Medicare Advantage, Part D, Medicaid

PBP b19 combined package (cleaned view)

medicare_semantic.vw_pbp_b19_combined_package·partial·semantic_view·annual

Rows

N/A

Columns

History

2021 (report_year) to 2026 (report_year); NOTE a gap — 2023 is absent. Present years: 2021, 2022, 2024, 2025, 2026. quarter is constant = 1 and is NOT a real time axis.

Card

yesgrain, traps, filters

Typed tools

What it is

1A Medicare Advantage "VBID combined package" descriptor table: it lists the Value-Based Insurance Design (VBID) / SSBCI / Uniformity-Flexibility special benefit packages each MA plan offers, as filed in PBP sections B19a and B19b, normalized into the shared benefit-card schema used across the medicare_semantic PBP views.
2It is for discovering WHICH VBID packages a plan offers and their structural policy attributes (package type, prerequisites, exemptions, which standard benefits get cost-sharing reductions, targeting model, state footprint) — NOT for dollar amounts.

Grain

Key Grain

Key	Grain
`report_yearcontract_idplan_idsegment_idcombined_package_idsource_pbp_section`	1One row per VBID combined-package, per MA plan-segment, per benefit-year, per source PBP sub-section. 2Minimal verified unique key = (report_year, contract_id, plan_id, segment_id, combined_package_id, source_pbp_section), which is unique across all 17,013 rows (= row_count). 3A single plan-year typically declares 1 package (9,124 plan-years) but can declare up to 6; the same package can appear once from the B19a feed and once from the B19b feed, which is why source_pbp_section is required to make the key unique.

report_yearcontract_idplan_idsegment_idcombined_package_idsource_pbp_section

1One row per VBID combined-package, per MA plan-segment, per benefit-year, per source PBP sub-section.
2Minimal verified unique key = (report_year, contract_id, plan_id, segment_id, combined_package_id, source_pbp_section), which is unique across all 17,013 rows (= row_count).
3A single plan-year typically declares 1 package (9,124 plan-years) but can declare up to 6; the same package can appear once from the B19a feed and once from the B19b feed, which is why source_pbp_section is required to make the key unique.

How to read it

1"Find which MA plans offer a VBID 'Reduction in Cost Sharing' package for 2026 and what standard benefits it touches: SELECT contract_id, plan_id, segment_id, combined_package_id, reduced_copay_mc_categories_list, exemption_categories_list, vbid_targeting_model_code FROM medicare_semantic.vw_pbp_b19_combined_package WHERE report_year=2026 AND combined_package_type_code='3'.
2Always dedup/group by the full grain (report_year, contract_id, plan_id, segment_id, combined_package_id, source_pbp_section) and remember this returns structural flags and category code-lists, not dollar amounts."

Traps

1NOT a dollar table. Every numeric/cost column is 100% NULL on purpose — copay_amount, coinsurance_pct, benefit_amount* (and annualized/pmpm), all limit_* and cost_share_string are CAST(null) in the view to fit the shared benefit-card schema. This view tells you WHICH VBID packages exist and their structural flags; for the actual cost-sharing dollars you must crosswalk to the underlying benefit sections (null_amount_reason='unknown_requires_crosswalk').
2Grain trap: (contract_id, plan_id, segment_id) is NOT unique, and neither is adding combined_package_id alone. The same combined_package_id recurs across plans and years (it is a per-plan-year sequence 1..6), AND the same package is emitted by both the B19a and B19b feeds. You MUST include report_year AND source_pbp_section to reach one-row-per (17,013 unique). combined_package_type_code is functionally determined by the package so it is not needed in the key.
3No is_current column and no snapshot dedup needed: version (1..23) is exactly one per (report_year,contract,plan,segment), so don't filter on a 'latest version' — every plan-year already appears once. quarter is a constant 1 and is a red herring as a time axis; report_year is the real period and 2023 is missing (years present: 2021,2022,2024,2025,2026).
4Many governance/enum columns are dead constants (same value on all 17,013 rows): offered_status='offered', numeric_amount_observability='offered_without_numeric_amounts', null_amount_reason, annualization_policy, combined_limit_policy, consumer_document_reconciliation_status='not_checked', confidence_tier='source_faithful', network_type, benefit_category, lmi_authorities. Don't filter/segment on them expecting variation.
5Boolean flags are 3-valued and NULL carries meaning: NULL = 'not applicable to this package type' (e.g. reduces_copay/reduces_coinsurance are ~81% NULL because they only apply to cost-sharing-reduction contexts), not 'unknown=false'. The category columns are semicolon-delimited PBP benefit-category code strings (e.g. '7b;7f;13d;') and states_ehc_* are positional bitmask strings (length 20 or 27) — both need the LMI/PBP code crosswalk (see lmi_authorities) to interpret; raw codes are not self-explanatory.
6Provenance columns are file-level, not row-level: sha256_content_hash and source_url have only 5 distinct values (one per year). The underlying silver tables are named '..._model_test_vbid_uf', and only package types 1/2/3 of the 01-07 taxonomy actually occur in the data.

