{"source_count": 105, "active_sources": 99, "stale_sources": 1, "critical_sources": 0, "sources": [{"source_id": "dmepos_fee_schedule", "display_name": "DMEPOS Fee Schedule (quarterly public use files, rural ZIP file, CBA ZIP files)", "source_type": "archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": null, "last_loaded_at": "2026-09-25T20:50:42.439362+00:00", "last_record_count": 1178, "primary_url": "https://www.cms.gov/medicare/payment/fee-schedules/dmepos/dmepos-fee-schedule", "notes": null, "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "0d old; within quarterly window"}, "warrants": ["W1"], "archive_file_count": 1178, "last_fetch_at": "2026-09-25T20:50:42.429805+00:00", "last_change_at": "2026-09-25T20:50:42.429805+00:00", "latest_publisher_version": "07/10/2025"}, {"source_id": "ncci_ptp", "display_name": "Medicare NCCI Procedure-to-Procedure (PTP) edits", "source_type": "archive", "license": "cms_ama_cpt_terms", "update_cadence": "quarterly", "accuracy_class": null, "last_loaded_at": "2026-09-25T20:45:01.163984+00:00", "last_record_count": 54, "primary_url": "https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-procedure-procedure-ptp-edits", "notes": null, "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "0d old; within quarterly window"}, "warrants": ["W2"], "archive_file_count": 54, "last_fetch_at": "2026-09-25T20:45:01.143818+00:00", "last_change_at": "2026-09-25T20:45:01.143818+00:00", "latest_publisher_version": "v323r0"}, {"source_id": "hcpcs_level2", "display_name": "HCPCS Level II quarterly code files (alpha-numeric HCPCS file)", "source_type": "archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": null, "last_loaded_at": "2026-09-25T20:43:25.707277+00:00", "last_record_count": 121, "primary_url": "https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/quarterly-update", "notes": null, "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "0d old; within quarterly window"}, "warrants": ["W1", "W2", "W3"], "archive_file_count": 121, "last_fetch_at": "2026-09-25T20:43:25.703093+00:00", "last_change_at": "2026-09-25T20:43:25.703093+00:00", "latest_publisher_version": "2026-09-23"}, {"source_id": "ncci_mue", "display_name": "Medicare NCCI Medically Unlikely Edits (MUE), including the DME supplier table", "source_type": "archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": null, "last_loaded_at": "2026-09-25T20:42:14.295162+00:00", "last_record_count": 258, "primary_url": "https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-medically-unlikely-edits-mues", "notes": null, "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "0d old; within quarterly window"}, "warrants": ["W2"], "archive_file_count": 258, "last_fetch_at": "2026-09-25T20:42:14.286108+00:00", "last_change_at": "2026-09-25T20:42:14.286108+00:00", "latest_publisher_version": null}, {"source_id": "oig_exclusions", "display_name": "HHS OIG List of Excluded Individuals/Entities (LEIE)", "source_type": "hhs_oig_leie", "license": "public_domain", "update_cadence": "weekly", "accuracy_class": "authoritative_for_federal_exclusions", "last_loaded_at": "2026-09-25T20:00:27.112426+00:00", "last_record_count": 83842, "primary_url": "https://oig.hhs.gov/exclusions/", "notes": "Providers excluded from participation in federal health programs. Source for license_disciplinary_actions joins.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "0d old; within weekly window"}, "warrants": ["W0"], "archive_file_count": 41, "last_fetch_at": "2026-09-25T20:00:27.103864+00:00", "last_change_at": "2026-09-25T20:00:27.103864+00:00", "latest_publisher_version": "2026-09-10"}, {"source_id": "ct_dph", "display_name": "Connecticut eLicense State Licenses and Credentials", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "daily", "accuracy_class": "authoritative_for_ct_license_status", "last_loaded_at": "2026-09-25T12:03:48.147796+00:00", "last_record_count": 793630, "primary_url": "https://data.ct.gov/Business/State-Licenses-and-Credentials/ngch-56tr", "notes": "Official CT eLicense export on data.ct.gov (dataset ngch-56tr), refreshed daily. Covers every state licensing agency; the loader filters to DPH health professions (numeric credential-type codes: physicians, PAs, APRNs, RNs/LPNs, dentists, podiatrists, optometrists, psychologists, counselors, and more) plus DCP pharmacy credentials (PCT/PTN/PCI) and MSW, individuals only. Statuses derive from the (status, statusreason) pair; disciplinary reasons (revoked/suspended/surrendered/probation) override the base status. Includes licensee mailing address. No NPI; backfilled from NPPES via digit + last-name match. Disciplinary detail beyond status lives in the DPH eLicense lookup documents (future scraper).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "daily", "stale_threshold_days": 2, "critical_threshold_days": 8, "detail": "0d old; within daily window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "wa_doh", "display_name": "Washington DOH Health Care Provider Credential Data", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "daily", "accuracy_class": "authoritative_for_wa_license_status", "last_loaded_at": "2026-09-25T11:42:38.751385+00:00", "last_record_count": 2455566, "primary_url": "https://data.wa.gov/Health/Health-Care-Provider-Credential-Data/qxh8-f4bd", "notes": "Official WA DOH credential file on the state Socrata portal (dataset qxh8-f4bd). All DOH-regulated professions: physicians, osteopathic physicians, PAs, ARNPs, RNs/LPNs, dentists, pharmacists, and ~200 more credential types. Updated daily at 10:00 a.m. Pacific; DOH calls it a primary source for verification. Contains an ActionTaken yes/no disciplinary flag only \u2014 disciplinary detail lives in the Provider Credential Search document system (future scraper). No addresses, no NPI; NPI backfilled from NPPES taxonomy_license via prefix+digits normalization.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 0, "cadence": "daily", "stale_threshold_days": 2, "critical_threshold_days": 8, "detail": "0d old; within daily window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "co_dora", "display_name": "Colorado DORA Professional and Occupational Licenses", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "daily", "accuracy_class": "authoritative_for_co_license_status", "last_loaded_at": "2026-09-24T13:28:17.780973+00:00", "last_record_count": 1551569, "primary_url": "https://data.colorado.gov/Regulations/Professional-and-Occupational-Licenses-in-Colorado/7s5z-vewr", "notes": "Official DORA license export on data.colorado.gov (dataset 7s5z-vewr), refreshed daily. All DORA professions; the loader keeps individuals and normalizes clinical types (DR/ME physicians with MD-vs-DO from the degrees field, PA, APN incl. CNM subcategory, RN/PN, DEN, PHA, PSY and behavioral, OT/PT/SLP, CHR, OPT, POD). File repeats a license row per disciplinary action; programaction/casenumber/discipline dates load into license_disciplinary_actions for NPI-matched licensees (full-refresh per run). No NPI; backfilled from NPPES via digit + last-name match.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 1, "cadence": "daily", "stale_threshold_days": 2, "critical_threshold_days": 8, "detail": "1d old; within daily window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_dailymed", "display_name": "DailyMed drug labels (official SPL record)", "source_type": "nih_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T09:33:59.165090+00:00", "last_record_count": 52571, "primary_url": "https://dailymed.nlm.nih.gov/dailymed/spl-resources-all-drug-labels.cfm", "notes": "Human prescription labels from DailyMed, the official Structured Product Labeling record (not openFDA's copy): set_id, version, effective date, title, labeler, and the boxed warning, indications, dosage and administration, and contraindications sections by LOINC code, with the official SPL-to-RxNorm and pharmacologic class mapping files. Every label URL is pinned to the stored version.