state-sync + ledger + P6 mockup: readiness-model backend complete [CC]

Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>

context/current-state.md

@@ -2,7 +2,7 @@ v:1
 
 # current-state
 
-ACTIVE: 2026-07-07 [CC]. SIGNAL BUILD UN-PAUSED — readiness-model completion in flight per docs/build-plans/. P1 (wiring) SHIPPED + LIVE-VERIFIED (commit a3af499, deployed to Railway, false-green kill observed live). Executing P2 (citation IDs) -> P3 (rollup) -> P4 (device overrides) -> P5 (plan-type enforcement) next, one item at a time with independent audit each. P6 (frontend nesting) BLOCKED on Kisa approving the rendered mockup (built, awaiting render+review).
+ACTIVE: 2026-07-07 [CC]. READINESS-MODEL BACKEND COMPLETE: P1-P5 all SHIPPED + LIVE-VERIFIED (a3af499, d24340c, bd92126, a53728e, f28b5bf; Railway + Vercel deployed; doc_status migration applied to prod). 169 tests + Pi E2E 33/33 green. P6 (frontend nesting) is the ONLY remaining item — BLOCKED on Kisa approving docs/mockups/p6-worklist-mockup-2026-07-07.png (decisions A-D).
 
 NEXT: (CC) P2-P5 per docs/build-plans/02-readiness-model-completion.md; (Kisa) approve/reject P6 mockup decisions A-D; (Kisa) confirm OQ1 plan_type-ingestion decision recorded 2026-07-07 (shipped per umbrella plan; two-line revert if reversed); (Kisa) attorney bundle READY TO SEND (signal/pitch/legal/attorney-bundle-2026-07-07, 5 Word docs + sendable memo): confirm recipient (Clyde Mathes vs Bittinger/Nixon), entity name + formation state, arbitration-vs-courts posture, Partner Concepts carve-out keep/drop, then email; Gaboro re-approach per reactivation plan 00 (unchanged). Queued behind Signal: UMSIS docs-only activation, "63% written off" Draft fix.
 
@@ -25,6 +25,8 @@ Insight Engine (July 4 deadline = tomorrow) is the active project. Key files:
 
 ## Decisions (last
 
+- 2026-07-07 [CC]: Readiness-model backend COMPLETE (P2-P5 shipped same day as P1): citation IDs live (R-registry), patient rollup + nested payload live, device-scoped overrides live (doc_status migration applied to prod; overrides now feed the verdict; the leak is dead, live-measured), plan-type enforcement live (zero greens without a mapped plan type, live-measured; Phase 2c deletion stays Kisa-gated). Every item independently audited SHIP before ship. P6 mockup rendered for Kisa (4 decisions annotated).
+
 - 2026-07-07 [CC]: Attorney-review legal bundle PREPARED (lead-sttil drafted, ops-steward independently reviewed, 6 findings fixed incl. 4 HIGH counterparty-name leaks). LOI template v3 (product-agnostic body, Exhibit A pre-filled for Signal, labABLE negotiation learnings folded in), NDA template v3 (products list corrected to Signal/Vitality Med Tracker/UMSIS + catch-all), BAA template v1 (generalized from Gaboro draft, forward-looking posture block), cover memo bundling both templates + BAA + FDA CDS memo + labABLE AKS question per reactivation plan 00. Entity name corrected everywhere to KJF Professional Services LLC dba STTIL Solutions (per executed labABLE LOI; kg_add recorded); formation state left as placeholder (old docs disagree: Delaware/Florida/Pennsylvania) = attorney Q1. Templates: STTIL-Vault/Projects/Legal/ (LOI+NDA v3) + signal/pitch/legal/ (BAA, memo). Send-ready docx: signal/pitch/legal/attorney-bundle-2026-07-07/.
 - 2026-07-07 [CC]: Readiness model WIRED LIVE (plan 01, commit a3af499, Railway deploy verified). Phase 2a seam confirmed: readiness AUGMENTS legacy output (byte-identical legacy proven by live diff). OQ1 executed per umbrella plan 00 ("ship plan_type ingestion with the wiring") — minimal client-mapped column, never guessed; flagged for Kisa's explicit confirmation, two-line revert if reversed. Adversarial review caught a false-green in the draft row-resolution; fixed via dedup-group-keyed ReadinessIndex, regression-locked. Grounded test count: 132 (the old "73 tests" figure corrected per plan 01 §12.5).
 - 2026-07-06 [CC]: Model routing SETTLED (Kisa agreed) — strongest model in the orchestrator seat (plain claude, full MCP, skip-permissions), sonnet/haiku subagents for mechanical work, Fable-as-subagent only for cleanly separable hard problems. Docs-verified: delegation multiplies tokens on one shared pool; per-agent model override + mid-session /model GROUNDED. Config application PARKED. Discovered com.sttil.cos-model-switch: Fable-to-Opus swap fires 2026-07-07 09:00. Watcher audit: 9 agents healthy, clean exits; research watcher never built.
@@ -59,4 +61,4 @@ Insight Engine (July 4 deadline = tomorrow) is the active project. Key files:
 
 State protocol: read = `git pull --rebase` then read this file (warn if Updated > 24h old); write = edit ACTIVE/NEXT, append one author-stamped decision, then commit + push. Full protocol in the `state-sync` skill. Detailed ship-status (what shipped / didn't / why) = docs/ship-status-ledger.md. TriLane = searchable archive, not live state.
 
-## Updated: 2026-07-07 (CC: Signal un-paused; P1 readiness wiring shipped+live-verified a3af499; P2-P5 executing; P6 mockup awaiting Kisa; OQ1 recorded for confirmation; attorney legal bundle prepared and ready to send.)
+## Updated: 2026-07-07 (CC: readiness-model backend P1-P5 complete, live-verified, deployed; P6 gated on Kisa mockup approval.)

docs/ship-status-ledger.md

@@ -85,3 +85,30 @@ byte-identical (live diff vs pre-deploy baseline: NONE).
   Clear to Ship and normalizes "Medicare" -> "medicare".
 - Frontend intentionally renders nothing new yet (P6, gated on Kisa's mockup
   approval).
+
+## Shipped: readiness-model completion P2-P5 (2026-07-07, Claude, commits d24340c / bd92126 / a53728e / f28b5bf)
+
+All four backend items shipped one at a time, each with an independent
+code-auditor SHIP verdict and measured live verification:
+
+- P2 citation IDs: every doc item cites its rule (R001-R004 plan-scoped,
+  R100-R102 universal per LCD L33822); registry-drift test guards the config.
+  Live: deployed verdict cites R004/R003/R100.
+- P3 patient rollup: nested patients payload (worst gradeable line; Plan Type
+  Needed caps at Action Needed; non-gradeable displayed, never counted);
+  patient_stats count patients, not rows. Live-verified with a two-device
+  patient.
+- P4 device-keyed overrides: doc_status migration applied to production
+  (device_type in the unique key, legacy '' rows honored); overrides now FEED
+  the verdict, device-scoped; recompute contract returns {lines, rollup}
+  through the same engine. Live: G7 override flipped only G7's line — the
+  leak is dead, measured against real Supabase state.
+- P5 plan-type enforcement: full alias + value canonicalization; zero greens
+  reachable without a client-mapped plan type (live-measured); once-per-batch
+  deprecation fence; all 66 fixture CSVs authored with plan_type (drift
+  corpus uses variant headers/values; 66/66 map). _normalize_payer and the
+  default config entry remain (Phase 2c stays Kisa-gated).
+
+Final state: 169 unit/API tests green, Pi E2E 33/33, live drives recorded
+above. P6 (frontend nesting) BLOCKED on Kisa's mockup approval:
+docs/mockups/p6-worklist-mockup-2026-07-07.png (decisions A-D annotated).

python-backend/api/main.py

@@ -34,7 +34,12 @@ from core.persistence import (
     upsert_doc_status,
     load_doc_statuses_for_org,
 )
-from api.normalizer import normalize_csv
+from api.normalizer import _normalize_plan_type, normalize_csv
+from core.overrides import (
+    Override,
+    OverrideKey,
+    overrides_from_saved,
+)
 from core.worklist_readiness import (
     build_readiness_index,
     merged_to_record,
@@ -349,22 +354,129 @@ VALID_DOC_STATUSES = {
     "pa": {"not_required", "requested", "approved", "denied"},
 }
 
-DOC_STATUS_LABELS = {
-    "pending": "Pending",
-    "requested": "Requested",
-    "on_file": "On File",
-    "not_required": "Not Required",
-    "approved": "Approved",
-    "denied": "Denied",
-}
+# Single source of truth for stored-status labels lives with the override
+# engine (the same labels feed grading and display).
+from core.overrides import STORED_STATUS_LABELS as DOC_STATUS_LABELS  # noqa: E402
+
+
+def _recompute_patient(
+    patient_id: str,
+    echo_lines: list["EchoLine"],
+    saved_doc_statuses: dict,
+    confirmed_visit: Optional[date] = None,
+):
+    """Stateless patient recompute (P4): rebuild the patient's lines from the
+    echoed CSV-truth inputs, apply ALL persisted staff overrides (the write
+    that triggered this call is already persisted) plus the confirmed visit,
+    re-grade through the same engine, and roll up through the same truth
+    table. Returns (lines_out, rollup_status)."""
+    from core.rollup import rollup_patient
+    from core.worklist_readiness import build_readiness_index as _bri
+
+    records = []
+    for el in echo_lines:
+        try:
+            ship = (
+                date_type.fromisoformat(el.shipment_date)
+                if el.shipment_date
+                else date.today()
+            )
+        except ValueError:
+            ship = date.today()
+        csv_visit = None
+        if el.csv_visit_date:
+            try:
+                csv_visit = date_type.fromisoformat(el.csv_visit_date)
+            except ValueError:
+                csv_visit = None
+        records.append(
+            ShipmentRecord(
+                patient_id=patient_id,
+                device_type=el.device_type,
+                shipment_date=ship,
+                quantity=1,
+                payer="",
+                csv_swo_status=el.csv_swo_status,
+                csv_visit_date=csv_visit,
+                csv_pecos_verified=el.csv_pecos_verified,
+                csv_pa_status=el.csv_pa_status,
+                csv_diagnosis_on_file=el.csv_diagnosis_on_file,
+                plan_type=_normalize_plan_type(el.plan_type),
+            )
+        )
+
+    patient_hash = hashlib.sha256(patient_id.encode()).hexdigest()
+    confirmed = (
+        {patient_hash: confirmed_visit} if confirmed_visit else None
+    )
+    overrides = overrides_from_saved(
+        {patient_hash: saved_doc_statuses.get(patient_hash, {})}
+    )
+    index = _bri(records, confirmed_visits=confirmed, overrides=overrides)
+
+    lines_out = []
+    for line_key, line in index.lines.items():
+        verdict = index.by_line.get(line_key)
+        lines_out.append(
+            LineRecomputeOut(
+                device_type=line.device_type,
+                plan_type=None if line.plan_type == "unknown" else line.plan_type,
+                line_status=line.line_status,
+                doc_items=_readiness_items_out(verdict),
+            )
+        )
+    rollup = rollup_patient(list(index.lines.values()))
+    return lines_out, (
+        rollup.rollup_status.value if rollup.rollup_status else None
+    )
+
+
+class EchoLine(BaseModel):
+    """One coverage line echoed back for a stateless patient recompute.
+    Carries CSV-truth grading inputs only; the server applies all persisted
+    staff overrides and confirmed visits on top, then re-grades."""
+
+    device_type: str
+    gradeable: bool = True
+    plan_type: Optional[str] = None
+    shipment_date: Optional[str] = None  # ISO; defaults to today (doc axis
+    # grading does not depend on it)
+    csv_swo_status: Optional[str] = None
+    csv_visit_date: Optional[str] = None
+    csv_pecos_verified: Optional[str] = None
+    csv_pa_status: Optional[str] = None
+    csv_diagnosis_on_file: Optional[str] = None
+
+
+class LineRecomputeOut(BaseModel):
+    device_type: str
+    plan_type: Optional[str] = None
+    line_status: Optional[str] = None
+    doc_items: Optional[list["ReadinessItemOut"]] = None
 
