Claims Data Dictionary

Table Name	Column Name	Data Type	notes
INPATIENT_EVENTS	UTILIZATION_ID	String	Equivalent of claim ID
INPATIENT_EVENTS	VISIT_ID	String
INPATIENT_EVENTS	VISIT_TYPE	String
INPATIENT_EVENTS	PATIENT_ID	String	Hashed unique patient identifier
INPATIENT_EVENTS	ADMIT_DATE	Date	Admission dates for inpatient procedures
INPATIENT_EVENTS	DISCHARGE_DATE	Date	Discharge date for inpatient procedures
INPATIENT_EVENTS	CLAIM_FROM_DATE	Date
INPATIENT_EVENTS	CLAIM_THROUGH_DATE	Date
INPATIENT_EVENTS	TOTAL_LOS	Integer	Total length of inpatient stay
INPATIENT_EVENTS	DRG_CODE	String	DRG code - usually only available for acute inpatient care
INPATIENT_EVENTS	DRG_CODE_DESCRIPTION	String	DRG code Description
INPATIENT_EVENTS	DRG_CODE_TYPE	String	MS-DRG vs APR-DRG
INPATIENT_EVENTS	DRG_CODE_VERSION	String	Version of DRG code
INPATIENT_EVENTS	DRG_CODE_IMPUTATION_FLAG	Boolean	Flag to determine imputation status of DRG code
INPATIENT_EVENTS	MDC_CODE	String	Three digit numeric code that groups beneficiary diagnosis codes into broad categories based on condition type and body region. a higher level grouping on MS-DRG
INPATIENT_EVENTS	MDC_DESCRIPTION	String	MDC code description
INPATIENT_EVENTS	ADMIT_SOURCE_CODE	String
INPATIENT_EVENTS	ADMIT_TYPE_CODE	String
INPATIENT_EVENTS	DISCHARGE_STATUS_CODE	String	Discharge status code
INPATIENT_EVENTS	ACUTE_SUBACUTE	String	Acute Inpatient vs Sub-acute Inpatient
INPATIENT_EVENTS	UTILIZATION_CATEGORY	String	Sub categories under Acute Inpatient & Sub-acute Inpatient
INPATIENT_EVENTS	ADMISSION_DIAGNOSIS_CODE	String	ICD 10 Dx code
INPATIENT_EVENTS	PRIMARY_DIAGNOSIS_CODE	String	ICD 10 Dx code
INPATIENT_EVENTS	SECONDARY_DIAGNOSIS _CODES	Array	ICD 10 Dx code
INPATIENT_EVENTS	ICD_PCS_CODES	Array	ICD PCS codes from all service line for the claims collected as array
INPATIENT_EVENTS	CPT_HCPCS_CODES	Array	HCPCS & CPT codes from all service line for the claims collected as array
INPATIENT_EVENTS	REVENUE_CODES	Array	Revenue codes from all service line for the claims collected as array
INPATIENT_EVENTS	BILL_TYPE_CODE	String	Bill type code. First digit is facility type code. Second digit is facility class code. Third digit is claim frequency code
INPATIENT_EVENTS	FACILITY_TYPE_CLASS_CODE _DESC	String	Description of the first & second digit of the bill type code
INPATIENT_EVENTS	FACILITY_NPI	String	NPI of the facility or the laboratory in which the services were rendered for Institutional Claim;
INPATIENT_EVENTS	FACILITY_NPI_CLASSIFICATION	String	Classification based on the NUCC taxonomy code for that NPI
INPATIENT_EVENTS	FACILITY_NPI_SPECIALIZATION	String	Specialization of the primary taxonomy code
INPATIENT_EVENTS	BILLING_NPI	String	Facility that is submitting the institutional claim or the human provider who rendered the care and is submitting the professional claim
INPATIENT_EVENTS	BILLING_NPI_CLASSIFICATION	String
INPATIENT_EVENTS	BILLING_NPI_SPECIALIZATION	String
INPATIENT_EVENTS	BILLING_NPI_SPECIALTY	String	Specialization of the Billing NPI
INPATIENT_EVENTS	ATTENDING_NPI	String	The human provider that was the attending physician in a hospital setting in which the services were rendered.