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "4d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_drugsfda", "display_name": "Drugs@FDA (FDA approved drug applications, products, submissions)", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T09:10:43.266134+00:00", "last_record_count": 29336, "primary_url": "https://www.fda.gov/drugs/drug-approvals-and-databases/drugsfda-data-files", "notes": "FDA-approved drug applications (NDA, ANDA, BLA) with their products, submission history, marketing status, and therapeutic equivalence codes, from the FDA's own Drugs@FDA data files (not openFDA's copy). First approval date is the earliest approved submission.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "4d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_drug_recalls", "display_name": "openFDA drug recalls (FDA enforcement reports)", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "weekly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T08:58:11.533273+00:00", "last_record_count": 17964, "primary_url": "https://open.fda.gov/apis/drug/enforcement/", "notes": "FDA recall enforcement reports for drugs: classification, status, recalling firm, reason, dates, and distribution pattern. NDCs are extracted from the openFDA block, the product description, and the code info, then matched against the current NDC directory; the match is fuzzy because product descriptions are free text and older recalls cite discontinued NDCs.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "4d old; within weekly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_fda_establishments", "display_name": "FDA Drug Establishments Current Registration Site (DECRS)", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T08:53:22.093747+00:00", "last_record_count": 9878, "primary_url": "https://www.fda.gov/drugs/drug-approvals-and-databases/drug-establishments-current-registration-site-decrs", "notes": "Registered drug establishments worldwide with FEI, DUNS, address, country, and operations. The public file does not link plants to NDCs; linkage is by labeler and registrant name.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "4d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_costplus", "display_name": "Mark Cuban Cost Plus Drug Company public price list", "source_type": "web_public_catalog", "license": "public_web_content", "update_cadence": "weekly", "accuracy_class": "observed", "last_loaded_at": "2026-09-21T08:22:37.053499+00:00", "last_record_count": 2398, "primary_url": "https://www.costplusdrugs.com/medications/", "notes": "Products discovered from the public sitemap (robots.txt allows /medications/*). Prices captured as change-only dated snapshots with the page URL and a content hash. Not affiliated with Cost Plus Drugs.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "4d old; within weekly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_fda_shortages", "display_name": "FDA Drug Shortages (openFDA)", "source_type": "openfda_api", "license": "public_domain", "update_cadence": "weekly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T08:19:51.824794+00:00", "last_record_count": 1601, "primary_url": "https://open.fda.gov/apis/drug/drugshortages/", "notes": "Current and resolved shortages with reason, company, and package NDC.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "4d old; within weekly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_nadac", "display_name": "CMS National Average Drug Acquisition Cost (NADAC)", "source_type": "medicaid_gov_bulk", "license": "public_domain", "update_cadence": "weekly", "accuracy_class": "survey", "last_loaded_at": "2026-09-21T08:19:48.826094+00:00", "last_record_count": 3517936, "primary_url": "https://data.medicaid.gov/dataset/dfa2ab14-06c2-457a-9e36-5cb6d80f8d93", "notes": "Weekly retail pharmacy acquisition cost survey. Stored as change-only history per NDC and effective date, 2013 to present.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "4d old; within weekly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "asc", "display_name": "CMS Ambulatory Surgical Center Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "weekly", "accuracy_class": "authoritative_for_asc_quality", "last_loaded_at": "2026-09-21T08:14:45.556579+00:00", "last_record_count": 6541, "primary_url": "https://data.cms.gov/provider-data/topics/ambulatory-surgical-centers", "notes": "Quality measures, patient experience. ~24K facilities.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "weekly", "stale_threshold_days": 10, "critical_threshold_days": 21, "detail": "4d old; within weekly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "clinicians", "display_name": "CMS Doctors and Clinicians (MIPS)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_clinician_mips", "last_loaded_at": "2026-09-21T08:14:38.346386+00:00", "last_record_count": 1082166, "primary_url": "https://data.cms.gov/provider-data/topics/doctors-clinicians", "notes": "MIPS scores, measures across 70 quarters. 1M+ clinicians.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 4, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "4d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_asp_pricing", "display_name": "CMS Medicare Part B ASP payment limits and NDC-HCPCS crosswalk", "source_type": "cms_bulk", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-21T07:48:58.138748+00:00", "last_record_count": 157010, "primary_url": "https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files", "notes": "Quarterly payment limits per HCPCS billing unit for clinician-administered drugs, and the NDC to HCPCS crosswalk with billing units per package. History kept per quarter; preliminary files are flagged and replaced by the final file.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 5, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "5d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_fmp_company_financials", "display_name": "SEC EDGAR company financials for PBM parents and generic manufacturers (via FMP)", "source_type": "sec_edgar_via_fmp", "license": "commercial_feed_of_public_filings", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T23:24:16.146335+00:00", "last_record_count": 496, "primary_url": "https://www.sec.gov/edgar", "notes": "Segment revenue and income statements for CVS, Cigna, UnitedHealth, Humana, and generic manufacturers. Figures are as filed with the SEC; the feed is a parsing convenience. Published surfaces cite EDGAR.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "14d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_purple_book", "display_name": "FDA Purple Book (licensed biologics, biosimilars, interchangeables)", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T23:23:50.722651+00:00", "last_record_count": 2242, "primary_url": "https://purplebooksearch.fda.gov/downloads", "notes": "Monthly full database: 351(a) reference products and 351(k) biosimilars with reference product, licensure, and exclusivity dates.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "14d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_orange_book", "display_name": "FDA Orange Book (approved drug products, patents, exclusivity)", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T23:23:38.823901+00:00", "last_record_count": 48664, "primary_url": "https://www.fda.gov/drugs/drug-approvals-and-databases/orange-book-data-files", "notes": "NDA and ANDA products with therapeutic equivalence codes, listed patents with expiry, and exclusivity periods. Feeds rx.v_generic_launch_radar.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "14d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "cdc_svi", "display_name": "CDC/ATSDR Social Vulnerability Index 2022", "source_type": "cdc_bulk", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T23:22:48.387195+00:00", "last_record_count": 84120, "primary_url": "https://www.atsdr.cdc.gov/place-health/php/svi/svi-data-documentation-download.html", "notes": "County and census-tract vulnerability percentile ranks across four themes, with uninsured, poverty, and no-vehicle rates. Released every two years; checked quarterly.