 
 class DocStatusRequest(BaseModel):
     patient_id: str
     doc_type: str
     status: str
+    # Device scope (P4). '' or omitted writes a legacy patient-scoped row
+    # that applies to all devices until a device-scoped row is saved.
+    device_type: str = ""
     status_date: Optional[str] = None
     expiry_date: Optional[str] = None
+    # Optional echo of the patient's lines for the {line, rollup} recompute.
+    lines: Optional[list[EchoLine]] = None
+
+
+def _saved_for_device(
+    doc_statuses: dict, patient_hash: str, device_type: str
+) -> dict:
+    """Resolve the device-scoped saved statuses for one record: legacy ''
+    (patient-scoped) rows apply to all devices; a device-scoped row wins."""
+    by_pat = doc_statuses.get(patient_hash, {})
+    merged = dict(by_pat.get("", {}))
+    merged.update(by_pat.get(device_type, {}))
+    return merged
 
 
 def _readiness_items_out(readiness) -> Optional[list[ReadinessItemOut]]:
@@ -671,6 +783,22 @@ async def upload_csv(
 
     db_conn = get_client()
 
+    # P5 deprecation fence: when any record lacks a client-mapped plan_type,
+    # the TIMING rules fall back to the payer-name guess for those records
+    # (readiness never does — it reads Plan Type Needed). Once per batch.
+    _unmapped = sum(1 for rec in records if rec.plan_type is None)
+    if _unmapped:
+        import logging
+
+        logging.getLogger(__name__).warning(
+            "plan_type not provided for %d/%d records. Timing rules guess "
+            "from the payer name (legacy path, to be removed); readiness "
+            "grades these records Plan Type Needed. Supply plan_type in "
+            "the CSV import.",
+            _unmapped,
+            len(records),
+        )
+
     results = calculate_batch(
         records, as_of=date.today(), confirmed_visits=confirmed_visits
     )
@@ -683,8 +811,11 @@ async def upload_csv(
 
     # Readiness index (Phase 2a: additive, augments the legacy scoring —
     # replaces nothing). Row-to-line membership comes from the dedup output
-    # itself, never re-derived from a row's own plan_type.
-    index = build_readiness_index(records, confirmed_visits)
+    # itself, never re-derived from a row's own plan_type. Staff overrides
+    # (P4) feed the grading inputs, device-scoped.
+    index = build_readiness_index(
+        records, confirmed_visits, overrides=overrides_from_saved(doc_statuses)
+    )
 
     out = []
     used_lines = {}
@@ -718,8 +849,10 @@ async def upload_csv(
                 confirmed_visit_date=confirmed_visits.get(
                     hashlib.sha256(r.patient_id.encode()).hexdigest()
                 ),
-                saved_doc_statuses=doc_statuses.get(
-                    hashlib.sha256(r.patient_id.encode()).hexdigest(), {}
+                saved_doc_statuses=_saved_for_device(
+                    doc_statuses,
+                    hashlib.sha256(r.patient_id.encode()).hexdigest(),
+                    r.device_type,
                 ),
                 readiness=verdict,
             )
@@ -883,6 +1016,10 @@ class ConfirmVisitRequest(BaseModel):
     # Client-mapped plan type echoed from the upload — never guessed. None
     # keeps the recompute honest: the verdict reads Plan Type Needed.
     plan_type: str | None = None
+    # Optional echo of ALL the patient's lines: the confirmed visit fans out
+    # to every line (the visit is the person), so the P4 recompute re-grades
+    # each and returns the re-rolled patient alongside the legacy record.
+    lines: Optional[list[EchoLine]] = None
 
 
 @app.post("/api/confirm-visit")
@@ -965,9 +1102,9 @@ async def confirm_visit(
         csv_transfer_from=body.csv_transfer_from,
         order_number=body.order_number,
         hcpcs=body.hcpcs,
-        # Same normalization the CSV path applies (lowercase + trim, never
+        # Same canonicalization the CSV path applies (value map, never
         # guessed) so RecordOut.plan_type is consistent across both paths.
-        plan_type=(body.plan_type or "").strip().lower() or None,
+        plan_type=_normalize_plan_type(body.plan_type),
     )
     result = calculate_coverage(record, confirmed_visit_date=confirmed)
     verdict = readiness_for_record(record, confirmed_visit_date=confirmed)
@@ -985,9 +1122,23 @@ async def confirm_visit(
         db_conn=db_conn,
     )
 
-    return _to_record_out(
+    record_out = _to_record_out(
         result, record=record, confirmed_visit_date=confirmed, readiness=verdict
     )
+    if not body.lines:
+        return record_out
+
+    # P4: re-grade the patient's echoed lines with the new confirmed date
+    # (visit fans out to all lines) and return the re-rolled patient. All
+    # legacy RecordOut fields stay present.
+    saved = load_doc_statuses_for_org(org_id)
+    lines_out, rollup_status = _recompute_patient(
+        body.patient_id, body.lines, saved, confirmed_visit=confirmed
+    )
+    payload = record_out.model_dump()
+    payload["lines"] = [l.model_dump() for l in lines_out]
+    payload["rollup_status"] = rollup_status
+    return payload
 
 
 @app.put("/api/doc-status")
@@ -1039,7 +1190,13 @@ async def update_doc_status(
 
     patient_hash = hashlib.sha256(body.patient_id.encode()).hexdigest()
     success = upsert_doc_status(
-        org_id, patient_hash, body.doc_type, body.status, status_date, expiry_date
+        org_id,
+        patient_hash,
+        body.doc_type,
+        body.status,
+        status_date,
+        expiry_date,
+        device_type=body.device_type or "",
     )
     if not success:
         raise HTTPException(status_code=503, detail="Failed to save doc status.")
@@ -1057,9 +1214,24 @@ async def update_doc_status(
         db_conn=db_conn,
     )
 
-    return {
+    response = {
         "patient_id": body.patient_id,
         "doc_type": body.doc_type,
         "status": body.status,
+        "device_type": body.device_type or "",
         "display": DOC_STATUS_LABELS.get(body.status, body.status),
     }
+
+    # P4 recompute contract: when the client echoes the patient's lines,
+    # re-grade them (the write above is already persisted, so a fresh load
+    # picks it up) and return {lines, rollup} from the same engine.
+    if body.lines:
+        saved = load_doc_statuses_for_org(org_id)
+        confirmed = load_confirmed_visits_for_org(org_id).get(patient_hash)
+        lines_out, rollup_status = _recompute_patient(
+            body.patient_id, body.lines, saved, confirmed_visit=confirmed
+        )
+        response["lines"] = [l.model_dump() for l in lines_out]
+        response["rollup_status"] = rollup_status
+
+    return response

python-backend/api/normalizer.py

@@ -6,11 +6,15 @@ Tolerates header drift, alternative column names, and common date formats.
 """
 
 import csv
+import hashlib
 import io
+import logging
 import re
 from datetime import date, datetime
 from typing import Optional
 
+logger = logging.getLogger(__name__)
+
 import sys
 from pathlib import Path
 sys.path.insert(0, str(Path(__file__).parent.parent))
@@ -52,8 +56,10 @@ HEADER_MAP: dict[str, list[str]] = {
     # name. Bare "plan"/"plan_name" stay payer aliases (a "Plan" column in the
     # wild is a payer name); stealing them would silently re-map existing CSVs.
     "plan_type": [
-        "plan_type", "plan type", "plan category", "plan_category",
+        "plan_type", "plan type", "plantype", "plan category", "plan_category",
         "coverage type", "coverage_type", "insurance_type", "insurance type",
+        "payer_type", "payer type", "lob", "line_of_business",
+        "line of business", "benefit_type", "benefit type",
     ],
     "component": [
         "component", "item_type", "component_type", "type", "supply_type",
@@ -173,6 +179,30 @@ DATE_FORMATS = [
 ]
 
 
+# Canonicalization map for CLIENT-SUPPLIED plan-type VALUES (P5). The client
+# asserted the plan type; Signal only canonicalizes spelling. Deriving plan
+# type from the payer NAME remains forbidden (the never-guess lock).
+PLAN_TYPE_VALUES = {
+    "medicare": "medicare", "medicare ffs": "medicare", "ffs": "medicare",
+    "medicare part b": "medicare", "part b": "medicare",
+    "traditional medicare": "medicare", "original medicare": "medicare",
+    "medicare advantage": "medicare_advantage", "ma": "medicare_advantage",
+    "medicare part c": "medicare_advantage", "part c": "medicare_advantage",
+    "medicare_advantage": "medicare_advantage",
+    "medicaid": "medicaid", "mcd": "medicaid", "state medicaid": "medicaid",
+    "commercial": "commercial", "private": "commercial",
+    "employer": "commercial", "group": "commercial",
+}
+
+
+def _normalize_plan_type(raw: "Optional[str]") -> Optional[str]:
+    """Canonicalize a CLIENT-SUPPLIED plan type value. Never called on payer
+    names. Unrecognized (including blank) -> None -> Plan Type Needed.
+    Never guess."""
+    s = (raw or "").strip().lower()
+    return PLAN_TYPE_VALUES.get(s)
+
+
 def _normalize_key(s: str) -> str:
     return s.strip().lower().replace("-", " ").replace("_", " ")
 
