# batch_0999

schema=1.0 quality=2.0 generator=0.5.0 • generated 2026-06-09T05:34:58.510520Z

Batch ID
999
Batch size
1,000 members
Schema version
1.0
Quality version
2.0
Generator version
0.5.0
Generated at
2026-06-09T05:34:58.510520Z
Python
3.9.6 (default, Mar 12 2025, 20:22:46) [Clang 17.0.0 (clang-1700.0.13.3)]
Master seed
`0x5a17e5da7a`
Git SHA
`4948a2f388df0882b7e33ef765edd5a10d2c7092` (dirty: False)

## Quality (control totals vs MA benchmarks)

Summary: 6 / 33 metrics outside ±15% tolerance.

Metric | Target | Actual | Δ% | Flag
--- | --- | --- | --- | ---
avg_age | 74.0000 | 72.6846 | -1.78% | OK
pct_female | 0.5500 | 0.5131 | -6.71% | OK
pct_dual | 0.2000 | 0.1921 | -3.97% | OK
pct_lis | 0.3000 | 0.3270 | 9.00% | OK
pct_esrd | 0.0120 | 0.0129 | 7.16% | OK
pct_originally_disabled | 0.1300 | 0.1328 | 2.15% | OK
avg_risk_score_blended | 1.0500 | 1.0330 | -1.62% | OK
avg_risk_score_v24 | 1.0600 | 1.0232 | -3.47% | OK
avg_risk_score_v28 | 1.0400 | 1.0382 | -0.18% | OK
pmpm_medical_total | 900.0000 | 1,054.7131 | 17.19% | HIGH
pmpm_rx_gross | 280.0000 | 256.9106 | -8.25% | OK
pmpm_rx_net | 180.0000 | 160.2304 | -10.98% | OK
pmpm_total | 1,080.0000 | 1,214.9434 | 12.49% | OK
pmpm_revenue_part_c | 1,100.0000 | 1,210.7276 | 10.07% | OK
pmpm_revenue_part_d | 110.0000 | 121.1428 | 10.13% | OK
pmpm_revenue_total | 1,210.0000 | 1,331.8703 | 10.07% | OK
pmpm_ip | 270.0000 | 385.7439 | 42.87% | HIGH
pmpm_op | 210.0000 | 234.1843 | 11.52% | OK
pmpm_prof | 290.0000 | 298.7272 | 3.01% | OK
pmpm_snf_hh | 90.0000 | 91.6631 | 1.85% | OK
pmpm_dme_other | 40.0000 | 44.3946 | 10.99% | OK
mlr_total | 0.8600 | 0.9122 | 6.07% | OK
admits_per_1000 | 255.0000 | 278.5817 | 9.25% | OK
er_per_1000 | 600.0000 | 576.9152 | -3.85% | OK
pcp_visits_per_1000 | 3,500.0000 | 4,769.6317 | 36.28% | HIGH
specialist_visits_per_1000 | 3,100.0000 | 4,944.1053 | 59.49% | HIGH
rx_fills_per_1000 | 55,000.0000 | 57,908.3739 | 5.29% | OK
hcc_prev_HCC18 | 0.1300 | 0.2827 | 117.46% | HIGH
hcc_prev_HCC85 | 0.1300 | 0.1268 | -2.49% | OK
hcc_prev_HCC111 | 0.1100 | 0.1097 | -0.31% | OK
hcc_prev_HCC108 | 0.1600 | 0.1509 | -5.68% | OK
hcc_prev_HCC138 | 0.1000 | 0.1187 | 18.71% | HIGH
hcc_prev_HCC58 | 0.1000 | 0.0936 | -6.44% | OK

### FK / schema / sanity checks (0 = clean)

Check | Count
--- | ---
orphan_medical_claims | 0
orphan_rx_claims | 0
orphan_revenue_rows | 0
medical_line_id_duplicates | 0
rx_line_id_duplicates | 0
medical_paid_before_service | 0
rx_paid_before_service | 0
negative_or_high_ages | 0

## PMPM by service bucket

## Actuarial summary

### Annual cost trend

### PMPM by year

Year | Member-months | PMPM Medical | PMPM Rx Net | PMPM Total | PMPM Revenue | MLR
--- | --- | --- | --- | --- | --- | ---
2024 | 10,049 | $1099.50 | $163.21 | $1262.71 | $1264.91 | 99.8%
2025 | 9,790 | $1053.35 | $161.87 | $1215.22 | $1346.02 | 90.3%
2026 | 9,323 | $1007.87 | $155.29 | $1163.16 | $1389.19 | 83.7%

### PMPM / MLR by dual status

Cohort | Members | PMPM Medical | PMPM Rx | PMPM Revenue | MLR
--- | --- | --- | --- | --- | ---
non_dual | 814 | $976.43 | $139.87 | $1259.95 | 88.6%
dual | 190 | $1456.98 | $259.55 | $1741.22 | 98.6%

### PMPM by age band

Age Band | Members | PMPM Medical
--- | --- | ---
65-69 | 236 | $950.94
70-74 | 267 | $1076.00
75-79 | 177 | $1015.16
80-84 | 100 | $1274.77
85-89 | 61 | $1410.52
90+ | 32 | $1013.08
<65 | 121 | $957.31

### Utilization per 1000 member-years

Metric | Value
--- | ---
ip_admits_per_1000 | 278.6
er_visits_per_1000 | 576.9
pcp_visits_per_1000 | 6,369.9
specialist_visits_per_1000 | 5,024.3
rx_fills_per_1000 | 57,908.4

## HCC prevalence (top 20)

## Data dictionaries

Each dataset has its own dictionary with field-level type, key role, description, expected values, and observed unique values.