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "14d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "dol_5500", "display_name": "DOL Form 5500 (ERISA retirement plan filings)", "source_type": "dol_efast2", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_w2_employee_count_and_plan_assets", "last_loaded_at": "2026-09-11T22:56:07.831041+00:00", "last_record_count": 1193974, "primary_url": "https://www.efast.dol.gov/", "notes": "EFAST2 bulk annual download. Filtered to healthcare NAICS codes 621xxx/622xxx/623xxx. active_participants_total summed across an EIN's plans = floor on W-2 employee count. Anchor for accuracy benchmarking.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "14d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_meps", "display_name": "AHRQ MEPS-HC Prescribed Medicines (with Full-Year Consolidated)", "source_type": "ahrq_puf", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "survey", "last_loaded_at": "2026-09-11T21:56:57.514376+00:00", "last_record_count": 1825370, "primary_url": "https://meps.ahrq.gov/mepsweb/data_stats/download_data_files.jsp", "notes": "Fill-level prescription events with 11-digit NDC, quantity, payer splits, and person weights, 2018 to the latest release. Joined to the consolidated file for age and insurance coverage; person_segment separates the privately insured under 65 (the employer population) from Medicare-age, public-only, and uninsured.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "14d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_costplus_history", "display_name": "Cost Plus Drugs catalog history (Internet Archive Wayback Machine)", "source_type": "web_archive", "license": "public_web_content", "update_cadence": "monthly", "accuracy_class": "observed", "last_loaded_at": "2026-09-11T21:34:59.848953+00:00", "last_record_count": 42, "primary_url": "https://web.archive.org/web/*/costplusdrugs.com/sitemap.xml", "notes": "Monthly presence of each medication slug in archived sitemaps since January 2022, plus first and last archived capture of each medication page. Yields the month a drug entered the Cost Plus catalog. Months without a usable capture are gaps, not removals.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "14d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_cms_spending", "display_name": "CMS Medicare Part D, Part B, and Medicaid Spending by Drug", "source_type": "cms_data_api", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T21:12:51.532732+00:00", "last_record_count": 288571, "primary_url": "https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug", "notes": "Annual spending, units, claims, and beneficiaries by brand, generic, and manufacturer, unpivoted to one row per year. Includes the quarterly Part D file and Part D by geography and drug.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "14d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_rxnorm", "display_name": "NLM RxNorm (current prescribable content)", "source_type": "nlm_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T20:52:56.244784+00:00", "last_record_count": 428255, "primary_url": "https://www.nlm.nih.gov/research/umls/rxnorm/docs/rxnormfiles.html", "notes": "Prescribable subset only; no UMLS license required. NDC-to-RXCUI links and ingredient relationships.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "14d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_ndc_directory", "display_name": "FDA National Drug Code Directory", "source_type": "fda_bulk", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative", "last_loaded_at": "2026-09-11T17:08:40.028368+00:00", "last_record_count": 217900, "primary_url": "https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory", "notes": "Product and package listings for all listed drugs. Package NDCs normalized to 11-digit 5-4-2.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 14, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "14d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "dac_providers", "display_name": "CMS DAC National Downloadable File", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_practice_location", "last_loaded_at": "2026-09-01T09:35:02.553425+00:00", "last_record_count": 2012610, "primary_url": "https://data.cms.gov/provider-data/dataset/mj5m-pzi6", "notes": "Practice location, specialty, group size, hospital affiliations for Medicare-enrolled clinicians.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "wy_medicaid_exclusions", "display_name": "Wyoming Medicaid Provider Exclusion List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_wy_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:17:09.192794+00:00", "last_record_count": 116, "primary_url": "https://health.wyo.gov/healthcarefin/medicaid/", "notes": "Dated PDF discovered from the landing page. No NPI published; state Medicaid provider number only.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "wv_medicaid_exclusions", "display_name": "West Virginia Medicaid Provider Exclusions and Terminations", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_wv_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:17:06.184010+00:00", "last_record_count": 167, "primary_url": "https://www.wvmmis.com/SitePages/Medicaid%20Provider%20SanctionedExclusion", "notes": "PDF behind a SharePoint RadGrid; the loader rebuilds the SharepointDownload URL from the grid row. NPI and addresses published.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "wa_medicaid_exclusions", "display_name": "Washington HCA Provider Termination and Exclusion List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_wa_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:17:01.240252+00:00", "last_record_count": 245, "primary_url": "https://www.hca.wa.gov/billers-providers-partners/become-apple-health-provider/provider-termination-and-exclusion-list", "notes": "Two stable-URL XLSX files (HCA list + DSHS list). NPI cell mixes NPI and P1 IDs; only valid NPIs are kept as NPI. Multi-NPI cells split into one row per NPI.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "tx_medicaid_exclusions", "display_name": "Texas HHSC OIG Exclusions", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_tx_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:57.448188+00:00", "last_record_count": 13407, "primary_url": "https://oig.hhsc.state.tx.us/oigportal2/Exclusions", "notes": "Legacy .xls via ASP.NET form postback (loader replays __VIEWSTATE). Carries NPI, license, reinstatement dates. US-geofenced.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "tn_medicaid_exclusions", "display_name": "Tennessee TennCare Terminated Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_tn_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:50.379899+00:00", "last_record_count": 21, "primary_url": "https://www.tn.gov/tenncare/fraud-and-abuse/program-integrity.html", "notes": "JSON endpoint behind the page's data table component. Small list with NPI, effective date, reason.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "sc_medicaid_exclusions", "display_name": "South Carolina Medicaid Sanctioned Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_sc_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:44.121169+00:00", "last_record_count": 1377, "primary_url": "https://www.scdhhs.gov/fraud", "notes": "Dated XLSX discovered from the landing page. Carries NPI, city/state/zip, excluded-vs-terminated marker, action date.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "pa_medicaid_exclusions", "display_name": "Pennsylvania Medicheck Precluded Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_pa_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:39.114692+00:00", "last_record_count": 6731, "primary_url": "https://www.humanservices.dhs.pa.gov/providers/Providers/Pages/Medicheck-List.aspx", "notes": "Direct CSV (Medchk endpoint). Carries NPI, FEIN, begin/end dates, structured name parts.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "or_medicaid_exclusions", "display_name": "Oregon OHA Medicaid Provider Exclusions", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_or_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:32.296067+00:00", "last_record_count": 132, "primary_url": "https://www.oregon.gov/oha/FOD/PIAU/Pages/Provider-Exclusion.aspx", "notes": "SharePoint list via the public Lists.asmx SOAP endpoint. Names + per-person exclusion-letter PDF URLs only \u2014 no dates, no NPI, no provider type. Letter URLs kept in raw_payload.