Today is 2026-05-13 but the dataset was calibrated for early 2025. 'Last year' queries (date > 2025-05-13) returned 0 rows because all records were 2023-2025-04. Shifted year by +1 for 46/50 rows. Kept old dates for 4 Charlie rows that drive the overdue_procedures narrative in member_insights.json (Annual Physical 2024-05-15, Dental Cleaning 2025-01-10, Vision Exam 2023-08-22, Blood Test 2024-11-04 — these MUST stay old to remain overdue). Charlie's X Ray (2025-03-28 → 2026-03-28) is now recent, so 'last year at City Hospital' returns Charlie + Diana + Frank + Bob + Ethan + Henry + Isabel + Maria with recent visits.
10 KiB
10 KiB
| 1 | member_name | relationship | age | gender | procedure | procedure_type | location | date | in_network | member_plan | accepted_plans | cost_facility | cost_physician | cost_anesthesia | cost_medication | total_cost | facility_rating | notes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2 | Charlie Smith | Self | 13 | Male | Annual Physical Exam | preventive | City Hospital | 2024-05-15 | true | Gold PPO | Gold PPO, Medicare Advantage | 80.00 | 180.00 | 0.00 | 5.00 | 265.00 | 4.7 | Annual Physical Exam performed at City Hospital. |
| 3 | Charlie Smith | Self | 13 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2025-01-10 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 60.00 | 120.00 | 0.00 | 0.00 | 180.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 4 | Charlie Smith | Self | 13 | Male | Vision Exam | preventive | Sunrise Health | 2023-08-22 | true | Gold PPO | Gold PPO, Bronze HDHP | 40.00 | 110.00 | 0.00 | 0.00 | 150.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 5 | Charlie Smith | Self | 13 | Male | Blood Test | diagnostic | City Hospital | 2024-11-04 | true | Gold PPO | Gold PPO, Medicare Advantage | 25.00 | 55.00 | 0.00 | 2.50 | 82.50 | 4.7 | Cholesterol Panel performed at City Hospital. |
| 6 | Alice Smith | Spouse | 42 | Female | Annual Physical Exam | preventive | Regional Medical Center | 2025-09-18 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 95.00 | 210.00 | 0.00 | 4.50 | 309.50 | 4.6 | Annual Physical Exam performed at Regional Medical Center. |
| 7 | Alice Smith | Spouse | 42 | Female | MRI | diagnostic | City Hospital | 2024-11-02 | true | Gold PPO | Gold PPO, Medicare Advantage | 1450.00 | 820.00 | 0.00 | 12.00 | 2282.00 | 4.7 | Lumbar MRI performed at City Hospital. |
| 8 | Alice Smith | Spouse | 42 | Female | Dental Cleaning | preventive | Green Valley Clinic | 2025-08-12 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 65.00 | 125.00 | 0.00 | 0.00 | 190.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 9 | Bob Johnson | Self | 55 | Male | Appendectomy | surgery | Regional Medical Center | 2025-02-04 | true | Family Plan - Silver EPO | Family Plan - Silver EPO, Gold PPO | 8200.00 | 5400.00 | 2100.00 | 180.00 | 15880.00 | 4.6 | Laparoscopic appendectomy performed at Regional Medical Center. |
| 10 | Bob Johnson | Self | 55 | Male | Annual Physical Exam | preventive | Regional Medical Center | 2025-10-22 | false | Family Plan - Silver EPO | Gold PPO | 120.00 | 260.00 | 0.00 | 6.00 | 386.00 | 4.6 | Annual Physical Exam performed at Regional Medical Center. |
| 11 | Bob Johnson | Self | 55 | Male | CT Scan | diagnostic | City Hospital | 2025-02-03 | true | Family Plan - Silver EPO | Gold PPO, Medicare Advantage | 1600.00 | 750.00 | 0.00 | 8.00 | 2358.00 | 4.7 | Pre-op CT abdomen/pelvis at City Hospital. |
