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provider panel status

prvdr_pnl_sts
provider·Updated Jun 12, 2026

Definition

ISO-11179 Definition

A coded value indicating the current status of a primary care provider patient panel with respect to accepting new patients, reflecting panel capacity relative to the provider practice size and patient load. Common panel status values include open indicating the provider is actively accepting new patients, closed indicating no new patients are being accepted, and restricted indicating limited acceptance such as existing patients of the practice only or specific plan members only. Panel status is a critical network adequacy data element because health plans must demonstrate that sufficient open-panel primary care providers exist within access standards for each member ZIP code.

Healthcare data teams maintain prvdr_pnl_sts with regular update timestamps in provider directory systems, monitor panel closure rates to identify developing network adequacy gaps, and report open panel availability to CMS in network adequacy filings.

Standard Abbreviation

prvdr_pnl_sts

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.

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