episodic_authorization_results.csv

episode_id,patient_id,age,procedure_cpt,length_of_stay,estimated_episode_cost,comorbidities,authorization_decision,decision_reason
EPI1001,PAT001,72,27447,4.0,25500,diabetes;hypertension,Episodic Authorization Required,"TKA procedure detected; Age > 65 (higher risk); High estimated cost ($25,500); Length of stay > 3 days (4.0d); 2 major comorbidities"
EPI1002,PAT002,58,27447,2.0,18000,none,Standard Authorization (auto-approve),TKA procedure detected
EPI1003,PAT003,67,27446,3.5,22000,ckd;chf,Episodic Authorization Required,"TKA procedure detected; Age > 65 (higher risk); High estimated cost ($22,000); Length of stay > 3 days (3.5d); 2 major comorbidities"
EPI1004,PAT004,45,27447,1.0,15000,obesity,Standard Authorization (auto-approve),TKA procedure detected
EPI1005,PAT005,80,27447,5.0,30000,diabetes;ckd,Episodic Authorization Required,"TKA procedure detected; Age > 65 (higher risk); High estimated cost ($30,000); Length of stay > 3 days (5.0d); 2 major comorbidities"