Synthetic Data Guide

For development and testing purposes, the following claims data APIs:

• CMS Blue Button 2.0 (BB2.0)
• Beneficiary Claims Data API (BCDA)
• Data at the Point of Care (DPC)
• Medicare Claims Data to Part D Sponsors API (AB2D)

provide a set of public synthetic beneficiary and claims data, captured in synthetic Patient, Coverage, and ExplanationOfBenefit (EOB) resources. This is a resource that you can use as you explore and develop against the APIs in the sandbox environments. The synthetic data contains no personally-identifiable information (PII) or personal health information (PHI).

Our synthetic data will remain unchanged so that you can rely on it for ongoing use. That is, you can write tests, demos, etc. against this data, and the underlying data should not change later and produce unexpected results.

Use Cases for Synthetic Data

This data is intended for use in development and testing activities, e.g. building out an application prior to getting production access and having a safe set of data to use for ongoing development activities. It's also a great resource when demoing your application, giving you a safe way to do that without exposing any beneficiary PII or PHI.

How to Access the Synthetic Data

The synthetic data will be available in each API's sandbox environment. Refer to specific API documentation for details.

• CMS Blue Button 2.0 (BB2.0)
• Beneficiary Claims Data API (BCDA) - Guide
• Data at the Point of Care (DPC)
• Medicare Claims Data to Part D Sponsors API (AB2D) - Understanding AB2D Data

Distinguishing Synthetic Data from Production Data

It's easy to distinguish the synthetic data from production data: all synthetic records have Patient.id and ExplanationOfBenefit.id values that are negative. All production records have positive values for those fields.

Please note that, while we are working to improve the coverage and quality of our synthetic data, there are absolutely still differences between it and our production data. In general, you should expect that:

• Not all fields will be present in the synthetic data.
• Some of the fields that are present may not have realistic values.
• The various releases of synthetic data (see below) will have differences from each other.

Available Synthetic Beneficiaries

Title	Beneficiary ID Ranges	Characteristics
from October, 2021	-10000000000000 to -10000000009999	Beneficiary Characteristics File

Release History

Time	Description	Details
October, 2021	10,000 Enhanced synthetic beneficiaries	Adding 10,000 more synthetic beneficiaries to the sandbox and production environments with more realistic and robust data in response to user requests. For example, this set will contain: More recent dates More realistic values for NPIs and ZIP Codes (e.g. not all "99999", though NPIs will not tie to real organizations or providers) More realistic patient information (e.g. dates of birth that are in line with most Medicare beneficiaries) More realistic clinical scenarios (e.g. prescriptions and procedures that make sense with given diagnoses) All of the same Explanation of Benefits (EOB) profiles that production data can include, which are: Carrier Durable Medical Equipment (DME) Home Health Aide (HHA) Hospice Inpatient Outpatient Part D Events (PDE) Skilled Nursing Facility (SNF)
Early 2021	Added outpatient claims	Enhanced the initial set of beneficiaries to include outpatient claims, bringing the full list of EOB profiles to: Carrier Inpatient Outpatient Part D Events (PDE)
2017	Initial 30,000 Synthetic Beneficiaries	30,000 synthetic beneficiaries and about 1,000,000 synthetic claims that covered the following Explanation of Benefits (EOB) profiles: Carrier Inpatient Part D Events (PDE)

For further questions on this synthetic data, please see the FAQ.