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BFD-4590: Populate EoB.providers and EoB.careteam members in synthetic data (#3079)
1 parent d302025 commit ec03538

10 files changed

Lines changed: 127 additions & 132 deletions

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‎apps/bfd-model-idr/claims_adj.py‎

Lines changed: 17 additions & 16 deletions
Original file line numberDiff line numberDiff line change
@@ -17,8 +17,6 @@
1717
PHARMACY_CLM_TYPE_CDS,
1818
TARGET_RLT_COND_CODES,
1919
TARGET_SEQUENCE_NUMBERS,
20-
TYPE_1_NPIS,
21-
TYPE_2_NPIS,
2220
AVAILABLE_SSA_STATE_CDS,
2321
get_drg_dgns_codes,
2422
get_hcpcs_proc_codes,
@@ -51,6 +49,8 @@ def gen_clm(
5149
init_clm: RowAdapter | None = None,
5250
min_date: str = "2018-01-01",
5351
max_date: str = str(NOW),
52+
type_1_npis: list = [0],
53+
type_2_npis: list = [0],
5454
):
5555
clm = init_clm or RowAdapter({})
5656
clm[f.CLM_DT_SGNTR_SK] = gen_basic_id(field=f.CLM_DT_SGNTR_SK, length=12)
@@ -96,7 +96,7 @@ def gen_clm(
9696
if clm_type_cd not in PHARMACY_CLM_TYPE_CDS:
9797
clm[f.CLM_QUERY_CD] = random.choice(gen_utils.code_systems[f.CLM_QUERY_CD])
9898
else:
99-
clm[f.CLM_SRVC_PRVDR_GNRC_ID_NUM] = random.choice(TYPE_2_NPIS)
99+
clm[f.CLM_SRVC_PRVDR_GNRC_ID_NUM] = random.choice(type_2_npis)
100100
clm[f.PRVDR_SRVC_ID_QLFYR_CD] = random.choice(
101101
gen_utils.code_systems[f.PRVDR_ID_QLFYR_CD]
102102
)
@@ -105,7 +105,7 @@ def gen_clm(
105105
clm[f.PRVDR_PRSBNG_ID_QLFYR_CD] = random.choice(
106106
gen_utils.code_systems[f.PRVDR_ID_QLFYR_CD]
107107
)
108-
clm[f.CLM_PRSBNG_PRVDR_GNRC_ID_NUM] = random.choice(TYPE_1_NPIS)
108+
clm[f.CLM_PRSBNG_PRVDR_GNRC_ID_NUM] = random.choice(type_1_npis)
109109
clm[f.PRVDR_PRSCRBNG_PRVDR_NPI_NUM] = clm[f.CLM_PRSBNG_PRVDR_GNRC_ID_NUM]
110110
clm[f.CLM_SBMT_CHRG_AMT] = round(random.uniform(1, 1000000), 2)
111111
clm[f.CLM_SBMT_FRMT_CD] = random.choice(gen_utils.code_systems[f.CLM_SBMT_FRMT_CD])
@@ -138,26 +138,26 @@ def gen_clm(
138138
clm[f.CLM_LTST_CLM_IND] = clm_ltst_clm_ind
139139