INPATIENT_EVENTS	ATTENDING_NPI_SPECIALTY	String	Specialty of the Attending NPI
INPATIENT_EVENTS	OPERATING_NPI	String	The human provider that was the operating physician when operating physician data is required on the institutional claim
INPATIENT_EVENTS	OPERATING_NPI_SPECIALTY	String	Specialty of the Operating NPI
INPATIENT_EVENTS	NETWORK_STATUS	String
INPATIENT_EVENTS	ENCOUNTER_TYPE	String
INPATIENT_EVENTS	CLAIM_PAYER_NAME_PRIMARY	String
INPATIENT_EVENTS	CLAIM_INSURANCE_GROUP _PRIMARY	String
INPATIENT_EVENTS	CLAIM_INSURANCE_SEGMENT _PRIMARY	String
INPATIENT_EVENTS	CLAIM_PAYER_NAME _SECONDARY	String
INPATIENT_EVENTS	CLAIM_INSURANCE_GROUP _SECONDARY	String
INPATIENT_EVENTS	CLAIM_INSURANCE_SEGMENT _SECONDARY	String
INPATIENT_EVENTS	PATIENT_INSURANCE_GROUP	String
INPATIENT_EVENTS	PATIENT_INSURANCE _SEGMENT	String
INPATIENT_EVENTS	PAYMENT_MODEL	String	Payment model of the claim
INPATIENT_EVENTS	PROVIDER_ZIP	String	Provider zip code
INPATIENT_EVENTS	PATIENT_ZIP	String	First three digits of the patient zip code
INPATIENT_EVENTS	PROVIDER_STATE	String
INPATIENT_EVENTS	PATIENT_STATE	String
INPATIENT_EVENTS	SERVICE_AREA_TYPE	String
INPATIENT_EVENTS	TOTAL_PROVIDER_BILLED _AMOUNT_ORIGINAL	Float
INPATIENT_EVENTS	TOTAL_PLAN_ALLOWED _AMOUNT_ORIGINAL	Float
INPATIENT_EVENTS	TOTAL_PLAN_PAID_AMOUNT _ORIGINAL	Float
INPATIENT_EVENTS	TOTAL_PATIENT _RESPONSIBILITY_ORIGINAL	Float
INPATIENT_EVENTS	ESTIMATED_ALLOWED_AMNT	Float	Komodo Health estimated total allowed amount
NON_INPATIENT _EVENTS	UTILIZATION_ID	String	Equivelant of claim ID
NON_INPATIENT _EVENTS	LINE_NUMBER	Integer	Equivelent of claim service line number
NON_INPATIENT _EVENTS	VISIT_ID	String
NON_INPATIENT _EVENTS	VISIT_TYPE	String
NON_INPATIENT _EVENTS	PATIENT_ID	String	Hashed unique patient identifier
NON_INPATIENT _EVENTS	CLAIM_TYPE_CODE	String	Claim type code
NON_INPATIENT _EVENTS	SERVICE_DATE	Date	Service From Date
NON_INPATIENT _EVENTS	SERVICE_TO_DATE	Date	Service To Date
NON_INPATIENT _EVENTS	REVENUE_CODE	String	Revenue code
NON_INPATIENT _EVENTS	PROCEDURE_CODE	String	Procedure code
NON_INPATIENT _EVENTS	MODIFIERS	Array	Procedure code modifier
NON_INPATIENT _EVENTS	UNITS	Float	Cleaned unit
NON_INPATIENT _EVENTS	IMPUTED_UNIT_FLAG	Boolean	If unit is imputed or normalized
NON_INPATIENT _EVENTS	UNIT_TYPE	String
NON_INPATIENT _EVENTS	NDC11	String	NDC 11
NON_INPATIENT _EVENTS	UTILIZATION_TYPE	String	KH Utilization Classification L1; related to Payment model
NON_INPATIENT _EVENTS	SERVICE_CATEGORY	String	KH Utilization Classification L2, related to type of service
NON_INPATIENT _EVENTS	SERVICE_SUBCATEGORY	String	KH Utilization Classification L3, realted to type of service
NON_INPATIENT _EVENTS	PLACE_OF_SERVICE	String	Place of service code; usually provided only for claim type code ='P'
NON_INPATIENT _EVENTS	BILL_TYPE_CODE	String	Bill type code; usually provided only for claim type code ='I'
NON_INPATIENT _EVENTS	FACILITY_TYPE_CLASS _CODE_DESC	String	Description of the first and second digit of the bill type code
NON_INPATIENT _EVENTS	APC_CODE	String	Imputed APC code
NON_INPATIENT _EVENTS	APC_DESCRIPTION	String	Imputed APC code description
NON_INPATIENT _EVENTS	PRIMARY_DIAGNOSIS _CODE_ARRAY	Array	Primary diagnosis code; For facility claims, this is primary diagnosis code from header, size will be 1; For professional claims, this is the diagnosis codes that the service line was pointed to, size can be greater than 1;
NON_INPATIENT _EVENTS	DIAGNOSIS_CODES	Array	All diagnosis code assigned with the claim; primary diagnosis code will be part of the array
NON_INPATIENT _EVENTS	ICD_PCS_CODES	Array	All ICD PCS codes that are associated with the claim
NON_INPATIENT _EVENTS	ATTENDING_NPI	String	The human provider that was the attending physician in a hospital setting in which the services were rendered.
