CLAIM

NDC_OBSLT_HIST NDC FCLTY_CLM_OCRNC CLM_PROV__1 FCLTY_CLM_CNDTN CLM__1 FCLTY_CLM_OCRNC_SPAN FCLTY_CLM_VALUES CLM_PROV GNRC_CD_CNVRSN CLM__

PROVIDER
INDIV_PROV_HIST PROV_STTS INDIV_PROV_IDFCTN MDCD_PGM__1 PDC

DEMOGRAPHIC REFERENCE / STATISTICAL AREAS NTWK_PROV Demographic Reference includes standardized or pre-defined geographic information and locations associated with Statistical Areas used for reporting.

MLSA_ZIP_CD

NTWK PDC_CMNCTN NTWK_STTS

MLSA_ZIP_CD_HIST

MLSA_ZIP_CNTY

MLSA_ZIP_CNTY_HIST

FDB_SMARTKEY

NDC_FDB

CLM_ADDNL__1

CLM_ADDNL__

CLM

PHRMCY_CLM CLM_ICD_PROC FCLTY_CLM EDW_INDIV_PROV INDIV_PROV

IPS ADRS MLSA_ZIP_CD_CBSA_HIST MLSA_ZIP_CD_CBSA MLSA_CNTY MLSA_CNTY_HIST

PRFSNL_CLM ORGNL_CLM_LINE FCLTY_CLM__ INDIV_PROV_LANG ICD_PROC NPC HMO_SITE__1 PROV_ADRS MLSA_CBSA_HIST MLSA_CBSA MLSA_DLVRY_STTSTCS MLSA_DLVRY_STTSTCS_HIST

PROV_ADRS__1 NDC_MEDISPAN DRG__ INTRM_CLM_LINE DRG INDIV_PED FCLTY_CLM__1 IPS_BRD_EXAM CLM_INPAT_CASE NDC_MEDISPAN_GPI BILL_CLSFCTN ICD_PROC_HIST RPTG_TXNMY PAP_ALT_ID__1

HMO_LGCY_ID__1

MLSA_CITY_NM_ABRVN_HIST

MLSA_CITY_NM_ABRVN

MLSA_MSA

MLSA_MSA_HIST

HMO_SPCLST_PCP_ID_ADRS__1

PROV
CLM_PA PROV_ALT_ID__1 CLM_PAID__ INPAT_CASE CLM_PAID CLM_MAX_RVSN PROV_CRDNTLG__ PROV_CRDNTLG PROV_ALT_ID HMO_SPCLST_PCP_ID__1 TAX_ID CLM_LINE__1 CLM_LINE_DISP PROV_CLM_ACTN PRL PRL_PRVLG CLM_LINE_PAID__1 CLM_LINE_PAID__ CLM_LINE_PAID PN TAX_ID_PROV FEE_SCHDL PN__1

MLSA_CNSUS_HIST

MLSA_CNSUS

MLSA_UNIQ_ZIP

MLSA_UNIQ_ZIP_HIST

PMP

PRL_PROV_ADRS__1

INPAT_CASE_DRG

CAPITATION
CPD

LOAD LOG
CRCTD_LOAD_LOG EDW_LOAD_LOG

DRG_OUTPT

DRG_OUTPT__

MEDCR_PART_D

PGT

PROV_ORG_PGT

PRL__1

HMO_PROV_ORG__1 CLM_LINE_INPAT_CASE DRG_REIMBMNT CNTRCT PHRMCY_CLM_LINE CLM_LINE_ADDNL__ DRG_GRPR CLM_LINE_PROV__1 PROV_ORG EDW_PROV_ORG PROV_ORG_IDFCTN CPD_PROV CLM_LINE_ADDNL__1 CLM_LINE_PROV

PROV_ORG__1

PROV_PROD_PLAN_QLTY_PRFRMN

DRG_GRPR_DIAG HLTH_SRVC_HIST

CPD_MBR_PROD_ENRLMNT

CPD_COA

LAB
LAB_RQST_DTL_MAX_RVSN LAB_MBR_ADRS LAB_RQST_DTL_ORDRG_PROV LAB_RQST_DIAG DIAG LAB_RQST_DTL DIAG_HIST LAB_RSLT_NOTE__ LAB_MBR_INSRNC LAB_RQST