140140
if (clm_type_cd < 65 and clm_type_cd >= 10) or clm_type_cd in FISS_CLM_TYPE_CDS:
141-
clm[f.PRVDR_BLG_PRVDR_NPI_NUM] = random.choice(TYPE_2_NPIS)
142-
clm[f.CLM_ATNDG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
141+
clm[f.PRVDR_BLG_PRVDR_NPI_NUM] = random.choice(type_2_npis)
142+
clm[f.CLM_ATNDG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
143143
clm[f.PRVDR_ATNDG_PRVDR_NPI_NUM] = clm[f.CLM_ATNDG_PRVDR_NPI_NUM]
144144
clm[f.CLM_OPRTG_FED_PRVDR_SPCLTY_CD] = random.choice(
145145
gen_utils.code_systems[f.CLM_PRVDR_SPCLTY_CD]
146146
)
147147
clm[f.CLM_OPRTG_PRVDR_NAME] = random.choice(["Random last, First", "~"])
148-
clm[f.CLM_OPRTG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
148+
clm[f.CLM_OPRTG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
149149
clm[f.PRVDR_OPRTG_PRVDR_NPI_NUM] = clm[f.CLM_OPRTG_PRVDR_NPI_NUM]
150150
clm[f.CLM_OTHR_FED_PRVDR_SPCLTY_CD] = random.choice(
151151
gen_utils.code_systems[f.CLM_PRVDR_SPCLTY_CD]
152152
)
153153
clm[f.CLM_OTHR_PRVDR_NAME] = random.choice(["Random last, First", "~"])
154-
clm[f.CLM_OTHR_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
154+
clm[f.CLM_OTHR_PRVDR_NPI_NUM] = random.choice(type_1_npis)
155155
clm[f.PRVDR_OTHR_PRVDR_NPI_NUM] = clm[f.CLM_OTHR_PRVDR_NPI_NUM]
156156
clm[f.CLM_RNDRG_FED_PRVDR_SPCLTY_CD] = random.choice(
157157
gen_utils.code_systems[f.CLM_PRVDR_SPCLTY_CD]
158158
)
159159
clm[f.CLM_RNDRG_PRVDR_NAME] = random.choice(["Random last, First", "~"])
160-
clm[f.CLM_RNDRG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
160+
clm[f.CLM_RNDRG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
161161
clm[f.PRVDR_RNDRNG_PRVDR_NPI_NUM] = clm[f.CLM_RNDRG_PRVDR_NPI_NUM]
162162
clm[f.CLM_ATNDG_FED_PRVDR_SPCLTY_CD] = random.choice(
163163
gen_utils.code_systems[f.CLM_PRVDR_SPCLTY_CD]
@@ -184,13 +184,13 @@ def gen_clm(
184184
clm[f.CLM_ACO_CARE_MGMT_HCBS_SW] = "Y" if "7" in used_enhancements else "N"
185185

186186
if clm_type_cd == 40 or (clm_type_cd > 70 and clm_type_cd <= 82):
187-
clm[f.PRVDR_RFRG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
187+
clm[f.PRVDR_RFRG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
188188
if clm_type_cd > 70 and clm_type_cd <= 82:
189-
clm[f.CLM_BLG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
189+
clm[f.CLM_BLG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
190190
clm[f.CLM_RLT_COND_SGNTR_SK] = "0"
191191
if random.choice([0, 1]):
192-
clm[f.CLM_BLG_PRVDR_NPI_NUM] = random.choice(TYPE_2_NPIS)
193-
clm[f.PRVDR_BLG_PRVDR_NPI_NUM] = clm[f.CLM_BLG_PRVDR_NPI_NUM]
192+
clm[f.CLM_BLG_PRVDR_NPI_NUM] = random.choice(type_2_npis)
193+
clm[f.PRVDR_BLG_PRVDR_NPI_NUM] = clm[f.CLM_BLG_PRVDR_NPI_NUM]
194194

195195
# generate claim header financial elements here
196196
clm[f.CLM_SBMT_CHRG_AMT] = round(random.uniform(1, 1000000), 2)
@@ -744,6 +744,7 @@ def gen_clm_line(
744744
clm_line_num: int,
745745
diagnoses: list[RowAdapter],
746746
init_clm_line: RowAdapter | None = None,
747+
type_1_npis: list = [0],
747748
):
748749
clm_type_cd = int(clm[f.CLM_TYPE_CD])
749750
clm_line = init_clm_line or RowAdapter({})
@@ -780,7 +781,7 @@ def gen_clm_line(
780781
if clm_type_cd >= 71 and clm_type_cd <= 72:
781782
clm_line[f.CLM_RNDRG_PRVDR_TAX_NUM] = random.choice(["1928347912", "912834729"])
782783
clm_line[f.CLM_RNDRG_PRVDR_PIN_NUM] = random.choice(["29364819", "19238747"])
783-
clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
784+
clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
784785
clm_line[f.CLM_RNDRG_PRVDR_NPI_NUM] = clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM]
785786
clm_line[f.CLM_RNDRG_FED_PRVDR_SPCLTY_CD] = random.choice(
786787
gen_utils.code_systems[f.CLM_PRVDR_SPCLTY_CD]
@@ -810,8 +811,8 @@ def gen_clm_line(
810811
)
811812

812813
if clm_type_cd == 81 or clm_type_cd == 82:
813-
clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM] = random.choice(TYPE_1_NPIS)
814-
clm_line[f.CLM_RNDRNG_PRVDR_NPI_NUM] = clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM]
814+
clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM] = random.choice(type_1_npis)
815+
clm_line[f.CLM_RNDRG_PRVDR_NPI_NUM] = clm_line[f.PRVDR_RNDRNG_PRVDR_NPI_NUM]
815816