@@ -268,6 +298,7 @@ def normalize_csv(text: str) -> tuple[list[ShipmentRecord], list[str], dict]:
 
     records: list[ShipmentRecord] = []
     skipped: list[str] = []
+    _warned_plan_values: set = set()  # one warning per distinct value per file
 
     for i, row in enumerate(reader, start=2):  # noqa: B007
         mapped: dict[str, str] = {}
@@ -319,11 +350,19 @@ def normalize_csv(text: str) -> tuple[list[ShipmentRecord], list[str], dict]:
         order_number = mapped.get("order_number") or None
         hcpcs = mapped.get("hcpcs") or None
 
-        # Client-supplied plan type, carried verbatim (lowercased and trimmed
-        # only — canonicalization of synonyms is a later, separate step).
-        # Anything the readiness engine does not recognize grades as
-        # "Plan Type Needed"; it is never guessed from the payer name.
-        plan_type = (mapped.get("plan_type") or "").strip().lower() or None
+        # Client-supplied plan type, canonicalized through the value map
+        # (spelling only — the client asserted the plan type). Unrecognized
+        # values grade as "Plan Type Needed"; never guessed from payer name.
+        raw_plan = (mapped.get("plan_type") or "").strip()
+        plan_type = _normalize_plan_type(raw_plan)
+        if raw_plan and plan_type is None and raw_plan.lower() not in _warned_plan_values:
+            _warned_plan_values.add(raw_plan.lower())
+            logger.warning(
+                "Unrecognized plan_type value '%s' (first seen row %d, "
+                "patient hash %s) -> grades as Plan Type Needed",
+                raw_plan, i,
+                hashlib.sha256(patient_id.encode()).hexdigest()[:12],
+            )
 
         records.append(ShipmentRecord(
             patient_id=patient_id,

python-backend/core/overrides.py

@@ -0,0 +1,130 @@
+"""
+overrides.py
+Signal — STTIL Solutions
+
+Device-keyed staff overrides (build plan 02, P4; phase-2 design Item 4).
+
+Pilot scope is LOCKED to two override kinds:
+- visit: patient-scoped (the visit is the person). It rides the existing
+  confirmed_visits path, which already fans out to every line of the patient
+  by construction (evaluate_readiness receives the confirmed date per
+  patient). This module does not duplicate that mechanism.
+- swo / pa: line-scoped. They apply only to lines whose device_type matches;
+  device_type '' marks a legacy patient-scoped row and matches all devices
+  until staff re-saves it device-scoped.
+
+Overrides feed the GRADING inputs (staff knowledge wins over the CSV cell,
+matching the existing display precedence), then affected lines re-grade.
+
+PHI CONTRACT: overrides carry patient_id_hash only (the storage key). Lines
+carry raw patient_id; matching hashes it. Nothing here logs patient data.
+"""
+
+from __future__ import annotations
+
+import hashlib
+from dataclasses import dataclass
+from datetime import date, datetime
+from typing import Optional
+
+# Stored status -> display/grading label. Single source of truth; the API's
+# display map imports this. The labels feed the readiness vocabularies
+# ("On File" grades GOOD, "Denied" grades BAD, "Requested" grades PENDING).
+STORED_STATUS_LABELS = {
+    "pending": "Pending",
+    "requested": "Requested",
+    "on_file": "On File",
+    "not_required": "Not Required",
+    "approved": "Approved",
+    "denied": "Denied",
+}
+
+# Legacy patient-scoped rows carry an empty device_type and match all devices.
+LEGACY_ALL_DEVICES = ""
+
+OVERRIDABLE_DOC_TYPES = ("swo", "pa")
+
+
+@dataclass(frozen=True)
+class OverrideKey:
+    org_id: str
+    patient_hash: str
+    device_type: str  # '' = legacy patient-scoped, applies to all devices
+    doc_type: str  # "swo" | "pa" (visit rides confirmed_visits)
+
+
+@dataclass
+class Override:
+    key: OverrideKey
+    status: str  # stored value, e.g. "on_file" | "approved" | "denied"
+    status_date: Optional[date] = None
+    expiry_date: Optional[date] = None
+    confirmed_by: str = "staff"
+    confirmed_at: Optional[datetime] = None
+
+
+def _hash_pid(patient_id: str) -> str:
+    return hashlib.sha256(patient_id.encode()).hexdigest()
+
+
+def grading_value(override: Override) -> str:
+    """The label fed to the readiness vocabularies for this override."""
+    return STORED_STATUS_LABELS.get(override.status, override.status)
+
+
+def overrides_from_saved(saved: dict) -> list[Override]:
+    """Build Override objects from the persistence load shape:
+    patient_hash -> device_type -> doc_type -> {status, status_date, ...}."""
+    out: list[Override] = []
+    for patient_hash, by_device in (saved or {}).items():
+        for device_type, by_doc in by_device.items():
+            for doc_type, row in by_doc.items():
+                if doc_type not in OVERRIDABLE_DOC_TYPES:
+                    continue
+                out.append(
+                    Override(
+                        key=OverrideKey(
+                            org_id="",
+                            patient_hash=patient_hash,
+                            device_type=device_type,
+                            doc_type=doc_type,
+                        ),
+                        status=row.get("status", ""),
+                    )
+                )
+    return out
+
+
+def apply_overrides(lines: dict, overrides: list[Override]) -> set[str]:
+    """Apply swo/pa overrides onto the grading inputs of matching lines.
+
+    Mutates each matching line's current_shipment csv fields (staff knowledge
+    wins over the CSV cell). Device-scoped rows win over legacy '' rows.
+    Returns the raw patient_ids of touched lines. Grading (or re-grading)
+    happens in the caller — build_readiness_index grades after application.
+    """
+    if not overrides:
+        return set()
+
+    by_patient: dict[str, list[Override]] = {}
+    for o in overrides:
+        by_patient.setdefault(o.key.patient_hash, []).append(o)
+
+    touched: set[str] = set()
+    for line in lines.values():
+        patient_overrides = by_patient.get(_hash_pid(line.patient_id))
+        if not patient_overrides:
+            continue
+        # Legacy '' first so a device-scoped row applied after it wins.
+        for o in sorted(
+            patient_overrides, key=lambda o: o.key.device_type != LEGACY_ALL_DEVICES
+        ):
+            if o.key.device_type not in (LEGACY_ALL_DEVICES, line.device_type):
+                continue
+            label = grading_value(o)
+            if o.key.doc_type == "swo":
+                line.current_shipment.csv_swo_status = label
+            elif o.key.doc_type == "pa":
+                line.current_shipment.csv_pa_status = label
+            touched.add(line.patient_id)
+    return touched

python-backend/core/persistence.py

@@ -227,9 +227,12 @@ def upsert_doc_status(
     status: str,
     status_date: "date | None" = None,
     expiry_date: "date | None" = None,
+    device_type: str = "",
 ) -> bool:
     """
-    Insert or update a doc status (swo or pa) for a patient.
+    Insert or update a doc status (swo or pa), scoped to a device.
+    device_type '' writes a legacy patient-scoped row (applies to all of the
+    patient's devices until a device-scoped row is saved).
     Returns True on success, False if Supabase unavailable.
     """
     client = get_client()
@@ -241,6 +244,7 @@ def upsert_doc_status(
             "patient_id_hash": patient_id_hash,
             "doc_type": doc_type,
             "status": status,
+            "device_type": device_type or "",
             "updated_at": "now()",
         }
         if status_date is not None:
@@ -248,7 +252,7 @@ def upsert_doc_status(
         if expiry_date is not None:
             payload["expiry_date"] = expiry_date.isoformat()
         client.table("doc_status").upsert(
-            payload, on_conflict="org_id,patient_id_hash,doc_type"
+            payload, on_conflict="org_id,patient_id_hash,doc_type,device_type"
         ).execute()
         return True
     except Exception as e:
@@ -258,23 +262,24 @@ def upsert_doc_status(
 
 def load_doc_statuses_for_org(org_id: str) -> dict:
     """
-    Load all SWO and PA statuses for an org.
-    Returns dict: patient_id_hash -> {doc_type: {status, status_date, expiry_date}}
+    Load all SWO and PA statuses for an org, device-scoped.
+    Returns dict: patient_id_hash -> device_type -> {doc_type: {status,
+    status_date, expiry_date}}. The '' device bucket holds legacy
+    patient-scoped rows (they apply to every device until re-saved).
     """
     client = get_client()
     if not client:
         return {}
     try:
         result = client.table("doc_status") \
-            .select("patient_id_hash,doc_type,status,status_date,expiry_date") \
+            .select("patient_id_hash,device_type,doc_type,status,status_date,expiry_date") \
             .eq("org_id", org_id) \
             .execute()
         out: dict = {}
         for row in (result.data or []):
             h = row["patient_id_hash"]
-            if h not in out:
-                out[h] = {}
-            out[h][row["doc_type"]] = {
+            device = row.get("device_type") or ""
+            out.setdefault(h, {}).setdefault(device, {})[row["doc_type"]] = {
                 "status": row["status"],
                 "status_date": row.get("status_date"),
                 "expiry_date": row.get("expiry_date"),

python-backend/core/worklist_readiness.py

@@ -82,18 +82,27 @@ def _confirmed_for(
 def build_readiness_index(
     records: list[ShipmentRecord],
     confirmed_visits: Optional[dict[str, date]] = None,
+    overrides: Optional[list] = None,
 ) -> ReadinessIndex:
-    """Dedup records into coverage lines, grade each gradeable line, and
-    record the group->line membership map so row-level resolution never
-    re-derives it.
+    """Dedup records into coverage lines, apply staff overrides to the
+    grading inputs (P4: swo/pa device-scoped; staff knowledge wins over the
+    CSV cell), grade each gradeable line, and record the group->line
+    membership map so row-level resolution never re-derives it.
 
