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cost

Spend per member month, pivoted wide across the service-category hierarchy in both paid and allowed terms. Every measure shares the member-month grain, so totals and category columns are directly comparable and you can compute per-member-per-month cost without re-aggregating claims. Read the totals for headline spend and the category columns to decompose it.

At a glance​

Schemadax_core
Tablecost
LayerCore Data Model
Object typetable
Columns99
Grainperson_id, member_id, year_month, payer, data_source, plan
Tagscore, cost

Columns​

ColumnTypeKeyConstraintsDescription
member_month_idvarcharPKnot null, uniqueThe person-month this row summarises.
person_idvarchar—The covered individual.
member_idvarchar——
year_monthvarchar—Calendar month being summarised.
payervarchar——
planvarchar——
payer_attributed_providervarchar——
payer_attributed_provider_practicevarchar——
payer_attributed_provider_organizationvarchar——
payer_attributed_provider_lobvarchar——
custom_attributed_providervarchar——
custom_attributed_provider_practicevarchar——
custom_attributed_provider_organizationvarchar——
custom_attributed_provider_lobvarchar——
dax_attributed_providervarchar——
dax_attributed_provider_bucketvarchar——
dax_attributed_provider_specialtyvarchar——
total_paidnumber—All paid spend in the month, medical and pharmacy combined.
medical_paidnumber—Paid spend on medical claims.
pharmacy_paidnumber—Paid spend on pharmacy claims.
inpatient_paidnumber—Paid spend in inpatient settings.
outpatient_paidnumber—Paid spend in outpatient settings.
office_based_paidnumber—Paid spend in office-based settings.
ancillary_paidnumber——
other_paidnumber——
acute_inpatient_paidnumber——
ambulance_paidnumber——
ambulatory_surgery_center_paidnumber——
dialysis_paidnumber——
durable_medical_equipment_paidnumber——
emergency_department_paidnumber——
home_health_paidnumber——
inpatient_hospice_paidnumber——
inpatient_long_term_acute_care_paidnumber——
inpatient_psychiatric_paidnumber——
inpatient_rehabilitation_paidnumber——
inpatient_substance_use_paidnumber——
lab_paidnumber——
observation_paidnumber——
office_based_other_paidnumber——
office_based_pt_ot_st_paidnumber——
office_based_radiology_paidnumber——
office_based_surgery_paidnumber——
office_based_visit_paidnumber——
other_paid_2number——
outpatient_hospice_paidnumber——
outpatient_hospital_or_clinic_paidnumber——
outpatient_pt_ot_st_paidnumber——
outpatient_psychiatric_paidnumber——
outpatient_radiology_paidnumber——
outpatient_rehabilitation_paidnumber——
outpatient_substance_use_paidnumber——
outpatient_surgery_paidnumber——
pharmacy_paid_2number——
skilled_nursing_paidnumber——
telehealth_visit_paidnumber——
urgent_care_paidnumber——
total_allowednumber—All allowed spend in the month.
medical_allowednumber——
pharmacy_allowednumber——
inpatient_allowednumber——
outpatient_allowednumber——
office_based_allowednumber——
ancillary_allowednumber——
other_allowednumber——
acute_inpatient_allowednumber——
ambulance_allowednumber——
ambulatory_surgery_center_allowednumber——
dialysis_allowednumber——
durable_medical_equipment_allowednumber——
emergency_department_allowednumber——
home_health_allowednumber——
inpatient_hospice_allowednumber——
inpatient_long_term_acute_care_allowednumber——
inpatient_psychiatric_allowednumber——
inpatient_rehabilitation_allowednumber——
inpatient_substance_use_allowednumber——
lab_allowednumber——
observation_allowednumber——
office_based_other_allowednumber——
office_based_pt_ot_st_allowednumber——
office_based_radiology_allowednumber——
office_based_surgery_allowednumber——
office_based_visit_allowednumber——
other_allowed_2number——
outpatient_hospice_allowednumber——
outpatient_hospital_or_clinic_allowednumber——
outpatient_pt_ot_st_allowednumber——
outpatient_psychiatric_allowednumber——
outpatient_radiology_allowednumber——
outpatient_rehabilitation_allowednumber——
outpatient_substance_use_allowednumber——
outpatient_surgery_allowednumber——
pharmacy_allowed_2number——
skilled_nursing_allowednumber——
telehealth_visit_allowednumber——
urgent_care_allowednumber——
dax_last_runtimestamp—Timestamp of the warehouse build that produced this row.
data_sourcevarchar—Label for the contributing system.

Querying​

select *
from dax_core.cost
limit 100;
Last updated on