816817
clm_line[f.CLM_LINE_HCPCS_CD] = random.choice(get_hcpcs_proc_codes(self.enable_samhsa))
817818
num_mods = random.randint(0, 5)

‎apps/bfd-model-idr/claims_generator.py‎

Lines changed: 6 additions & 2 deletions
Original file line numberDiff line numberDiff line change
@@ -468,7 +468,6 @@ class _ClaimsFile(StrEnum):
468468
f.CLM_LINE_RX_NUM,
469469
f.CLM_LINE_GRS_CVRD_CST_TOT_AMT,
470470
f.CLM_LINE_OTHR_TP_PD_AMT,
471-
f.CLM_RNDRNG_PRVDR_NPI_NUM,
472471
f.CLM_LINE_BNFT_ENHNCMT_1_CD,
473472
f.CLM_LINE_BNFT_ENHNCMT_2_CD,
474473
f.CLM_LINE_BNFT_ENHNCMT_3_CD,
@@ -740,8 +739,10 @@ def generate(
740739

741740
other_util = OtherGeneratorUtil()
742741

742+
generated_provider_histories, generated_type_1_npis, generated_type_2_npis = other_util.gen_provider_history(amount=14, init_provider_historys=files[PRVDR_HSTRY])
743+
743744
out_tables[PRVDR_HSTRY].extend(
744-
other_util.gen_provider_history(amount=14, init_provider_historys=files[PRVDR_HSTRY])
745+
generated_provider_histories
745746
)
746747

747748
# This table is special in that its data is mostly static and read from a static file, so we
@@ -862,6 +863,8 @@ def generate(
862863
bene_sk=str(pt_bene_sk),
863864
init_clm=init_adj_clm,
864865
min_date=clm_from_dt_min,
866+
type_1_npis=generated_type_1_npis,
867+
type_2_npis=generated_type_2_npis,
865868
)
866869
adj_clms_tbls[CLM].append(clm)
867870

@@ -959,6 +962,7 @@ def generate(
959962
else idx,
960963
diagnoses=diagnoses,
961964
init_clm_line=init_clm_line,
965+
type_1_npis= generated_type_1_npis
962966
)
963967
adj_clms_tbls[CLM_LINE].append(clm_line)
964968

‎apps/bfd-model-idr/claims_other.py‎

Lines changed: 15 additions & 3 deletions
Original file line numberDiff line numberDiff line change
@@ -79,8 +79,20 @@ def gen_provider_history(
7979
all_provider_historys = init_provider_historys + additional_provider_historys
8080

8181
provider_historys: list[RowAdapter] = []
82-
for provider_history in all_provider_historys:
82+
generated_type_1_npis = set()
83+
generated_type_2_npis = set()
84+
for idx, provider_history in enumerate(all_provider_historys):
8385
prvdr_sk = gen_basic_id(field="PRVDR_SK", length=9)
86+
# make half of providers type 1 npi and half type 2
87+
# type 1 npis never have a legal name
88+
# need to return both the subsets of type 1/2 npis that were used so that
89+
# generated claims can reference provider histories that actually exist
90+
if idx % 2 == 0:
91+
prvdr_lgl_name = ""
92+
generated_type_1_npis.add(prvdr_sk)
93+
else:
94+
prvdr_lgl_name = random.choice(AVAILABLE_PROVIDER_LEGAL_NAMES)
95+
generated_type_2_npis.add(prvdr_sk)
8496
provider_history.extend(
8597
{
8698
f.PRVDR_SK: prvdr_sk,
@@ -90,7 +102,7 @@ def gen_provider_history(
90102
f.PRVDR_MDL_NAME: random.choice(AVAILABLE_GIVEN_NAMES),
91103
f.PRVDR_LAST_NAME: random.choice(AVAILABLE_FAMILY_NAMES),
92104
f.PRVDR_NAME: random.choice(AVAILABLE_PROVIDER_NAMES),
93-
f.PRVDR_LGL_NAME: random.choice(AVAILABLE_PROVIDER_LEGAL_NAMES),
105+
f.PRVDR_LGL_NAME: prvdr_lgl_name,
94106
f.PRVDR_NPI_NUM: prvdr_sk,
95107
f.PRVDR_EMPLR_ID_NUM: gen_basic_id(field=f.PRVDR_EMPLR_ID_NUM, length=9),
96108
f.PRVDR_OSCAR_NUM: gen_basic_id(field=f.PRVDR_OSCAR_NUM, length=6),
@@ -102,4 +114,4 @@ def gen_provider_history(
102114

