JOURNEY_TABLE
This table offers comprehensive detail of longitudinal patient journeys, with line-item encounter detail, insight into payor, provider, procedure, revenue code, charges and SmartAllowedAmount®.
Queries that source from JOURNEY_TABLE table
What is in the JOURNEY_TABLE table?
Results are returned as a json, pySpark DataFrame, or pandas DataFrame (default).
| feature | description | example |
|---|---|---|
| journey_id | Randomly generated identifier unique to each longitudinal patient journey. | 355ed5199ebed017821c7faa62965a61 |
| episode_id | Randomly generated identifier unique to each sequence of encounters with at least 30 days between visits. | 9318831e2ce3f30a83b1317b4d02ebfd |
| visit_id | Randomly generated identifier unique to each set of encounters that occur within the same event of care. | 315cb4170e73bed429a86e3dbb4e95a d6c6ce162412dfc97fce0c7a660ea2350 |
| encounter_id | Randomly generated identifier, unique to an isolated event of care. | 5ee14a8a88b18ce16f748baa7742b28d 60a057208872b0f650ccfae7a40ffa9e |
| date | Primary date of each encounter. | 2022-05-02 |
| patient_state | US State residence of the patient on each encounter. | CO |
| patient_short_zip | First three digits of the patient's zip code | 801 |
| patient_age | Age (within 5 years) of the patient at the moment of each encounter. | 65 |
| patient_gender | Gender/Sex of the patient | M |
| place_of_service | Type of facility where a encounter occurred. | Office |
| visit_type | Description of the setting of care. | Outpatient Visit |
| payor | Name of the primary payor on each encounter. | Centers for Medicare & Medicaid Services (CMS) |
| payor_channel | Payor channel-of-business, line-of-business, or plan type. | Medicare |
| ref_npi | Referring individual provider of an encounter, identified via their National Provider Identifier (NPI). | 1003878000 |
| hcp_npi | Primary individual provider of an encounter, identified via their National Provider Identifier (NPI). | 1003878000 |
| hcp_taxonomy | Primary taxonomy code of the individual provider on an encounter. | 207Q00000X - Allopathic and Osteopathic Physicians/Family Medicine |
| hcp_specialty | Primary specialty of the individual provider provider on an encounter. | Family Practice |
| hco_npi | Organizational provider of an encounter, identified via their National Provider Identifier (NPI). | 1063001238 |
| hcp_npi_list | List of all individual providers on an encounter, including primary and supporting providers, all designated by their National Provider Identifier (NPI) | 1003878000, 01920493029 |
| hco_npi_list | List of all organizational providers on an encounter, including primary and auxiliary providers, all designated by their National Provider Identifier (NPI) | 1063001238, 29380050392 |
| diag_list | All diagnoses coded (problem list) within each claim encounter. The first diagnosis listed is the primary diagnosis. | I10, E7849, E7800, E7800, I639 |
| diag_1 - diag_25 (optional) | Depending on the diag_num listed within the query parameters, the user may receive diagnoses 1 through 25 as their own columns rather than an combined list. Defaulted to return the top 5 diagnoses. | I10....I639 |
| rev_center_code | Revenue code corresponding to encounter | '0510' |
| rev_center_units | Number of days a revenue code has been triggered, corresponding to each encounter | 1.0 |
| proc_code | Procedure code performed within encounter. | 99457 |
| proc_units | Total number of procedure units within encounter. | 1.0 |
| proc_modifier | Procedure code modifier for procedure performed within encounter. | GW |
| line_charge | Line-item charge submitted to insurers for the procedures rendered by the provider. The line charge is the pre-adjudicated value submitted to insurers. | 63.02 |
| claim_charge | Line-item charge submitted to insurers along with facility and revenue center charge considerations. The line charge is the pre-adjudicated value submitted to insurers. | 284.49 |
| smart_allowed | Line-item estimate of allowed amount, utilizing proprietary ML on CMS, Price Transparency and Actual Adjudicated amounts to provide estimates within an average of 5% variance from actuals. | $80.54 |
Helper Function within the CareQuery API to help understand the underlying JOURNEY_TABLE dataset.