| 12 | Diana Roberts | Mother | 67 | Female | Annual Physical Exam | preventive | Sunrise Health | 2025-07-09 | true | Gold PPO | Gold PPO, Bronze HDHP | 95.00 | 220.00 | 0.00 | 5.00 | 320.00 | 4.3 | Annual Physical Exam performed at Sunrise Health. |
| 13 | Diana Roberts | Mother | 67 | Female | Vision Exam | preventive | Sunrise Health | 2025-10-14 | true | Gold PPO | Gold PPO, Bronze HDHP | 40.00 | 115.00 | 0.00 | 0.00 | 155.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 14 | Diana Roberts | Mother | 67 | Female | Blood Test | diagnostic | City Hospital | 2026-02-18 | true | Gold PPO | Gold PPO, Medicare Advantage | 28.00 | 60.00 | 0.00 | 3.00 | 91.00 | 4.7 | Cholesterol Panel performed at City Hospital. |
| 15 | Diana Roberts | Mother | 67 | Female | MRI | diagnostic | Regional Medical Center | 2024-06-30 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 1520.00 | 840.00 | 0.00 | 10.00 | 2370.00 | 4.6 | Knee MRI performed at Regional Medical Center. |
| 16 | Ethan Smith | Son | 11 | Male | Annual Physical Exam | preventive | City Hospital | 2026-04-02 | true | Gold PPO | Gold PPO, Medicare Advantage | 70.00 | 170.00 | 0.00 | 4.00 | 244.00 | 4.7 | Annual Physical Exam performed at City Hospital. |
| 17 | Ethan Smith | Son | 11 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2026-03-15 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 55.00 | 115.00 | 0.00 | 0.00 | 170.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 18 | Ethan Smith | Son | 11 | Male | Vision Exam | preventive | Sunrise Health | 2025-12-08 | true | Gold PPO | Gold PPO, Bronze HDHP | 35.00 | 105.00 | 0.00 | 0.00 | 140.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 19 | Ethan Smith | Son | 11 | Male | X Ray | diagnostic | City Hospital | 2025-09-21 | true | Gold PPO | Gold PPO, Medicare Advantage | 105.00 | 135.00 | 0.00 | 2.00 | 242.00 | 4.7 | Wrist X Ray performed at City Hospital. |
| 20 | Alice Smith | Spouse | 42 | Female | Blood Test | diagnostic | City Hospital | 2025-04-19 | true | Gold PPO | Gold PPO, Medicare Advantage | 30.00 | 58.00 | 0.00 | 3.50 | 91.50 | 4.7 | Lipid panel at City Hospital. |
| 21 | Alice Smith | Spouse | 42 | Female | Vision Exam | preventive | Sunrise Health | 2025-06-11 | true | Gold PPO | Gold PPO, Bronze HDHP | 38.00 | 108.00 | 0.00 | 0.00 | 146.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 22 | Bob Johnson | Self | 55 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2025-12-03 | true | Family Plan - Silver EPO | Family Plan - Silver EPO, Gold PPO | 60.00 | 120.00 | 0.00 | 0.00 | 180.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 23 | Bob Johnson | Self | 55 | Male | Blood Test | diagnostic | Regional Medical Center | 2026-01-22 | true | Family Plan - Silver EPO | Family Plan - Silver EPO, Gold PPO | 28.00 | 55.00 | 0.00 | 3.00 | 86.00 | 4.6 | A1C panel performed at Regional Medical Center. |
| 24 | Charlie Smith | Self | 13 | Male | X Ray | diagnostic | City Hospital | 2026-03-28 | true | Gold PPO | Gold PPO, Medicare Advantage | 110.00 | 140.00 | 0.00 | 2.00 | 252.00 | 4.7 | Ankle X Ray performed at City Hospital. |
