eligibility

One row per enrollment span. Each span states that a person was covered by a given payer and plan between two dates, and carries the programme attributes that drive risk and benefit logic. Spans are the basis for denominators: use them to establish who was eligible before you measure what happened to them.

At a glance

Schema	dax_core
Table	eligibility
Layer	Core Data Model
Object type	table
Columns	37
Grain	eligibility_id
Tags	core

Columns

Column	Type	Key	Terminology	Constraints	Description
eligibility_id	varchar	PK	—	not null, unique	Dax identifier for the enrollment span.
person_id	varchar		—	not null	The covered individual.
member_id	varchar		—	—	Payer-assigned member identifier for the span.
subscriber_id	varchar		—	—	Identifier of the subscriber holding the policy.
subscriber_relation	varchar		—	—	—
enrollment_start_date	date		—	—	First date of coverage in the span.
enrollment_end_date	date		—	—	Last date of coverage in the span.
payer	varchar		—	—	Payer providing coverage.
payer_type	varchar		Payer type	—	Category of payer, for example commercial or Medicare.
plan	varchar		—	—	Benefit plan providing coverage.
birth_date	date		—	—	—
death_date	date		—	—	—
original_reason_entitlement_code	varchar		Medicare orec	—	Reason the person first became entitled.
dual_status_code	varchar		Medicare dual eligibility	—	Medicare/Medicaid dual eligibility status.
medicare_status_code	varchar		Medicare status	—	Basis of Medicare entitlement.
enrollment_status	varchar		—	—	Status of the enrollment span.
hospice_flag	integer		—	—	Set when the person was enrolled in hospice during the span.
institutional_snp_flag	integer		—	—	—
medicaid_indicator	integer		—	—	Set when Medicaid coverage applied during the span.
long_term_institutional_flag	integer		—	—	—
part_d_raf_type	varchar		—	—	—
low_income_subsidy_indicator	integer		—	—	Set when a low-income subsidy applied.
metal_level	varchar		—	—	Actuarial value tier, for marketplace plans.
csr_indicator	integer		—	—	—
enrollment_duration_months	integer		—	—	Length of the span in months.
esrd_status	integer		—	—	End-stage renal disease status during the span.
transplant_duration_months	integer		—	—	—
group_id	varchar		—	—	—
group_name	varchar		—	—	—
fips_state_name	varchar		—	—	—
fips_state_code	varchar		—	—	—
fips_state_abbreviation	varchar		—	—	—
file_date	date		—	—	—
ingest_datetime	timestamp		—	—	—
file_name	varchar		—	—	—
dax_last_run	timestamp		—	—	Timestamp of the warehouse build that produced this row.
data_source	varchar		—	not null	Label for the contributing system.

Querying

select *
from dax_core.eligibility
limit 100;