Medicare Advantage, Part D, Medicaid

Vlada locked benefit engine atoms (pointer view), every county x plan segment's benefits 2022 to 2027, its members followed to next year's plan

medicare_semantic.vw_benefit_engine_atoms·live·mart

Rows

802,687

Columns

344

History

N/A

Card

nocolumns only

Typed tools

What it is

1The served atom table of the locked national benefit engine (ops/sb_llm/tools/benefit_engine.py, docs/research/benefits-2027/CALC-LOCK.md and METHODS.md), version v20261008a: the pointer view over medicare_semantic.benefit_engine_atoms_v20261008a (rebuilt 2026-10-08 on benefit vector v20261007a; regional PPOs followed for base years 2022-2024).
2Book rows are each year's members in that year's plan; next rows are the same members followed to the plan serving them in the next year (same plan or CMS's crosswalk), so base 2026 next rows are the 2027 benefits of the 2026 members.
3Columns: kind, base_year, value_year, county_ssa, state, county_fips, county_name, bucket (non-SNP HMO, non-SNP PPO, D-SNP HMO, D-SNP PPO, C-SNP HMO, C-SNP PPO, plus I-SNP and non-SNP other), parent (canonical_parent_name, vw_ma_parent_resolved_v1), base_key, plan_segment_key, followed, weight, plan_type, product_type, successor, then the metric and pair columns.
4Every engine metric = SUM(weight x column) / SUM(weight where the column is not null) over a slice; verified 46 of 46 against the engine on 2026-10-05, and the MA data platform's snapshot rails tie its sums to the engine TSV for every bucket and the largest parents on every build.
5Owner: the Benefits lane.

Grain

Key	Grain
N/A	1One row per kind ('book' \| 'next') x base_year (2022 to 2026) x county_ssa x plan segment (base_key; the followed successor's plan_segment_key on next rows), with weight (September county members), the engine's 155 OUT_METRICS columns and 98 like-for-like cost-share pair columns on next rows. 2802,687 rows, 432,333 of them book (measured 2026-10-05).

Columns (344)

