Cost

Epic equivalent: Professional/facility billing / Itemized charges / Revenue cycle exports

The cost table stores financial data linked to clinical events — billed charges, allowed amounts, patient out-of-pocket, and payer payments. Each row ties a cost to a specific procedure, drug, device, or visit.

Heavily used in claims-derived OMOP. In EHR-derived instances like Emory's, this table is sparse.

Epic-to-OMOP Field Mapping

Field reference (click to expand)

OMOP Field	Epic Equivalent	What It Captures
cost_id	Cost record ID	Unique identifier
cost_event_id	Linked event ID	The clinical event this cost belongs to
cost_domain_id	Event type	Which domain (procedure, drug, etc.)
cost_type_concept_id	Cost type	Billed, paid, negotiated rate, etc.
currency_concept_id	Currency	USD, etc.
total_charge	Billed amount	List price from the provider
total_cost	Allowed amount	Payer-approved amount
total_paid	Paid amount	Sum from all sources
paid_by_payer	Payer contribution	Amount covered by insurer
paid_by_patient	Patient payment	Copay + deductible + coinsurance
paid_patient_copay, paid_patient_coinsurance, paid_patient_deductible	Detailed patient responsibility	Granular patient cost breakdown
payer_plan_period_id	Coverage link	Links to insurance enrollment period
drg_concept_id	DRG	Inpatient billing classification

What to Watch For

Common pitfalls

Sparse at Emory

Most EHR systems don't include detailed cost data unless merged with claims. See Known Issues for current status.

Charge vs. cost vs. paid

total_charge (list price) and total_cost (allowed amount) can differ enormously. Know which is appropriate for your analysis.

Multiple cost rows per event

Surgeries may have separate facility, professional, and anesthesia cost components.

Research Patterns

Question	Tables Involved
Out-of-pocket cost for MRI by region	procedure_occurrence + cost + location.zip
Commercial vs. Medicaid payment structures	cost + payer_plan_period.payer_concept_id
Total hospitalization cost for COVID-19	condition_occurrence + visit_occurrence + cost
Insulin therapy cost by plan type	drug_exposure + cost + plan_concept_id
Colonoscopy copays in high-deductible plans	procedure_occurrence + cost.paid_patient_copay