eligibility

dict_eligibility.md · dict_eligibility.csv

revenue

dict_revenue.md · dict_revenue.csv

medical_claims

dict_medical_claims.md · dict_medical_claims.csv

rx_claims

dict_rx_claims.md · dict_rx_claims.csv

## Value distributions

Per-field frequency tables / histograms. See value_distributions.json for the full data.

eligibility: 17 fields (14 categorical, 1 numeric, 1 date, 1 high-cardinality)

revenue: 24 fields (11 categorical, 11 numeric, 0 date, 1 high-cardinality)

medical_claims: 48 fields (14 categorical, 5 numeric, 3 date, 5 high-cardinality)

rx_claims: 41 fields (26 categorical, 8 numeric, 2 date, 5 high-cardinality)

## Generator config & knobs

knobs.json (all calibration constants in use at run time)

    {
      "benchmarks.DEFAULT_TOLERANCE": 0.15,
      "benchmarks.TARGETS": {
        "admits_per_1000": 255.0,
        "avg_age": 74.0,
        "avg_risk_score_blended": 1.05,
        "avg_risk_score_v24": 1.06,
        "avg_risk_score_v28": 1.04,
        "er_per_1000": 600.0,
        "hcc_prev_HCC108": 0.16,
        "hcc_prev_HCC111": 0.11,
        "hcc_prev_HCC138": 0.1,
        "hcc_prev_HCC18": 0.13,
        "hcc_prev_HCC58": 0.1,
        "hcc_prev_HCC85": 0.13,
        "mlr_total": 0.86,
        "pcp_visits_per_1000": 3500.0,
        "pct_dual": 0.2,
        "pct_esrd": 0.012,
        "pct_female": 0.55,
        "pct_lis": 0.3,
        "pct_originally_disabled": 0.13,
        "pmpm_dme_other": 40.0,
        "pmpm_ip": 270.0,
        "pmpm_medical_total": 900.0,
        "pmpm_op": 210.0,
        "pmpm_prof": 290.0,
        "pmpm_revenue_part_c": 1100.0,
        "pmpm_revenue_part_d": 110.0,
        "pmpm_revenue_total": 1210.0,
        "pmpm_rx_gross": 280.0,
        "pmpm_rx_net": 180.0,
        "pmpm_snf_hh": 90.0,
        "pmpm_total": 1080.0,
        "rx_fills_per_1000": 55000.0,
        "specialist_visits_per_1000": 3100.0
      },
      "demographics.AGE_PYRAMID": [
        [
          40,
          64,
          0.12
        ],
        [
          65,
          69,
          0.25
        ],
        [
          70,
          74,
          0.25
        ],
        [
          75,
          79,
          0.18
        ],
        [
          80,
          84,
          0.11
        ],
        [
          85,
          89,
          0.06
        ],
        [
          90,
          99,
          0.03
        ]
      ],
      "demographics.ANNUAL_NEW_ENROLLEE_RATE": 0.1,
      "demographics.MONTHLY_DISENROLL": 0.0055,
      "demographics.MONTHLY_MORTALITY_BY_AGE": {
        "(40, 64)": 0.0008,
        "(65, 69)": 0.001,
        "(70, 74)": 0.0017,
        "(75, 79)": 0.0028,
        "(80, 84)": 0.005,
        "(85, 89)": 0.009,
        "(90, 99)": 0.015
      },
      "demographics.PCT_ESRD_BY_AGE": {
        "(40, 64)": 0.045,
        "(65, 69)": 0.012,
        "(70, 74)": 0.01,
        "(75, 79)": 0.008,
        "(80, 84)": 0.006,
        "(85, 89)": 0.004,
        "(90, 99)": 0.002
      },
      "demographics.PCT_FEMALE_BY_AGE": {
        "(40, 64)": 0.5,
        "(65, 69)": 0.53,
        "(70, 74)": 0.54,
        "(75, 79)": 0.56,
        "(80, 84)": 0.59,
        "(85, 89)": 0.63,
        "(90, 99)": 0.68
      },
      "demographics.PCT_ORIG_DISABLED_BY_AGE": {
        "(40, 64)": 0.6,
        "(65, 69)": 0.1,
        "(70, 74)": 0.06,
        "(75, 79)": 0.04,
        "(80, 84)": 0.03,
        "(85, 89)": 0.02,
        "(90, 99)": 0.01
      },
      "dq_profiles.DQ_PROFILE": {
        "adjustment_rate": 0.05,
        "denial_rate": 0.02,
        "duplicate_rate": 0.003,
        "missing_field_rate": 0.01,
        "paid_lag_mu": 3.0,
        "paid_lag_sigma": 0.7,
        "reversal_rate": 0.005
      },
      "drugs.BACKGROUND_NDCS": [
        "00093505098",
        "00185013505",
        "00378515193",
        "00378150001"
      ],
      "drugs.CLASSES": [
        "ACE",
        "ANTIBIOTIC_BROAD",
        "ANTICOAGULANT_NOAC",
        "ANTIEPILEPTIC",
        "ANTIPLATELET",
        "ANTIPSYCHOTIC",
        "ANTIVIRAL_HEP",
        "ARB",
        "ARV",
        "BETA_BLOCKER",
        "BIGUANIDES",
        "BIOLOGIC_TNF",
        "BRONCHODILATOR",
        "BUPRENORPHINE",
        "CHOLINESTERASE",
        "DIURETIC_K_SPARING",
        "DMARD",
        "DPP4",
        "ESA",
        "GABAPENTIN",
        "GLP1",
        "HORMONE_BLOCKERS",
        "ICS",
        "IMMUNOSUPPRESSANT",
        "INSULIN",
        "IVIG",
        "LAMA",
        "LEVODOPA",
        "LOOP_DIURETIC",
        "MS_DMD",
        "MUSCLE_RELAXANT",
        "NSAID",
        "ONCOLOGY_IV",
        "ONCOLOGY_ORAL",
        "PANCREATIC_ENZYME",
        "PHOSPHATE_BINDER",
        "SGLT2",
        "SNRI",
        "SSRI",
        "STATIN",
        "THYROID"
      ],
      "drugs.MAINTENANCE_CLASSES": [
        "ACE",
        "ANTICOAGULANT_NOAC",
        "ANTIEPILEPTIC",
        "ANTIPLATELET",
        "ANTIPSYCHOTIC",
        "ARB",
        "BETA_BLOCKER",
        "BIGUANIDES",
        "BRONCHODILATOR",
        "CHOLINESTERASE",
        "DIURETIC_K_SPARING",
        "DMARD",
        "DPP4",
        "GABAPENTIN",
        "GLP1",
        "HORMONE_BLOCKERS",
        "ICS",
        "IMMUNOSUPPRESSANT",
        "INSULIN",
        "LAMA",
        "LEVODOPA",
        "LOOP_DIURETIC",
        "PHOSPHATE_BINDER",
