Back to search

provider attribution

prvdr_attr
provider·Updated Jun 23, 2026

Definition

ISO-11179 Definition

The assignment of health plan members to a specific primary care provider or provider group for quality measurement, value-based payment calculation, care management coordination, and population health management purposes. Provider attribution methodologies vary by program and payer — CMS uses plurality of primary care evaluation and management visits for Medicare Shared Savings Program attribution while commercial plans may use voluntary patient assignment, plurality visit algorithms, or hybrid approaches. Attribution drives which provider receives credit or accountability for member outcomes, quality measure performance, and total cost of care.

Healthcare data teams build attribution pipelines that process claims data to identify qualifying primary care visits, apply program-specific attribution logic and lookback periods, resolve conflicts when members qualify for attribution to multiple providers, and produce stable quarterly attribution files used in performance reporting and shared savings settlement calculations.

Standard Abbreviation

prvdr_attr

Category

provider

Production DDL — DIM_PROVIDER

DIM_PROVIDER.sql
CREATE OR REPLACE TABLE DIM_PROVIDER (
    prvdr_key           INTEGER        NOT NULL  -- surrogate key,
    prvdr_npi           VARCHAR(10)              -- NPI number,
    prvdr_tin           VARCHAR(10)              -- tax ID number,
    prvdr_first_nm      VARCHAR(100)             -- first name,
    prvdr_last_nm       VARCHAR(100)             -- last name,
    prvdr_org_nm        VARCHAR(255)             -- organization name,
    prvdr_typ_cd        VARCHAR(20)              -- provider type code,
    prvdr_spclty_cd     VARCHAR(10)              -- specialty code,
    prvdr_tax           VARCHAR(10)              -- taxonomy code,
    prvdr_state_cd      CHAR(2)                  -- state code,
    prvdr_zip_cd        VARCHAR(10)              -- zip code,
    prvdr_ntwk_sts      VARCHAR(10)              -- network status,
    prvdr_accpt_pt_ind  CHAR(1)                  -- accepting patients,
    prvdr_excl_ind      CHAR(1)                  -- exclusion indicator,
    load_dt             TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical provider table. Convert to BigQuery or Databricks →

Why This Term Matters

Provider data management is one of the most operationally complex data domains in healthcare because providers move, merge, and update their credentials continuously. A data engineer who understands provider terminology can build NPI validation, credentialing, and network adequacy pipelines that keep provider directories accurate and prevent claim rejections. Stale or incorrect provider data is a leading cause of prior authorization delays and CMS compliance findings.

Related Content

Looking for more healthcare terms?

Browse our complete library of 100,000+ standardized healthcare data terms

Browse All Terms