Sample Data.xlsx

This file is a sample dataset in spreadsheet format containing historical medical claims data. The dataset includes two claim records from WVU Hospitals for a patient treated on January 10, 2020, under payor plan VB230081 with FCI McDowell in Welch, West Virginia. The records contain comprehensive claim information including patient demographics (with redacted personally identifiable information), clinical details with multiple diagnostic codes (D57.1, H36, H43.11, H53.002, Z87.891), procedure codes (G0463 for hospital outpatient clinic visit assessment and 92250 for fundus photography), and billing information with facility NPI 1841271459 and TIN 550643304. The claim line items reference revenue codes 510 and 920, place of service code 73 and 532 respectively, with service units and charge amounts documented.

The dataset structure includes standard healthcare claims data fields such as claim type, claim ID, patient identifiers, insurance authorization information, admit and discharge details, provider NPIs and TINs, and procedural descriptions with HCPCS modifiers. This sample data appears designed to demonstrate the format and content requirements for the Department of Justice Bureau of Prisons solicitation 15BCMS26Q70000005 for Historical Medical Claims Data Analysis, serving as a template or example of the claims data that contractors would be expected to process or analyze under that federal contract opportunity.