103115
provider_historys.append(provider_history)
104116

105-
return provider_historys
117+
return provider_historys, list(generated_type_1_npis), list(generated_type_2_npis)

‎apps/bfd-model-idr/claims_static.py‎

Lines changed: 0 additions & 21 deletions
Original file line numberDiff line numberDiff line change
@@ -98,26 +98,6 @@ def normalized_code(self) -> str:
9898
*MCS_CLM_TYPE_CDS,
9999
*VMS_CDS,
100100
]
101-
TYPE_1_NPIS = [
102-
1942945159,
103-
1437702123,
104-
1972944437,
105-
1447692959,
106-
1558719914,
107-
1730548868,
108-
1023051596,
109-
1003488552,
110-
1720749690,
111-
]
112-
TYPE_2_NPIS = [
113-
1093792350,
114-
1548226988,
115-
1477643690,
116-
1104867175,
117-
1669572467,
118-
1508565987,
119-
1649041195,
120-
]
121101
AVAIL_OSCAR_CODES_INSTITUTIONAL = [
122102
"-39T14",
123103
"-000000",
@@ -230,7 +210,6 @@ def normalized_code(self) -> str:
230210
"CBS Health Corporation",
231211
"WALPART INC",
232212
"Bite Aid Corporation",
233-
"",
234213
]
235214
AVAILABLE_PROVIDER_TX_CODES = [
236215
"2081P0301X",

‎apps/bfd-model-idr/field_constants.py‎

Lines changed: 0 additions & 1 deletion
Original file line numberDiff line numberDiff line change
@@ -246,7 +246,6 @@
246246
CLM_RNDRG_PRVDR_PRTCPTG_CD = "CLM_RNDRG_PRVDR_PRTCPTG_CD"
247247
CLM_RNDRG_PRVDR_TAX_NUM = "CLM_RNDRG_PRVDR_TAX_NUM"
248248
CLM_RNDRG_PRVDR_TYPE_CD = "CLM_RNDRG_PRVDR_TYPE_CD"
249-
CLM_RNDRNG_PRVDR_NPI_NUM = "CLM_RNDRNG_PRVDR_NPI_NUM"
250249
CLM_OPRTG_FED_PRVDR_SPCLTY_CD = "CLM_OPRTG_FED_PRVDR_SPCLTY_CD"
251250
CLM_OPRTG_PRVDR_NAME = "CLM_OPRTG_PRVDR_NAME"
252251
CLM_OTHR_FED_PRVDR_SPCLTY_CD = "CLM_OTHR_FED_PRVDR_SPCLTY_CD"

