DPC Data Dictionary and Analytics Guide

[Sujith Peta]

Hi,

I have experience using CMS Medicare 100% data through VRDC, but I’m new to DPC data. While I understand there are similarities, I’m looking for resources or guides that can help me learn the structure and nuances of DPC data.

Specifically, I’d appreciate any documentation or best practices on:

• Key tables and fields to use for calculating metrics like Total Cost of Care
• Common limitations or caveats to be aware of
• Any analytics guidance for working with this dataset

If there are official guides, examples, or internal resources you can share, that would be extremely helpful.

Thank you for your time and support!

Best regards,
Sujith

[Data at the Point of Care (DPC) Community]

Hello!

Thanks for your question regarding DPC data. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team
Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Data at the Point of Care (DPC) Community]

Hi Sujith,

Apologies for the delay — the recent government shutdown impacted our communications approvals – and thanks for your question!

Thank you for your questions on regarding DPC data! 

Here are a few resources that may be helpful for you:

• DPC provides Medicare FFS Part A, B, and D claims that come through the API as FHIR resources. For analytics such as cost, you’ll primarily look at the ExplanationOfBenefit (EOB) data for a given patient or population of patients – each EOB contains provided services and adjudication information.
• The recommended starting point is the DPC data and API documentation pages, which describe the EOB STU3 resource used by the API and how DPC exposes claims.
• We also recommend using the DPC sandbox to test out how you may run exports and review the EOB resources end-to-end.

Please let us know if you have any additional questions! We're happy to help.

Best,

The DPC API Team

Plase be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.