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2025 Medicare Part C & Part D Reporting Requirements & Data Validation

Conceptual Framework for Data Extraction

The following steps outline the extraction and processing of data:

  1. Source data reside on operational systems, like claims adjudication systems, provider files, enrollment files, and data systems maintained by delegated entities
  2. Officials upload source data to an analytic data warehouse where data are cleaned and put into database structures to support analysis
  3. Officials extract the data in the warehouse to create an interim data set, which often has manipulated and merged data
  4. Officials combine data from interim data sets into a final stage data set
  5. Officials aggregate this final stage data set to create sums and counts, which officials enter into the HPMS PRDVM

The extraction process produces at least 2 sets of data for each reporting section, and for some reporting sections it could be 3 sets of data.

If the process produces interim data sets, the reviewer considers extracting these data to make sure that officials have joined data sets properly.