‎apps/bfd-pipeline-idr/test_samples2/SYNTHETIC_CLM_LINE.csv‎

Lines changed: 7 additions & 7 deletions
Original file line numberDiff line numberDiff line change
@@ -1,7 +1,7 @@
1-
CLM_UNIQ_ID,GEO_BENE_SK,CLM_DT_SGNTR_SK,CLM_TYPE_CD,CLM_NUM_SK,CLM_LINE_NUM,CLM_FROM_DT,CLM_LINE_FROM_DT,CLM_LINE_THRU_DT,CLM_LINE_HCPCS_CD,HCPCS_1_MDFR_CD,HCPCS_2_MDFR_CD,HCPCS_3_MDFR_CD,HCPCS_4_MDFR_CD,HCPCS_5_MDFR_CD,CLM_LINE_ANSTHSA_UNIT_CNT,CLM_LINE_SRVC_UNIT_QTY,CLM_LINE_REV_CTR_CD,CLM_LINE_BENE_PMT_AMT,CLM_LINE_BENE_PD_AMT,CLM_LINE_ALOWD_CHRG_AMT,CLM_LINE_SBMT_CHRG_AMT,CLM_LINE_CVRD_PD_AMT,CLM_LINE_BLOOD_DDCTBL_AMT,CLM_LINE_MDCR_DDCTBL_AMT,CLM_LINE_PRVDR_PMT_AMT,CLM_LINE_NCVRD_CHRG_AMT,CLM_LINE_FINL_ACTN_IND,CLM_LINE_LTST_CLM_IND,CLM_LINE_OTAF_AMT,CLM_LINE_NDC_CD,CLM_LINE_NDC_QTY,CLM_LINE_NDC_QTY_QLFYR_CD,CLM_RNDRG_PRVDR_TYPE_CD,CLM_LINE_MDCR_COINSRNC_AMT,CLM_LINE_DGNS_CD,CLM_POS_CD,CLM_RNDRG_PRVDR_PRTCPTG_CD,CLM_RNDRG_PRVDR_TAX_NUM,CLM_RNDRG_PRVDR_PIN_NUM,PRVDR_RNDRNG_PRVDR_NPI_NUM,CLM_RNDRG_PRVDR_NPI_NUM,CLM_LINE_PMD_UNIQ_TRKNG_NUM,CLM_LINE_NCVRD_PD_AMT,CLM_LINE_RX_NUM,CLM_LINE_GRS_CVRD_CST_TOT_AMT,CLM_LINE_OTHR_TP_PD_AMT,CLM_RNDRNG_PRVDR_NPI_NUM,IDR_INSRT_TS,IDR_UPDT_TS,GEO_RNDRG_SSA_STATE_CD
2-
1071939711294,86974,322823692140,40,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.8976543456785,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.1578675768791,Y,Y,162.6923458770913,,,,,,W213,64,,,,,,,,,,,,2025-10-20 11:07:32.133605,2025-11-03 03:00:55.296466,03
3-
1071939711295,86974,322823692141,10,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.3576543456789,2.6836545678907,13.45,0.61,203.91,474.15,N,N,,,,,,,W5529,64,,,,,,,,,,,,2026-02-02 02:47:56.064241,,03
4-
1071939711296,86974,322823692142,40,1,1,2021-09-26,2021-12-21,2021-12-26,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.4387654678987,0.35,2.68,13.45,0.61,203.91,474.15,Y,N,42.6908965653512,,,,,,W213,68,,,,,,0LA00000109286,,,,,,2025-05-31 19:18:02.646721,,03
5-
1071939711297,86974,322823692143,1013,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.6076545678906,203.91,474.15,,,,,,,,,W5529,64,,,,,,,,,,,,,,03
6-
1071939711298,86974,322823692144,2013,1,1,2021-09-26,2021-12-21,2021-12-26,J2270,PC,23,,,,,4.75,0929,1.89,4.0587654567654,2.44,0.35,2.68,13.45,0.61,203.9087656789089,474.15,,,,,,,,,W213,68,,,,,,,,,,,,,,03
7-
1409088853949,97992,271048844531,1,1,1,2025-08-10,2025-08-10,2025-08-12,,,,,,,,10.0,,0.44,,,1.55,148391.6,10.06,1.74,,,,,,00338004904,1.0,ML,,,,,,,,,,,446.2189675454909,15180.94,550.4712467907887,531.2712874098763,,,,03