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "oh_medicaid_exclusions", "display_name": "Ohio Medicaid Provider Exclusion and Suspension List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_oh_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:30.961410+00:00", "last_record_count": 2122, "primary_url": "https://medicaid.ohio.gov/resources-for-providers/enrollment-and-support/provider-enrollment/provider-exclusion-and-suspension-list", "notes": "Dated XLSX discovered from the landing page. Two sheets (Individuals + Organizations); multi-NPI cells split into one row per NPI.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ny_medicaid_exclusions", "display_name": "New York OMIG Medicaid Exclusions", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ny_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:07.468968+00:00", "last_record_count": 9050, "primary_url": "https://omig.ny.gov/medicaid-fraud/medicaid-exclusions", "notes": "Direct XLSX export (apps.omig.ny.gov/exclusions/exporttoexcel.aspx). ~9K rows with NPI and license number.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nv_medicaid_exclusions", "display_name": "Nevada Medicaid Master Exclusion List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_nv_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:16:01.902722+00:00", "last_record_count": 1312, "primary_url": "https://www.omig.nv.gov/provider-enrollment--termination/provider-exclusions-sanctions-and-press-releases/", "notes": "Dated PDF discovered from the landing page. Parsed positionally \u2014 three sanction columns share a header. Federal-authority rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ne_medicaid_exclusions", "display_name": "Nebraska NMEP Medicaid Excluded Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ne_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:44.866397+00:00", "last_record_count": 1439, "primary_url": "https://dhhs.ne.gov/Pages/Medicaid-Program-Exclusions.aspx", "notes": "Stable-URL PDF. NPI, coded provider type / reason / sanction / duration columns kept as published.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nd_medicaid_exclusions", "display_name": "North Dakota Medicaid Provider Exclusion List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_nd_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:25.985880+00:00", "last_record_count": 193, "primary_url": "https://www.hhs.nd.gov/healthcare/medicaid/provider/compliance/fraud-and-abuse", "notes": "Stable-URL XLSX. Reason \"Reciprocal to OIG Exclusion\" loads with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nc_medicaid_exclusions", "display_name": "North Carolina Medicaid State Excluded Provider List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_nc_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:23.348918+00:00", "last_record_count": 178, "primary_url": "https://medicaid.ncdhhs.gov/providers/excluded-providers", "notes": "Stable download path, XLSX. Pure-FEDERAL rows load with oig_reciprocal = TRUE; OIG/STATE rows keep their state action.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "mt_medicaid_exclusions", "display_name": "Montana Medicaid Terminated/Excluded Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_mt_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:21.516043+00:00", "last_record_count": 179, "primary_url": "https://dphhs.mt.gov/montanahealthcareprograms/terminatedexcludedproviders", "notes": "Dated XLSX discovered from the landing page. Rows marked State Termination vs OIG Exclusion; OIG rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ms_medicaid_exclusions", "display_name": "Mississippi Medicaid Sanctioned Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ms_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:18.864947+00:00", "last_record_count": 210, "primary_url": "https://medicaid.ms.gov/providers/provider-terminations/", "notes": "Dated XLSX discovered from the landing page. Structured org/individual split, NPI, term dates, sanction-type codes. ME (Medicare Exclusion) rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "mo_medicaid_exclusions", "display_name": "Missouri MMAC Provider Sanction List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_mo_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:16.789240+00:00", "last_record_count": 279, "primary_url": "https://mmac.mo.gov/providers/provider-sanctions/", "notes": "Dated XLSX discovered from the landing page. Name + NPI + term/letter dates + reason.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "mi_medicaid_exclusions", "display_name": "Michigan Medicaid Sanctioned Provider List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_mi_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:13.892221+00:00", "last_record_count": 4044, "primary_url": "https://www.michigan.gov/mdhhs/doing-business/providers/providers/billingreimbursement/list-of-sanctioned-providers", "notes": "XLSX discovered from the landing page. Two sanction date/source pairs per row; the earliest date is the exclusion date.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "md_medicaid_exclusions", "display_name": "Maryland Medicaid Sanctioned Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_md_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:10.158357+00:00", "last_record_count": 1617, "primary_url": "https://health.maryland.gov/mmcp/provider/Pages/sanctioned_list.aspx", "notes": "XLSX discovered from the landing page. Sanction-type codes kept as published (MDH, LB, ...).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "la_medicaid_exclusions", "display_name": "Louisiana LDH Adverse Actions (Exclusions)", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_la_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:08.240777+00:00", "last_record_count": 5952, "primary_url": "https://adverseactions.ldh.la.gov/SelSearch/", "notes": "Direct CSV export (SelSearch/GetCsv). Rows typed State vs OIG; OIG rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ky_medicaid_exclusions", "display_name": "Kentucky Medicaid Terminated and Excluded Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ky_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:05.036924+00:00", "last_record_count": 402, "primary_url": "https://www.chfs.ky.gov/agencies/dms/dpi/pe/Pages/default.aspx", "notes": "Direct XLSX (KYMedicaidTerminationList.xlsx). Carries NPI and license.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ks_medicaid_exclusions", "display_name": "Kansas KMAP Provider Termination List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ks_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:03.936071+00:00", "last_record_count": 211, "primary_url": "https://www.kdhe.ks.gov/172/Medicaid", "notes": "Stable DocumentCenter XLSX. Multi-NPI cells split into one row per NPI.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "in_medicaid_exclusions", "display_name": "Indiana Medicaid/CHIP Provider Terminations", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_in_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:03.166740+00:00", "last_record_count": 113, "primary_url": "https://www.in.gov/fssa/ompp/provider-information/termination-of-provider-participation-in-medicaid-and-chip/", "notes": "Stable-URL XLSX (OMPP_Terminations.xlsx). Name + NPI + city/state + termination date.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ia_medicaid_exclusions", "display_name": "Iowa Medicaid Excluded Individuals and Entities", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ia_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:15:01.925112+00:00", "last_record_count": 1307, "primary_url": "https://hhs.iowa.gov/programs/welcome-iowa-medicaid/provider-services/excluded-individuals-and-entities", "notes": "XLSX behind a media download link (resolved by content type). Federal Exclusion rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hi_medicaid_exclusions", "display_name": "Hawaii Med-QUEST Provider Exclusion/Reinstatement List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_hi_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:58.294780+00:00", "last_record_count": 213, "primary_url": "https://medquest.hawaii.gov/en/plans-providers/provider-exclusion-reinstatement-list.html", "notes": "Dated PDF discovered from the landing page. No NPI published; reinstatement dates tracked.