        "SGLT2",
        "SNRI",
        "SSRI",
        "STATIN",
        "THYROID"
      ],
      "drugs.N_NDCS": 51,
      "drugs.PA_REQUIRED_CLASSES": [
        "ANTIPSYCHOTIC",
        "ANTIVIRAL_HEP",
        "BIOLOGIC_TNF",
        "GLP1",
        "IMMUNOSUPPRESSANT",
        "INSULIN",
        "IVIG",
        "MS_DMD",
        "ONCOLOGY_IV",
        "ONCOLOGY_ORAL",
        "SGLT2"
      ],
      "drugs.SPECIALTY_CHANNEL_CLASSES": [
        "ANTIVIRAL_HEP",
        "ARV",
        "BIOLOGIC_TNF",
        "ESA",
        "IVIG",
        "MS_DMD",
        "ONCOLOGY_IV"
      ],
      "drugs.TIER_BY_CLASS": {
        "ACE": 1,
        "ANTIBIOTIC_BROAD": 1,
        "ANTICOAGULANT_NOAC": 3,
        "ANTIEPILEPTIC": 1,
        "ANTIPLATELET": 1,
        "ANTIPSYCHOTIC": 2,
        "ANTIVIRAL_HEP": 5,
        "ARB": 1,
        "ARV": 5,
        "BETA_BLOCKER": 1,
        "BIGUANIDES": 1,
        "BIOLOGIC_TNF": 5,
        "BRONCHODILATOR": 1,
        "BUPRENORPHINE": 2,
        "CHOLINESTERASE": 1,
        "DIURETIC_K_SPARING": 1,
        "DMARD": 1,
        "DPP4": 3,
        "ESA": 5,
        "GABAPENTIN": 1,
        "GLP1": 4,
        "HORMONE_BLOCKERS": 3,
        "ICS": 3,
        "IMMUNOSUPPRESSANT": 3,
        "INSULIN": 4,
        "IVIG": 5,
        "LAMA": 3,
        "LEVODOPA": 1,
        "LOOP_DIURETIC": 1,
        "MS_DMD": 5,
        "MUSCLE_RELAXANT": 1,
        "NSAID": 1,
        "ONCOLOGY_IV": 5,
        "ONCOLOGY_ORAL": 5,
        "PANCREATIC_ENZYME": 3,
        "PHOSPHATE_BINDER": 3,
        "SGLT2": 3,
        "SNRI": 2,
        "SSRI": 1,
        "STATIN": 1,
        "THYROID": 1
      },
      "episodes.keys": [
        "chf_exacerbation",
        "ami",
        "dka",
        "diabetic_foot_ulcer",
        "copd_exacerbation",
        "pneumonia_ip",
        "sepsis_ip",
        "stroke",
        "hip_fracture"
      ],
      "episodes.summary": {
        "ami": {
          "annual_rate_per_member": 0.25,
          "label": "Acute MI",
          "n_lines": 7,
          "trigger_hccs": [
            "HCC86",
            "HCC87"
          ]
        },
        "chf_exacerbation": {
          "annual_rate_per_member": 0.18,
          "label": "CHF Exacerbation",
          "n_lines": 4,
          "trigger_hccs": [
            "HCC85"
          ]
        },
        "copd_exacerbation": {
          "annual_rate_per_member": 0.22,
          "label": "COPD Exacerbation",
          "n_lines": 4,
          "trigger_hccs": [
            "HCC111"
          ]
        },
        "diabetic_foot_ulcer": {
          "annual_rate_per_member": 0.08,
          "label": "Diabetic Foot Ulcer",
          "n_lines": 3,
          "trigger_hccs": [
            "HCC18"
          ]
        },
        "dka": {
          "annual_rate_per_member": 0.12,
          "label": "Diabetic Ketoacidosis",
          "n_lines": 3,
          "trigger_hccs": [
            "HCC17",
            "HCC18"
          ]
        },
        "hip_fracture": {
          "annual_rate_per_member": 0.55,
          "label": "Hip Fracture",
          "n_lines": 5,
          "trigger_hccs": [
            "HCC170"
          ]
        },
        "pneumonia_ip": {
          "annual_rate_per_member": 0.3,
          "label": "Pneumonia (IP)",
          "n_lines": 2,
          "trigger_hccs": [
            "HCC114",
            "HCC115"
          ]
        },
        "sepsis_ip": {
          "annual_rate_per_member": 0.35,
          "label": "Sepsis (IP)",
          "n_lines": 2,
          "trigger_hccs": [
            "HCC2"
          ]
        },
        "stroke": {
          "annual_rate_per_member": 0.3,
          "label": "Stroke (Acute)",
          "n_lines": 5,
          "trigger_hccs": [
            "HCC100"
          ]
        }
      },
      "geography.STATE_DISTRIBUTION": [
        [
          "CA",
          0.14,
          [
            [
              "Los Angeles",
              "06037"
            ],
            [
              "Orange",
              "06059"
            ]
          ]
        ],
        [
          "FL",
          0.13,
          [
            [
              "Miami-Dade",
              "12086"
            ],
            [
              "Broward",
              "12011"
            ]
          ]
        ],
        [
          "TX",
          0.1,
          [
            [
              "Harris",
              "48201"
            ],
            [
              "Dallas",
              "48113"
            ]
          ]
        ],
        [
          "NY",
          0.07,
          [
            [
              "Kings",
              "36047"
            ],
            [
              "Queens",
              "36081"
            ]
          ]
        ],
        [
          "PA",
          0.06,
          [
            [
              "Philadelphia",
              "42101"
            ],
            [
              "Allegheny",
              "42003"
            ]
          ]
        ],
        [
          "OH",
          0.05,
          [
            [
              "Cuyahoga",
              "39035"
            ],
            [
              "Franklin",
              "39049"
            ]
          ]
        ],
        [
          "MI",
          0.04,
          [
            [
              "Wayne",
              "26163"
