mammogram copay amount

mammo_cpay_amt

pharmacy

Updated 5/16/2026

Definition

The patient responsibility value for a breast imaging. Used to capture financial data associated with mammogram transactions. This field is commonly used in electronic health records (EHR), healthcare information systems (HIS), and clinical data warehouses for mammogram management and reporting.

Standard Abbreviation

mammo_cpay_amt

Database Usage

-- Example column naming
CREATE TABLE claims (
  clm_id VARCHAR(50),
  mammo_cpay_amt NUMBER(12,2),  -- mammogram copay amount (precision 12, scale 2)
  ...
);

-- Example in SELECT
SELECT
  clm_id,
  mammo_cpay_amt as mammogram_copay_amount
FROM claims;

Example database column name

ISO-11179 snake_case standard

-- Recommended column name
mammogram_copay_amount

-- Example DDL
CREATE TABLE healthcare_data (
  record_id   VARCHAR(50)   NOT NULL,
  mammogram_copay_amount NUMBER(12,2),  -- mammogram copay amount (precision 12, scale 2)
  created_dt  TIMESTAMP     NOT NULL DEFAULT NOW()
);

Column names follow the ISO-11179 naming convention: lowercase, underscore-separated, using the standard abbreviation as a prefix where applicable.

Why This Term Matters

Pharmacy data is among the most regulated and codified data in healthcare, governing controlled substances, PBM adjudication, and Medicare Part D reporting. A data engineer fluent in pharmacy terminology builds pipelines that correctly parse NDC codes, validate DEA numbers, and detect drug utilization anomalies before they reach compliance teams. Errors in pharmacy field definitions frequently trigger PBM contract disputes and CMS audit findings.

Common uses in healthcare data

PBM claims adjudication and drug utilization review
Controlled substance monitoring and DEA compliance
Pharmacy data warehouse and ETL pipeline design
Prior authorization and step therapy workflows
Medicare Part D reporting and CMS submissions
PBM feed normalization in Snowflake pharmacy claims fact tables
Epic Willow and Cerner Pharmacy integration data mapping and reconciliation
Databricks streaming pipeline for real-time drug utilization monitoring and alerting

Related Healthcare Standards

NCPDP SCRIPT

The ANSI-accredited standard for electronic prescribing and pharmacy transactions, defining data fields and message formats used by PBMs and pharmacies.

NDC (FDA)

The National Drug Code — the FDA's universal product identifier for drugs, used in all pharmacy claims, dispensing records, and formulary data.

DEA Controlled Substance Regulations (21 CFR)

Governs controlled substance prescribing, dispensing, and reporting requirements, including DEA number format and Schedule classification.

Data Quality Considerations

NDC codes arrive in multiple formats (5-4-2 segmented, 11-digit flat, with or without dashes) — normalize to 11-digit no-dash format at ingestion to prevent duplicate drug records in Snowflake or Databricks.
DEA number check-digit validation (using the standard DEA checksum algorithm) catches a significant share of data entry errors before they reach claim submission — implement this as a mandatory ETL quality gate.
Days supply values from PBM feeds frequently contain outliers (e.g., 999 for unlimited supply) — cap at clinically valid maximums per drug class and flag for pharmacy analytics review downstream.

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