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ga_medicaid_exclusions", "display_name": "Georgia DCH OIG Exclusions List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ga_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:54.823989+00:00", "last_record_count": 1375, "primary_url": "https://dch.georgia.gov/office-inspector-general/georgia-oig-exclusions-list", "notes": "XLSX behind a Drupal document link. NPI column sparsely populated; SANCDATE is YYYYMMDD.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "de_medicaid_exclusions", "display_name": "Delaware DMAP Sanctioned Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_de_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:52.683020+00:00", "last_record_count": 1794, "primary_url": "https://medicaidpublications.dhss.delaware.gov/docs/Search?Command=Core_Download&EntryId=1671", "notes": "Stable download URL, PDF. NPI, taxonomy, license, DEA, reinstatement dates. OIG-typed rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "co_medicaid_exclusions", "display_name": "Colorado Medicaid Provider Terminations for Cause", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_co_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:30.848169+00:00", "last_record_count": 355, "primary_url": "https://hcpf.colorado.gov/provider-termination", "notes": "Two dated XLSX files discovered from the landing page: terminations for cause, plus reinstated providers (loaded with reinstatement_date set and is_currently_excluded = FALSE).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ca_medicaid_exclusions", "display_name": "California Medi-Cal Suspended & Ineligible Provider List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ca_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:29.589240+00:00", "last_record_count": 22547, "primary_url": "https://mcweb.apps.prd.cammis.medi-cal.ca.gov/references/sandi", "notes": "DHCS S&I list (~22K rows). XLSX behind the Medi-Cal reference portal; loader resolves the file through the portal's public Directus CMS API (token published in the site's environment.js).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "az_medicaid_exclusions", "display_name": "Arizona AHCCCS Provider Suspensions and Terminations", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_az_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:14.336657+00:00", "last_record_count": 208, "primary_url": "https://www.azahcccs.gov/Fraud/Downloads/ProviderSuspensionsTerminations.pdf", "notes": "Stable-URL PDF. Name, NPI, action type, effective date.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ar_medicaid_exclusions", "display_name": "Arkansas DHS Excluded Provider List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ar_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:10.848333+00:00", "last_record_count": 2221, "primary_url": "https://humanservices.arkansas.gov/divisions-shared-services/medical-services/helpful-information-for-providers/excluded-provider-list/", "notes": "Direct CSV (dhs.arkansas.gov exclusions publicsearch Download). Name/city/state/zip only \u2014 no NPI, no dates.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "al_medicaid_exclusions", "display_name": "Alabama Medicaid Suspended Providers", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_al_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:14:06.961235+00:00", "last_record_count": 2085, "primary_url": "https://medicaid.alabama.gov/content/8.0_Fraud/8.7_Suspended_Providers.aspx", "notes": "Dated XLSX discovered from the landing page. Name + suspension date + initiating agency, grouped under profession section headers. No NPI published.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ak_medicaid_exclusions", "display_name": "Alaska Medicaid Excluded Provider List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ak_medicaid_exclusions", "last_loaded_at": "2026-09-01T09:13:58.575394+00:00", "last_record_count": 299, "primary_url": "https://health.alaska.gov/en/office-of-the-commissioner/medicaid-program-integrity/", "notes": "Dated PDF discovered from the landing page. No NPI published. OIG-authority rows load with oig_reciprocal = TRUE.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "pecos_enrollment", "display_name": "CMS PECOS Individual Enrollment (855I)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_medicare_enrollment", "last_loaded_at": "2026-09-01T09:13:28.302030+00:00", "last_record_count": 2978925, "primary_url": "https://data.cms.gov/provider-characteristics/medicare-provider-supplier-enrollment", "notes": "Medicare provider enrollment, specialty, multi-state. 2.98M records.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nppes", "display_name": "CMS NPPES NPI Registry", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_identity", "last_loaded_at": "2026-09-01T09:07:21.200358+00:00", "last_record_count": 73243, "primary_url": "https://npiregistry.cms.hhs.gov/", "notes": "National Provider Identifier registry \u2014 provider identity, taxonomy, address.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "medicare_enrollment", "display_name": "CMS Medicare Monthly Enrollment", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_medicare_enrollment_counts", "last_loaded_at": "2026-09-01T09:02:14.058773+00:00", "last_record_count": 567095, "primary_url": "https://data.cms.gov/summary-statistics-on-beneficiary-enrollment", "notes": "County-level enrollment, MA penetration, demographics. 567K rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hpsa", "display_name": "HRSA Health Professional Shortage Areas (HPSA)", "source_type": "hrsa_data", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_shortage_areas", "last_loaded_at": "2026-09-01T09:00:38.179145+00:00", "last_record_count": 166410, "primary_url": "https://data.hrsa.gov/data/download", "notes": "Federally designated primary care / dental / mental health shortage areas. 163K rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hospital_enrollments", "display_name": "CMS Hospital Enrollment Data (PECOS)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_hospital_ccn", "last_loaded_at": "2026-09-01T09:00:20.216407+00:00", "last_record_count": 9161, "primary_url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/hospital-enrollments", "notes": "PECOS hospital enrollment records linking CCNs to associate IDs.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 24, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "24d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hospice", "display_name": "CMS Hospice Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_hospice_quality", "last_loaded_at": "2026-08-31T08:00:28.681562+00:00", "last_record_count": 8517, "primary_url": "https://data.cms.gov/provider-data/topics/hospice-care", "notes": "Quality measures, patient experience. 30 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 26, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "26d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "npdb_puf", "display_name": "NPDB Public Use Data File (adverse actions)", "source_type": "federal_bulk_download", "license": "public_dua_restricted", "update_cadence": "quarterly", "accuracy_class": "benchmark_only_deidentified", "last_loaded_at": "2026-08-18T17:20:42.663658+00:00", "last_record_count": 1378478, "primary_url": "https://www.npdb.hrsa.gov/resources/publicData.jsp", "notes": "De-identified by statute: no names, no NPIs; never joins to provider data and is never exposed through a public endpoint. Internal benchmark for state discipline coverage. Download requires a click-through DUA, so the quarterly refresh is manual: scripts/load_npdb.py --file <zip>. Adverse-action subset (RECTYPEs A/C).