            ],
            [
              "Oakland",
              "26125"
            ]
          ]
        ],
        [
          "IL",
          0.04,
          [
            [
              "Cook",
              "17031"
            ],
            [
              "DuPage",
              "17043"
            ]
          ]
        ],
        [
          "NC",
          0.04,
          [
            [
              "Mecklenburg",
              "37119"
            ],
            [
              "Wake",
              "37183"
            ]
          ]
        ],
        [
          "GA",
          0.04,
          [
            [
              "Fulton",
              "13121"
            ],
            [
              "Gwinnett",
              "13135"
            ]
          ]
        ],
        [
          "AZ",
          0.03,
          [
            [
              "Maricopa",
              "04013"
            ],
            [
              "Pima",
              "04019"
            ]
          ]
        ],
        [
          "NJ",
          0.03,
          [
            [
              "Bergen",
              "34003"
            ],
            [
              "Essex",
              "34013"
            ]
          ]
        ],
        [
          "MA",
          0.03,
          [
            [
              "Middlesex",
              "25017"
            ],
            [
              "Suffolk",
              "25025"
            ]
          ]
        ],
        [
          "VA",
          0.03,
          [
            [
              "Fairfax",
              "51059"
            ],
            [
              "Henrico",
              "51087"
            ]
          ]
        ],
        [
          "WA",
          0.02,
          [
            [
              "King",
              "53033"
            ],
            [
              "Pierce",
              "53053"
            ]
          ]
        ],
        [
          "TN",
          0.03,
          [
            [
              "Davidson",
              "47037"
            ],
            [
              "Shelby",
              "47157"
            ]
          ]
        ],
        [
          "MO",
          0.02,
          [
            [
              "St. Louis",
              "29189"
            ],
            [
              "Jackson",
              "29095"
            ]
          ]
        ],
        [
          "IN",
          0.02,
          [
            [
              "Marion",
              "18097"
            ],
            [
              "Lake",
              "18089"
            ]
          ]
        ],
        [
          "WI",
          0.02,
          [
            [
              "Milwaukee",
              "55079"
            ],
            [
              "Dane",
              "55025"
            ]
          ]
        ],
        [
          "MN",
          0.02,
          [
            [
              "Hennepin",
              "27053"
            ],
            [
              "Ramsey",
              "27123"
            ]
          ]
        ],
        [
          "CO",
          0.02,
          [
            [
              "Denver",
              "08031"
            ],
            [
              "Jefferson",
              "08059"
            ]
          ]
        ],
        [
          "AL",
          0.02,
          [
            [
              "Jefferson",
              "01073"
            ],
            [
              "Mobile",
              "01097"
            ]
          ]
        ],
        [
          "LA",
          0.02,
          [
            [
              "Orleans",
              "22071"
            ],
            [
              "Jefferson",
              "22051"
            ]
          ]
        ],
        [
          "KY",
          0.02,
          [
            [
              "Jefferson",
              "21111"
            ],
            [
              "Fayette",
              "21067"
            ]
          ]
        ],
        [
          "OR",
          0.01,
          [
            [
              "Multnomah",
              "41051"
            ],
            [
              "Washington",
              "41067"
            ]
          ]
        ],
        [
          "CT",
          0.01,
          [
            [
              "Hartford",
              "09003"
            ],
            [
              "Fairfield",
              "09001"
            ]
          ]
        ],
        [
          "OK",
          0.01,
          [
            [
              "Oklahoma",
              "40109"
            ],
            [
              "Tulsa",
              "40143"
            ]
          ]
        ],
        [
          "SC",
          0.01,
          [
            [
              "Greenville",
              "45045"
            ],
            [
              "Richland",
              "45079"
            ]
          ]
        ],
        [
          "UT",
          0.01,
          [
            [
              "Salt Lake",
              "49035"
            ],
            [
              "Utah",
              "49049"
            ]
          ]
        ],
        [
          "XX",
          0.07,
          [
            [
              "National Avg",
              "99999"
            ]
          ]
        ]
      ],