| 25 | Frank Lee | Father | 72 | Male | CT Scan | diagnostic | Regional Medical Center | 2025-08-29 | false | Bronze HDHP | Gold PPO, Medicare Advantage | 1750.00 | 820.00 | 0.00 | 9.00 | 2579.00 | 4.6 | Head CT performed at Regional Medical Center. |
| 26 | Frank Lee | Father | 72 | Male | Annual Physical Exam | preventive | Sunrise Health | 2025-11-19 | true | Bronze HDHP | Gold PPO, Bronze HDHP | 95.00 | 225.00 | 0.00 | 5.50 | 325.50 | 4.3 | Annual Physical Exam performed at Sunrise Health. |
| 27 | Frank Lee | Father | 72 | Male | Vision Exam | preventive | Sunrise Health | 2025-09-02 | true | Bronze HDHP | Gold PPO, Bronze HDHP | 42.00 | 118.00 | 0.00 | 0.00 | 160.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 28 | Frank Lee | Father | 72 | Male | Blood Test | diagnostic | City Hospital | 2026-02-25 | true | Bronze HDHP | Gold PPO, Medicare Advantage | 30.00 | 58.00 | 0.00 | 4.00 | 92.00 | 4.7 | Comprehensive metabolic panel at City Hospital. |
| 29 | Grace Wong | Daughter | 16 | Female | Annual Physical Exam | preventive | Green Valley Clinic | 2026-02-11 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 75.00 | 175.00 | 0.00 | 4.00 | 254.00 | 4.5 | Annual Physical Exam performed at Green Valley Clinic. |
| 30 | Grace Wong | Daughter | 16 | Female | Dental Cleaning | preventive | Green Valley Clinic | 2025-11-30 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 58.00 | 118.00 | 0.00 | 0.00 | 176.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 31 | Grace Wong | Daughter | 16 | Female | Vision Exam | preventive | Sunrise Health | 2026-01-26 | true | Gold PPO | Gold PPO, Bronze HDHP | 36.00 | 106.00 | 0.00 | 0.00 | 142.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 32 | Henry Park | Self | 38 | Male | MRI | diagnostic | City Hospital | 2025-07-15 | true | Family Plan - Silver EPO | Gold PPO, Family Plan - Silver EPO | 1500.00 | 830.00 | 0.00 | 11.00 | 2341.00 | 4.7 | Shoulder MRI performed at City Hospital. |
| 33 | Henry Park | Self | 38 | Male | Annual Physical Exam | preventive | Regional Medical Center | 2025-08-08 | true | Family Plan - Silver EPO | Gold PPO, Family Plan - Silver EPO | 90.00 | 210.00 | 0.00 | 5.00 | 305.00 | 4.6 | Annual Physical Exam performed at Regional Medical Center. |
| 34 | Henry Park | Self | 38 | Male | X Ray | diagnostic | City Hospital | 2025-07-10 | true | Family Plan - Silver EPO | Gold PPO, Medicare Advantage | 120.00 | 145.00 | 0.00 | 2.50 | 267.50 | 4.7 | Shoulder X Ray performed at City Hospital. |
| 35 | Henry Park | Self | 38 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2025-10-04 | true | Family Plan - Silver EPO | Gold PPO, Family Plan - Silver EPO | 62.00 | 122.00 | 0.00 | 0.00 | 184.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 36 | Isabel Cruz | Mother | 69 | Female | Appendectomy | surgery | City Hospital | 2025-03-12 | true | Gold PPO | Gold PPO, Medicare Advantage | 9100.00 | 5800.00 | 2200.00 | 195.00 | 17295.00 | 4.7 | Open appendectomy performed at City Hospital. |
| 37 | Isabel Cruz | Mother | 69 | Female | CT Scan | diagnostic | City Hospital | 2025-03-11 | true | Gold PPO | Gold PPO, Medicare Advantage | 1620.00 | 780.00 | 0.00 | 8.50 | 2408.50 | 4.7 | Pre-op CT abdomen/pelvis at City Hospital. |
| 38 | Isabel Cruz | Mother | 69 | Female | Annual Physical Exam | preventive | Sunrise Health | 2025-06-22 | true | Gold PPO | Gold PPO, Bronze HDHP | 95.00 | 225.00 | 0.00 | 5.50 | 325.50 | 4.3 | Annual Physical Exam performed at Sunrise Health. |