PRODUCT
PROD BNFT_PKG_PRCP_SP PROD_OFRG_NTWK

HLTH_SRVC DRG_GRPR_PROC

GENERAL LEDGER CHART OF ACCOUNTS

GL_COA FNCL_MBU_CF

WELLPOINT LEGACY WGS20 & QCARE TRANSLATION

CRDW TRANSLATION

CS90 TRANSLATION
COA_CS90

DIAG_GRPG CLM_DIAG

COA_CRDW_TRNSLTN WLP_CNVRT_LOB

BNFT_PKG CS90_TO_WLP_TRNSLTR BNFT_PKG_PRCP FNCL_PROD_CF GL_CF_HRZNTL_HRCHY__ FNCL_FUNDG_CF LGCY_ATH_WLP_BU_TRNSLTN

FO_VST

CLM_LINE_FO_VST

LAB_RSLT_NOTE LAB_MBR_NM PENDD_CLM_LINE_COA FO_TOS_UNIT CLM_LINE_FO_TOS_UNIT CLM_LINE_HCS_MDFR LAB_RSLT

LOINC_CD LGCY_ATH_WLP_LOB_TRNSLTN

PROPBM TRANSLATION

CS90_MBR_PROD_ENRLMNT_COA

PRCP LAB_ABNRML GL_CF_VRTCL_HRCHY__ CLM_LINE_COA

COA_PROPBM_PAID_CLM

COA_WLP_LOB LAB_RSLT_MAX_RVSN MBR_PROD_ENRLMNT_LAB_RQST CLM_LINE PRFSNL_VST CLM_LINE_PRFSNL_VST RVNU_CD PENDD_CLM_LINE_DISP__ PENDD_CLM_LINE PENDD_CLM_DIAG CMPNY_CF BRND_LOGO_IMG_DCMNT COA_STAR LAB_RSLT_VAL

CRX_BU

FACETS & NASCO TRANSLATION

CRX_RGNL_DVSN

COA_FACETS

CRX_FUNDG_ARNGMNT MBR_PROD_ENRLMNT_PENDD_CLM CLM_LINE_RDCTN COA_FACETS_TRNSLTN WLPGL_PROD

MEMBERSHIP
PROD_OFRG PENDD_CLM_RVSN PENDD_CLM__1 PROD_OFRG_STTS PENDD_CLM_PROV PENDD_CLM PENDD_CLM_PROV__1 PRCHSR_ORG__ PRCHSR_ORG_RLTNSHP PRCHSR_ORG_ADRS PRCHSR_ORG_ADRS_HIST

PROD_OFRG__

REVENUE
PRCHSR_ORG_BILL_ENTY EARND_RVNU_COA

ACES & LEGACY ANTHEM TRANSLATION

CRX_SRVC_AREA WLPGL_FUNDG COA_ACES COA_NASCO_TRNSLTN__

NFNCL_PHRMCY_CLM_MAX_RVSN__

NFNCL_PHRMCY_CLM_MAX_RVSN

CLM_LINE_EOB

CRX_BUS_DVSN WLPGL_BU

CLM_LINE_EOR

CRX_PROD_GRP WLPGL_MBU

NFNCL_PHRMCY_CLM_PROV__

NFNCL_PHRMCY_CLM

CLM_LINE_TOS

CRX_CVRG PRCHSR_ORG_CNTCT_HIST PENDD_FCLTY_CLM NFNCL_PHRMCY_CLM_PROV NFNCL_PHRMCY_CLM__ CLM_LINE_PTOS_UNIT PTOS_UNIT NAICS MBR_PROD_ENRLMNT_HIST NFNCL_PHRMCY_CLM_PROV__1 CLM_LINE_CDHP PRCHSR_ORG_RPTG MBR_PROD_ENRLMNT_NFNCL_CLM PRORT_CLM_LINE EARND_RVNU_PRCP_TYPE MBR_PROD_ENRLMNT_CLM MBR_PROD_ENRLMNT COA_VA_PAR_PPO_MBRSHP NFNCL_PHRMCY_CLM_LINE NFNCL_PHRMCY_CLM_LINE_COA COA_NASCO COA_QCARE EMPLYMNT EMPLYMNT_HIST BR COA_FEP__ COA_QFEP HLTH_PGM_BNFT_PKG ALT_MBR_PROD_ENRLMNT_ORG SIC_CD PRCHSR_ORG_ADMNSTRN MBR_PCP SRC_SYS_COA CLM_LINE_ADJSTMNT_CD Column Added PRCHSR_ORG_CNTCT PRCHSR_ORG PRCHSR_ORG_DMGRPHC PRCHSR_ORG_DMGRPHC_HIST EARND_RVNU

