cost
Standard Clinical Data Table
Table Columns
| field | type | required |
|---|---|---|
| cost_id | integer | Yes |
| cost_event_id | integer | Yes |
| cost_domain_id | varchar(20) | Yes |
| cost_type_concept_id | integer | Yes |
| currency_concept_id | integer | No |
| total_charge | float | No |
| total_cost | float | No |
| total_paid | float | No |
| paid_by_payer | float | No |
| paid_by_patient | float | No |
| paid_patient_copay | float | No |
| paid_patient_coinsurance | float | No |
| paid_patient_deductible | float | No |
| paid_by_primary | float | No |
| paid_ingredient_cost | float | No |
| paid_dispensing_fee | float | No |
| payer_plan_period_id | integer | No |
| amount_allowed | float | No |
| revenue_code_concept_id | integer | No |
| revenue_code_source_value | varchar(50) | No |
| drg_concept_id | integer | No |
| drg_source_value | varchar(3) | No |
Columns Description
cost_id
A unique identifier for each COST record.
cost_event_id
A foreign key identifier to the event (e.g. Measurement, Procedure, Visit, Drug Exposure, etc) record for which cost data are recorded.
cost_domain_id
The concept representing the domain of the cost event, from which the corresponding table can be inferred that contains the entity for which cost information is recorded.
cost_type_concept_id
A foreign key identifier to a concept in the CONCEPT table for the provenance or the source of the COST data: Calculated from insurance claim information, EHR provider charge, etc.
currency_concept_id
A foreign key identifier to the concept representing the 3-letter code used to delineate international currencies, such as USD for US Dollar.
total_charge
The total charge(s) for the services/products, in nominal value.
total_cost
The cost of the service/product, in nominal value.
total_paid
The total paid from all payers, in nominal value.
paid_by_payer
The amount paid by the Payer for the services/products, in nominal value.
paid_by_patient
The total paid by the Person as a deductible in the object currency.
paid_patient_copay
The amount paid by the Person as a fixed contribution to the expenses.
paid_patient_coinsurance
The amount paid by the Person as a joint assumption of risk.
paid_patient_deductible
The amount paid by the Person that is counted toward the deductible.
paid_by_primary
The amount paid by a primary Payer through the coordination of benefits.
paid_ingredient_cost
The amount paid by the Payer to a pharmacy for the drug, excluding the amount paid for dispensing the drug.
paid_dispensing_fee
The amount paid by the Payer to a pharmacy for dispensing a drug, excluding the amount paid for the drug ingredient.
payer_plan_period_id
A foreign key to the PAYER_PLAN_PERIOD table, where the details of the Payer, Plan and Family are stored.
amount_allowed
The contracted amount agreed between the payer and provider.
revenue_code_concept_id
A foreign key referring to a Standard Concept ID in the Standardized Vocabularies for Revenue codes.
revenue_code_source_value
Revenue codes are a method to charge for a class of procedures and conditions in the U.S. hospital system.
drg_concept_id
A foreign key to the predefined concept in the DRG Vocabulary reflecting the DRG for a visit.
drg_source_value
Diagnosis Related Groups are US codes used to classify hospital cases into one of approximately 500 groups.
ETL Conventions
One cost record is generated for each response by a payer. In a claims databases, the payment and payment terms reported by the payer for the goods or services billed will generate one cost record. If the source data has payment information for more than one payer (i.e. primary insurance and secondary insurance payment for one entity), then a cost record is created for each reporting payer. Therefore, it is possible for one procedure to have multiple cost records for each payer, but typically it contains one or no record per entity. Payer reimbursement cost records will be identified by using the PAYER_PLAN_ID field. Drug costs are composed of ingredient cost (the amount charged by the wholesale distributor or manufacturer), the dispensing fee (the amount charged by the pharmacy and the sales tax).