Columns (86)

Column	Type	Meaning
`contract_id`	string	MA contract id (e.g. H0028). Part of the grain. 723 distinct.
`plan_id`	string	Plan id within the contract (e.g. '007', zero-padded 3-char). Part of grain. 485 distinct.
`segment_id`	string	Plan benefit segment id (e.g. '0'). Part of grain. 18 distinct. (contract_id, plan_id, segment_id) is the standard CMS PBP plan key.
`version`	double	PBP submission/revision number for that plan-year (1..23). Functionally determined by (report_year,contract,plan,segment) — exactly one version per plan-year, 0 multi-version groups — so it is NOT part of the grain and there is NO snapshot/is_current dedup to do; the view already exposes a single version per plan-year.
`report_year`	double	Benefit/contract year the PBP filing applies to (2021,2022,2024,2025,2026). THIS is the real time dimension (the profiler mis-picked 'quarter'). 2023 is missing.
`quarter`	double	Always 1.0 (constant). Reflects the CMS PBP release file used, not a quarterly cadence. Do not treat as a time grain.
`benefit_category`	string	Constant literal 'b19_combined_package'. A tag identifying this view inside the shared benefit-card schema.
`cost_share_string`	string	100% NULL by design (view emits CAST(null)). VBID combined packages carry no parsed cost-share text here.
`copay_amount`	double	100% NULL by design. No dollar copays in this table.
`coinsurance_pct`	double	100% NULL by design. No coinsurance percentages in this table.
`limit_text`	string	100% NULL by design.
`auth_required`	boolean	100% NULL by design (boolean stub).
`referral_required`	boolean	100% NULL by design.
`network_type`	varchar(20)	Constant 'n_a_combined_package' — network concept does not apply to a VBID package wrapper.
`max_oop_applies`	boolean	100% NULL by design.
`limit_quantity`	double	100% NULL by design.
`limit_unit`	string	100% NULL by design.
`limit_period_code`	string	100% NULL by design.
`limit_period_label`	string	100% NULL by design.
`limit_quantity_per_year`	double	100% NULL by design.
`benefit_amount`	double	100% NULL by design. No benefit dollar amount in this table.
`benefit_amount_kind`	string	100% NULL by design.
`benefit_amount_period_code`	string	100% NULL by design.
`benefit_amount_period_label`	string	100% NULL by design.
`benefit_amount_annualized`	double	100% NULL by design.
`benefit_amount_pmpm`	double	100% NULL by design.
`normalization_status`	string	100% NULL by design.
`normalization_basis`	string	100% NULL by design.
`aggregation_policy`	string	100% NULL by design.
`offered_status`	varchar(15)	Constant 'offered'. Computed from a hard-coded true in the view (every row in this table represents an offered package), so it carries no discriminating signal.
`numeric_amount_observability`	varchar(31)	Constant 'offered_without_numeric_amounts' — a governance flag stating this table has no numeric cost amounts (because all numeric cols are null).
`null_amount_reason`	varchar(30)	Constant 'unknown_requires_crosswalk' — declares that to get actual dollar effects you must cross-walk to the underlying benefit sections; this view does not hold them.
`annualization_policy`	varchar(17)	Constant 'not_numeric' (nothing to annualize).
`combined_limit_policy`	varchar(29)	Constant 'none_detected'.
`consumer_document_reconciliation_status`	varchar(11)	Constant 'not_checked' — not reconciled against consumer documents (e.g. plan finder).
`confidence_tier`	varchar(23)	Constant 'source_faithful' — values are taken faithfully from the PBP source, not cross-document verified.
`aggregate_cap_period_code`	string	Period code for an aggregate cap when has_aggregate_cap; ~73% NULL. From pbp_b19a_agg_mode / pbp_b19b_agg_period. Mixed encoding: some single-digit period codes (3,5,7) and some bitmask-like strings ('10000','00100') — raw PBP code, treat cautiously.