      "geography.STATE_DUAL_MULT": {
        "AL": 1.2,
        "AZ": 0.9,
        "CA": 1.1,
        "CO": 0.85,
        "CT": 1.0,
        "FL": 1.05,
        "GA": 0.95,
        "IL": 1.0,
        "IN": 1.0,
        "KY": 1.2,
        "LA": 1.3,
        "MA": 1.1,
        "MI": 1.1,
        "MN": 0.9,
        "MO": 1.05,
        "MS": 1.45,
        "NC": 1.0,
        "NJ": 1.05,
        "NY": 1.25,
        "OH": 1.05,
        "OK": 1.1,
        "OR": 0.9,
        "PA": 1.1,
        "SC": 1.1,
        "TN": 1.05,
        "TX": 0.95,
        "UT": 0.8,
        "VA": 0.9,
        "WA": 0.9,
        "WI": 0.95,
        "WV": 1.4,
        "XX": 1.0
      },
      "hcc_library.HCC_HIERARCHY": {
        "HCC1": [
          "HCC6"
        ],
        "HCC10": [
          "HCC11",
          "HCC12"
        ],
        "HCC100": [
          "HCC99"
        ],
        "HCC103": [
          "HCC104"
        ],
        "HCC104": [],
        "HCC106": [
          "HCC107",
          "HCC108"
        ],
        "HCC107": [
          "HCC108"
        ],
        "HCC108": [],
        "HCC11": [
          "HCC12"
        ],
        "HCC111": [
          "HCC112"
        ],
        "HCC112": [],
        "HCC114": [
          "HCC115"
        ],
        "HCC115": [],
        "HCC12": [],
        "HCC134": [
          "HCC135",
          "HCC136",
          "HCC137",
          "HCC138"
        ],
        "HCC135": [
          "HCC136",
          "HCC137",
          "HCC138"
        ],
        "HCC136": [
          "HCC137",
          "HCC138"
        ],
        "HCC137": [
          "HCC138"
        ],
        "HCC138": [],
        "HCC157": [
          "HCC158",
          "HCC159"
        ],
        "HCC158": [
          "HCC159"
        ],
        "HCC159": [],
        "HCC169": [],
        "HCC17": [
          "HCC18",
          "HCC19"
        ],
        "HCC170": [
          "HCC169"
        ],
        "HCC18": [
          "HCC19"
        ],
        "HCC19": [],
        "HCC27": [
          "HCC28",
          "HCC29"
        ],
        "HCC28": [
          "HCC29"
        ],
        "HCC29": [],
        "HCC46": [
          "HCC47",
          "HCC48"
        ],
        "HCC47": [
          "HCC48"
        ],
        "HCC48": [],
        "HCC51": [
          "HCC52"
        ],
        "HCC52": [],
        "HCC54": [
          "HCC55",
          "HCC56"
        ],
        "HCC55": [
          "HCC56"
        ],
        "HCC56": [],
        "HCC57": [
          "HCC58",
          "HCC59",
          "HCC60"
        ],
        "HCC58": [
          "HCC59",
          "HCC60"
        ],
        "HCC59": [
          "HCC60"
        ],
        "HCC6": [],
        "HCC60": [],
        "HCC70": [
          "HCC71",
          "HCC72",
          "HCC103",
          "HCC104"
        ],
        "HCC71": [
          "HCC72",
          "HCC103",
          "HCC104"
        ],
        "HCC72": [
          "HCC103",
          "HCC104"
        ],
        "HCC8": [
          "HCC9",
          "HCC10",
          "HCC11",
          "HCC12"
        ],
        "HCC85": [],
        "HCC86": [
          "HCC87",
          "HCC88"
        ],
        "HCC87": [
          "HCC88"
        ],
        "HCC88": [],
        "HCC9": [
          "HCC10",
          "HCC11",
          "HCC12"
        ],
        "HCC99": []
      },
      "hcc_library.N_HCCS": 81,
      "hcc_library.codes": [
        "HCC1",
        "HCC2",
        "HCC6",
        "HCC8",
        "HCC9",
        "HCC10",
        "HCC11",
        "HCC12",
        "HCC17",
        "HCC18",
        "HCC19",
        "HCC21",
        "HCC22",
        "HCC23",
        "HCC27",
        "HCC28",
        "HCC29",
        "HCC34",
        "HCC35",
        "HCC40",
        "HCC43",
        "HCC46",
        "HCC47",
        "HCC48",
        "HCC51",
        "HCC52",
        "HCC54",
        "HCC55",
        "HCC56",
        "HCC57",
        "HCC58",
        "HCC59",
        "HCC60",
        "HCC70",
        "HCC71",
        "HCC72",
        "HCC73",
        "HCC74",
        "HCC75",
        "HCC77",
        "HCC78",
        "HCC79",
        "HCC80",
        "HCC82",
        "HCC83",
        "HCC84",
        "HCC85",
        "HCC86",
        "HCC87",
        "HCC88",
        "HCC96",
        "HCC99",
        "HCC100",
        "HCC103",
        "HCC104",
        "HCC106",
        "HCC107",
        "HCC108",
        "HCC110",
        "HCC111",
        "HCC112",
        "HCC114",
        "HCC115",
        "HCC110A",
        "HCC134",
        "HCC135",
        "HCC136",
        "HCC137",
        "HCC138",
        "HCC157",
        "HCC158",
        "HCC159",
        "HCC161",
        "HCC162",
        "HCC166",
        "HCC169",
        "HCC170",
        "HCC176",
        "HCC186",
        "HCC188",
        "HCC189"
      ],
      "hcc_library.summary": {
        "HCC1": {
          "drug_classes": [
            "ARV"
          ],
          "dual_multiplier": 1.8,
          "hierarchy_group": "INFECTION",
          "hierarchy_rank": 1,
          "label": "HIV/AIDS",
          "n_typical_dx": 2,
          "prevalence_base": 0.005,
          "v24_coef": 0.35,
          "v28_coef": 0.3
        },
        "HCC10": {
          "drug_classes": [
            "ONCOLOGY_IV"
          ],
          "dual_multiplier": 1.05,