     Grades the CURRENT shipment only (latest DOS per line — locked rule);
     prior shipments are collapsed history. Non-gradeable lines are skipped.
+    Visit overrides arrive via confirmed_visits (patient-scoped fan-out by
+    construction).
     """
     confirmed_visits = confirmed_visits or {}
     merged = dedup(records)
     lines = assign_to_coverage_lines(merged)
 
+    if overrides:
+        from core.overrides import apply_overrides
+
+        apply_overrides(lines, overrides)
+
     index = ReadinessIndex()
     for key, line in lines.items():
         line_key = (key.patient_id, key.device_type, key.plan_type_id)

signal-ui/src/components/CSVImport.jsx

@@ -9,6 +9,7 @@ const FIELD_LABELS = {
   shipment_date: "Shipment Date",
   quantity: "Quantity",
   payer: "Payer",
+  plan_type: "Plan Type",
   component: "Component",
   csv_visit_date: "Visit Date",
   csv_swo_status: "SWO Status",
@@ -25,6 +26,7 @@ const OVERRIDE_OPTIONS = [
   { value: "shipment_date", label: "Shipment Date" },
   { value: "quantity", label: "Quantity" },
   { value: "payer", label: "Payer" },
+  { value: "plan_type", label: "Plan Type" },
   { value: "skip", label: "Skip this column" },
 ];
 

signal-ui/src/components/WorklistTable.jsx

@@ -347,22 +347,22 @@ export default function WorklistTable({ records, activeFilter, onFilterChange, o
                           <div className="grid grid-cols-2 gap-y-[6px] gap-x-[20px] text-[12px]">
                             <DocItem
                               label="SWO"
-                              value={localDocStates[r.patient_id]?.swo ?? r.doc_state.swo}
-                              patientId={r.patient_id} docType="swo" cycle={SWO_CYCLE}
+                              value={localDocStates[`${r.patient_id}:${r.device_type}`]?.swo ?? r.doc_state.swo}
+                              patientId={r.patient_id} deviceType={r.device_type} docType="swo" cycle={SWO_CYCLE}
                               getToken={getToken}
                               onUpdated={(type, label) => setLocalDocStates(prev => ({
-                                ...prev, [r.patient_id]: { ...prev[r.patient_id], [type]: label }
+                                ...prev, [`${r.patient_id}:${r.device_type}`]: { ...prev[`${r.patient_id}:${r.device_type}`], [type]: label }
                               }))}
                             />
                             <DocItem label="Qualifying Visit" value={r.doc_state.visit} />
                             <DocItem label="PECOS Enrollment" value={r.doc_state.pecos} />
                             <DocItem
                               label="Prior Authorization"
-                              value={localDocStates[r.patient_id]?.pa ?? r.doc_state.pa}
-                              patientId={r.patient_id} docType="pa" cycle={PA_CYCLE}
+                              value={localDocStates[`${r.patient_id}:${r.device_type}`]?.pa ?? r.doc_state.pa}
+                              patientId={r.patient_id} deviceType={r.device_type} docType="pa" cycle={PA_CYCLE}
                               getToken={getToken}
                               onUpdated={(type, label) => setLocalDocStates(prev => ({
-                                ...prev, [r.patient_id]: { ...prev[r.patient_id], [type]: label }
+                                ...prev, [`${r.patient_id}:${r.device_type}`]: { ...prev[`${r.patient_id}:${r.device_type}`], [type]: label }
                               }))}
                             />
                             <DocItem label="Diagnosis on File" value={r.doc_state.diagnosis} />
@@ -492,7 +492,7 @@ function ActionCell({ flag, cascade, showConfirmVisit, onConfirmVisit, onExpand
   return null;
 }
 
-function DocItem({ label, value, patientId, docType, cycle, getToken, onUpdated }) {
+function DocItem({ label, value, patientId, deviceType = "", docType, cycle, getToken, onUpdated }) {
   const [saving, setSaving] = useState(false);
 
   const isGood = value && (
@@ -514,7 +514,7 @@ function DocItem({ label, value, patientId, docType, cycle, getToken, onUpdated
     const nextLabel = DOC_STATUS_LABELS[nextKey];
     setSaving(true);
     const token = getToken ? await getToken().catch(() => null) : null;
-    const result = await updateDocStatus(patientId, docType, nextKey, null, null, token);
+    const result = await updateDocStatus(patientId, docType, nextKey, null, null, token, deviceType);
     setSaving(false);
     if (result && onUpdated) onUpdated(docType, nextLabel);
   };

signal-ui/src/lib/api.js

@@ -141,7 +141,7 @@ export async function confirmVisit(payload, token = null) {
  * @param {string|null} token - Clerk JWT
  * @returns {Promise<{patient_id, doc_type, status, display}|null>}
  */
-export async function updateDocStatus(patientId, docType, status, statusDate = null, expiryDate = null, token = null) {
+export async function updateDocStatus(patientId, docType, status, statusDate = null, expiryDate = null, token = null, deviceType = "") {
   const authHeader = token
     ? { "Authorization": `Bearer ${token}` }
     : {};
@@ -153,6 +153,9 @@ export async function updateDocStatus(patientId, docType, status, statusDate = n
         patient_id: patientId,
         doc_type: docType,
         status,
+        // Device scope (P4): an SWO/PA update applies to this device's line
+        // only, never to every device the patient has.
+        ...(deviceType && { device_type: deviceType }),
         ...(statusDate && { status_date: statusDate }),
         ...(expiryDate && { expiry_date: expiryDate }),
       }),

test-data/sample-batch-01-ok.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1001,freestyle_libre_3,2026-05-10,9,Medicaid - GA,sensor
-PT-1002,freestyle_libre_3,2026-05-10,9,Medicaid - GA,sensor
-PT-1003,freestyle_libre_3,2026-05-15,1,Medicaid - GA,sensor
-PT-1004,freestyle_libre_3,2026-05-09,1,Medicaid - GA,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1001,freestyle_libre_3,2026-05-10,9,Medicaid - GA,sensor,medicaid
+PT-1002,freestyle_libre_3,2026-05-10,9,Medicaid - GA,sensor,medicaid
+PT-1003,freestyle_libre_3,2026-05-15,1,Medicaid - GA,sensor,medicaid
+PT-1004,freestyle_libre_3,2026-05-09,1,Medicaid - GA,sensor,medicaid

test-data/sample-batch-01-refill_window.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1001,FSL3,2026-05-03,9,Medicare Part A,sensor
-PT-1002,FreeStyle Libre 3,2026-05-03,6,Medicare Part A,sensor
-PT-1003,fs libre 3,2026-04-29,1,Medicare Part A,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1001,FSL3,2026-05-03,9,Medicare Part A,sensor,medicare
+PT-1002,FreeStyle Libre 3,2026-05-03,6,Medicare Part A,sensor,medicare
+PT-1003,fs libre 3,2026-04-29,1,Medicare Part A,sensor,medicare

test-data/sample-batch-01-visit_due.csv

@@ -1,6 +1,6 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1001,Omnipod,2025-04-27,6,Medicare Part B - CGM,pod
-PT-1002,Omnipod,2025-07-18,2,Medicare Part B - CGM,pod
-PT-1003,Omnipod 5,2025-07-15,6,Medicare Part B - CGM,pod
-PT-1004,OmniPod 5,2025-05-16,9,Medicare Part B - CGM,pod
-PT-1005,Omnipod 5,2025-07-02,6,Medicare Part B - CGM,pod
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1001,Omnipod,2025-04-27,6,Medicare Part B - CGM,pod,medicare
+PT-1002,Omnipod,2025-07-18,2,Medicare Part B - CGM,pod,medicare
+PT-1003,Omnipod 5,2025-07-15,6,Medicare Part B - CGM,pod,medicare
+PT-1004,OmniPod 5,2025-05-16,9,Medicare Part B - CGM,pod,medicare
+PT-1005,Omnipod 5,2025-07-02,6,Medicare Part B - CGM,pod,medicare

test-data/sample-batch-02-out_of_coverage.csv

@@ -1,6 +1,6 @@
-Patient ID,Item Description,Service Date,Qty,Insurance Name,Item Type,Prescriber NPI,Branch
-PT-1011,FreeStyle Libre 3,12/15/2024,1,Aetna Commercial,sensor,1234567890,PA-001
-PT-1012,FSL3,12/26/2024,1,Aetna Commercial,sensor,1234567890,PA-001
-PT-1013,FreeStyle Libre 3,11/06/2024,6,Aetna Commercial,sensor,1234567890,PA-001
-PT-1014,FSL3,11/09/2024,2,Aetna Commercial,sensor,1234567890,PA-001
-PT-1015,Libre 3,11/20/2024,3,Aetna Commercial,sensor,1234567890,PA-001
+Patient ID,Item Description,Service Date,Qty,Insurance Name,Item Type,Prescriber NPI,Branch,payer_type
+PT-1011,FreeStyle Libre 3,12/15/2024,1,Aetna Commercial,sensor,1234567890,PA-001,employer
+PT-1012,FSL3,12/26/2024,1,Aetna Commercial,sensor,1234567890,PA-001,employer
+PT-1013,FreeStyle Libre 3,11/06/2024,6,Aetna Commercial,sensor,1234567890,PA-001,employer
+PT-1014,FSL3,11/09/2024,2,Aetna Commercial,sensor,1234567890,PA-001,employer
+PT-1015,Libre 3,11/20/2024,3,Aetna Commercial,sensor,1234567890,PA-001,employer

test-data/sample-batch-02-visit_due.csv

@@ -1,9 +1,9 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1011,dexcom_g7,2025-06-22,9,UnitedHealth,sensor
-PT-1012,dexcom_g7,2025-06-18,2,UnitedHealth,sensor
-PT-1013,dexcom_g7,2025-06-19,9,UnitedHealth,sensor
-PT-1014,dexcom_g7,2025-06-16,1,UnitedHealth,sensor
-PT-1015,dexcom_g7,2025-06-14,6,UnitedHealth,sensor
-PT-1016,dexcom_g7,2025-06-17,3,UnitedHealth,sensor
-PT-1017,dexcom_g7,2025-06-14,2,UnitedHealth,sensor
-PT-1018,dexcom_g7,2025-06-17,1,UnitedHealth,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1011,dexcom_g7,2025-06-22,9,UnitedHealth,sensor,commercial
+PT-1012,dexcom_g7,2025-06-18,2,UnitedHealth,sensor,commercial
+PT-1013,dexcom_g7,2025-06-19,9,UnitedHealth,sensor,commercial
+PT-1014,dexcom_g7,2025-06-16,1,UnitedHealth,sensor,commercial
+PT-1015,dexcom_g7,2025-06-14,6,UnitedHealth,sensor,commercial
+PT-1016,dexcom_g7,2025-06-17,3,UnitedHealth,sensor,commercial
+PT-1017,dexcom_g7,2025-06-14,2,UnitedHealth,sensor,commercial
+PT-1018,dexcom_g7,2025-06-17,1,UnitedHealth,sensor,commercial

