Medicare Advantage, Part D, Medicaid

Medicare Physician & Other Practitioners — by Provider and Service (granular price)

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

Rows

116,297,407

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The CMS Medicare Physician & Other Practitioners PUF at the **provider×service** grain: per rendering NPI, HCPCS, and place of service, the average submitted charge, **Medicare allowed**, Medicare paid, and standardized amounts, plus beneficiary/service counts.
2The GRANULAR per-provider price — the provider-level counterpart to the geo benchmark (`fact_physician_payment_by_geo`). ~9.8M rows/year, partitioned by data_year (2013-2024 available).

Grain

Key	Grain
N/A	1One row per (data_year, rendering NPI, HCPCS, place of service) — charge/allowed/paid.

Columns (37)

Column	Type	Meaning
`data_year`	int
`rndrng_npi`	string
`last_org_name`	string
`first_name`	string
`credentials`	string
`entity_code`	string
`state`	string
`zip5`	string
`ruca`	string
`provider_type`	string
`participating_ind`	string
`hcpcs_cd`	string
`hcpcs_desc`	string
`hcpcs_drug_ind`	string
`place_of_service`	string
`tot_benes`	double
`tot_services`	double
`tot_bene_day_services`	double
`avg_submitted_charge`	double
`avg_medicare_allowed`	double
`avg_medicare_payment`	double
`avg_medicare_standardized`	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_physician_by_provider_service")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.fact_physician_by_provider_service WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`rndrng_npi`
Join	`how_to_join(source_fqn="medicare_silver.fact_physician_by_provider_service")`
Raw door	Athena (read-only via query_substrate): medicare_silver.fact_physician_by_provider_service
Company names	`last_org_name` resolve to a permanent Vlada ID: `resolve_entity(text=<name>)`; the company pages hold owners and holdings
Note	Iceberg medicare_silver.fact_physician_by_provider_service, partition by data_year; bulk-load (append_buffered per 500k-row chunk → flush_buffered_replace_partitions per year, atomic, idempotent by SHA-256).

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