Medicare Advantage, Part D, Medicaid

Medicare Outpatient Hospitals — by Provider and Service (granular APC price)

medicare_silver.fact_outpatient_by_provider_service·live·silver·Medicare Fee-for-Service Utilization & Payments

Rows

1,008,975

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The CMS Medicare Outpatient Hospitals PUF at the provider×APC grain: per hospital (CCN) and comprehensive APC, beneficiary/service counts plus average submitted charge, Medicare allowed, Medicare paid, and outlier amounts.
2The complete official C-APC series is loaded for 2015-2024 at 1,008,975 rows.
3This is a claims-derived provider benchmark, not the contractual OPPS fee schedule.

Grain

Key	Grain
N/A	1One row per (data_year, hospital CCN, APC) — bene/services + charge + Medicare allowed/paid + outlier.

Columns (30)

Column	Type	Meaning
`data_year`	int
`ccn`	string
`org_name`	string
`state`	string
`zip5`	string
`ruca`	string
`apc_cd`	string
`apc_desc`	string
`bene_cnt`	double
`capc_services`	double
`avg_submitted_charge`	double
`avg_medicare_allowed`	double
`avg_medicare_payment`	double
`outlier_services`	double
`avg_medicare_outlier`	double
`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_outpatient_by_provider_service")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_outpatient_by_provider_service WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`ccn`
Join	`how_to_join(source_fqn="medicare_silver.fact_outpatient_by_provider_service")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_outpatient_by_provider_service
Company names	`org_name` resolve to a permanent Vlada ID: `resolve_entity(text=<name>)`; the company pages hold owners and holdings
Note	Iceberg medicare_silver.fact_outpatient_by_provider_service, partition by data_year, replace (idempotent by SHA-256).

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