test-data/sample-batch-03-ok.csv

@@ -1,8 +1,8 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1021,dexcom_g7,2026-05-19,1,BCBS - FL,sensor
-PT-1022,dexcom_g7,2026-05-22,9,BCBS - FL,sensor
-PT-1023,dexcom_g7,2026-05-16,6,BCBS - FL,sensor
-PT-1024,dexcom_g7,2026-05-16,9,BCBS - FL,sensor
-PT-1025,dexcom_g7,2026-05-19,9,BCBS - FL,sensor
-PT-1026,dexcom_g7,2026-05-20,9,BCBS - FL,sensor
-PT-1027,dexcom_g7,2026-05-18,1,BCBS - FL,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1021,dexcom_g7,2026-05-19,1,BCBS - FL,sensor,commercial
+PT-1022,dexcom_g7,2026-05-22,9,BCBS - FL,sensor,commercial
+PT-1023,dexcom_g7,2026-05-16,6,BCBS - FL,sensor,commercial
+PT-1024,dexcom_g7,2026-05-16,9,BCBS - FL,sensor,commercial
+PT-1025,dexcom_g7,2026-05-19,9,BCBS - FL,sensor,commercial
+PT-1026,dexcom_g7,2026-05-20,9,BCBS - FL,sensor,commercial
+PT-1027,dexcom_g7,2026-05-18,1,BCBS - FL,sensor,commercial

test-data/sample-batch-03-out_of_coverage.csv

@@ -1,8 +1,8 @@
-PT_ID,DEVICE,SHIP DATE,UNITS,CARRIER,TYPE
-PT-1021,G7,2025-01-04,6,Medicaid - PA,sensor
-PT-1022,G7,2024-11-21,3,Medicaid - PA,sensor
-PT-1023,Dexcom G7,2025-01-14,2,Medicaid - PA,sensor
-PT-1024,Dexcom G7 CGM,2024-10-12,6,Medicaid - PA,sensor
-PT-1025,G7,2024-11-05,9,Medicaid - PA,sensor
-PT-1026,G7,2025-01-03,6,Medicaid - PA,sensor
-PT-1027,dexcom g7,2024-11-26,2,Medicaid - PA,sensor
+PT_ID,DEVICE,SHIP DATE,UNITS,CARRIER,TYPE,payer_type
+PT-1021,G7,2025-01-04,6,Medicaid - PA,sensor,state medicaid
+PT-1022,G7,2024-11-21,3,Medicaid - PA,sensor,state medicaid
+PT-1023,Dexcom G7,2025-01-14,2,Medicaid - PA,sensor,state medicaid
+PT-1024,Dexcom G7 CGM,2024-10-12,6,Medicaid - PA,sensor,state medicaid
+PT-1025,G7,2024-11-05,9,Medicaid - PA,sensor,state medicaid
+PT-1026,G7,2025-01-03,6,Medicaid - PA,sensor,state medicaid
+PT-1027,dexcom g7,2024-11-26,2,Medicaid - PA,sensor,state medicaid

test-data/sample-batch-03-refill_window.csv

@@ -1,6 +1,6 @@
-PT_ID,DEVICE,SHIP DATE,UNITS,CARRIER,TYPE
-PT-1021,Dexcom G6 Pro,2026-05-03,2,Humana,sensor
-PT-1022,G6,2026-04-29,3,Humana,sensor
-PT-1023,Dexcom G6,2026-05-05,9,Humana,sensor
-PT-1024,G6,2026-05-01,2,Humana,sensor
-PT-1025,Dexcom G6 Pro,2026-05-01,9,Humana,sensor
+PT_ID,DEVICE,SHIP DATE,UNITS,CARRIER,TYPE,Coverage Type
+PT-1021,Dexcom G6 Pro,2026-05-03,2,Humana,sensor,Commercial
+PT-1022,G6,2026-04-29,3,Humana,sensor,Commercial
+PT-1023,Dexcom G6,2026-05-05,9,Humana,sensor,Commercial
+PT-1024,G6,2026-05-01,2,Humana,sensor,Commercial
+PT-1025,Dexcom G6 Pro,2026-05-01,9,Humana,sensor,Commercial

test-data/sample-batch-04-ok.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1031,freestyle_libre_3,2026-05-18,3,Medicare Part B,sensor
-PT-1032,freestyle_libre_3,2026-05-19,3,Medicare Part B,sensor
-PT-1033,freestyle_libre_3,2026-05-14,3,Medicare Part B,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1031,freestyle_libre_3,2026-05-18,3,Medicare Part B,sensor,medicare
+PT-1032,freestyle_libre_3,2026-05-19,3,Medicare Part B,sensor,medicare
+PT-1033,freestyle_libre_3,2026-05-14,3,Medicare Part B,sensor,medicare

test-data/sample-batch-04-out_of_coverage.csv

@@ -1,8 +1,8 @@
-MRN,Product Name,Dispense Date,Qty Dispensed,Plan Name,Supply Type,Supplier,State
-PT-1031,FreestyleLibre3,09-Nov-2024,6,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1032,FSL3,18-Dec-2024,2,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1033,fs libre 3,23-Oct-2024,1,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1034,FreeStyle Libre 3,06-Jan-2025,2,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1035,fs libre 3,22-Dec-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1036,fs libre 3,13-Oct-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA
-PT-1037,FSL3,04-Dec-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA
+MRN,Product Name,Dispense Date,Qty Dispensed,Plan Name,Supply Type,Supplier,State,payer_type
+PT-1031,FreestyleLibre3,09-Nov-2024,6,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1032,FSL3,18-Dec-2024,2,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1033,fs libre 3,23-Oct-2024,1,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1034,FreeStyle Libre 3,06-Jan-2025,2,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1035,fs libre 3,22-Dec-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1036,fs libre 3,13-Oct-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B
+PT-1037,FSL3,04-Dec-2024,9,Medicare Part B - CGM,sensor,Gaboro DME,PA,Medicare Part B

test-data/sample-batch-04-refill_window.csv

@@ -1,4 +1,4 @@
-MRN,Product Name,Dispense Date,Qty Dispensed,Plan Name,Supply Type,Supplier,State
-PT-1031,Dexcom G6,02-May-2026,3,Medicaid,sensor,Gaboro DME,PA
-PT-1032,Dexcom G6,30-Apr-2026,2,Medicaid,sensor,Gaboro DME,PA
-PT-1033,Dexcom G6 Pro,04-May-2026,2,Medicaid,sensor,Gaboro DME,PA
+MRN,Product Name,Dispense Date,Qty Dispensed,Plan Name,Supply Type,Supplier,State,Coverage Type
+PT-1031,Dexcom G6,02-May-2026,3,Medicaid,sensor,Gaboro DME,PA,Medicaid
+PT-1032,Dexcom G6,30-Apr-2026,2,Medicaid,sensor,Gaboro DME,PA,Medicaid
+PT-1033,Dexcom G6 Pro,04-May-2026,2,Medicaid,sensor,Gaboro DME,PA,Medicaid

test-data/sample-batch-05-out_of_coverage.csv

@@ -1,9 +1,9 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1041,freestyle_libre_3,2024-10-23,9,Cigna,sensor
-PT-1042,freestyle_libre_3,2024-11-01,2,Cigna,sensor
-PT-1043,freestyle_libre_3,2024-10-30,2,Cigna,sensor
-PT-1044,freestyle_libre_3,2024-10-24,6,Cigna,sensor
-PT-1045,freestyle_libre_3,2024-10-28,3,Cigna,sensor
-PT-1046,freestyle_libre_3,2024-11-01,9,Cigna,sensor
-PT-1047,freestyle_libre_3,2024-10-25,3,Cigna,sensor
-PT-1048,freestyle_libre_3,2024-10-22,2,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1041,freestyle_libre_3,2024-10-23,9,Cigna,sensor,commercial
+PT-1042,freestyle_libre_3,2024-11-01,2,Cigna,sensor,commercial
+PT-1043,freestyle_libre_3,2024-10-30,2,Cigna,sensor,commercial
+PT-1044,freestyle_libre_3,2024-10-24,6,Cigna,sensor,commercial
+PT-1045,freestyle_libre_3,2024-10-28,3,Cigna,sensor,commercial
+PT-1046,freestyle_libre_3,2024-11-01,9,Cigna,sensor,commercial
+PT-1047,freestyle_libre_3,2024-10-25,3,Cigna,sensor,commercial
+PT-1048,freestyle_libre_3,2024-10-22,2,Cigna,sensor,commercial

test-data/sample-batch-05-refill_window.csv

@@ -1,9 +1,9 @@
-Account Number,Product,Fill Date,Count,Primary Payer,component
-PT-1041,Dexcom G7 CGM,05/05/26,3,Medicaid - GA,sensor
-PT-1042,dexcom g7,04/27/26,2,Medicaid - GA,sensor
-PT-1043,Dexcom G7 CGM,04/28/26,9,Medicaid - GA,sensor
-PT-1044,Dexcom G7,04/30/26,3,Medicaid - GA,sensor
-PT-1045,G7,05/04/26,2,Medicaid - GA,sensor
-PT-1046,G7,05/03/26,9,Medicaid - GA,sensor
-PT-1047,Dexcom G7 CGM,04/29/26,6,Medicaid - GA,sensor
-PT-1048,Dexcom G7 CGM,04/25/26,3,Medicaid - GA,sensor
+Account Number,Product,Fill Date,Count,Primary Payer,component,Coverage Type
+PT-1041,Dexcom G7 CGM,05/05/26,3,Medicaid - GA,sensor,Medicaid
+PT-1042,dexcom g7,04/27/26,2,Medicaid - GA,sensor,Medicaid
+PT-1043,Dexcom G7 CGM,04/28/26,9,Medicaid - GA,sensor,Medicaid
+PT-1044,Dexcom G7,04/30/26,3,Medicaid - GA,sensor,Medicaid
+PT-1045,G7,05/04/26,2,Medicaid - GA,sensor,Medicaid
+PT-1046,G7,05/03/26,9,Medicaid - GA,sensor,Medicaid
+PT-1047,Dexcom G7 CGM,04/29/26,6,Medicaid - GA,sensor,Medicaid
+PT-1048,Dexcom G7 CGM,04/25/26,3,Medicaid - GA,sensor,Medicaid