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 38, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "38d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "irs_990", "display_name": "IRS Form 990 (Schedules R, J)", "source_type": "irs_990_xml", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_nonprofit_org_chart_and_compensation", "last_loaded_at": "2026-08-18T09:12:35.945642+00:00", "last_record_count": 3554, "primary_url": "https://projects.propublica.org/nonprofits/", "notes": "Schedule R (related orgs) + Schedule J (top compensated employees) deep-parsed in Loop 2. Schedule R supersedes hand-curated nonprofit_subsidiary_crosswalk seed. Schedule J names fuzzy-matched to NPIs where possible.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 38, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "38d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nj_medicaid_exclusions", "display_name": "New Jersey OSC Medicaid Debarment/Disqualification List", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "monthly", "accuracy_class": "authoritative_for_nj_medicaid_exclusions", "last_loaded_at": "2026-08-18T03:35:56.969453+00:00", "last_record_count": 4030, "primary_url": "https://www.nj.gov/comptroller/doc/nj_debarment_list.pdf", "notes": "PDF table (~129 pages) parsed with pdfplumber (bundled in the pipeline runtime since 2026-08-18). Carries NPI, address, action type, effective/expiration dates.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 39, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "39d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ca_medical_board", "display_name": "California Medical Board License Database (via CA Open Data)", "source_type": "state_open_data_api", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_ca_license_status", "last_loaded_at": "2026-08-17T16:00:29.291978+00:00", "last_record_count": 5208667, "primary_url": "https://www.mbc.ca.gov/Resources/Statistics/Public-Information.aspx", "notes": "California Medical Board licensee data. Not currently loaded from primary source \u2014 see docs/STATE_MEDICAL_BOARD_ROLLOUT.md. Real path is (a) MBC bulk file via ToS-gated BOX file share, or (b) DCA Search API for MBC + Osteopathic + PA + BRN in one integration. data.ca.gov path from earlier notes yields Physician Survey aggregates, not the licensee roster. Freshness follows the monthly NPPES reload (data is NPPES-derived until a real CA loader ships).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 39, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "39d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "pecos_reassignment", "display_name": "CMS PECOS Medicare Billing Reassignment", "source_type": "cms_dac_derived", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_billing", "last_loaded_at": "2026-08-17T07:51:51.632361+00:00", "last_record_count": 1767571, "primary_url": "https://data.cms.gov/provider-data/dataset/mj5m-pzi6", "notes": "NPI-to-organization billing relationship per Medicare. Includes voluntary attendings, locums, employed staff \u2014 does not distinguish W-2 employment.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 40, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "40d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "nursing_homes", "display_name": "CMS Nursing Home Compare (Quality)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "monthly", "accuracy_class": "authoritative_for_nh_quality", "last_loaded_at": "2026-08-14T07:08:49.767681+00:00", "last_record_count": 16166, "primary_url": "https://data.cms.gov/provider-data/topics/nursing-homes", "notes": "Star ratings, quality measures, staffing, penalties. 83 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "monthly", "stale_threshold_days": 45, "critical_threshold_days": 100, "detail": "43d old; within monthly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "dialysis", "display_name": "CMS Dialysis Facility Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_dialysis_quality", "last_loaded_at": "2026-08-14T03:43:07.012881+00:00", "last_record_count": 8635, "primary_url": "https://data.cms.gov/provider-data/topics/dialysis-facilities", "notes": "Star ratings, quality measures, patient experience. 30 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "home_health", "display_name": "CMS Home Health Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_hh_quality", "last_loaded_at": "2026-08-14T03:42:47.307032+00:00", "last_record_count": 14702, "primary_url": "https://data.cms.gov/provider-data/topics/home-health-services", "notes": "Star ratings, patient experience. 30 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hospitals", "display_name": "CMS Hospital Compare (Quality)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_hospital_quality", "last_loaded_at": "2026-08-14T03:42:22.400901+00:00", "last_record_count": 6022, "primary_url": "https://data.cms.gov/provider-data/topics/hospitals", "notes": "Star ratings, HCAHPS, HVBP, HAC, mortality, readmissions, HAIs. 31 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "irf", "display_name": "CMS Inpatient Rehab Facility (IRF) Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_irf_quality", "last_loaded_at": "2026-08-14T03:41:42.760984+00:00", "last_record_count": 1457, "primary_url": "https://data.cms.gov/provider-data/topics/inpatient-rehabilitation-facilities", "notes": "Quality measures. 28 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ltch", "display_name": "CMS Long-Term Care Hospital (LTCH) Compare", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_ltch_quality", "last_loaded_at": "2026-08-14T03:41:26.034326+00:00", "last_record_count": 405, "primary_url": "https://data.cms.gov/provider-data/topics/long-term-care-hospitals", "notes": "Quality measures. 27 quarters of history.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "cms_pos", "display_name": "CMS Provider of Services File (Hospital & Other)", "source_type": "government", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-08-13T22:56:45.906955+00:00", "last_record_count": 583212, "primary_url": "https://data.cms.gov/provider-characteristics/hospitals-and-other-facilities/provider-of-services-file-hospital-non-hospital-facilities", "notes": "Quarterly CMS Provider of Services file. Service-line availability (~50 clinical service flags), accreditation agency/dates, medical school affiliation/teaching status, bed counts, legal business name. Loaded via scripts/enrichment/enrich_from_pos.py, run manually each quarter when CMS publishes a new extract (not yet on the automated pipeline cadence).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 43, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "43d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "clinical_trials", "display_name": "ClinicalTrials.gov", "source_type": "government", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": "2026-08-13T06:41:01.629930+00:00", "last_record_count": 194386, "primary_url": "https://clinicaltrials.gov/data-api/api", "notes": "ClinicalTrials.gov API v2, all studies with at least one US-located site (~194K as of 2026-07). Site-to-facility and investigator-to-NPI matching is approximate (normalized name + location) and conservative \u2014 unmatched does not mean unaffiliated.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 44, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "44d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hcris", "display_name": "CMS Hospital Cost Report Information System (HCRIS)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_hospital_financials", "last_loaded_at": "2026-08-13T06:32:16.014958+00:00", "last_record_count": 52090, "primary_url": "https://www.cms.gov/data-research/statistics-trends-and-reports/cost-reports", "notes": "Hospital cost reports \u2014 revenue, expenses, margins. 42K rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 44, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "44d old; within quarterly window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hrrp", "display_name": "Hospital Readmissions Reduction Program (HRRP)", "source_type": "government", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative", "last_loaded_at": "2026-08-13T06:14:01.206462+00:00", "last_record_count": 18133, "primary_url": "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp", "notes": "IPPS Final Rule HRRP Supplemental Data Files, FY2021+. Payment adjustment factors, per-condition excess readmission ratios, peer groups. New FY published each August with the IPPS final rule.