Teradata: Sum Total Amount of Paid Claims by Duplicate DX Flag per Member - teradata

Question

First, I'm sure there is a cleaner way to do this, but it's the only way I've been able to make the code combine the DX's into one column. Originally they were in separate columns as 0/1's and I needed them in one column. I tried the PIVOT function, but was not able to figure it out.
The issue is I need the paid amounts to be based on duplicated instances DX's. Which sounds counterintuitive, but for this report it's what I need.
For example. If member A has COPD, ASTHMA, AND DIABETES. The member's paid claims were 40,000 so I need the paid amount for that member to reflect 120,000, etc. and so forth.
The code:
SELECT
DX_FLAG
,Sum( AMT_PAID) AS PHARM_PAID_AMT
,Count(DISTINCT(MEMBER_AMISYS_NBR)) AS MEMBER_COUNT
FROM
(SELECT
st.MEMBER_AMISYS_NBR
,ph.PHARMACY_CLAIM_CK
,ph.AMT_PAID
,FILL.DATE_DATE AS Fill_Date
,Coalesce(CASE WHEN DX_ASTHMA = 'ASTHMA' THEN 'Asthma' END,
CASE WHEN DX_COPD = 'COPD' THEN 'COPD' END,
CASE WHEN DX_DIABETES = 'DIABETES' THEN 'DIABETES' END,
CASE WHEN DX_HEART_FAILURE = 'HEART FAILURE' THEN 'HEART_FAILURE' END,
CASE WHEN DX_HYPERTENSION = 'HYPERTENSION' THEN 'HYPERTENSION' END)
AS DX_FLAG
FROM
STATE_OVERALL_MBRS st
JOIN FT_PHARMACY_CLAIM ph ON st.MEMBER_CURR_CK = ph.PRESCRIBER_MEMBER_CURR_CK AND ph.DELETED_IND = 'N'
JOIN DIM_DATE FILL ON ph.FILL_DATE_DIM_CK = FILL.DATE_DIM_CK
WHERE FILL.DATE_DATE BETWEEN '2021-10-01' AND '2022-09-30'
AND ph.PLAN_DIM_CK =10
AND ph.REVERSAL_IND = 'N'
AND ph.AMT_PAID > 0
) rx
My output looks like this .
DX_FLAG
PHARM_PAID_AMT
MEMBER_COUNT
DIABETES
70,000,000
14,144
COPD
38,266,409
6,641
HEART_FAILURE
10,908,000
2,544
ASTHMA
125,000,000
30,000
HYPERTENSION
52,900
22,325
I have tried adding/removing the Distinct from each select statement and the only one that made a difference was removing distinct from this line, in which case I ended up with far too many member counts (even taking into account the duplicate DX counts).
,Count(DISTINCT(MEMBER_AMISYS_NBR)) AS MEMBER_COUNT
The State_Overall_Mbrs table with DX_Flag looks like this and I needed all the diagnosis to be in one column (with duplicate rows for members depending on how many diagnoses they have):
Member ID Asthma COPD Hypertension Diabetes CHF
55555555 0 1 1 1 0
66666666 1 0 0 1 0
77777777 0 0 1 0 0

Answer 1

Normalize the members table, then join and aggregate; something like this:
SELECT
DX_FLAG
,Sum(AMT_PAID) AS PHARM_PAID_AMT
,Count(DISTINCT(MEMBER_AMISYS_NBR)) AS MEMBER_COUNT
FROM
(SELECT * FROM State_Overall_Members
UNPIVOT (has_dx /* New column to hold the 0 or 1 value */
FOR DX_FLAG IN (Asthma,COPD,Hypertension,Diabetes,CHF)
/* Original column names become the values in new column DX_FLAG */
) nmlz
WHERE has_dx = 1 /* Only unpivot rows with a 1 in original column */
) st
JOIN FT_PHARMACY_CLAIM ph ON st.MEMBER_CURR_CK = ph.PRESCRIBER_MEMBER_CURR_CK AND ph.DELETED_IND = 'N'
JOIN DIM_DATE FILL ON ph.FILL_DATE_DIM_CK = FILL.DATE_DIM_CK
WHERE FILL.DATE_DATE BETWEEN '2021-10-01' AND '2022-09-30'
AND ph.PLAN_DIM_CK =10
AND ph.REVERSAL_IND = 'N'
AND ph.AMT_PAID > 0
GROUP BY DX_FLAG;
Another option to normalize the members table would be to have a subquery for each DX and UNION those, along these lines:
... FROM
(SELECT MEMBER_CURR_CK, MEMBER_AMISYS_NBR, AMT_PAID, 'Asthma' (VARCHAR(16)) AS DX_FLAG
FROM State_Overall_Members
WHERE Asthma = 1
UNION ALL
SELECT MEMBER_CURR_CK, MEMBER_AMISYS_NBR, AMT_PAID, 'COPD' (VARCHAR(16)) AS DX_FLAG
FROM State_Overall_Members
WHERE COPD = 1
UNION ALL
...
) st
JOIN ...