orgPayorAggs

Query to specify organizational provider and payor aggregations at a monthly, quarterly, yearly or entire period basis.

Get Started with orgPayorAggs

If you have already setup CareQuery, run the below code to get started with your first orgPayorAggs query.

Quick Example:

🔍

United Medicare Advantage volumes 4 specific organizational NPIs


# 1) import 
from care_query.care_query import CareQuery

# 2) instantiate and connect
cq = CareQuery(email = "your-email", 
               token = "your-api-token",
               sftp_key = "path/to/your/company.PEM")

# 3) build query
query_name = cq.orgPayorAggs(min_date = "2022-10-01",
                            max_date = "2023-12-31",
                            npi = [1275085144, 1891744843, 1275916090, 1871939991],
                            payor = ["united healthcare", "cigna corporation"],
                            payor_channel = "medicare advantage")

# 4A) submit query to return data
sample_data = query_name.sample()

# 4B) submit query to return data
size_estimate = query_name.estimate()

# 4C) submit query to return data
result_data = query_name.execute()

Query Parameters

The following a parameters are available within the orgPayorAggs query, including details on the parameter values

parameter

description

options

min_date

Lower threshold date within the date range
of interest, observational start date

Date String

max_date

Upper threshold date within the date range
of interest, observational end date

Date String

npi

National Provider Identifier (NPI) of individual and/or
organizational provider(s) that appear on the encounter.

Any Valid NPI

place_of_service

Setting in which a healthcare service was provided by healthcare providers, insurers, and government agencies to track and bill for healthcare services

values available

payor

Name of the health Insurance payor associated with the claim

values available

payor_channel

Health Insurance Payor channel-of-business or line-of-business

values available

taxonomy_code

Taxonomy of the organization or individual provider, 10-digit code that used to identify the type, classification, and area of specialization of an individual or organizational healthcare provider

values available

specialty_category

Specialty category of the organization or individual provider(s), broad focus of a provider by patient population, disease, skill or philosophy

values available

specialty

Specialty of the organization or individual provider(s), specific focus of a provider by patient population, disease, skill or philosophy

values available

subspecialty

Specialty subcategory of the organization or individual
provider(s), hyper-specific focus of a provider by patient
population, disease, skill or philosophy

values available

state

US State residence of the query patient population

values available

division

Nine distinct US State groupings as defined by the US Census Bureau

values available

region

Four major US State groupings as defined by the US Census Bureau

values available

metro

Metropolitan and micropolitan statistical
areas according to the US Census Bureau

values available

short_zip

First three digits the zip code of the
query patient population specified

First 3 digits of zip code(s)

agg_level

The level of aggregation to which the aggregate
values are to be returned

'month', 'quarter', 'annual'
or 'entire period'

limit

Number of rows returned in the data request

Integer or False

show

Binary indicator as to whether you'd like
query to be printed for review upon it's creation

True or False

Query Return Data

The orgPayorAggs query returns the ORG_PAYOR_TABLE for all aggregate totals that meet the criterion specified within the query.

featuredescriptionexample
yearYear in which the aggregated values are calculated.2022
monthInteger indicator for the month of the year in which the aggregated values are calculated5
hco_npiOrganizational provider, identified via their National Provider Identifier (NPI).1063001238
hco_nameName of the organizational provider identified.Higi Care Network
hco_posSetting in which a healthcare service was provided by healthcare providers, insurers, and government agencies to track and bill for healthcare servicesOffice
hco_zipPrimary zip code of the organizational provider.87101
hco_statePrimary US State code code of the organizational provider.NM
payorName of the primary payor on each encounter.Centers for Medicare & Medicaid Services (CMS)
payor_channelPayor channel-of-business, line-of-business, or plan type.Medicare
num_patientsTotal number of patients seen within the aggregation period.25
num_visitsTotal number of visits within the aggregation period.32
num_encountersTotal number of encounters within the aggregation period.41
total_line_chargesSum of line item charges within the aggregation period. Line item charges are directly related to the procedure performed.$5,729.18
total_claim_chargesSum of the claim item charges within the aggregation period. Claim charges include the procedure charge and related facility charges.$9,103.40
total_smart_allowedSum of allowed amount estimates within the aggregation period. Smart Allowed® values are derived from multiple sources to estimate the final adjudicated amount at the line-item level.$3,958.01
mean_line_chargeAverage line item charge at the line itemwithin the aggregation period. Line item charges are directly related to the procedure performed.$139.73
mean_claim_chargeAverage claim item charge at the line item within the aggregation period. Claim charges include the procedure charge and related facility charges.$222.03
mean_smart_allowedAverage allowed amount at the line item within the aggregation period. Smart Allowed® values are derived from multiple sources to estimate the final adjudicated amount at the line-item level.$96.50