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This tool does not predict payer actions. It highlights statistical variance patterns that may warrant clearer documentation.
Module intelligence
Complexity Shield Full Mode
Complexity-adjusted fragility table and defensibility bands for expanded explainability packets. Use this page to confirm readiness, cross-state checks, and implementation fit. Readiness: Ready.
These metrics measure statistical consistency, not clinical appropriateness.
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Module: complexity-full-modeCross-state readiness check: Not requiredReadiness: ReadyProduction-ready: Yes
Maturity
Shipped
Readiness
Ready
Cross-state readiness
Not required
Coverage rows
N/A
Complexity module readiness
This module brings together complexity-adjusted consistency context for documentation and compliance review planning.
Context coverage
99.99%
Min sample size
100
Min active months
12
Complexity source
provider_fingerprint_v1
This tool does not predict payer actions. It highlights statistical variance patterns that may warrant clearer documentation.
Module details
This module ID is complexity-full-mode, and the data package type is N/A.
The transform version is complexity-shield-full-mode-v2, generated 3/9/2026, 5:20:04 AM.
The production-ready flag is Yes.
The primary buyers are Provider compliance teams, Large medical groups.
The roadmap document is docs/prd/medicaid-intelligence-platform-breakthrough.md.
Release file path public/data/medicaid/derived/v1/latest/complexity_shield_full_mode_v2_manifest.json
Published data path public/data/medicaid/derived/v1/latest/complexity_shield_full_mode_v2.csv
Module API route /api/medicaid/intelligence/module/complexity-full-mode.json
Data sample
| code | fragility_score | fragility_band | complexity_tier | expected_variance_points | adjustment_points | complexity_adjusted_fragility_score | residual_risk_delta | defensibility_band | complexity_source | is_proxy | provider_support | explainability_coverage_flag | limitation | snapshot_id | dq_gate_version |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 00000 | 97 | Fragile | High | 7.744 | 8 | 89 | 8 | residual_attention | provider_fingerprint_v1 | no | 1383 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00001 | 93 | Fragile | High | 8.0 | 8 | 85 | 8 | residual_attention | provider_fingerprint_v1 | no | 164 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00003 | 4 | Stable | High | 7.406 | 7 | 0 | 4 | context_explained | provider_fingerprint_v1 | no | 147860 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00014 | 8 | Sensitive | Moderate | 3.737 | 4 | 4 | 4 | context_mixed | provider_fingerprint_v1 | no | 20 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00015 | 5 | Stable | Moderate | 3.808 | 4 | 1 | 4 | context_mixed | provider_fingerprint_v1 | no | 31 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00016 | 0 | Stable | Moderate | 4.0 | 4 | 0 | 0 | context_mixed | provider_fingerprint_v1 | no | 12 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00017 | 7 | Stable | Moderate | 3.982 | 4 | 3 | 4 | context_mixed | provider_fingerprint_v1 | no | 13 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00018 | 0 | Stable | High | 8.0 | 8 | 0 | 0 | context_explained | provider_fingerprint_v1 | no | 1234 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0001A | 32 | Fragile | High | 7.069 | 7 | 25 | 7 | context_explained | provider_fingerprint_v1 | no | 42603 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0001F | 10 | Sensitive | High | 7.984 | 8 | 2 | 8 | context_explained | provider_fingerprint_v1 | no | 8307 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0001M | 0 | Stable | High | 6.878 | 7 | 0 | 0 | context_explained | provider_fingerprint_v1 | no | 130 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0002A | 27 | Sensitive | High | 7.097 | 7 | 20 | 7 | context_explained | provider_fingerprint_v1 | no | 37945 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0003A | 29 | Fragile | High | 7.389 | 7 | 22 | 7 | context_explained | provider_fingerprint_v1 | no | 5606 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0003M | 46 | Fragile | High | 8.0 | 8 | 38 | 8 | context_mixed | provider_fingerprint_v1 | no | 27 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00042 | 4 | Stable | Moderate | 3.588 | 4 | 0 | 4 | context_mixed | provider_fingerprint_v1 | no | 109 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00045 | 4 | Stable | Moderate | 4.0 | 4 | 0 | 4 | context_mixed | provider_fingerprint_v1 | no | 31 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0004A | 45 | Fragile | High | 7.338 | 7 | 38 | 7 | context_mixed | provider_fingerprint_v1 | no | 9928 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0005F | 0 | Stable | High | 8.0 | 8 | 0 | 0 | context_explained | provider_fingerprint_v1 | no | 59 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0005U | 17 | Sensitive | Moderate | 4.0 | 4 | 13 | 4 | context_mixed | provider_fingerprint_v1 | no | 54 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00067 | 4 | Stable | Moderate | 4.0 | 4 | 0 | 4 | context_mixed | provider_fingerprint_v1 | no | 192 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00068 | 5 | Stable | Moderate | 3.909 | 4 | 1 | 4 | context_mixed | provider_fingerprint_v1 | no | 1794 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00069 | 5 | Stable | Low | 2.931 | 3 | 2 | 3 | residual_attention | provider_fingerprint_v1 | no | 4044 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00103 | 20 | Sensitive | Moderate | 3.641 | 4 | 16 | 4 | context_mixed | provider_fingerprint_v1 | no | 153 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 00104 | 4 | Stable | Moderate | 5.003 | 5 | 0 | 4 | context_mixed | provider_fingerprint_v1 | no | 3326 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
| 0011A | 48 | Fragile | High | 6.981 | 7 | 41 | 7 | context_mixed | provider_fingerprint_v1 | no | 28301 | yes | Complexity-adjusted context is aggregate and non-adjudicative; it does not predict payer actions. | 2026-03-09__083005Z | 1.0.0 |
Method and limitations
- This tool does not predict payer actions. It highlights statistical variance patterns that may warrant clearer documentation.
- Statistical consistency context; not payer prediction, not clinical appropriateness.
- Availability and cross-state checks are data-readiness indicators, not clinical or payer outcomes.
- All data samples are aggregate-only and must not be interpreted as provider-level adjudication evidence.
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Page updated: 2026-02-16