`combined_package_id`	string	The VBID package/group number within the plan-year (pbp_vbid_group_id), integer 1..6. REQUIRED part of the grain. NOTE: this is a per-plan-year sequence, NOT a globally unique id — '1' recurs across plans.
`combined_package_plan_package_count`	double
`combined_package_sub_benefit`	varchar(28)	100% NULL in current data (view emits CAST(null)). Placeholder for a sub-benefit breakout.
`combined_package_type_code`	string	VBID package type. Stored single-digit in data ('1','2','3'); the view CASE also accepts zero-padded '01'..'07'. Taxonomy: 01=VBID Hospice, 02=VBID Wellness/Health Care Planning, 03=VBID Reduction in Cost Sharing, 04=VBID Additional Supplemental Benefits, 05=VBID Rewards & Incentives, 06=MA Uniformity Flexibility, 07=SSBCI. Only types 1/2/3 actually occur (3=Reduction in Cost Sharing is most common, 8,621 rows). Functionally determined by the package within a (year,plan,pkg,section), so NOT needed in the key.
`combined_package_type_label`	varchar(25)	Human label decoded from combined_package_type_code (e.g. 'VBID Reduction in Cost Sharing'). NULL if code outside 01-07.
`cost_share_to_zero`	boolean	Boolean (Y/N→true/false, else NULL): does the package reduce cost sharing to $0. From pbp_b19a_reduct_zero_yn. ~84% NULL; populated mainly where cost-sharing fields apply.
`exemption_categories_list`	string	Semicolon-delimited list of PBP benefit-category codes exempt from the reduction (e.g. '13d;' or '7b;7f;10b;13a;...'). Non-null on 6,503 rows. From pbp_b19a_red_exempt_mc_cats.
`has_aggregate_cap`	boolean	Boolean: package has an aggregate cap (pbp_b19a_agg_yn). True 6,014 / False 10,999 (no NULLs).
`has_deductible_reduction`	boolean	Boolean: package reduces a deductible (pbp_b19a_reduct_deduct_yn). Almost always NULL/False (True on just 1 row) — effectively unused.
`has_exemption`	boolean	Boolean: package has exemption categories (pbp_b19a_reduct_exempt_yn). True 6,503 / False 9,847 / NULL 663.
`has_prereq`	boolean	Boolean: package has a prerequisite/eligibility condition (pbp_b19a_reduct_prereq_yn). True 6,538 / False 10,475.
`otc_component_amount_status`	varchar(41)
`package_aggregate_amount`	double
`package_aggregate_amount_scope`	varchar(34)
`package_aggregate_categories_list`	string
`package_aggregate_delivery_mode_code`	string
`package_aggregate_delivery_mode_description`	string
`package_aggregate_delivery_mode_label`	string
`package_aggregate_period_code`	string
`package_aggregate_period_label`	string
`package_includes_otc`	boolean
`package_name`	string
`reduced_benefits_list`	string	Semicolon list of PBP benefit codes whose cost sharing is reduced (pbp_b19a_red_bens). Non-null 3,243 rows.
`reduced_coins_benefits_list`	string	Semicolon list of benefit codes with reduced coinsurance (pbp_b19a_red_coins_bens). Non-null 763 rows.
`reduced_coins_mc_categories_list`	string	Semicolon list of Medicare-covered (MC) categories with reduced coinsurance. Non-null 763 rows.
`reduced_coinsurance_pct_max`	double
`reduced_coinsurance_pct_min`	double
`reduced_copay_amount_max`	double
`reduced_copay_amount_min`	double
`reduced_copay_benefits_list`	string	Semicolon list of benefit codes with reduced copay (pbp_b19a_red_copay_bens). Non-null 2,576 rows.
`reduced_copay_mc_categories_list`	string	Semicolon list of Medicare-covered categories with reduced copay. Non-null 2,568 rows.
`reduced_copay_nmc_categories_list`	string	Semicolon list of non-Medicare-covered (NMC, i.e. supplemental) categories with reduced copay. Non-null 333 rows.