NON_INPATIENT _EVENTS	ATTENDING_NPI_SPECIALTY	String	Specialty of the Attending NPI
NON_INPATIENT _EVENTS	OPERATING_NPI	String	The human provider that was the operating physician when operating physician data is required on the institutional claim
NON_INPATIENT _EVENTS	OPERATING_NPI_SPECIALTY	String	Specialty of the Operating NPI
NON_INPATIENT _EVENTS	BILLING_NPI	String
NON_INPATIENT _EVENTS	BILLING_NPI_CLASSIFICATION	String
NON_INPATIENT _EVENTS	BILLING_NPI_SPECIALIZATION	String
NON_INPATIENT _EVENTS	FACILITY_NPI	String	NPI of the facility or the laboratory in which the services were rendered for Institutional Claim;
NON_INPATIENT _EVENTS	FACILITY_NPI_CLASSIFICATION	String
NON_INPATIENT _EVENTS	FACILITY_NPI_SPECIALIZATION	String	Specialty of the Facility NPI
NON_INPATIENT _EVENTS	RENDERING_NPI	String	The provider directly rendering the care, or in the case that a mid-level provider is rendering the care, this is the supervising provider, only found on an Professional Claim or on an outpatient facility claims; this is distinct for each service line.
NON_INPATIENT _EVENTS	RENDERING_NPI_SPECIALTY	String	Specialty of the Rendering NPI
NON_INPATIENT _EVENTS	REFERRING_NPI	String	The provider ordering a laboratory test or a specialty pharmacy product that is covered under the medical benefit.
NON_INPATIENT _EVENTS	REFERRING_NPI_SPECIALTY	String	Specialty of the Reffering NPI
NON_INPATIENT _EVENTS	NETWORK_STATUS	String
NON_INPATIENT _EVENTS	ENCOUNTER_TYPE	String
NON_INPATIENT _EVENTS	CLAIM_PAYER_NAME_PRIMARY	String
NON_INPATIENT _EVENTS	CLAIM_INSURANCE_GROUP _PRIMARY	String
NON_INPATIENT _EVENTS	CLAIM_INSURANCE_SEGMENT _PRIMARY	String
NON_INPATIENT _EVENTS	CLAIM_PAYER_NAME _SECONDARY	String
NON_INPATIENT _EVENTS	CLAIM_INSURANCE_GROUP _SECONDARY	String
NON_INPATIENT _EVENTS	CLAIM_INSURANCE_SEGMENT _SECONDARY	String
NON_INPATIENT _EVENTS	PATIENT_INSURANCE_GROUP	String	Payer channel
NON_INPATIENT _EVENTS	PATIENT_INSURANCE _SEGMENT	String	Payer channel
NON_INPATIENT _EVENTS	PAYMENT_MODEL	String	Name of cost function
NON_INPATIENT _EVENTS	PROVIDER_ZIP	String	Provider zip code
NON_INPATIENT _EVENTS	PATIENT_ZIP	String	First three digits of the patient zip code
NON_INPATIENT _EVENTS	PROVIDER_STATE	String
NON_INPATIENT _EVENTS	PATIENT_STATE	String
NON_INPATIENT _EVENTS	SERVICE_AREA_TYPE	String
NON_INPATIENT _EVENTS	PROVIDER_BILLED_AMOUNT _ORIGINAL	Float
NON_INPATIENT _EVENTS	PLAN_ALLOWED_AMOUNT _ORIGINAL	Float
NON_INPATIENT _EVENTS	PLAN_PAID_AMOUNT _ORIGINAL	Float
NON_INPATIENT _EVENTS	ESTIMATED_ALLOWED _AMNT	Float	Estimated total allowed amount

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