High Cost Claims by Provider

URL: https://hub.mph.in.gov/dataset/3345e009-33ac-435f-8dc6-c3812e54acc2/resource/91a1fe19-bc12-4eb4-94a7-a89534feb503/download/high_cost_claims_by_provider.csv

Archived as of 6/26/2025: The datasets will no longer receive updates but the historical data will continue to be available for download.

This dataset provides information related to the 100 most costly diagnostic claims. It contains information about the total number of recipients, total number of claims, and total dollar amount, grouped by provider.

Restricted to claims with service date between 01/2012 to 12/2017. Restricted to top 100 costly diagnosis codes (by total cost). Provider is the billing provider. If a claim has several diagnostic codes, primary diagnosis is used. This data is for research purposes and is not intended to be used for reporting. Due to differences in geographic aggregation, time period considerations, and units of analysis, these numbers may differ from those reported by FSSA.

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Data Dictionary

Column Type Label Description
PROVIDER_ID text
PROVIDER_NPI text
PROVIDER_NAME text
provider_address_street_line_1 text
provider_address_street_line_2 text
PROVIDER_ADDRESS_CITY text
PROVIDER_ADDRESS_STATE text
PROVIDER_ADDRESS_ZIP_CODE text
PROVIDER_GEOCODE_LATITUDE text
PROVIDER_GEOCODE_LONGITUDE text
PROVIDER_TYPE text
PROVIDER_PRIME_SPECIALTY text
DOMINANT_DIAGNOSIS text
TOTAL_NUMBER_OF_RECIPIENTS numeric
TOTAL_NUMBER_OF_CLAIMS numeric
total_dollar_amount_of_claims numeric
Year numeric

Additional Information

Field Value
Data last updated Oktubre 16, 2025
Metadata last updated Oktubre 16, 2025
Created Oktubre 16, 2025
Format text/csv
License No License Provided
created1 linggo ang nakalipas
datastore activeTrue
formatCSV
has viewsTrue
id91a1fe19-bc12-4eb4-94a7-a89534feb503
last modified1 linggo ang nakalipas
metadata modified1 linggo ang nakalipas
mimetypetext/csv
on same domainTrue
package id3345e009-33ac-435f-8dc6-c3812e54acc2
position10
size20.1 MiB
stateactive
url typeupload