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 44, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "44d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ipps_impact", "display_name": "CMS IPPS Impact File (Case Mix Index, Wage Index)", "source_type": "government", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative", "last_loaded_at": "2026-08-13T06:13:37.757546+00:00", "last_record_count": 12666, "primary_url": "https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/historical-impact-files-fy-1994-through-present", "notes": "IPPS Final Rule Impact Files, FY2023+. Case mix index (transfer-adjusted, by current MS-DRG grouper version), wage index, DSH patient percentage, resident-to-ADC ratio. New FY published each August with the IPPS final rule.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 44, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "44d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "cbsa_population", "display_name": "Census Bureau CBSA Population Estimates", "source_type": "government", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative", "last_loaded_at": "2026-08-13T06:13:25.130516+00:00", "last_record_count": 5550, "primary_url": "https://www.census.gov/programs-surveys/metro-micro/data/datasets.html", "notes": "Annual Metropolitan/Micropolitan Statistical Area population estimates (vintage year updates each spring, typically covering the prior July 1 estimate). Source file: cbsa-est{YEAR}-alldata.csv, filtered to CBSA-level rows only (MDIV and STCOU both blank).", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 44, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "44d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ahrq_sdoh", "display_name": "AHRQ Social Determinants of Health Database", "source_type": "ahrq_data", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_sdoh", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 38795, "primary_url": "https://www.ahrq.gov/sdoh/data-analytics/sdoh-data.html", "notes": "Census-tract-level SDOH indicators: income, insurance, housing, education, language. 38.8K rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 91, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "91d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "cbsa_crosswalk", "display_name": "Census / OMB Core-Based Statistical Area Crosswalk", "source_type": "census_omb", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_metro_geography", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 29974, "primary_url": "https://www.census.gov/programs-surveys/metro-micro.html", "notes": "OMB-defined ZIP \u2192 CBSA (metro / micro area) mapping used for market geography. 30K rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 91, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "91d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "cdc_places", "display_name": "CDC PLACES (Local Data for Better Health)", "source_type": "cdc_data", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_community_health", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 1357832, "primary_url": "https://www.cdc.gov/places/", "notes": "40 health outcome, prevention, and risk-factor measures at county and ZCTA level. 1.4M rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 91, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "91d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "dartmouth_crosswalk", "display_name": "Dartmouth Atlas of Health Care \u2014 ZIP / HRR / HSA Crosswalk", "source_type": "academic_dataset", "license": "dartmouth_atlas_research_use", "update_cadence": "static", "accuracy_class": "authoritative_for_hrr_hsa_geography", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 40866, "primary_url": "https://www.dartmouthatlas.org/", "notes": "40.9K ZIPs \u2192 306 Hospital Referral Regions \u2192 3,436 Hospital Service Areas. Used for regional analytics. Cadence audit 2026-08-17: multi-year reference crosswalk; Dartmouth updates rarely.", "is_active": true, "freshness": {"freshness": "exempt", "age_days": 91, "cadence": "static", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "static reference data; publisher updates rarely"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "medicare_geo_variation", "display_name": "CMS Medicare Geographic Variation Public Use File", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_medicare_per_capita", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 33549, "primary_url": "https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-geographic-comparisons", "notes": "Per-capita Medicare spending and utilization by county/state.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 91, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "91d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "vbc_aco", "display_name": "CMS Shared Savings Program ACOs (MSSP / REACH / NGACO / HAC)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_aco_participation", "last_loaded_at": "2026-06-26T18:56:01.666755+00:00", "last_record_count": 1821702, "primary_url": "https://data.cms.gov/medicare-shared-savings-program", "notes": "MSSP ACO directory + participants + SNF affiliates + beneficiaries; MSSP financial and quality results PY2013-PY2024 (benchmarks, expenditures, shared savings and losses, quality scores); ACO REACH entities, financials and participants PY2021-PY2026; NGACO performance; HAC reduction measures.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 91, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "91d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "sec_10k", "display_name": "SEC EDGAR Form 10-K (annual reports)", "source_type": "sec_filings_via_fmp", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_public_company_financials", "last_loaded_at": "2026-06-17T21:25:23.399804+00:00", "last_record_count": 30, "primary_url": "https://www.sec.gov/edgar.shtml", "notes": "Annual reports for ~50 public healthcare services (HCA, Tenet, UHS, Surgery Partners, etc.) via Financial Modeling Prep parsed feed. Income statement + balance sheet per fiscal year. Segment breakdown where disclosed.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 100, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "100d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "sec_8k", "display_name": "SEC EDGAR Form 8-K (M&A Events)", "source_type": "sec_filings_via_fmp", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative_for_material_corporate_events", "last_loaded_at": "2026-06-17T21:25:20.105704+00:00", "last_record_count": 781, "primary_url": "https://www.sec.gov/edgar.shtml", "notes": "Item 1.01 (Material Definitive Agreement) and Item 2.01 (Completion of Acquisition or Disposition) are SEC-mandated M&A disclosure items. Public healthcare services file these in real time. Our /ma-events/* surface aggregates them. Cadence audit 2026-08-17: loads with the quarterly SEC/FMP pass.", "is_active": true, "freshness": {"freshness": "stale", "age_days": 100, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "100d old; past quarterly refresh window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "physician_employer_systems", "display_name": "Verzi-curated employer typology crosswalk", "source_type": "internal_curation", "license": "verzi_proprietary", "update_cadence": "manual", "accuracy_class": "high_for_top_300_systems", "last_loaded_at": "2026-06-11T04:01:48.529120+00:00", "last_record_count": 1057, "primary_url": null, "notes": "Hand-curated mapping of PECOS PAC IDs to parent systems with employer_type classification (hospital_system, pe_platform, payer_vertical, etc.). Cadence audit 2026-08-17: hand-curated, no refresh clock.", "is_active": true, "freshness": {"freshness": "exempt", "age_days": 107, "cadence": "manual", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "hand-curated; refreshes when curation happens, not on a clock"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "hsaf", "display_name": "CMS Hospital Service Area File (HSAF)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_hospital_service_area", "last_loaded_at": "2026-05-04T03:50:10.354742+00:00", "last_record_count": 9817990, "primary_url": "https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-service-type-reports/hospital-service-area-file", "notes": "Market share by ZIP for inpatient services. 