1+
CLM_UNIQ_ID,GEO_BENE_SK,CLM_DT_SGNTR_SK,CLM_TYPE_CD,CLM_NUM_SK,CLM_LINE_NUM,CLM_FROM_DT,CLM_LINE_FROM_DT,CLM_LINE_THRU_DT,CLM_LINE_HCPCS_CD,HCPCS_1_MDFR_CD,HCPCS_2_MDFR_CD,HCPCS_3_MDFR_CD,HCPCS_4_MDFR_CD,HCPCS_5_MDFR_CD,CLM_LINE_ANSTHSA_UNIT_CNT,CLM_LINE_SRVC_UNIT_QTY,CLM_LINE_REV_CTR_CD,CLM_LINE_BENE_PMT_AMT,CLM_LINE_BENE_PD_AMT,CLM_LINE_ALOWD_CHRG_AMT,CLM_LINE_SBMT_CHRG_AMT,CLM_LINE_CVRD_PD_AMT,CLM_LINE_BLOOD_DDCTBL_AMT,CLM_LINE_MDCR_DDCTBL_AMT,CLM_LINE_PRVDR_PMT_AMT,CLM_LINE_NCVRD_CHRG_AMT,CLM_LINE_FINL_ACTN_IND,CLM_LINE_LTST_CLM_IND,CLM_LINE_OTAF_AMT,CLM_LINE_NDC_CD,CLM_LINE_NDC_QTY,CLM_LINE_NDC_QTY_QLFYR_CD,CLM_RNDRG_PRVDR_TYPE_CD,CLM_LINE_MDCR_COINSRNC_AMT,CLM_LINE_DGNS_CD,CLM_POS_CD,CLM_RNDRG_PRVDR_PRTCPTG_CD,CLM_RNDRG_PRVDR_TAX_NUM,CLM_RNDRG_PRVDR_PIN_NUM,PRVDR_RNDRNG_PRVDR_NPI_NUM,CLM_RNDRG_PRVDR_NPI_NUM,CLM_LINE_PMD_UNIQ_TRKNG_NUM,CLM_LINE_NCVRD_PD_AMT,CLM_LINE_RX_NUM,CLM_LINE_GRS_CVRD_CST_TOT_AMT,CLM_LINE_OTHR_TP_PD_AMT,IDR_INSRT_TS,IDR_UPDT_TS,GEO_RNDRG_SSA_STATE_CD
2+
1071939711294,86974,322823692140,40,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.8976543456785,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.1578675768791,Y,Y,162.6923458770913,,,,,,W213,64,,,,,,,,,,,2025-10-20 11:07:32.133605,2025-11-03 03:00:55.296466,03
3+
1071939711295,86974,322823692141,10,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.3576543456789,2.6836545678907,13.45,0.61,203.91,474.15,N,N,,,,,,,W5529,64,,,,,,,,,,,2026-02-02 02:47:56.064241,,03
4+
1071939711296,86974,322823692142,40,1,1,2021-09-26,2021-12-21,2021-12-26,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.4387654678987,0.35,2.68,13.45,0.61,203.91,474.15,Y,N,42.6908965653512,,,,,,W213,68,,,,,,0LA00000109286,,,,,2025-05-31 19:18:02.646721,,03
5+
1071939711297,86974,322823692143,1013,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.6076545678906,203.91,474.15,,,,,,,,,W5529,64,,,,,,,,,,,,,03
6+
1071939711298,86974,322823692144,2013,1,1,2021-09-26,2021-12-21,2021-12-26,J2270,PC,23,,,,,4.75,0929,1.89,4.0587654567654,2.44,0.35,2.68,13.45,0.61,203.9087656789089,474.15,,,,,,,,,W213,68,,,,,,,,,,,,,03
7+
1409088853949,97992,271048844531,1,1,1,2025-08-10,2025-08-10,2025-08-12,,,,,,,,10.0,,0.44,,,1.55,148391.6,10.06,1.74,,,,,,00338004904,1.0,ML,,,,,,,,,,,446.2189675454909,15180.94,550.4712467907887,531.2712874098763,,,03