          "hierarchy_group": "CANCER",
          "hierarchy_rank": 3,
          "label": "Lymphoma & Other Cancers",
          "n_typical_dx": 3,
          "prevalence_base": 0.018,
          "v24_coef": 0.68,
          "v28_coef": 0.75
        },
        "HCC100": {
          "drug_classes": [
            "ANTIPLATELET",
            "STATIN"
          ],
          "dual_multiplier": 1.2,
          "hierarchy_group": "STROKE",
          "hierarchy_rank": 1,
          "label": "Ischemic / Hemorrhagic Stroke (Acute)",
          "n_typical_dx": 2,
          "prevalence_base": 0.012,
          "v24_coef": 0.24,
          "v28_coef": 0.3
        },
        "HCC103": {
          "drug_classes": [],
          "dual_multiplier": 1.3,
          "hierarchy_group": "PARALYSIS",
          "hierarchy_rank": 4,
          "label": "Hemiplegia/Hemiparesis",
          "n_typical_dx": 1,
          "prevalence_base": 0.008,
          "v24_coef": 0.43,
          "v28_coef": 0.4
        },
        "HCC104": {
          "drug_classes": [],
          "dual_multiplier": 1.3,
          "hierarchy_group": "PARALYSIS",
          "hierarchy_rank": 5,
          "label": "Monoplegia, Other Paralytic Syndromes",
          "n_typical_dx": 1,
          "prevalence_base": 0.004,
          "v24_coef": 0.32,
          "v28_coef": 0.3
        },
        "HCC106": {
          "drug_classes": [
            "ANTIPLATELET"
          ],
          "dual_multiplier": 1.4,
          "hierarchy_group": "VASCULAR",
          "hierarchy_rank": 1,
          "label": "Atherosclerosis of Extremities w/ Ulceration/Gangrene",
          "n_typical_dx": 2,
          "prevalence_base": 0.008,
          "v24_coef": 1.32,
          "v28_coef": 1.2
        },
        "HCC107": {
          "drug_classes": [
            "ANTIPLATELET",
            "STATIN"
          ],
          "dual_multiplier": 1.2,
          "hierarchy_group": "VASCULAR",
          "hierarchy_rank": 2,
          "label": "Vascular Disease w/ Complications",
          "n_typical_dx": 2,
          "prevalence_base": 0.025,
          "v24_coef": 0.38,
          "v28_coef": 0.35
        },
        "HCC108": {
          "drug_classes": [
            "STATIN",
            "ANTIPLATELET"
          ],
          "dual_multiplier": 1.1,
          "hierarchy_group": "VASCULAR",
          "hierarchy_rank": 3,
          "label": "Vascular Disease",
          "n_typical_dx": 2,
          "prevalence_base": 0.165,
          "v24_coef": 0.3,
          "v28_coef": 0.28
        },
        "HCC11": {
          "drug_classes": [
            "ONCOLOGY_ORAL"
          ],
          "dual_multiplier": 1.0,
          "hierarchy_group": "CANCER",
          "hierarchy_rank": 4,
          "label": "Colorectal, Bladder, Other Cancers",
          "n_typical_dx": 3,
          "prevalence_base": 0.035,
          "v24_coef": 0.31,
          "v28_coef": 0.35
        },
        "HCC110": {
          "drug_classes": [
            "BRONCHODILATOR"
          ],
          "dual_multiplier": 1.3,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Cystic Fibrosis",
          "n_typical_dx": 1,
          "prevalence_base": 0.0008,
          "v24_coef": 0.5,
          "v28_coef": 0.45
        },
        "HCC110A": {
          "drug_classes": [
            "ICS",
            "BRONCHODILATOR"
          ],
          "dual_multiplier": 1.15,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Asthma",
          "n_typical_dx": 2,
          "prevalence_base": 0.08,
          "v24_coef": 0.0,
          "v28_coef": 0.0
        },
        "HCC111": {
          "drug_classes": [
            "BRONCHODILATOR",
            "ICS",
            "LAMA"
          ],
          "dual_multiplier": 1.25,
          "hierarchy_group": "COPD",
          "hierarchy_rank": 1,
          "label": "COPD",
          "n_typical_dx": 3,
          "prevalence_base": 0.11,
          "v24_coef": 0.34,
          "v28_coef": 0.32
        },
        "HCC112": {
          "drug_classes": [
            "BRONCHODILATOR"
          ],
          "dual_multiplier": 1.15,
          "hierarchy_group": "COPD",
          "hierarchy_rank": 2,
          "label": "Fibrosis of Lung & Other Chronic Lung Disorders",
          "n_typical_dx": 2,
          "prevalence_base": 0.025,
          "v24_coef": 0.22,
          "v28_coef": 0.2
        },
        "HCC114": {
          "drug_classes": [
            "ANTIBIOTIC_BROAD"
          ],
          "dual_multiplier": 1.3,
          "hierarchy_group": "PNEUMONIA",
          "hierarchy_rank": 1,
          "label": "Aspiration & Specified Bacterial Pneumonias",
          "n_typical_dx": 2,
          "prevalence_base": 0.02,
          "v24_coef": 0.51,
          "v28_coef": 0.45
        },
        "HCC115": {
          "drug_classes": [
            "ANTIBIOTIC_BROAD"
          ],
          "dual_multiplier": 1.2,
          "hierarchy_group": "PNEUMONIA",
          "hierarchy_rank": 2,
          "label": "Pneumococcal Pneumonia, Empyema, Lung Abscess",
          "n_typical_dx": 1,
          "prevalence_base": 0.01,
          "v24_coef": 0.13,
          "v28_coef": 0.12
        },
        "HCC12": {
          "drug_classes": [
            "ONCOLOGY_ORAL",
            "HORMONE_BLOCKERS"
          ],
          "dual_multiplier": 1.0,
          "hierarchy_group": "CANCER",