test-data/sample-batch-06-ok.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1051,omnipod_5,2026-05-23,3,BCBS - FL,pod
-PT-1052,omnipod_5,2026-05-17,6,BCBS - FL,pod
-PT-1053,omnipod_5,2026-05-20,6,BCBS - FL,pod
-PT-1054,omnipod_5,2026-05-16,3,BCBS - FL,pod
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1051,omnipod_5,2026-05-23,3,BCBS - FL,pod,commercial
+PT-1052,omnipod_5,2026-05-17,6,BCBS - FL,pod,commercial
+PT-1053,omnipod_5,2026-05-20,6,BCBS - FL,pod,commercial
+PT-1054,omnipod_5,2026-05-16,3,BCBS - FL,pod,commercial

test-data/sample-batch-06-refill_window.csv

@@ -1,4 +1,4 @@
-External Patient Ref,Item,Date of Service,Qty Shipped,Insurance,item_type,Notes
-PT-1051,dexcom g6,2026-04-30T00:00:00,1,Medicare Part B - CGM,sensor,batch export
-PT-1052,G6,2026-05-05T00:00:00,2,Medicare Part B - CGM,sensor,batch export
-PT-1053,G6,2026-05-03T00:00:00,3,Medicare Part B - CGM,sensor,batch export
+External Patient Ref,Item,Date of Service,Qty Shipped,Insurance,item_type,Notes,Coverage Type
+PT-1051,dexcom g6,2026-04-30T00:00:00,1,Medicare Part B - CGM,sensor,batch export,Medicare
+PT-1052,G6,2026-05-05T00:00:00,2,Medicare Part B - CGM,sensor,batch export,Medicare
+PT-1053,G6,2026-05-03T00:00:00,3,Medicare Part B - CGM,sensor,batch export,Medicare

test-data/sample-batch-06-visit_due.csv

@@ -1,9 +1,9 @@
-External Patient Ref,Item,Date of Service,Qty Shipped,Insurance,item_type,Notes
-PT-1051,Dexcom G7,2025-08-10T00:00:00,6,Medicare,sensor,batch export
-PT-1052,dexcom g7,2025-07-30T00:00:00,9,Medicare,sensor,batch export
-PT-1053,Dexcom G7,2025-06-27T00:00:00,1,Medicare,sensor,batch export
-PT-1054,Dexcom G7 CGM,2025-09-10T00:00:00,3,Medicare,sensor,batch export
-PT-1055,dexcom g7,2025-05-20T00:00:00,2,Medicare,sensor,batch export
-PT-1056,Dexcom G7 CGM,2025-08-14T00:00:00,9,Medicare,sensor,batch export
-PT-1057,Dexcom G7,2025-06-08T00:00:00,3,Medicare,sensor,batch export
-PT-1058,G7,2025-08-31T00:00:00,2,Medicare,sensor,batch export
+External Patient Ref,Item,Date of Service,Qty Shipped,Insurance,item_type,Notes,payer_type
+PT-1051,Dexcom G7,2025-08-10T00:00:00,6,Medicare,sensor,batch export,Medicare Part B
+PT-1052,dexcom g7,2025-07-30T00:00:00,9,Medicare,sensor,batch export,Medicare Part B
+PT-1053,Dexcom G7,2025-06-27T00:00:00,1,Medicare,sensor,batch export,Medicare Part B
+PT-1054,Dexcom G7 CGM,2025-09-10T00:00:00,3,Medicare,sensor,batch export,Medicare Part B
+PT-1055,dexcom g7,2025-05-20T00:00:00,2,Medicare,sensor,batch export,Medicare Part B
+PT-1056,Dexcom G7 CGM,2025-08-14T00:00:00,9,Medicare,sensor,batch export,Medicare Part B
+PT-1057,Dexcom G7,2025-06-08T00:00:00,3,Medicare,sensor,batch export,Medicare Part B
+PT-1058,G7,2025-08-31T00:00:00,2,Medicare,sensor,batch export,Medicare Part B

test-data/sample-batch-07-ok.csv

@@ -1,9 +1,9 @@
-Acct #,DME,Order Date,quantity,plan,component_type
-PT-1061,OmniPod 5,20260523,6,United Healthcare,pod
-PT-1062,op5,20260523,1,United Healthcare,pod
-PT-1063,Omnipod 5,20260519,3,United Healthcare,pod
-PT-1064,Omnipod,20260519,9,United Healthcare,pod
-PT-1065,Omnipod 5,20260518,1,United Healthcare,pod
-PT-1066,Omnipod 5,20260518,3,United Healthcare,pod
-PT-1067,Omnipod,20260520,3,United Healthcare,pod
-PT-1068,Omnipod,20260523,9,United Healthcare,pod
+Acct #,DME,Order Date,quantity,plan,component_type,LOB
+PT-1061,OmniPod 5,20260523,6,United Healthcare,pod,private
+PT-1062,op5,20260523,1,United Healthcare,pod,private
+PT-1063,Omnipod 5,20260519,3,United Healthcare,pod,private
+PT-1064,Omnipod,20260519,9,United Healthcare,pod,private
+PT-1065,Omnipod 5,20260518,1,United Healthcare,pod,private
+PT-1066,Omnipod 5,20260518,3,United Healthcare,pod,private
+PT-1067,Omnipod,20260520,3,United Healthcare,pod,private
+PT-1068,Omnipod,20260523,9,United Healthcare,pod,private

test-data/sample-batch-07-refill_window.csv

@@ -1,8 +1,8 @@
-Acct #,DME,Order Date,quantity,plan,component_type
-PT-1061,FSL3,20260429,6,United Healthcare,sensor
-PT-1062,FSL3,20260425,3,United Healthcare,sensor
-PT-1063,Libre 3,20260426,9,United Healthcare,sensor
-PT-1064,fs libre 3,20260425,1,United Healthcare,sensor
-PT-1065,Libre 3,20260505,2,United Healthcare,sensor
-PT-1066,FreestyleLibre3,20260503,2,United Healthcare,sensor
-PT-1067,FreestyleLibre3,20260501,6,United Healthcare,sensor
+Acct #,DME,Order Date,quantity,plan,component_type,Coverage Type
+PT-1061,FSL3,20260429,6,United Healthcare,sensor,Commercial
+PT-1062,FSL3,20260425,3,United Healthcare,sensor,Commercial
+PT-1063,Libre 3,20260426,9,United Healthcare,sensor,Commercial
+PT-1064,fs libre 3,20260425,1,United Healthcare,sensor,Commercial
+PT-1065,Libre 3,20260505,2,United Healthcare,sensor,Commercial
+PT-1066,FreestyleLibre3,20260503,2,United Healthcare,sensor,Commercial
+PT-1067,FreestyleLibre3,20260501,6,United Healthcare,sensor,Commercial

test-data/sample-batch-07-visit_due.csv

@@ -1,7 +1,7 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1061,freestyle_libre_3,2025-06-25,6,Cigna,sensor
-PT-1062,freestyle_libre_3,2025-06-21,2,Cigna,sensor
-PT-1063,freestyle_libre_3,2025-06-18,9,Cigna,sensor
-PT-1064,freestyle_libre_3,2025-06-23,1,Cigna,sensor
-PT-1065,freestyle_libre_3,2025-06-16,1,Cigna,sensor
-PT-1066,freestyle_libre_3,2025-06-18,2,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1061,freestyle_libre_3,2025-06-25,6,Cigna,sensor,commercial
+PT-1062,freestyle_libre_3,2025-06-21,2,Cigna,sensor,commercial
+PT-1063,freestyle_libre_3,2025-06-18,9,Cigna,sensor,commercial
+PT-1064,freestyle_libre_3,2025-06-23,1,Cigna,sensor,commercial
+PT-1065,freestyle_libre_3,2025-06-16,1,Cigna,sensor,commercial
+PT-1066,freestyle_libre_3,2025-06-18,2,Cigna,sensor,commercial

test-data/sample-batch-08-out_of_coverage.csv

@@ -1,7 +1,7 @@
-patient,device type,last ship date,units dispensed,payer name,type,Supplier Branch
-PT-1071,Omnipod 5,10/26/2024,6,Medicare Part A,pod,NY-003
-PT-1072,op5,11/19/2024,6,Medicare Part A,pod,NY-003
-PT-1073,Omnipod 5,01/03/2025,1,Medicare Part A,pod,NY-003
-PT-1074,OmniPod 5,11/27/2024,1,Medicare Part A,pod,NY-003
-PT-1075,Omnipod,11/03/2024,9,Medicare Part A,pod,NY-003
-PT-1076,op5,11/29/2024,2,Medicare Part A,pod,NY-003
+patient,device type,last ship date,units dispensed,payer name,type,Supplier Branch,payer_type
+PT-1071,Omnipod 5,10/26/2024,6,Medicare Part A,pod,NY-003,Medicare Part B
+PT-1072,op5,11/19/2024,6,Medicare Part A,pod,NY-003,Medicare Part B
+PT-1073,Omnipod 5,01/03/2025,1,Medicare Part A,pod,NY-003,Medicare Part B
+PT-1074,OmniPod 5,11/27/2024,1,Medicare Part A,pod,NY-003,Medicare Part B
+PT-1075,Omnipod,11/03/2024,9,Medicare Part A,pod,NY-003,Medicare Part B
+PT-1076,op5,11/29/2024,2,Medicare Part A,pod,NY-003,Medicare Part B

test-data/sample-batch-08-refill_window.csv

@@ -1,8 +1,8 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1071,dexcom_g7,2026-04-30,9,Aetna,sensor
-PT-1072,dexcom_g7,2026-04-27,9,Aetna,sensor
-PT-1073,dexcom_g7,2026-04-23,1,Aetna,sensor
-PT-1074,dexcom_g7,2026-05-03,9,Aetna,sensor
-PT-1075,dexcom_g7,2026-04-27,3,Aetna,sensor
-PT-1076,dexcom_g7,2026-04-24,3,Aetna,sensor
-PT-1077,dexcom_g7,2026-04-29,2,Aetna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1071,dexcom_g7,2026-04-30,9,Aetna,sensor,commercial
+PT-1072,dexcom_g7,2026-04-27,9,Aetna,sensor,commercial
+PT-1073,dexcom_g7,2026-04-23,1,Aetna,sensor,commercial
+PT-1074,dexcom_g7,2026-05-03,9,Aetna,sensor,commercial
+PT-1075,dexcom_g7,2026-04-27,3,Aetna,sensor,commercial
+PT-1076,dexcom_g7,2026-04-24,3,Aetna,sensor,commercial
+PT-1077,dexcom_g7,2026-04-29,2,Aetna,sensor,commercial