‎apps/bfd-pipeline-idr/test_samples2/merged_benes/SYNTHETIC_CLM_LINE.csv‎

Lines changed: 3 additions & 3 deletions
Original file line numberDiff line numberDiff line change
@@ -1,3 +1,3 @@
1-
CLM_UNIQ_ID,GEO_BENE_SK,CLM_DT_SGNTR_SK,CLM_TYPE_CD,CLM_NUM_SK,CLM_LINE_NUM,CLM_FROM_DT,CLM_LINE_FROM_DT,CLM_LINE_THRU_DT,CLM_LINE_HCPCS_CD,HCPCS_1_MDFR_CD,HCPCS_2_MDFR_CD,HCPCS_3_MDFR_CD,HCPCS_4_MDFR_CD,HCPCS_5_MDFR_CD,CLM_LINE_ANSTHSA_UNIT_CNT,CLM_LINE_SRVC_UNIT_QTY,CLM_LINE_REV_CTR_CD,CLM_LINE_BENE_PMT_AMT,CLM_LINE_BENE_PD_AMT,CLM_LINE_ALOWD_CHRG_AMT,CLM_LINE_SBMT_CHRG_AMT,CLM_LINE_CVRD_PD_AMT,CLM_LINE_BLOOD_DDCTBL_AMT,CLM_LINE_MDCR_DDCTBL_AMT,CLM_LINE_PRVDR_PMT_AMT,CLM_LINE_NCVRD_CHRG_AMT,CLM_LINE_FINL_ACTN_IND,CLM_LINE_LTST_CLM_IND,CLM_LINE_OTAF_AMT,CLM_LINE_NDC_CD,CLM_LINE_NDC_QTY,CLM_LINE_NDC_QTY_QLFYR_CD,CLM_RNDRG_PRVDR_TYPE_CD,CLM_LINE_MDCR_COINSRNC_AMT,CLM_LINE_DGNS_CD,CLM_POS_CD,CLM_RNDRG_PRVDR_PRTCPTG_CD,CLM_RNDRG_PRVDR_TAX_NUM,CLM_RNDRG_PRVDR_PIN_NUM,PRVDR_RNDRNG_PRVDR_NPI_NUM,CLM_RNDRG_PRVDR_NPI_NUM,CLM_LINE_PMD_UNIQ_TRKNG_NUM,CLM_LINE_NCVRD_PD_AMT,CLM_LINE_RX_NUM,CLM_LINE_GRS_CVRD_CST_TOT_AMT,CLM_LINE_OTHR_TP_PD_AMT,CLM_RNDRNG_PRVDR_NPI_NUM,IDR_INSRT_TS,IDR_UPDT_TS,GEO_RNDRG_SSA_STATE_CD
2-
1071939712294,86974,322823692240,40,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.15,N,N,510.63,,,,,,W213,64,,,,,,,,,,,,2026-01-10 02:26:00.525670,2026-01-16 18:26:17.613808,03
3-
1071939712295,86974,322823692241,10,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.15,N,Y,,,,,,,W5529,64,,,,,,,,,,,,2025-06-11 23:34:41.078412,2025-10-14 04:49:42.584062,03
1+
CLM_UNIQ_ID,GEO_BENE_SK,CLM_DT_SGNTR_SK,CLM_TYPE_CD,CLM_NUM_SK,CLM_LINE_NUM,CLM_FROM_DT,CLM_LINE_FROM_DT,CLM_LINE_THRU_DT,CLM_LINE_HCPCS_CD,HCPCS_1_MDFR_CD,HCPCS_2_MDFR_CD,HCPCS_3_MDFR_CD,HCPCS_4_MDFR_CD,HCPCS_5_MDFR_CD,CLM_LINE_ANSTHSA_UNIT_CNT,CLM_LINE_SRVC_UNIT_QTY,CLM_LINE_REV_CTR_CD,CLM_LINE_BENE_PMT_AMT,CLM_LINE_BENE_PD_AMT,CLM_LINE_ALOWD_CHRG_AMT,CLM_LINE_SBMT_CHRG_AMT,CLM_LINE_CVRD_PD_AMT,CLM_LINE_BLOOD_DDCTBL_AMT,CLM_LINE_MDCR_DDCTBL_AMT,CLM_LINE_PRVDR_PMT_AMT,CLM_LINE_NCVRD_CHRG_AMT,CLM_LINE_FINL_ACTN_IND,CLM_LINE_LTST_CLM_IND,CLM_LINE_OTAF_AMT,CLM_LINE_NDC_CD,CLM_LINE_NDC_QTY,CLM_LINE_NDC_QTY_QLFYR_CD,CLM_RNDRG_PRVDR_TYPE_CD,CLM_LINE_MDCR_COINSRNC_AMT,CLM_LINE_DGNS_CD,CLM_POS_CD,CLM_RNDRG_PRVDR_PRTCPTG_CD,CLM_RNDRG_PRVDR_TAX_NUM,CLM_RNDRG_PRVDR_PIN_NUM,PRVDR_RNDRNG_PRVDR_NPI_NUM,CLM_RNDRG_PRVDR_NPI_NUM,CLM_LINE_PMD_UNIQ_TRKNG_NUM,CLM_LINE_NCVRD_PD_AMT,CLM_LINE_RX_NUM,CLM_LINE_GRS_CVRD_CST_TOT_AMT,CLM_LINE_OTHR_TP_PD_AMT,IDR_INSRT_TS,IDR_UPDT_TS,GEO_RNDRG_SSA_STATE_CD
2+
1071939712294,86974,322823692240,40,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.15,N,N,510.63,,,,,,W213,64,,,,,,,,,,,2026-01-10 02:26:00.525670,2026-01-16 18:26:17.613808,03
3+
1071939712295,86974,322823692241,10,1,1,2021-09-26,2024-03-04,2024-04-01,J2270,PC,23,,,,,4.75,0929,1.89,4.06,2.44,0.35,2.68,13.45,0.61,203.91,474.15,N,Y,,,,,,,W5529,64,,,,,,,,,,,2025-06-11 23:34:41.078412,2025-10-14 04:49:42.584062,03

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