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Synthetic Data Guide

Mike Eng edited this page Jun 22, 2021 · 62 revisions

Note: this is in draft state - don't consult this for official use or publicize widely yet.

For development and testing purposes, the following claims data APIs:

provide a set of public synthetic beneficiary and claims data, captured in synthetic Patient, Coverage, and ExplanationOfBenefit (EOB) resources. This is a resource that you can use as you explore and develop against the APIs in the sandbox environments. The synthetic data contains no personally-identifiable information (PII) or personal health information (PHI).

Our synthetic data will persist unchanged so that you can rely on it for ongoing use. That is, you can write tests, demos, etc. against this data, and the underlying data should not change later and produce unexpected results.

Use Cases for Synthetic Data

This data is intended for use in development and testing activities, e.g. building out an application prior to getting production access and having a safe set of data to use for ongoing development activities. It's also a great resource when demoing your application, giving you a safe way to do that without exposing any beneficiary PII or PHI.

How to Access the Synthetic Data

The synthetic data will be available in each API's sandbox environment. Refer to specific API documentation for details.

Distinguishing Synthetic Data from Production Data

It's easy to distinguish the synthetic data from production data: all synthetic records have Patient.id and ExplanationOfBenefit.id values that are negative. All production records have positive values for those fields.

Please note that, while we are working to improve the coverage and quality of our synthetic data, there are absolutely still differences between it and our production data. In general, you should expect that:

  • Not all fields will be present in the synthetic data.
  • Some of the fields that are present may not have realistic values.
  • The various releases of synthetic data (see below) will have differences from each other.

Available Synthetic Beneficiaries

Title Beneficiary ID Ranges Characteristics
Sample A? -88888888888888 A single synthetic beneficiary with exactly one claim for each of the following EOB profiles:
  • Carrier
  • Durable Medical Equipment (DME)
  • Home Health Aide (HHA)
  • Hospice
  • Inpatient
  • Outpatient
  • Skilled Nursing Facility
  • Part D Events (PDE)
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Release History

Time Description Details
Coming soon in 2021 10,000 Enhanced synthetic beneficiaries Adding 10,000 more synthetic beneficiaries to the sandbox environment (not production yet) with more realistic and robust data in response to user requests. For example, this set will contain:
  • More recent dates
  • More realistic values for NPIs and ZIP Codes (e.g. not all "99999", though NPIs will not tie to real organizations or providers)
  • More realistic patient information (e.g. dates of birth that are in line with most Medicare beneficiaries)
  • More realistic clinical scenarios (e.g. prescriptions and procedures that make sense with given diagnoses)
  • All of the same Explanation of Benefits (EOB) profiles that production data can include, which are:
    • Carrier
    • Durable Medical Equipment (DME)
    • Home Health Aide (HHA)
    • Hospice
    • Inpatient
    • Outpatient
    • Skilled Nursing Facility (SNF)
    • Part D Events (PDE)
Early 2021 Additional Synthetic Beneficiary A single synthetic beneficiary was added with exactly one claim for each of the following EOB profiles:
  • Carrier
  • Durable Medical Equipment (DME)
  • Home Health Aide (HHA)
  • Hospice
  • Inpatient
  • Outpatient
  • Skilled Nursing Facility
  • Part D Events (PDE)
Early 2021 Added outpatient claims Enhanced the initial set of beneficiaries to include outpatient claims, bringing the full list of EOB profiles to:
  • Carrier
  • Inpatient
  • Outpatient
  • Part D Events (PDE)
2017 Initial 30,000 Synthetic Beneficiaries 30,000 synthetic beneficiaries and about 1,000,000 synthetic claims that covered the following Explanation of Benefits (EOB) profiles:
  • Carrier
  • Inpatient
  • Part D Events (PDE)

For further questions on this synthetic data, please see the FAQ.

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