          "hierarchy_rank": 5,
          "label": "Breast, Prostate & Other Cancers/Tumors",
          "n_typical_dx": 3,
          "prevalence_base": 0.075,
          "v24_coef": 0.15,
          "v28_coef": 0.18
        },
        "HCC134": {
          "drug_classes": [
            "ESA",
            "PHOSPHATE_BINDER"
          ],
          "dual_multiplier": 1.4,
          "hierarchy_group": "RENAL",
          "hierarchy_rank": 1,
          "label": "Dialysis Status (ESRD)",
          "n_typical_dx": 2,
          "prevalence_base": 0.012,
          "v24_coef": 1.46,
          "v28_coef": 1.5
        },
        "HCC135": {
          "drug_classes": [],
          "dual_multiplier": 1.2,
          "hierarchy_group": "RENAL",
          "hierarchy_rank": 2,
          "label": "Acute Renal Failure",
          "n_typical_dx": 2,
          "prevalence_base": 0.04,
          "v24_coef": 0.43,
          "v28_coef": 0.4
        },
        "HCC136": {
          "drug_classes": [
            "ESA",
            "PHOSPHATE_BINDER"
          ],
          "dual_multiplier": 1.3,
          "hierarchy_group": "RENAL",
          "hierarchy_rank": 3,
          "label": "Chronic Kidney Disease, Stage 5",
          "n_typical_dx": 1,
          "prevalence_base": 0.018,
          "v24_coef": 0.29,
          "v28_coef": 0.28
        },
        "HCC137": {
          "drug_classes": [],
          "dual_multiplier": 1.25,
          "hierarchy_group": "RENAL",
          "hierarchy_rank": 4,
          "label": "Chronic Kidney Disease, Stage 4",
          "n_typical_dx": 1,
          "prevalence_base": 0.025,
          "v24_coef": 0.29,
          "v28_coef": 0.2
        },
        "HCC138": {
          "drug_classes": [],
          "dual_multiplier": 1.15,
          "hierarchy_group": "RENAL",
          "hierarchy_rank": 5,
          "label": "Chronic Kidney Disease, Stage 3",
          "n_typical_dx": 3,
          "prevalence_base": 0.105,
          "v24_coef": 0.1,
          "v28_coef": 0.1
        },
        "HCC157": {
          "drug_classes": [],
          "dual_multiplier": 1.5,
          "hierarchy_group": "WOUND",
          "hierarchy_rank": 1,
          "label": "Pressure Ulcer of Skin, Stage 4",
          "n_typical_dx": 1,
          "prevalence_base": 0.003,
          "v24_coef": 1.93,
          "v28_coef": 1.8
        },
        "HCC158": {
          "drug_classes": [],
          "dual_multiplier": 1.45,
          "hierarchy_group": "WOUND",
          "hierarchy_rank": 2,
          "label": "Pressure Ulcer of Skin, Stage 3",
          "n_typical_dx": 1,
          "prevalence_base": 0.006,
          "v24_coef": 0.97,
          "v28_coef": 0.95
        },
        "HCC159": {
          "drug_classes": [],
          "dual_multiplier": 1.4,
          "hierarchy_group": "WOUND",
          "hierarchy_rank": 3,
          "label": "Pressure Ulcer of Skin, Unstageable / Other",
          "n_typical_dx": 1,
          "prevalence_base": 0.012,
          "v24_coef": 0.51,
          "v28_coef": 0.5
        },
        "HCC161": {
          "drug_classes": [],
          "dual_multiplier": 1.2,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Chronic Ulcer of Skin, Except Pressure",
          "n_typical_dx": 1,
          "prevalence_base": 0.025,
          "v24_coef": 0.45,
          "v28_coef": 0.4
        },
        "HCC162": {
          "drug_classes": [],
          "dual_multiplier": 1.2,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Severe Skin Burn or Condition",
          "n_typical_dx": 1,
          "prevalence_base": 0.002,
          "v24_coef": 0.5,
          "v28_coef": 0.45
        },
        "HCC166": {
          "drug_classes": [],
          "dual_multiplier": 1.2,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Severe Head Injury",
          "n_typical_dx": 1,
          "prevalence_base": 0.003,
          "v24_coef": 0.51,
          "v28_coef": 0.5
        },
        "HCC169": {
          "drug_classes": [],
          "dual_multiplier": 1.2,
          "hierarchy_group": "FRACTURE",
          "hierarchy_rank": 2,
          "label": "Vertebral Fractures w/o Spinal Cord Injury",
          "n_typical_dx": 1,
          "prevalence_base": 0.018,
          "v24_coef": 0.46,
          "v28_coef": 0.42
        },
        "HCC17": {
          "drug_classes": [
            "INSULIN",
            "BIGUANIDES"
          ],
          "dual_multiplier": 1.4,
          "hierarchy_group": "DIABETES",
          "hierarchy_rank": 1,
          "label": "Diabetes w/ Acute Complications",
          "n_typical_dx": 3,
          "prevalence_base": 0.02,
          "v24_coef": 0.36,
          "v28_coef": 0.3
        },
        "HCC170": {
          "drug_classes": [],
          "dual_multiplier": 1.25,
          "hierarchy_group": "FRACTURE",
          "hierarchy_rank": 1,
          "label": "Hip Fracture / Dislocation",
          "n_typical_dx": 2,
          "prevalence_base": 0.012,
          "v24_coef": 0.4,
          "v28_coef": 0.55
        },
        "HCC176": {
          "drug_classes": [],
          "dual_multiplier": 1.15,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Complications of Specified Implanted Device or Graft",
          "n_typical_dx": 2,
          "prevalence_base": 0.02,
          "v24_coef": 0.55,
          "v28_coef": 0.5