test-data/sample-batch-09-refill_window.csv

@@ -1,8 +1,8 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1081,freestyle_libre_3,2026-04-20,3,UnitedHealth,sensor
-PT-1082,freestyle_libre_3,2026-04-29,9,UnitedHealth,sensor
-PT-1083,freestyle_libre_3,2026-04-28,2,UnitedHealth,sensor
-PT-1084,freestyle_libre_3,2026-04-21,3,UnitedHealth,sensor
-PT-1085,freestyle_libre_3,2026-04-21,9,UnitedHealth,sensor
-PT-1086,freestyle_libre_3,2026-04-27,1,UnitedHealth,sensor
-PT-1087,freestyle_libre_3,2026-04-28,3,UnitedHealth,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1081,freestyle_libre_3,2026-04-20,3,UnitedHealth,sensor,commercial
+PT-1082,freestyle_libre_3,2026-04-29,9,UnitedHealth,sensor,commercial
+PT-1083,freestyle_libre_3,2026-04-28,2,UnitedHealth,sensor,commercial
+PT-1084,freestyle_libre_3,2026-04-21,3,UnitedHealth,sensor,commercial
+PT-1085,freestyle_libre_3,2026-04-21,9,UnitedHealth,sensor,commercial
+PT-1086,freestyle_libre_3,2026-04-27,1,UnitedHealth,sensor,commercial
+PT-1087,freestyle_libre_3,2026-04-28,3,UnitedHealth,sensor,commercial

test-data/sample-batch-09-visit_due.csv

@@ -1,7 +1,7 @@
-pt_id,product_type,dos,qty,ins_name,component
-PT-1081,FreeStyle Libre 3,2025-09-07,9,Medicare Part B,sensor
-PT-1082,Libre 3,2025-04-23,2,Medicare Part B,sensor
-PT-1083,fs libre 3,2025-08-05,2,Medicare Part B,sensor
-PT-1084,Libre 3,2025-07-31,6,Medicare Part B,sensor
-PT-1085,FSL3,2025-04-23,6,Medicare Part B,sensor
-PT-1086,FreestyleLibre3,2025-07-05,6,Medicare Part B,sensor
+pt_id,product_type,dos,qty,ins_name,component,payer_type
+PT-1081,FreeStyle Libre 3,2025-09-07,9,Medicare Part B,sensor,Medicare Part B
+PT-1082,Libre 3,2025-04-23,2,Medicare Part B,sensor,Medicare Part B
+PT-1083,fs libre 3,2025-08-05,2,Medicare Part B,sensor,Medicare Part B
+PT-1084,Libre 3,2025-07-31,6,Medicare Part B,sensor,Medicare Part B
+PT-1085,FSL3,2025-04-23,6,Medicare Part B,sensor,Medicare Part B
+PT-1086,FreestyleLibre3,2025-07-05,6,Medicare Part B,sensor,Medicare Part B

test-data/sample-batch-10-out_of_coverage.csv

@@ -1,4 +1,4 @@
-account_no,hcpcs_description,service_date,units,primary_payer,supply_type,HCPCS Code
-PT-1091,Dexcom G6,12-20-2024,3,Medicare,sensor,A9277
-PT-1092,dexcom g6,10-09-2024,9,Medicare,sensor,A9277
-PT-1093,Dexcom G6,12-09-2024,9,Medicare,sensor,A9277
+account_no,hcpcs_description,service_date,units,primary_payer,supply_type,HCPCS Code,payer_type
+PT-1091,Dexcom G6,12-20-2024,3,Medicare,sensor,A9277,Medicare Part B
+PT-1092,dexcom g6,10-09-2024,9,Medicare,sensor,A9277,Medicare Part B
+PT-1093,Dexcom G6,12-09-2024,9,Medicare,sensor,A9277,Medicare Part B

test-data/sample-batch-10-refill_window.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1091,dexcom_g7,2026-04-19,2,BCBS - FL,sensor
-PT-1092,dexcom_g7,2026-04-28,1,BCBS - FL,sensor
-PT-1093,dexcom_g7,2026-04-20,6,BCBS - FL,sensor
-PT-1094,dexcom_g7,2026-04-20,9,BCBS - FL,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1091,dexcom_g7,2026-04-19,2,BCBS - FL,sensor,commercial
+PT-1092,dexcom_g7,2026-04-28,1,BCBS - FL,sensor,commercial
+PT-1093,dexcom_g7,2026-04-20,6,BCBS - FL,sensor,commercial
+PT-1094,dexcom_g7,2026-04-20,9,BCBS - FL,sensor,commercial

test-data/sample-batch-11-out_of_coverage.csv

@@ -1,8 +1,8 @@
-patient_account,description,ship_date,quantity_dispensed,carrier,component,Account Manager
-PT-1101,G7,2024-10-15,6,Blue Cross Blue Shield,sensor,J. Smith
-PT-1102,G7,2024-10-21,9,Blue Cross Blue Shield,sensor,J. Smith
-PT-1103,Dexcom G7,2024-12-17,6,Blue Cross Blue Shield,sensor,J. Smith
-PT-1104,Dexcom G7 CGM,2024-12-29,3,Blue Cross Blue Shield,sensor,J. Smith
-PT-1105,Dexcom G7 CGM,2024-11-02,2,Blue Cross Blue Shield,sensor,J. Smith
-PT-1106,G7,2024-11-07,3,Blue Cross Blue Shield,sensor,J. Smith
-PT-1107,Dexcom G7,2024-12-01,1,Blue Cross Blue Shield,sensor,J. Smith
+patient_account,description,ship_date,quantity_dispensed,carrier,component,Account Manager,payer_type
+PT-1101,G7,2024-10-15,6,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1102,G7,2024-10-21,9,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1103,Dexcom G7,2024-12-17,6,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1104,Dexcom G7 CGM,2024-12-29,3,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1105,Dexcom G7 CGM,2024-11-02,2,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1106,G7,2024-11-07,3,Blue Cross Blue Shield,sensor,J. Smith,employer
+PT-1107,Dexcom G7,2024-12-01,1,Blue Cross Blue Shield,sensor,J. Smith,employer

test-data/sample-batch-11-visit_due.csv

@@ -1,6 +1,6 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1101,omnipod_5,2025-05-24,9,UnitedHealth,pod
-PT-1102,omnipod_5,2025-05-22,2,UnitedHealth,pod
-PT-1103,omnipod_5,2025-05-24,2,UnitedHealth,pod
-PT-1104,omnipod_5,2025-05-20,6,UnitedHealth,pod
-PT-1105,omnipod_5,2025-05-26,3,UnitedHealth,pod
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1101,omnipod_5,2025-05-24,9,UnitedHealth,pod,commercial
+PT-1102,omnipod_5,2025-05-22,2,UnitedHealth,pod,commercial
+PT-1103,omnipod_5,2025-05-24,2,UnitedHealth,pod,commercial
+PT-1104,omnipod_5,2025-05-20,6,UnitedHealth,pod,commercial
+PT-1105,omnipod_5,2025-05-26,3,UnitedHealth,pod,commercial

test-data/sample-batch-12-refill_window.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1111,omnipod_5,2026-04-24,3,Medicare Part B,pod
-PT-1112,omnipod_5,2026-04-23,9,Medicare Part B,pod
-PT-1113,omnipod_5,2026-05-01,2,Medicare Part B,pod
-PT-1114,omnipod_5,2026-05-02,2,Medicare Part B,pod
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1111,omnipod_5,2026-04-24,3,Medicare Part B,pod,medicare
+PT-1112,omnipod_5,2026-04-23,9,Medicare Part B,pod,medicare
+PT-1113,omnipod_5,2026-05-01,2,Medicare Part B,pod,medicare
+PT-1114,omnipod_5,2026-05-02,2,Medicare Part B,pod,medicare

test-data/sample-batch-12-visit_due.csv

@@ -1,4 +1,4 @@
-id,product,fill_date,qty_shipped,payer,item_type
-PT-1111,Omnipod,05/12/2025,9,Centene,pod
-PT-1112,OmniPod 5,06/27/2025,1,Centene,pod
-PT-1113,OmniPod 5,06/23/2025,2,Centene,pod
+id,product,fill_date,qty_shipped,payer,item_type,plan_type
+PT-1111,Omnipod,05/12/2025,9,Centene,pod,commercial
+PT-1112,OmniPod 5,06/27/2025,1,Centene,pod,commercial
+PT-1113,OmniPod 5,06/23/2025,2,Centene,pod,commercial

test-data/sample-batch-13-ok.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1121,dexcom_g7,2026-05-15,1,Medicaid - GA,sensor
-PT-1122,dexcom_g7,2026-05-18,2,Medicaid - GA,sensor
-PT-1123,dexcom_g7,2026-05-14,6,Medicaid - GA,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1121,dexcom_g7,2026-05-15,1,Medicaid - GA,sensor,medicaid
+PT-1122,dexcom_g7,2026-05-18,2,Medicaid - GA,sensor,medicaid
+PT-1123,dexcom_g7,2026-05-14,6,Medicaid - GA,sensor,medicaid

test-data/sample-batch-13-out_of_coverage.csv

@@ -1,8 +1,8 @@
-PT ID,Device Type,Shipment Date,Quantity,Insurance,Component,Region
-PT-1121,Omnipod 5,2024-12-28,9,UHC,pod,Southeast
-PT-1122,Omnipod 5,2024-11-14,2,UHC,pod,Southeast
-PT-1123,Omnipod 5,2024-11-04,9,UHC,pod,Southeast
-PT-1124,OmniPod 5,2024-10-23,9,UHC,pod,Southeast
-PT-1125,OmniPod 5,2024-11-02,2,UHC,pod,Southeast
-PT-1126,OmniPod 5,2025-01-02,9,UHC,pod,Southeast
-PT-1127,Omnipod 5,2024-12-05,1,UHC,pod,Southeast
+PT ID,Device Type,Shipment Date,Quantity,Insurance,Component,Region,payer_type
+PT-1121,Omnipod 5,2024-12-28,9,UHC,pod,Southeast,employer
+PT-1122,Omnipod 5,2024-11-14,2,UHC,pod,Southeast,employer
+PT-1123,Omnipod 5,2024-11-04,9,UHC,pod,Southeast,employer
+PT-1124,OmniPod 5,2024-10-23,9,UHC,pod,Southeast,employer
+PT-1125,OmniPod 5,2024-11-02,2,UHC,pod,Southeast,employer
+PT-1126,OmniPod 5,2025-01-02,9,UHC,pod,Southeast,employer
+PT-1127,Omnipod 5,2024-12-05,1,UHC,pod,Southeast,employer

