SPOC-CO
Synthetic data prototype — no PHI. Numbers, names, and IDs are fabricated for design review only.

EPIC · Office-Based Provider

Panel-upload-driven SPOC-CO activations led by the PCP Office Pod for PCP and specialty office-based providers. Drives APCM (PCP panels), PCM (specialty panels), RPM add-ons, and interprofessional consults across longitudinal cohorts.

10 office-based episodes PCM Monthly Management TCM Operations
Filters
Synthetic data prototype — no PHI. Numbers, names, and IDs are fabricated for design review only.
Office-Based Filters
Core Flow
Panel IntakeEligibilityProgram AssignmentOutreach / ConsentCare PlanMonthly ManagementIPC ConsultRPM ActivationPreventive / Longitudinal
Specialty panel → PCM
PCP panel → APCM (G0556/G0557/G0558)
Monitoring need → RPM
Specialist coordination → IPC (99445)

Mock Ingestion

Synthetic Panel Upload

Mock representation of panel ingestion — no real CSV upload. Shows the panel sources currently feeding the office-based EPIC and their downstream processing status.

5 panels753 patients Mock — synthetic only
5 mock panels
Panel SourcePanel TypeProviderPatientsConditions DetectedRisk MixRecommendedStatus
PCP Panel UploadPCP Chronic DiseaseDr. Marcus Whelan (PCP)184
Type 2 DMHTNCKD-3CHF
L38M92H54
APCMRPM
Activated
Specialist Panel UploadSpecialty LongitudinalDr. Priya Ramaswamy (Urology)76
BPHRecurrent UTIStone Recurrence
L21M41H14
PCMIPC
Outreach Queued
Medicare Panel ListPCP Chronic DiseaseUSC Family Medicine Pod412
Type 2 DMHTNHyperlipidemiaCOPD
L110M218H84
APCMRPMIPC
Eligibility Running
Chronic Condition ListSpecialty LongitudinalDr. Janet Okafor (Endocrine)58
Type 1 DMThyroid disorder
L12M30H16
PCMRPM
Partial — Awaiting Consent
Manual Provider ReferralPCP Chronic DiseaseDr. Henry Coltrane (PCP)23
CHFAFib
L4M11H8
APCMIPC
Ingested

Operational Charts

Panel, Program, Risk & Utilization

Panel Candidates by Provider

Recommended Program Mix

Risk Mix

APCM Code Mix · G0556 / G0557 / G0558

PCM Monthly Readiness

IPC Consult Utilization · CPT 99445

RPM Add-on Utilization · By Device

Worklist

Panel Candidate Worklist

One row per panel-attributed candidate with eligibility, outreach/consent flags, recommended program, and the AI-generated next best action.

10 candidatesPCP Office Pod8 outreach needed3 consent needed
10 panel candidates
PatientPanel SourcePanel TypeProviderConditionRiskProgramEligibilityOutreachConsentStageNext Best Action
Ellen GreeneEPI-2026-0007PCP Panel UploadPCP Chronic DiseaseDr. Henry ColtranePCP - Chronic DiseaseLowAPCMEligibleNeededNeededLongitudinalShip RPM device + activate transmissions
Michelle TanakaEPI-2026-0019Specialist Panel UploadSpecialty LongitudinalDr. Henry ColtraneSpecialty - LongitudinalLowPCMEligibleNeededNeededRouted - OutreachContinue care plan; no urgent action
Sandra VargasEPI-2026-0021PCP Panel UploadPCP Chronic DiseaseDr. Sofia MarchettiPCP - Chronic DiseaseLowAPCMEligibleNeededOn FileLongitudinalShip RPM device + activate transmissions
Howard CarterEPI-2026-0028Specialist Panel UploadSpecialty LongitudinalDr. Henry ColtraneSpecialty - LongitudinalMediumPCMIneligible - CoverageNeededOn FileLongitudinalContinue care plan; no urgent action
Irene DelgadoEPI-2026-0029Specialist Panel UploadSpecialty LongitudinalDr. Priya RamaswamySpecialty - LongitudinalMediumPCMPending Verification—On FileCare Plan ActiveConfirm PCM consent + enroll
Laura HayesEPI-2026-0033Specialist Panel UploadSpecialty LongitudinalDr. Daniel ParkSpecialty - LongitudinalMediumPCMEligibleNeededOn FileRouted - OutreachContinue care plan; no urgent action
Nancy JacobsEPI-2026-0035Specialist Panel UploadSpecialty LongitudinalDr. Rebecca LimSpecialty - LongitudinalHighPCMEligibleNeededOn FileRouted - OutreachContinue care plan; no urgent action
Peggy LopezEPI-2026-0037Specialist Panel UploadSpecialty LongitudinalDr. Eliot KashaniSpecialty - LongitudinalMediumPCMEligibleNeededOn FileRouted - OutreachContinue care plan; no urgent action
Rachel NewmanEPI-2026-0039PCP Panel UploadPCP Chronic DiseaseDr. Priya RamaswamyPCP - Chronic DiseaseHighAPCMEligible—On FileLongitudinalShip RPM device + activate transmissions
Zachary VelascoEPI-2026-0046Specialist Panel UploadSpecialty LongitudinalDr. Priya RamaswamySpecialty - LongitudinalMediumPCMEligibleNeededNeededCare Plan ActiveConfirm PCM consent + enroll

Care Plan

Care Plan / Monthly Management

Active longitudinal care plans with monthly billing readiness for APCM and PCM cohorts.

4 billing-eligible7 active plans5 open tasks
10 care plans · 10 patients
PatientProgramCare PlanPrincipal ConditionSupervising / PCPMonthlyBillingOpen Tasks
Ellen GreeneAPCMActiveE11.9 · Type 2 diabetes mellitus without complicationsDr. Henry Coltrane1/2 mo billedEligible0
Michelle TanakaPCMActiveN18.3 · Chronic kidney disease, stage 3Dr. Henry ColtraneNo months yet—0
Sandra VargasAPCMActiveE11.9 · Type 2 diabetes mellitus without complicationsDr. Sofia Marchetti2/2 mo billedEligible0
Howard CarterPCMActiveN18.3 · Chronic kidney disease, stage 3Dr. Henry Coltrane1/2 mo billableEligible1
Irene DelgadoPCMActiveN18.3 · Chronic kidney disease, stage 3Dr. Priya RamaswamyNo months yet—1
Laura HayesPCMActiveN18.3 · Chronic kidney disease, stage 3Dr. Daniel ParkNo months yet—1
Nancy JacobsPCMPausedN18.3 · Chronic kidney disease, stage 3Dr. Rebecca LimNo months yet—0
Peggy LopezPCMCancelledN18.3 · Chronic kidney disease, stage 3Dr. Eliot KashaniNo months yet—0
Rachel NewmanAPCMActiveE11.9 · Type 2 diabetes mellitus without complicationsDr. Priya Ramaswamy2/2 mo billedEligible2
Zachary VelascoPCMPausedN18.3 · Chronic kidney disease, stage 3Dr. Priya RamaswamyNo months yet—0
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