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effective price

eff_prc
operations·Updated Jun 23, 2026

Definition

ISO-11179 Definition

The negotiated or contracted cost amount applicable as of the coverage effective date, such as a fee schedule rate, drug price, or service charge. Used in claims adjudication, pharmacy benefit management, and provider contract pricing systems.

Standard Abbreviation

eff_prc

Category

operations

Why This Term Matters

Healthcare data terminology is foundational for any data engineer working in this industry. Precise understanding of standard terms enables accurate schema design, reduces downstream data quality issues, and ensures pipelines meet the regulatory and interoperability requirements imposed by HIPAA, HL7 FHIR, and CMS reporting frameworks. Without this foundation, even technically well-built pipelines produce data that fails validation when it reaches payers or regulators.

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