utilization

Encounter counts per member month, pivoted wide across the same service categories used by cost. Because the grain and categories match, cost and utilization can be joined on member_month_id to derive cost per encounter for any category.

At a glance

Schema	dax_core
Table	utilization
Layer	Core Data Model
Object type	table
Columns	56
Grain	person_id, member_id, year_month, payer, data_source, plan
Tags	core, utilization

Columns

Column	Type	Key	Constraints	Description
member_month_id	varchar	PK	not null, unique	The person-month this row summarises.
person_id	varchar		—	The covered individual.
member_id	varchar		—	—
year_month	varchar		—	Calendar month being summarised.
payer	varchar		—	—
plan	varchar		—	—
payer_attributed_provider	varchar		—	—
payer_attributed_provider_practice	varchar		—	—
payer_attributed_provider_organization	varchar		—	—
payer_attributed_provider_lob	varchar		—	—
custom_attributed_provider	varchar		—	—
custom_attributed_provider_practice	varchar		—	—
custom_attributed_provider_organization	varchar		—	—
custom_attributed_provider_lob	varchar		—	—
dax_attributed_provider	varchar		—	—
dax_attributed_provider_bucket	varchar		—	—
dax_attributed_provider_specialty	varchar		—	—
total_encounter_count	integer		—	All encounters in the month.
inpatient_count	integer		—	Inpatient encounters in the month.
outpatient_count	integer		—	Outpatient encounters in the month.
office_based_count	integer		—	—
other_count	integer		—	—
acute_inpatient_count	integer		—	—
ambulance_orphaned_count	integer		—	—
ambulatory_surgery_center_count	integer		—	—
dialysis_count	integer		—	—
dme_orphaned_count	integer		—	—
emergency_department_count	integer		—	Emergency department encounters in the month.
home_health_count	integer		—	—
inpatient_hospice_count	integer		—	—
inpatient_long_term_acute_care_count	integer		—	—
inpatient_psych_count	integer		—	—
inpatient_rehabilitation_count	integer		—	—
inpatient_skilled_nursing_count	integer		—	—
inpatient_substance_use_count	integer		—	—
lab_orphaned_count	integer		—	—
office_visit_count	integer		—	—
office_visit_other_count	integer		—	—
office_visit_injections_count	integer		—	—
office_visit_pt_ot_st_count	integer		—	—
office_visit_radiology_count	integer		—	—
office_visit_surgery_count	integer		—	—
orphaned_claim_count	integer		—	Claims that could not be grouped into an encounter. A persistently high value here is a data quality signal worth investigating.
outpatient_hospice_count	integer		—	—
outpatient_hospital_or_clinic_count	integer		—	—
outpatient_injections_count	integer		—	—
outpatient_psych_count	integer		—	—
outpatient_pt_ot_st_count	integer		—	—
outpatient_radiology_count	integer		—	—
outpatient_rehabilitation_count	integer		—	—
outpatient_substance_use_count	integer		—	—
outpatient_surgery_count	integer		—	—
telehealth_count	integer		—	—
urgent_care_count	integer		—	—
dax_last_run	timestamp		—	Timestamp of the warehouse build that produced this row.
data_source	varchar		—	Label for the contributing system.

Querying

select *
from dax_core.utilization
limit 100;