        },
        "HCC18": {
          "drug_classes": [
            "BIGUANIDES",
            "SGLT2",
            "GLP1",
            "INSULIN",
            "DPP4"
          ],
          "dual_multiplier": 1.35,
          "hierarchy_group": "DIABETES",
          "hierarchy_rank": 2,
          "label": "Diabetes w/ Chronic Complications",
          "n_typical_dx": 7,
          "prevalence_base": 0.13,
          "v24_coef": 0.3,
          "v28_coef": 0.17
        },
        "HCC186": {
          "drug_classes": [
            "IMMUNOSUPPRESSANT"
          ],
          "dual_multiplier": 1.1,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Major Organ Transplant Status (except Kidney/Pancreas)",
          "n_typical_dx": 2,
          "prevalence_base": 0.003,
          "v24_coef": 0.84,
          "v28_coef": 0.8
        },
        "HCC188": {
          "drug_classes": [],
          "dual_multiplier": 1.3,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Artificial Openings for Feeding or Elimination",
          "n_typical_dx": 2,
          "prevalence_base": 0.008,
          "v24_coef": 0.61,
          "v28_coef": 0.58
        },
        "HCC189": {
          "drug_classes": [],
          "dual_multiplier": 1.3,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Amputation Status (Lower Limb / Toes)",
          "n_typical_dx": 1,
          "prevalence_base": 0.006,
          "v24_coef": 0.52,
          "v28_coef": 0.5
        },
        "HCC19": {
          "drug_classes": [
            "BIGUANIDES",
            "SGLT2",
            "DPP4"
          ],
          "dual_multiplier": 1.2,
          "hierarchy_group": "DIABETES",
          "hierarchy_rank": 3,
          "label": "Diabetes w/o Complications",
          "n_typical_dx": 2,
          "prevalence_base": 0.14,
          "v24_coef": 0.11,
          "v28_coef": 0.1
        },
        "HCC2": {
          "drug_classes": [
            "ANTIBIOTIC_BROAD"
          ],
          "dual_multiplier": 1.35,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Septicemia / Severe Sepsis",
          "n_typical_dx": 4,
          "prevalence_base": 0.02,
          "v24_coef": 0.51,
          "v28_coef": 0.65
        },
        "HCC21": {
          "drug_classes": [],
          "dual_multiplier": 1.6,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Protein-Calorie Malnutrition",
          "n_typical_dx": 3,
          "prevalence_base": 0.015,
          "v24_coef": 0.55,
          "v28_coef": 0.5
        },
        "HCC22": {
          "drug_classes": [
            "GLP1"
          ],
          "dual_multiplier": 1.25,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Morbid Obesity",
          "n_typical_dx": 2,
          "prevalence_base": 0.075,
          "v24_coef": 0.25,
          "v28_coef": 0.2
        },
        "HCC23": {
          "drug_classes": [
            "THYROID"
          ],
          "dual_multiplier": 1.1,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Other Significant Endocrine/Metabolic",
          "n_typical_dx": 2,
          "prevalence_base": 0.03,
          "v24_coef": 0.2,
          "v28_coef": 0.18
        },
        "HCC27": {
          "drug_classes": [
            "DIURETIC_K_SPARING"
          ],
          "dual_multiplier": 1.4,
          "hierarchy_group": "LIVER",
          "hierarchy_rank": 1,
          "label": "End-Stage Liver Disease",
          "n_typical_dx": 3,
          "prevalence_base": 0.01,
          "v24_coef": 0.93,
          "v28_coef": 1.1
        },
        "HCC28": {
          "drug_classes": [],
          "dual_multiplier": 1.3,
          "hierarchy_group": "LIVER",
          "hierarchy_rank": 2,
          "label": "Cirrhosis of Liver",
          "n_typical_dx": 2,
          "prevalence_base": 0.013,
          "v24_coef": 0.36,
          "v28_coef": 0.4
        },
        "HCC29": {
          "drug_classes": [
            "ANTIVIRAL_HEP"
          ],
          "dual_multiplier": 1.2,
          "hierarchy_group": "LIVER",
          "hierarchy_rank": 3,
          "label": "Chronic Hepatitis",
          "n_typical_dx": 2,
          "prevalence_base": 0.015,
          "v24_coef": 0.18,
          "v28_coef": 0.2
        },
        "HCC34": {
          "drug_classes": [
            "PANCREATIC_ENZYME"
          ],
          "dual_multiplier": 1.35,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Chronic Pancreatitis",
          "n_typical_dx": 2,
          "prevalence_base": 0.006,
          "v24_coef": 0.3,
          "v28_coef": 0.28
        },
        "HCC35": {
          "drug_classes": [
            "BIOLOGIC_TNF"
          ],
          "dual_multiplier": 1.1,
          "hierarchy_group": null,
          "hierarchy_rank": 0,
          "label": "Inflammatory Bowel Disease",
          "n_typical_dx": 2,
          "prevale

Full file: knobs.json

config_snapshot/ contains the verbatim source code of config/, engine/, core/, scripts/, versions/, reporters/, validate/ at run time.

## Files in this report bundle

- eligibility.parquet
- revenue.parquet
- medical_claims.parquet
- rx_claims.parquet
- run_metadata.json
- knobs.json
- quality_summary.md
- actuarial_summary.md
- credibility_audit.md
- value_distributions.json
- Samples: eligibility.csv revenue.csv medical_claims.csv rx_claims.csv