# import package
from care_query.care_query import CareQuery
# instantiate and connect
cq = CareQuery(email = "your-email",
token = "your-api-token")
# return details
print(cq.glossary.table_detail('JOURNEY_TABLE'))
Sneak Preview of the JOURNEY_TABLE results.
| journey_id | episode_id | visit_id | encounter_id | date | patient_state | patient_short_zip | patient_age | patient_gender | place_of_service | visit_type | payor | payor_channel | ref_npi | hcp_npi | hcp_taxonomy | hcp_specialty | hco_npi | hcp_npi_list | hco_npi_list | diag_list | rev_center_code | rev_center_units | proc_code | proc_units | proc_modifier | line_charge | claim_charge | smart_allowed |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| fd3ce8f485708043fe967c32ab21ac8b | 525032e3b778627c6e104c67ff14db82 | df1bfe0bef024d178c27f52b7accb1b72e2195004db3ae718a252407d1531e86 | c26bc009133594b38899a8652d44f865bc448c4e64b30688206e5552b585b1e6 | 2023-06-16 | TX | 751 | 30 | F | Ambulatory Surgical Center | outpatient visit | blue cross and blue shield of texas | commercial | 1679572499 | 207XX0005X - Allopathic and Osteopathic Physicians/Sports Medicine | Surgery - Orthopedic Surgery | 1992761936 | 1679572499 | 1992761936 | M238X1,Z96651 | 0490 | 1 | 29879 | 1 | RT | 10764 | 10764 | 738.59 | |
| 20cd44968bac3d1e31469e9c26950ea9 | 2b23e8ac8899bd649cc7a5de427e3656 | 32a5326acc11dbcf5353aad7d4570c571a736dc1a75c72c60ebe500ed1e10d04 | 60e91fb69e298c22ebee70e0c5cda67b4aebbab93b4bda8deb86e7d2ad07b72a | 2023-03-27 | TX | 750 | 55 | F | Ambulatory Surgical Center | outpatient visit | blue cross and blue shield of texas | commercial | 1679572499 | 207XX0005X - Allopathic and Osteopathic Physicians/Sports Medicine | Surgery - Orthopedic Surgery | 1992761936 | 1679572499 | 1992761936 | M23204,M94262 | 0490 | 1 | 29881 | 1 | LT | 12514 | 12514 | 808.18 | |
| 1f2b18854cf26eac9a2f5eb2486f395c | 98ef3ae09271766544820a0a12602a4f | 739fd3ee84c4b6748605f8396c5bb6b2f11b70eb34d50e60bdfcbaa3609eecda | 71a21473a2f604a033d3b5fdaab20a7403a61d2b5506aa963c164e5f5747fc26 | 2023-02-17 | TX | 751 | 55 | M | Ambulatory Surgical Center | outpatient visit | blue cross and blue shield of texas | commercial | 1679572499 | 207XX0005X - Allopathic and Osteopathic Physicians/Sports Medicine | Surgery - Orthopedic Surgery | 1992761936 | 1679572499 | 1992761936 | S83282A,M94262 | 0490 | 1 | 29881 | 1 | LT | 12514 | 12514 | 808.18 | |
| dee02164bbc32dd67b235a08849fd990 | bbed2f9fee21f76b48fcc5750ce9c8f3 | 8842f4865a24f1b0553835df3a22cfcff74fddb81f874fd8f2a0a2e3f54d83e9 | da9e0233442f5b528217702ee8008896b46cad42262c8b1c4ef873047ecbe1fc | 2023-02-24 | TX | 751 | 60 | F | Ambulatory Surgical Center | outpatient visit | blue cross and blue shield of texas | commercial | 1679572499 | 207XX0005X - Allopathic and Osteopathic Physicians/Sports Medicine | Surgery - Orthopedic Surgery | 1992761936 | 1679572499 | 1992761936 | T8484XA | 0490 | 1 | 20680 | 1 | 7111 | 7111 | 619.52 | ||
| f7e83a9e08b995de61d43709725b58f1 | e710bff1edc6d14fb8691545f353c5fa | 8dbc0438fa288cb022cf0d04e8749c0c1d73ca9ec6bb87505daeb49bff089349 | b5e004b16fdce2b73c816f67218e9d8ae458273d3879d7f00ff963b341ef1a33 | 2023-02-08 | TX | 750 | 55 | M | Ambulatory Surgical Center | outpatient visit | blue cross and blue shield of texas | commercial | 1679572499 | 207XX0005X - Allopathic and Osteopathic Physicians/Sports Medicine | Surgery - Orthopedic Surgery | 1992761936 | 1679572499 | 1992761936 | S83242A,M6752 | 0490 | 1 | 29881 | 1 | LT | 12514 | 12514 | 808.18 |
Updated 11 months ago