9.8M rows across 10 years.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 145, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "145d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "partd_prescriber", "display_name": "CMS Medicare Part D Prescriber", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_drug_prescribing", "last_loaded_at": "2026-04-30T04:49:12.801615+00:00", "last_record_count": 102882793, "primary_url": "https://data.cms.gov/provider-summary-by-type-of-service/medicare-part-d-prescribers", "notes": "Per-NPI drug prescribing patterns. 102.9M rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 149, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "149d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "ma_stars", "display_name": "CMS Medicare Advantage & Part D Star Ratings", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_ma_plan_quality", "last_loaded_at": "2026-04-29T18:21:40.887156+00:00", "last_record_count": 4187, "primary_url": "https://www.cms.gov/medicare/health-plans/medicareadvtgspecratestats/data", "notes": "MA / Part D plan star ratings by contract.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 149, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "149d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "open_payments", "display_name": "CMS Open Payments (Sunshine Act)", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "good_for_pharma_relationships", "last_loaded_at": "2026-04-29T17:13:21.271294+00:00", "last_record_count": 27689841, "primary_url": "https://openpaymentsdata.cms.gov/", "notes": "Pharma manufacturer payments to physicians + teaching hospitals.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 149, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "149d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "physician_utilization", "display_name": "CMS Medicare Physician & Other Practitioners by Provider and Service", "source_type": "cms_archive", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_medicare_billing", "last_loaded_at": "2026-04-29T17:07:23.546652+00:00", "last_record_count": 29090965, "primary_url": "https://data.cms.gov/provider-summary-by-type-of-service/medicare-physician-other-practitioners", "notes": "Per-NPI billing patterns: HCPCS codes, allowed charges, service counts. 29.1M rows.", "is_active": true, "freshness": {"freshness": "fresh", "age_days": 149, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "149d old; within annual window"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "docs_resources", "display_name": "Verzi Methodology + Resource Library", "source_type": "verzi_published_documents", "license": "verzi_published", "update_cadence": "manual", "accuracy_class": "methodology_reference", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://api.healthcaredata.io/resources", "notes": "Published methodology docs: API Style Guide, Accuracy Benchmark, HCA Case Study, License Intelligence, Employment Reconciliation, Financial Intelligence. Surfaced at /resources for customer audit. Cadence audit 2026-08-17: refreshes with docs deploys, not on a clock.", "is_active": false, "freshness": {"freshness": "exempt", "age_days": null, "cadence": "manual", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "hand-curated; refreshes when curation happens, not on a clock"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "fl_medical_board", "display_name": "Florida MQA Practitioner Licensure Database", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "pending", "accuracy_class": "authoritative_for_fl_license_status", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://data-download.mqa.flhealthsource.gov/", "notes": "Florida Department of Health Medical Quality Assurance (MQA) public data portal. Bulk practitioner licensure file covers all ~200 MQA-regulated professions (MD, DO, PA, APRN, RN, LPN, dentist, pharmacist, etc.) on a single feed. Pipe-delimited or CSV, refreshed daily. Requires free MQA account (Google sign-in OK) to download. Disciplinary actions available in a separate MQA download. Cadence audit 2026-08-17: loader written, awaiting MQA account; redeclare daily at activation.", "is_active": false, "freshness": {"freshness": "exempt", "age_days": null, "cadence": "pending", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "declared but not yet live; no load expected"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "google_geocoding", "display_name": "Google Maps Geocoding API", "source_type": "commercial_api", "license": "google_maps_platform_tos", "update_cadence": "as_needed", "accuracy_class": "authoritative_for_coordinates", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://developers.google.com/maps/documentation/geocoding", "notes": "Latitude / longitude for 60K facilities (98.6% coverage). Used under Google Maps Platform Terms of Service. Coordinates cached locally \u2014 Google data not redistributed.", "is_active": false, "freshness": {"freshness": "exempt", "age_days": null, "cadence": "as_needed", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "runs only when new inputs appear; quiet is normal"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "qpp_mips_tin", "display_name": "CMS Quality Payment Program MIPS Participation (TIN-NPI)", "source_type": "cms_qpp_csv", "license": "public_domain", "update_cadence": "annual", "accuracy_class": "authoritative_for_mips_tin_anchor", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://data.cms.gov/provider-data/dataset/0ba7-2cgq", "notes": "CMS Doctors and Clinicians dataset annual file. Each row links an NPI to the billing TIN (= EIN of billing entity), plus MIPS quality / cost / IA / PI score components. Use TIN as a strong employment signal: CMS confirmed this NPI billed under this EIN during the performance year.", "is_active": false, "freshness": {"freshness": "never", "age_days": null, "cadence": "annual", "stale_threshold_days": 400, "critical_threshold_days": 550, "detail": "never loaded"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "rx_sdud", "display_name": "CMS Medicaid State Drug Utilization Data (SDUD)", "source_type": "medicaid_gov_bulk", "license": "public_domain", "update_cadence": "quarterly", "accuracy_class": "authoritative", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://www.medicaid.gov/medicaid/prescription-drugs/state-drug-utilization-data", "notes": "NDC by state by quarter units, prescriptions, and reimbursement. Loaded from 2019 forward.", "is_active": false, "freshness": {"freshness": "never", "age_days": null, "cadence": "quarterly", "stale_threshold_days": 100, "critical_threshold_days": 200, "detail": "never loaded"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}, {"source_id": "tx_medical_board", "display_name": "Texas Medical Board Practitioner Roster (ORSSP)", "source_type": "state_bulk_download", "license": "public_records_permissive", "update_cadence": "pending", "accuracy_class": "authoritative_for_tx_license_status", "last_loaded_at": null, "last_record_count": null, "primary_url": "https://orssp.tmb.state.tx.us/", "notes": "Texas Medical Board Open Records Self-Service Portal (ORSSP). Predefined monthly reports for physicians (PHY), physician assistants (PA), and physicians-in-training (PIT). Fixed-width text and Excel; refreshed on the first business day of each month. Requires a paid ORSSP account. Field layout PDFs public at /layouts/{code}_layout.pdf. Disciplinary actions live in a separate SearchBA scraping surface, not in ORSSP. Cadence audit 2026-08-17: loader written, awaiting ORSSP account; redeclare monthly at activation.", "is_active": false, "freshness": {"freshness": "exempt", "age_days": null, "cadence": "pending", "stale_threshold_days": 0, "critical_threshold_days": 0, "detail": "declared but not yet live; no load expected"}, "warrants": null, "archive_file_count": null, "last_fetch_at": null, "last_change_at": null, "latest_publisher_version": null}], "meta": {"as_of": "current"}}