| Dimensional Warehouse Model Data Model |
| Description | The analysis of outpatient utilization of drug products, including costs and savings achieved by generic substitution, formulary usage, and mail order. |
| Primary Key | |
Outpatient Pharmacy Benefits Analysis PK |
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| Dependencies | |
NONE |
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| Reverse Dependencies | |
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| Attribute Details |
Administration Fee Amount
| Description | The total administration amount charged, for dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Days Supply Per Prescription
| Description | The average days supply per dispensed prescription, during the period of analysis. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Dispensed Alternative Drug Differential Per Member Amount
| Description | The average cost differential per member between originally prescribed drugs and dispensed drugs. (applies only to prescriptions where dispensed drug differs from originally prescribed drug). Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Dispensed Alternative Drug Differential Per Prescription Amount
| Description | The average difference in cost on prescription between originally prescribed drugs and dispensed drugs. (applies only to prescriptions where dispensed drug differs from originally prescribed drug). Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Member And Health Plan Cost Of Dispensed Prescriptions PMPM Amount
| Description | The average amount paid, for dispensed prescriptions, during the period of analysis, per member per month (PMPM). This includes all amounts paid by the member and health plan, net of any rebates. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Number Of Drug Switches Per Member
| Description | The average number of drug switches per member. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Number Of Prescriptions PMPY
| Description | The average number of prescriptions dispensed to members, per member year, during the period of analysis. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Patient Pay Per Prescription Amount
| Description | The average amount members paid for each dispensed prescription, during the period of analysis. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Average Professional Service Fee Paid Per Prescription Amount
| Description | The average amount charged, per prescription, for dispensing professional services, during the period of analysis. Formula: [A/B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Calendar Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Condition Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Coverage Eligibility Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Dispensed Alternative Drug Differential Amount
| Description | The total difference in cost between the originally prescribed drug(s) and dispensed drug(s). This only applies to prescriptions where dispensed drug differs from originally prescribed drug, during the period of analysis. Formula: [A-B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Dispensing Fee Amount
| Description | The total dispensing fee amount charged, for dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Geographic Area Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Group Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Health Plan Cost Of Dispensed Prescriptions
| Description | The total amount paid, by the health plan, for dispensed prescriptions, during the period of analysis. Formula: [A-B] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Health Plan Product Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Ingredient Cost Amount
| Description | The total undiscounted cost of drug ingredients or drug products, for dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Ingredient Cost Of Originally Prescribed Drug
| Description | The total undiscounted cost of the originally prescribed drug ingredients or drug products, for dispensed prescriptions where a drug switch occurred, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Ingredient Discount Amount
| Description | The total amount, that was discounted from the drug ingredient costs, for dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Medication Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Member And Health Plan Cost Of Dispensed Prescriptions
| Description | The total amount paid for dispensed prescriptions, during the period of analysis. This includes all amounts paid by the member and health plan, net of any rebates. Formula: [(A+B+C+D+E+F)-G] (see dependencies and their labels for measures used in the formula) |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Member Cost Of Dispensed Prescriptions
| Description | The total amount, paid by members, for dispensed prescriptions, in the form of deductibles, co-payment and other disallowed amounts, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Days Supply
| Description | The total of estimated number of days that prescriptions will last if taken according to prescriber instructions. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Drug Prescriptions Dispensed
| Description | The total number of drug prescriptions dispensed to members, during the period of analysis. A prescription for more than 30 days supply may count multiple times towards this measurement, i.e. 90 days supply may be considered as 3 prescriptions. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Drug Switches
| Description | The total number of drug switches, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Member Months
| Description | The total number of months that a member has one or more active memberships, in one or more health benefits plans, during the period of analysis. This may be a point in time calculation of the number of members, at a specific date in every month (15th) or it may be rounded sum of the number of months based on each members enrollment dates. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Members
| Description | The total count of members, during the period of analysis. This may be the total number of people with one or more active memberships at a given point in time during the period, or the average number of people with active memberships over the full period. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Number Of Member Years
| Description | The total number of years that member have one or more active memberships, in one or more health benefits plans, during the period of analysis. This may be a point in time calculation of the number of members, at a specific date in every year (1st of July), be based on the number of member months calculation or may be rounded sum of the number of years based on each members enrollment dates. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Count [INTEGER] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Pharmacy Order Dispense Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Plan Member Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Practitioner Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Professional Service Fee Amount
| Description | The total amount charged, for dispensed prescription professional services, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Provider Dk
| Description | A numeric surrogate key used to uniquely identify entities in the dimensional model. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG] |
| Is Part Of PrimaryKey | true |
| Is Required | true |
| Is Derived | false |
| Is Surrogate Key | false |
Rebate Amount
| Description | The total formulary or other rebate amount received by the health plan, in respect of dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
Sales Tax Amount
| Description | The total sales tax amount charged, for dispensed prescriptions, during the period of analysis. |
| Data Type | Standards - Data Domains.ddm/Data Domains/Currency Amount [DECIMAL(14,2)] |
| Is Part Of PrimaryKey | false |
| Is Required | false |
| Is Derived | false |
| Is Surrogate Key | false |
| Relationship Details |
Outpatient Pharmacy Benefits Analysis_Calendar Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Calendar Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Geographic Area Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Geographic Area Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Plan Member Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Plan Member Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Condition Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Condition Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Group Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Group Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Practitioner Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Practitioner Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Provider Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Provider Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Medication Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Medication Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Pharmacy Order Dispense Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Pharmacy Order Dispense Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Health Plan Product Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Health Plan Product Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
Outpatient Pharmacy Benefits Analysis_Coverage Eligibility Dimension_FK
| Is Identifying Relationship | true |
| Child Table | Outpatient Pharmacy Benefits Analysis |
| Child Multiplicity | ZERO_TO_MANY |
| Child Referential Integrity: On Delete | NONE |
| Child Referential Integrity: On Insert | NONE |
| Child Referential Integrity: On Update | NONE |
| Parent Table | Coverage Eligibility Dimension |
| Parent Multiplicity | ONE |
| Parent Referential Integrity: On Delete | NONE |
| Parent Referential Integrity: On Insert | NONE |
| Parent Referential Integrity: On Update | NONE |
| Primary Key Details |
Outpatient Pharmacy Benefits Analysis PK
| Key Attribute | Plan Member Dk |
| Key Attribute | Condition Dk |
| Key Attribute | Practitioner Dk |
| Key Attribute | Provider Dk |
| Key Attribute | Medication Dk |
| Key Attribute | Pharmacy Order Dispense Dk |
| Key Attribute | Health Plan Product Dk |
| Key Attribute | Coverage Eligibility Dk |
| Key Attribute | Calendar Dk |
| Key Attribute | Geographic Area Dk |
| Key Attribute | Group Dk |
| Dimensional Warehouse Model Data Model |