`reduced_mc_categories_list`	string	Semicolon list of Medicare-covered benefit-description categories that are reduced (pbp_b19a_red_mc_bendesc_cats). Non-null 3,235 rows.
`reduced_nmc_categories_list`	string	Semicolon list of non-Medicare-covered (supplemental) categories that are reduced (pbp_b19a_red_nmc_bendesc_cats). Most-populated list (13,546 rows).
`reduced_service_code`	string
`reduced_service_label`	string
`reduces_coinsurance`	boolean	Boolean: package reduces coinsurance (pbp_b19a_coins_yn). NULL ~81% — NULL means 'not a cost-sharing-reduction context for this row', not unknown.
`reduces_copay`	boolean	Boolean: package reduces copay (pbp_b19a_copay_yn). True 2,576 / False 600 / NULL 13,837 (NULL = not applicable).
`requires_all_diseases`	boolean	Boolean: targeting requires ALL listed chronic conditions (pbp_b19a_all_dis_yn). Almost entirely NULL (rare VBID targeting field).
`requires_disease_combination`	boolean	Boolean: targeting requires a specific disease combination (pbp_b19a_cmb_dis_yn). Almost entirely NULL; True on 22 rows.
`states_ehc_ssbci`	string	Bitmask STRING of state/territory eligibility for the SSBCI offering (e.g. '01111111111111110000'; lengths 20 or 27 observed). Non-null 7,589 rows. From pbp_b19a_states_ehc_ssbci.
`states_ehc_uniformity_flex`	string	Bitmask string of states for MA Uniformity Flexibility (pbp_b19a_states_ehc_uf). Non-null 4,827 rows.
`states_ehc_vbid`	string	Bitmask string of states for the VBID offering (pbp_b19a_states_ehc_vbd). Non-null 935 rows.
`vbid_targeting_model_code`	string	VBID targeting/eligibility model code (pbp_b19a_tm_vbid / pbp_b19b_tm_vbid). ~79% NULL; values look like flag codes ('10','001','01','010','100','101','110','011'). Raw PBP code — semantics need the PBP/LMI crosswalk.
`source_pbp_section`	varchar(4)	Which PBP sub-section the row came from: 'B19a' (3,906 rows) or 'B19b' (13,107). REQUIRED to make the grain unique because the same package can be emitted by both feeds. The two feeds carry the same conceptual columns (mapped from pbp_b19a_* vs pbp_b19b_* source columns).
`source_silver_table`	varchar(51)	The underlying medicare_silver table the row was unioned from: medicare_silver.pbp_section_b19a_model_test_vbid_uf or ..._b19b_.... 1:1 with source_pbp_section (equivalent discriminator). Note the source tables carry a 'model_test' name.
`lmi_authorities`	string	Constant pipe-delimited reference URLs to LMI / CMS authority PDFs (CY2026 PBP Service Category Descriptions + Part C Bid Review Memorandum) that document the VBID/category code systems. Documentation pointer, not data — same on all 17,013 rows.
`source_url`	string	CMS PBP source ZIP the year's rows came from (file-level provenance). Exactly one distinct URL per report_year (5 total).
`sha256_content_hash`	string	Content hash of the source PBP file — FILE-level, only 5 distinct values (one per report_year), NOT a per-row/per-package hash. Do not use as a row identity.

Query it

describe_data_source(source_fqn="medicare_semantic.vw_pbp_b19_combined_package")     # the card, live
query_substrate(sql="SELECT * FROM medicare_semantic.vw_pbp_b19_combined_package WHERE report_year = '<value>' AND contract_id = '<value>' AND plan_id = '<value>' AND segment_id = '<value>' AND combined_package_id = '<value>' AND source_pbp_section = '<value>' LIMIT 100")

Item	Value
Typed tools that read it	get_pbp_benefit
Identity key	`contract_id,plan_id,segment_id`
Join	`how_to_join(source_fqn="medicare_semantic.vw_pbp_b19_combined_package")`
Raw door	Athena (read-only via query_substrate): medicare_semantic.vw_pbp_b19_combined_package
Note	Cleaned PBP reasoning surface (categories/b19_combined_package/contract.yaml); raw is pbp_section_*.

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