Medicare Advantage, Part D, Medicaid

Medicare CLFS Private Payer Rates and Volumes (PAMA)

medicare_silver.fact_clfs_private_payer_rate·live·silver·Medicare Clinical Laboratory Fee Schedule (CLFS)

Rows

7,515,432

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The PAMA "applicable information" — private-payer rates and volumes labs report to CMS, per HCPCS.
2A RARE public private-rate signal (distinct from the standard CLFS fee schedule `medicare_clfs`).
3The CMS-computed weighted median of these sets the CLFS; this is the underlying per-observation distribution.

Grain

Key	Grain
N/A	1One row per reported (collection_year, row_seq) private-payer rate/volume observation, keyed to HCPCS.

Columns (20)

Column	Type	Meaning
`collection_year`	int
`row_seq`	bigint
`hcpcs_cd`	string
`private_payer_rate`	double
`volume_text`	string
`observed_period`	date
`asserted_at`	date
`effective_period_start`	date
`effective_period_end`	date
`cms_vintage_sequence`	int
`parse_revision`	int
`parser_artifact_hash`	string
`source_url`	string
`sha256_content_hash`	string
`source_id`	string
`is_current`	boolean
`bronze_object_key`	string
`s3_version_id`	string
`vintage_tag`	string
`drug_source_version_id`	string

Query it

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

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`hcpcs_cd`
Join	`how_to_join(source_fqn="medicare_silver.fact_clfs_private_payer_rate")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_clfs_private_payer_rate
Note	Iceberg medicare_silver.fact_clfs_private_payer_rate, partition by collection_year, replace (idempotent by SHA-256). row_seq makes each observation unique.

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