unique member information from claims and eligibility files
📄️ member_seen_match_hash
Text hash used for finding matches between claims (claim_member) and eligibility (member_seen)
📄️ member_seen_to_member_seen_match
Describes matches between rows in member_seen.
📄️ msdrg_lookup
Contains MS-DRG information
📄️ name_given_alias
Provides the canonical, formal version of names where applicable (e.g. Bob, Bobby, Rob -> Robert)
📄️ nanpa_area_code_lookup
A table for looking up information about NANPA area code
📄️ ndc_wasteful_drugs
Johns Hopkins University wasteful drugs.
📄️ npi_affiliate
Information about NPI's that are related to another NPI in some way.
📄️ npi_authorized_official
Contact information for the authorized official for a provider.
📄️ npi_ccn_addition
Association of NPI to CMS Certification Number (CCN).
📄️ npi_country
Global country codes used within NPI data. See https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Downloads/Data_Dissemination_File-Code_Values.pdf#page=12 section 1.10 for all Country Codes.
📄️ npi_endpoint
npi_endpoint stores information to securely transmit authenticated and encrypted medical information using a variety of Endpoint Types.
📄️ npi_license
Licensing data for a provider from License columns in npi_provider.
📄️ npi_location
A provider's location data.
📄️ npi_location_match_addition
Support team added locations that can be used for provider matching when the NPI Registry is out of date and causing matching problems.
📄️ npi_match_hash
Text hash used for finding possible providers for matching.
📄️ npi_name
Names associated with a provider
📄️ npi_name_match_addition
Support team added names that can be used for provider matching when the NPI Registry is out of date and causing matching problems.
📄️ npi_other_identifier
Other idenfifiers of providers.
📄️ npi_provider
The details about a provider. There will always be exactly one npi_provider row per provider but there may be many locations etc.
📄️ npi_state
Information about states and territories of the United States of America that providers may occupy.
📄️ npi_tax_id_addition
Tax IDs associated with an NPI in claims or contract data.
📄️ npi_taxonomy
A provider's taxonomy information.
📄️ nubc_admission_source_lookup
NUBC admission source codes (AKA Point of origin) used to describe where patient was admitted from
📄️ nubc_admission_type_lookup
NUBC admission type codes
📄️ nubc_bill_type_facility_lookup
NUBC bill type digit 1 (AKA type of facility) codes
📄️ nubc_bill_type_frequency_lookup
NUBC bill type digit 3 (AKA frequency) codes
📄️ nubc_bill_type_lookup
NUBC bill type codes. This includes digit 1 and 2
📄️ nubc_bill_type_to_place_of_service_crosswalk
NUBC bill type to CMS place of service crosswalk.
📄️ nubc_condition_lookup
NUBC condition codes used to explain special payment, patient, treatment, etc. conditions
📄️ nubc_occurrence_lookup
NUBC occurrence codes used to specify extra dates associated with a claim
📄️ nubc_patient_status_lookup
NUBC patient status codes (AKA discharge status) used to describe the patient's status at the end of the claim period.
📄️ nubc_revenue_code_group_lookup
NUBC revenue code groups provide a higher-level grouping of revenue codes
📄️ nubc_revenue_code_lookup
NUBC revenue codes describe the department performing a service in a facility
📄️ nubc_value_lookup
NUBC value codes are additional numeric values related to the claim
📄️ nucc_taxonomy_lookup
Structured taxonomy information from https://nucc.org.
📄️ pecos_address
📄️ pecos_enrollment
Information about providers and their Medicare enrollment
📄️ pecos_provider_type
Provider enrollment application and enrollment specialty code and description
📄️ pecos_reassignment
📄️ pecos_secondary_specialty
📄️ person_or_org
Contains unique people or organizations that are in some way connected to a member, provider, or payer
📄️ phone
A unique list of every phone number we've seen
📄️ place_of_service_group_lookup
Place of service group lookup.
📄️ place_of_service_lookup
CMS Place of Service codes which explain where a service was performed.
📄️ plan
The list of plans in use. To see the plans available for implementation, see the plan_template table
📄️ plan_hierarchy
Tracks relationships between different components of a plan.
📄️ plan_match
Information needed to match eligibility/enrollment and claims data to a plan
📄️ plan_member_assignment
Links specific mebers to a plan when other enrollment filters are not sufficient
📄️ plan_role
Roles assigned to the plan sponsor, solution, or individual login for a plan.
📄️ plan_solution
Identifies the solution(s) that are associated with a plan.
📄️ plan_sponsor
Information about the plan sponsor (usually employer) of a health plan.
📄️ plan_sponsor_match
Information needed to match eligibility/enrollment and claims data to a plan sponsor
📄️ plan_template
Information about an employee benefit plan. This contains all the plan design so that it can be easily applied to a new group.
📄️ provider_seen
A unique list of every provider we've ever seen
📄️ provider_seen_match
The list of providers that may be a match with the information in the provider_seen row
📄️ pub_sub
Messages received from Pub/Sub. Used to ensure that we only process each message once.
📄️ release
The list of releases that have been loaded into the database
📄️ role
Login roles available for assignment
📄️ snowflake_node
Keeps track of all the current snowflake nodes in use
📄️ solution
A list of individuals and organizations which provide services on behalf of plans
📄️ sql_metrics
Keeps track of SQL queries that are executed by the application
📄️ trading_partner
Provides information about trading partners we send data to and/or receive data from.
📄️ trading_partner_extract_ncpdp
Information needed to process NCPDP prescription drug data.
📄️ trading_partner_extract_text
Configuration for extracting text files.
📄️ trading_partner_extract_x12
Configuration for extracting X12 EDI files.
📄️ trading_partner_load
Configuration for loading files from trading partners into the database
📄️ trading_partner_load_claim
Configuration on how to load and send claims data by trading partner.
📄️ trading_partner_load_enrollment
Information needed to process eligibility / enrollment data.
📄️ trading_partner_load_rx
Information to load Prescription Drug data.
📄️ trading_partner_sftp
SFTP connection information for a trading partner.
📄️ trading_partner_sftp_sync
Configuration for sending and receiving files from a remote SFTP connection.
📄️ trading_partner_submission
Filename, submit time, and other information about data submitted via EDI, CSV or some other format
📄️ zip_to_cbsa_crosswalk
A crosswalk of ZIP to CBSA from https://www.huduser.gov/portal/datasets/usps_crosswalk.html.