Column	Type	Meaning
`kind`	string
`base_year`	int
`value_year`	int
`county_ssa`	string
`state`	string
`county_fips`	string
`county_name`	string
`bucket`	string
`parent`	string
`base_key`	string
`plan_segment_key`	string
`followed`	boolean
`weight`	double
`plan_type`	string
`product_type`	string
`successor`	string
`dental_pct_offered`	double
`dental_pct_max`	double
`dental_pct_no_max`	double
`dental_pct_card`	double
`dental_dollars_pmpm_if`	double
`dental_dollars_pmpm_all`	double
`dental_design_known`	double
`hearing_pct_offered`	double
`hearing_pct_allowance`	double
`hearing_pct_copay`	double
`hearing_pct_card`	double
`hearing_dollars_pmpm_if`	double
`hearing_dollars_pmpm_all`	double
`hearing_design_known`	double
`otc_pct_offered`	double
`otc_pct_own`	double
`otc_pct_card`	double
`otc_pct_no_amount`	double
`otc_dollars_pmpm_if`	double
`otc_dollars_pmpm_all`	double
`otc_design_known`	double
`eyewear_pct_offered`	double
`eyewear_pct_allowance`	double
`eyewear_pct_card`	double
`eyewear_pct_no_max`	double
`eyewear_dollars_pmpm_if`	double
`eyewear_dollars_pmpm_all`	double
`eyewear_design_known`	double
`hearing_copay_per_aid`	double
`otc_pct_filed_own_zero_card`	double
`card_pct_offered`	double
`card_dollars_pmpm_if`	double
`card_dollars_pmpm_all`	double
`allowance_total_pmpm_all`	double
`allowance_total_coverage`	double
`giveback_pct_offered`	double
`giveback_pct_token`	double
`giveback_pmpm_if`	double
`premium_pct_zero`	double
`svc_transportation_pct_offered`	double
`svc_transportation_known`	double
`svc_fitness_pct_offered`	double
`svc_fitness_known`	double
`svc_meals_post_discharge_pct_offered`	double
`svc_meals_post_discharge_known`	double
`svc_meals_any_pct_offered`	double
`svc_meals_any_known`	double
`svc_podiatry_pct_offered`	double
`svc_podiatry_known`	double
`svc_transportation_trips`	double
`svc_transportation_pct_unlimited`	double
`svc_podiatry_visits`	double
`deductible_pct_none`	double
`deductible_pct_partb`	double
`deductible_pct_plan`	double
`deductible_plan_amount`	double
`deductible_design_known`	double
`deductible_pct_scope_oon`	double
`premium`	double
`premium_coverage`	double
`moop`	double
`moop_coverage`	double
`medical_deductible`	double
`medical_deductible_coverage`	double
`partd_deductible`	double
`partd_deductible_coverage`	double
`primary_care`	double
`primary_care_coverage`	double
`specialist`	double
`specialist_coverage`	double
`telehealth`	double
`telehealth_coverage`	double
`mental_health_ind`	double
`mental_health_ind_coverage`	double
`er`	double
`er_coverage`	double
`urgent`	double
`urgent_coverage`	double
`ambulance_ground`	double
`ambulance_ground_coverage`	double
`hosp_5day`	double
`hosp_5day_coverage`	double
`inpatient`	double
`inpatient_coverage`	double
`snf`	double
`snf_coverage`	double
`outpatient_hosp`	double
`outpatient_hosp_coverage`	double
`asc`	double
`asc_coverage`	double
`imaging_complex`	double
`imaging_complex_coverage`	double
`radiology`	double
`radiology_coverage`	double
`lab`	double
`lab_coverage`	double
`physical_therapy`	double
`physical_therapy_coverage`	double
`dme`	double
`dme_coverage`	double
`partb_drugs`	double
`partb_drugs_coverage`	double
`partb_insulin`	double
`partb_insulin_coverage`	double
`dialysis`	double
`dialysis_coverage`	double
`partd_tier1_copay`	double
`partd_tier1_copay_coverage`	double
`partd_tier2_copay`	double
`partd_tier2_copay_coverage`	double
`partd_tier4_coins`	double
`partd_tier4_coins_coverage`	double
`partd_tier5_coins`	double
`partd_tier5_coins_coverage`	double
`primary_care_pct_copay`	double
`primary_care_pct_coins`	double
`primary_care_coins`	double
`specialist_pct_copay`	double
`specialist_pct_coins`	double
`specialist_coins`	double
`telehealth_pct_copay`	double
`telehealth_pct_coins`	double
`telehealth_coins`	double
`mental_health_ind_pct_copay`	double
`mental_health_ind_pct_coins`	double
`mental_health_ind_coins`	double
`physical_therapy_pct_copay`	double
`physical_therapy_pct_coins`	double
`physical_therapy_coins`	double
`er_pct_copay`	double
`er_pct_coins`	double
`er_coins`	double
`urgent_pct_copay`	double
`urgent_pct_coins`	double
`urgent_coins`	double
`ambulance_ground_pct_copay`	double
`ambulance_ground_pct_coins`	double
`ambulance_ground_coins`	double
`outpatient_hosp_pct_copay`	double
`outpatient_hosp_pct_coins`	double
`outpatient_hosp_coins`	double
`imaging_complex_pct_copay`	double
`imaging_complex_pct_coins`	double
`imaging_complex_coins`	double
`radiology_pct_copay`	double
`radiology_pct_coins`	double
`radiology_coins`	double
`lab_pct_copay`	double
`lab_pct_coins`	double
`lab_coins`	double
`inpatient_pct_copay`	double
`inpatient_pct_coins`	double
`inpatient_coins`	double
`snf_pct_copay`	double
`snf_pct_coins`	double
`snf_coins`	double
`otc_pct_one_pot`	double
`card_pct_dvh_same_pot`	double
`dental_any_pct_offered`	double
`dental_comprehensive_pct_offered`	double
`svc_transportation_pct_optional_only`	double
`svc_fitness_pct_optional_only`	double
`svc_meals_post_discharge_pct_optional_only`	double
`svc_meals_any_pct_optional_only`	double
`svc_podiatry_pct_optional_only`	double
`allowance_total_pct_no_cap`	double
`otc_pct_d5_pot`	double
`card_pct_dvh_shared_pot`	double
`allowance_shared_pot_overlap_pmpm`	double
`card_targeted_pct_offered`	double
`card_targeted_dollars_pmpm_if`	double