MBR_PROD_ENRLMNT__ COA_DIAMOND_950 RSTTD_MBRSHP_MNTH_CNT MBR__ MBR_CNSMR_LNK CNSMR MBR_PROD_ENRLMNT_COA_HIST COA_CRDW COA_PROSERV_WLP_LOB

NFNCL_PHRMCY_MEDCR_PART_D MDCD_MBR_PROD_ENRLMNT

MBR_PROD_ENRLMNT_COA RPTD_MBRSHP_MNTH_CNT CLNDR MBR_RPTG_RGN MBR_CNSMR_LNK_HIST MBR_CNSMR_LNK_SSPCT COA_VA_HMO_AMISYS

IDFCTN

IDFCTN__

MEDICAL MANAGEMENT
HLTH_PGM_ISSU HLTH_PGM_GOAL

UM_RQST_PROV

HLTH_CNDTN_TMLN

HLTH_CNDTN

MBR MBR_ETHNCTY

MBR_COB

MBR_COB__

MDCD_MBR_PROD_ENRLMNT_HIST HLTH_PGM UM_SRVC_PROV UM_SRVC_AFLTN UM_RQST HLTH_PGM_ENRLMNT_DCSN UM_INPAT_SRVC UM_RQST_HIST UM_SRVC_STTS UM_RQST_DIAG CM_UM_RQST_AFLTN HLTH_PGM_PARN UM_SRVC_STTS_HIST UM_SRVC MBR_MEDCR_CVRG SRC_SYS_MBR_XWALK

MBR_LANG MBR_CNTCT_HIST MBR_CNTCT

UM_SRVC_HIST

UM_INPAT_SRVC_HIST SRC_SYS_GRP_XWALK

MBR_ADRS

MBR_ADRS_HIST MBR_ADRS__1 MBR_ADRS_HIST__1

HLTH_PGM_INTRVNTN

MBR_HIST

MBR_HIST__

UM_RQST_DIAG__ HLTH_PGM_ASSMNT_CRTRIA

UM_INPAT_SRVC_STTS MDCL_RVW HLTH_PGM_DIAG MDCL_RVW_HLTH_ADVSR UM_RQST_HLTH_ADVSR UM_INPAT_SRVC_STTS_HIST

ENTITY LEGEND

RELATIONSHIP LEGEND
Relationships between Tables in the Same Subject Area will be BLACK

HLTH_PGM_PARN_HIST

WebMD
WEBMD_MBR_DMGRPHCS__V WEBMD_HA__V UM_SRVC_HLTH_ADVSR UM_INPAT_SRVC_HLTH_ADVSR MBR_WEBMD_HA MBR_PROD_ENRLMNT_WEBMD_HA UM_INPAT_STTS_HLTH_ADVSR MBR_WEBMD_HA__

WEBMD_WEB_ACTVTY_DMGRPHCS__V WEBMD_WEB_ACTVTY_TRKRS__V

Enterprise Data Warehouse (EDW) Integrated Subject Area Model June 5, 2010
2009 WellPoint as an Unpublished Document. All Rights Reserved. This model contains Proprietary and Confidential Information. DO NOT DISTRIBUTE WITHOUT PERMISSION.

GENERATE AND POPULATE FIRST PHASE Represents an Entity owned by this EDL R2 Subject Area, which will be generated as a database table for the first EDL R2 Release and will be populated with data. These Entities are checked as GENERATE in this subject area model's Table Properties. TBL_308 SHELF READY AND FUTURE POPULATION Represents an Entity owned by this EDL R2 Subject Area, which is shelf ready and will be populated in a future EDL R2 Release. These Entities are NOT checked as GENERATE in this subject area model's Table Properties.

TBL_309

PGM_HLTH_ADVSR

HLTH_ADVSR

Relationships between Tables in Different Subject Areas will be RED

WEBMD_WEB_ACTVTY_CNDTN_CTRS__V WEBMD_WEB_ACTVTY_UTILZN__V

NOT SHELF READY AND FUTURE POPULATION Represents Entities owned by this subject area, which will NOT be generated as database tables for the first EDL R2 Release. These Entities are NOT checked as GENERATE in this subject area model's Table Properties.

TBL_310

TBL_311

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