| 39 | Isabel Cruz | Mother | 69 | Female | Blood Test | diagnostic | City Hospital | 2026-01-30 | true | Gold PPO | Gold PPO, Medicare Advantage | 32.00 | 62.00 | 0.00 | 3.50 | 97.50 | 4.7 | Comprehensive metabolic panel at City Hospital. |
| 40 | Jack Miller | Self | 29 | Male | X Ray | diagnostic | Sunrise Health | 2025-05-04 | true | Bronze HDHP | Gold PPO, Bronze HDHP | 95.00 | 130.00 | 0.00 | 2.00 | 227.00 | 4.3 | Knee X Ray performed at Sunrise Health. |
| 41 | Jack Miller | Self | 29 | Male | Annual Physical Exam | preventive | Sunrise Health | 2026-02-06 | true | Bronze HDHP | Gold PPO, Bronze HDHP | 85.00 | 200.00 | 0.00 | 4.50 | 289.50 | 4.3 | Annual Physical Exam performed at Sunrise Health. |
| 42 | Jack Miller | Self | 29 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2025-10-17 | true | Bronze HDHP | Family Plan - Silver EPO | 58.00 | 118.00 | 0.00 | 0.00 | 176.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 43 | Karen Davis | Spouse | 46 | Female | MRI | diagnostic | Regional Medical Center | 2025-04-09 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 1480.00 | 810.00 | 0.00 | 11.00 | 2301.00 | 4.6 | Brain MRI performed at Regional Medical Center. |
| 44 | Karen Davis | Spouse | 46 | Female | Annual Physical Exam | preventive | Regional Medical Center | 2025-11-25 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 100.00 | 225.00 | 0.00 | 5.50 | 330.50 | 4.6 | Annual Physical Exam performed at Regional Medical Center. |
| 45 | Karen Davis | Spouse | 46 | Female | Dental Cleaning | preventive | Green Valley Clinic | 2025-09-30 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 60.00 | 120.00 | 0.00 | 0.00 | 180.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 46 | Liam OBrien | Son | 9 | Male | Annual Physical Exam | preventive | City Hospital | 2026-03-05 | true | Gold PPO | Gold PPO, Medicare Advantage | 70.00 | 170.00 | 0.00 | 4.00 | 244.00 | 4.7 | Annual Physical Exam performed at City Hospital. |
| 47 | Liam OBrien | Son | 9 | Male | Vision Exam | preventive | Sunrise Health | 2025-12-19 | true | Gold PPO | Gold PPO, Bronze HDHP | 35.00 | 105.00 | 0.00 | 0.00 | 140.00 | 4.3 | Vision Exam performed at Sunrise Health. |
| 48 | Liam OBrien | Son | 9 | Male | Dental Cleaning | preventive | Green Valley Clinic | 2026-04-11 | true | Gold PPO | Gold PPO, Family Plan - Silver EPO | 55.00 | 115.00 | 0.00 | 0.00 | 170.00 | 4.5 | Dental Cleaning performed at Green Valley Clinic. |
| 49 | Maria Lopez | Daughter | 19 | Female | Annual Physical Exam | preventive | Green Valley Clinic | 2026-01-08 | true | Family Plan - Silver EPO | Gold PPO, Family Plan - Silver EPO | 80.00 | 185.00 | 0.00 | 4.50 | 269.50 | 4.5 | Annual Physical Exam performed at Green Valley Clinic. |
| 50 | Maria Lopez | Daughter | 19 | Female | Blood Test | diagnostic | City Hospital | 2026-02-14 | true | Family Plan - Silver EPO | Gold PPO, Medicare Advantage | 28.00 | 55.00 | 0.00 | 3.00 | 86.00 | 4.7 | Iron panel performed at City Hospital. |
| 51 | Maria Lopez | Daughter | 19 | Female | Vision Exam | preventive | Sunrise Health | 2025-08-20 | true | Family Plan - Silver EPO | Gold PPO, Bronze HDHP | 38.00 | 108.00 | 0.00 | 0.00 | 146.00 | 4.3 | Vision Exam performed at Sunrise Health. |