`svc_transportation_round_trips`	double
`moop_pct_not_in_network`	double
`card_targeted_pct_ssbci`	double
`card_targeted_pct_vbid_uf`	double
`card_targeted_pct_no_amount`	double
`card_targeted_pct_pooled_in_card`	double
`card_pct_dvh_kind_only`	double
`allowance_pooled_pct_any`	double
`eyewear_pct_preferred_tier`	double
`eyewear_preferred_dollars_pmpm_if`	double
`dental_pct_d9_added`	double
`dental_pct_max_combined`	double
`card_pays_dental`	double
`card_pays_eyewear`	double
`card_pays_hearing`	double
`card_pays_otc`	double
`card_pays_food_living`	double
`card_pays_other`	double
`card_pct_kind_flex`	double
`card_pct_kind_dvh`	double
`card_pct_kind_otc`	double
`card_pct_kind_food_living`	double
`card_pct_kind_wellness`	double
`dental_pct_cap_plus_card`	double
`hearing_pct_cap_plus_card`	double
`otc_pct_cap_plus_card`	double
`eyewear_pct_cap_plus_card`	double
`primary_care_pct_zero`	double
`specialist_pct_zero`	double
`telehealth_pct_zero`	double
`mental_health_ind_pct_zero`	double
`physical_therapy_pct_zero`	double
`er_pct_zero`	double
`urgent_pct_zero`	double
`ambulance_ground_pct_zero`	double
`outpatient_hosp_pct_zero`	double
`imaging_complex_pct_zero`	double
`radiology_pct_zero`	double
`lab_pct_zero`	double
`inpatient_pct_zero`	double
`snf_pct_zero`	double
`dsnp_enrolls_full_duals`	double
`primary_care_dual_effective`	double
`specialist_dual_effective`	double
`telehealth_dual_effective`	double
`mental_health_ind_dual_effective`	double
`physical_therapy_dual_effective`	double
`er_dual_effective`	double
`urgent_dual_effective`	double
`ambulance_ground_dual_effective`	double
`outpatient_hosp_dual_effective`	double
`imaging_complex_dual_effective`	double
`radiology_dual_effective`	double
`lab_dual_effective`	double
`inpatient_dual_effective`	double
`snf_dual_effective`	double
`moop_dual_effective`	double
`medical_deductible_dual_effective`	double
`primary_care_ll_known`	double
`primary_care_llc_from`	double
`primary_care_llc_to`	double
`primary_care_lli_from`	double
`primary_care_lli_to`	double
`primary_care_sw_coins`	double
`primary_care_sw_copay`	double
`specialist_ll_known`	double
`specialist_llc_from`	double
`specialist_llc_to`	double
`specialist_lli_from`	double
`specialist_lli_to`	double
`specialist_sw_coins`	double
`specialist_sw_copay`	double
`telehealth_ll_known`	double
`telehealth_llc_from`	double
`telehealth_llc_to`	double
`telehealth_lli_from`	double
`telehealth_lli_to`	double
`telehealth_sw_coins`	double
`telehealth_sw_copay`	double
`mental_health_ind_ll_known`	double
`mental_health_ind_llc_from`	double
`mental_health_ind_llc_to`	double
`mental_health_ind_lli_from`	double
`mental_health_ind_lli_to`	double
`mental_health_ind_sw_coins`	double
`mental_health_ind_sw_copay`	double
`physical_therapy_ll_known`	double
`physical_therapy_llc_from`	double
`physical_therapy_llc_to`	double
`physical_therapy_lli_from`	double
`physical_therapy_lli_to`	double
`physical_therapy_sw_coins`	double
`physical_therapy_sw_copay`	double
`er_ll_known`	double
`er_llc_from`	double
`er_llc_to`	double
`er_lli_from`	double
`er_lli_to`	double
`er_sw_coins`	double
`er_sw_copay`	double
`urgent_ll_known`	double
`urgent_llc_from`	double
`urgent_llc_to`	double
`urgent_lli_from`	double
`urgent_lli_to`	double
`urgent_sw_coins`	double
`urgent_sw_copay`	double
`ambulance_ground_ll_known`	double
`ambulance_ground_llc_from`	double
`ambulance_ground_llc_to`	double
`ambulance_ground_lli_from`	double
`ambulance_ground_lli_to`	double
`ambulance_ground_sw_coins`	double
`ambulance_ground_sw_copay`	double
`outpatient_hosp_ll_known`	double
`outpatient_hosp_llc_from`	double
`outpatient_hosp_llc_to`	double
`outpatient_hosp_lli_from`	double
`outpatient_hosp_lli_to`	double
`outpatient_hosp_sw_coins`	double
`outpatient_hosp_sw_copay`	double
`imaging_complex_ll_known`	double
`imaging_complex_llc_from`	double
`imaging_complex_llc_to`	double
`imaging_complex_lli_from`	double
`imaging_complex_lli_to`	double
`imaging_complex_sw_coins`	double
`imaging_complex_sw_copay`	double
`radiology_ll_known`	double
`radiology_llc_from`	double
`radiology_llc_to`	double
`radiology_lli_from`	double
`radiology_lli_to`	double
`radiology_sw_coins`	double
`radiology_sw_copay`	double
`lab_ll_known`	double
`lab_llc_from`	double
`lab_llc_to`	double
`lab_lli_from`	double
`lab_lli_to`	double
`lab_sw_coins`	double
`lab_sw_copay`	double
`inpatient_ll_known`	double
`inpatient_llc_from`	double
`inpatient_llc_to`	double
`inpatient_lli_from`	double
`inpatient_lli_to`	double
`inpatient_sw_coins`	double
`inpatient_sw_copay`	double
`snf_ll_known`	double
`snf_llc_from`	double
`snf_llc_to`	double
`snf_lli_from`	double
`snf_lli_to`	double
`snf_sw_coins`	double
`snf_sw_copay`	double
`telehealth_pct_offered`	double

Query it

describe_data_source(source_fqn="medicare_semantic.vw_benefit_engine_atoms")     # the card, live
query_substrate(sql="SELECT * FROM medicare_semantic.vw_benefit_engine_atoms WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`kind,base_year,county_ssa,base_key`
Join	`how_to_join(source_fqn="medicare_semantic.vw_benefit_engine_atoms")`
Raw door	Athena (read-only via query_substrate): medicare_semantic.vw_benefit_engine_atoms

This page as markdown: /docs-md/data/medicare_semantic_vw_benefit_engine_atoms.md · every page in one file: /llms-full.txt