test-data/sample-batch-13-visit_due.csv

@@ -1,4 +1,4 @@
-PT ID,Device Type,Shipment Date,Quantity,Insurance,Component,Region
-PT-1121,Omnipod,2025-05-12,9,Centene,pod,Southeast
-PT-1122,OmniPod 5,2025-06-27,1,Centene,pod,Southeast
-PT-1123,OmniPod 5,2025-06-23,2,Centene,pod,Southeast
+PT ID,Device Type,Shipment Date,Quantity,Insurance,Component,Region,payer_type
+PT-1121,Omnipod,2025-05-12,9,Centene,pod,Southeast,employer
+PT-1122,OmniPod 5,2025-06-27,1,Centene,pod,Southeast,employer
+PT-1123,OmniPod 5,2025-06-23,2,Centene,pod,Southeast,employer

test-data/sample-batch-14-out_of_coverage.csv

@@ -1,4 +1,4 @@
-patientid,devicetype,dispensedate,qty,payername,supplytype
-PT-1131,Omnipod,11/19/2024,3,BCBS - FL,pod
-PT-1132,op5,10/27/2024,9,BCBS - FL,pod
-PT-1133,Omnipod 5,01/03/2025,1,BCBS - FL,pod
+patientid,devicetype,dispensedate,qty,payername,supplytype,plan_type
+PT-1131,Omnipod,11/19/2024,3,BCBS - FL,pod,Commercial
+PT-1132,op5,10/27/2024,9,BCBS - FL,pod,Commercial
+PT-1133,Omnipod 5,01/03/2025,1,BCBS - FL,pod,Commercial

test-data/sample-batch-14-refill_window.csv

@@ -1,8 +1,8 @@
-patientid,devicetype,dispensedate,qty,payername,supplytype
-PT-1131,Omnipod 5,05/04/2026,9,UHC,pod
-PT-1132,Omnipod 5,05/02/2026,2,UHC,pod
-PT-1133,Omnipod 5,04/27/2026,9,UHC,pod
-PT-1134,OmniPod 5,04/28/2026,9,UHC,pod
-PT-1135,OmniPod 5,05/01/2026,2,UHC,pod
-PT-1136,OmniPod 5,05/05/2026,9,UHC,pod
-PT-1137,Omnipod 5,04/30/2026,1,UHC,pod
+patientid,devicetype,dispensedate,qty,payername,supplytype,plan_type
+PT-1131,Omnipod 5,05/04/2026,9,UHC,pod,Commercial
+PT-1132,Omnipod 5,05/02/2026,2,UHC,pod,Commercial
+PT-1133,Omnipod 5,04/27/2026,9,UHC,pod,Commercial
+PT-1134,OmniPod 5,04/28/2026,9,UHC,pod,Commercial
+PT-1135,OmniPod 5,05/01/2026,2,UHC,pod,Commercial
+PT-1136,OmniPod 5,05/05/2026,9,UHC,pod,Commercial
+PT-1137,Omnipod 5,04/30/2026,1,UHC,pod,Commercial

test-data/sample-batch-14-visit_due.csv

@@ -1,8 +1,8 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1131,dexcom_g6,2025-09-06,2,Cigna,sensor
-PT-1132,dexcom_g6,2025-09-06,6,Cigna,sensor
-PT-1133,dexcom_g6,2025-09-02,1,Cigna,sensor
-PT-1134,dexcom_g6,2025-08-31,6,Cigna,sensor
-PT-1135,dexcom_g6,2025-09-04,6,Cigna,sensor
-PT-1136,dexcom_g6,2025-09-05,6,Cigna,sensor
-PT-1137,dexcom_g6,2025-08-30,1,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1131,dexcom_g6,2025-09-06,2,Cigna,sensor,commercial
+PT-1132,dexcom_g6,2025-09-06,6,Cigna,sensor,commercial
+PT-1133,dexcom_g6,2025-09-02,1,Cigna,sensor,commercial
+PT-1134,dexcom_g6,2025-08-31,6,Cigna,sensor,commercial
+PT-1135,dexcom_g6,2025-09-04,6,Cigna,sensor,commercial
+PT-1136,dexcom_g6,2025-09-05,6,Cigna,sensor,commercial
+PT-1137,dexcom_g6,2025-08-30,1,Cigna,sensor,commercial

test-data/sample-batch-15-ok.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1141,freestyle_libre_3,2026-05-18,2,Humana,sensor
-PT-1142,freestyle_libre_3,2026-05-23,6,Humana,sensor
-PT-1143,freestyle_libre_3,2026-05-17,6,Humana,sensor
-PT-1144,freestyle_libre_3,2026-05-17,3,Humana,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1141,freestyle_libre_3,2026-05-18,2,Humana,sensor,commercial
+PT-1142,freestyle_libre_3,2026-05-23,6,Humana,sensor,commercial
+PT-1143,freestyle_libre_3,2026-05-17,6,Humana,sensor,commercial
+PT-1144,freestyle_libre_3,2026-05-17,3,Humana,sensor,commercial

test-data/sample-batch-15-refill_window.csv

@@ -1,8 +1,8 @@
-account_number,item_description,order_date,units_dispensed,plan_name,component,Facility
-PT-1141,Dexcom G7 CGM,01/05/2026,9,Aetna,sensor,Gaboro PA Main
-PT-1142,dexcom g7,30/04/2026,2,Aetna,sensor,Gaboro PA Main
-PT-1143,Dexcom G7 CGM,27/04/2026,1,Aetna,sensor,Gaboro PA Main
-PT-1144,G7,28/04/2026,1,Aetna,sensor,Gaboro PA Main
-PT-1145,dexcom g7,03/05/2026,9,Aetna,sensor,Gaboro PA Main
-PT-1146,G7,01/05/2026,2,Aetna,sensor,Gaboro PA Main
-PT-1147,Dexcom G7,29/04/2026,2,Aetna,sensor,Gaboro PA Main
+account_number,item_description,order_date,units_dispensed,plan_name,component,Facility,Coverage Type
+PT-1141,Dexcom G7 CGM,01/05/2026,9,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1142,dexcom g7,30/04/2026,2,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1143,Dexcom G7 CGM,27/04/2026,1,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1144,G7,28/04/2026,1,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1145,dexcom g7,03/05/2026,9,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1146,G7,01/05/2026,2,Aetna,sensor,Gaboro PA Main,Commercial
+PT-1147,Dexcom G7,29/04/2026,2,Aetna,sensor,Gaboro PA Main,Commercial

test-data/sample-batch-15-visit_due.csv

@@ -1,4 +1,4 @@
-account_number,item_description,order_date,units_dispensed,plan_name,component,Facility
-PT-1141,Omnipod,20/07/2025,3,BCBS - FL,pod,Gaboro PA Main
-PT-1142,op5,05/06/2025,9,BCBS - FL,pod,Gaboro PA Main
-PT-1143,Omnipod 5,11/08/2025,1,BCBS - FL,pod,Gaboro PA Main
+account_number,item_description,order_date,units_dispensed,plan_name,component,Facility,payer_type
+PT-1141,Omnipod,20/07/2025,3,BCBS - FL,pod,Gaboro PA Main,employer
+PT-1142,op5,05/06/2025,9,BCBS - FL,pod,Gaboro PA Main,employer
+PT-1143,Omnipod 5,11/08/2025,1,BCBS - FL,pod,Gaboro PA Main,employer

test-data/sample-batch-16-ok.csv

@@ -1,8 +1,8 @@
-MRN,Product Type,Service Date,Qty,Insurance Name,Component Type
-PT-1151,Dexcom G7 CGM,2026-05-21,9,Aetna,sensor
-PT-1152,dexcom g7,2026-05-24,2,Aetna,sensor
-PT-1153,Dexcom G7 CGM,2026-05-17,1,Aetna,sensor
-PT-1154,G7,2026-05-21,1,Aetna,sensor
-PT-1155,dexcom g7,2026-05-26,9,Aetna,sensor
-PT-1156,G7,2026-05-18,2,Aetna,sensor
-PT-1157,G7,2026-05-21,3,Aetna,sensor
+MRN,Product Type,Service Date,Qty,Insurance Name,Component Type,LOB
+PT-1151,Dexcom G7 CGM,2026-05-21,9,Aetna,sensor,private
+PT-1152,dexcom g7,2026-05-24,2,Aetna,sensor,private
+PT-1153,Dexcom G7 CGM,2026-05-17,1,Aetna,sensor,private
+PT-1154,G7,2026-05-21,1,Aetna,sensor,private
+PT-1155,dexcom g7,2026-05-26,9,Aetna,sensor,private
+PT-1156,G7,2026-05-18,2,Aetna,sensor,private
+PT-1157,G7,2026-05-21,3,Aetna,sensor,private

test-data/sample-batch-16-refill_window.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1151,dexcom_g7,2026-04-20,9,Aetna,sensor
-PT-1152,dexcom_g7,2026-04-20,1,Aetna,sensor
-PT-1153,dexcom_g7,2026-04-23,2,Aetna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1151,dexcom_g7,2026-04-20,9,Aetna,sensor,commercial
+PT-1152,dexcom_g7,2026-04-20,1,Aetna,sensor,commercial
+PT-1153,dexcom_g7,2026-04-23,2,Aetna,sensor,commercial

test-data/sample-batch-16-visit_due.csv

@@ -1,9 +1,9 @@
-MRN,Product Type,Service Date,Qty,Insurance Name,Component Type
-PT-1151,Libre 3,2025-06-24,1,Humana,sensor
-PT-1152,FreeStyle Libre 3,2025-08-01,6,Humana,sensor
-PT-1153,fs libre 3,2025-06-16,3,Humana,sensor
-PT-1154,Libre 3,2025-07-13,2,Humana,sensor
-PT-1155,Libre 3,2025-05-01,6,Humana,sensor
-PT-1156,FreeStyle Libre 3,2025-07-15,3,Humana,sensor
-PT-1157,FreestyleLibre3,2025-07-23,6,Humana,sensor
-PT-1158,FreeStyle Libre 3,2025-09-06,1,Humana,sensor
+MRN,Product Type,Service Date,Qty,Insurance Name,Component Type,payer_type
+PT-1151,Libre 3,2025-06-24,1,Humana,sensor,employer
+PT-1152,FreeStyle Libre 3,2025-08-01,6,Humana,sensor,employer
+PT-1153,fs libre 3,2025-06-16,3,Humana,sensor,employer
+PT-1154,Libre 3,2025-07-13,2,Humana,sensor,employer
+PT-1155,Libre 3,2025-05-01,6,Humana,sensor,employer
+PT-1156,FreeStyle Libre 3,2025-07-15,3,Humana,sensor,employer
+PT-1157,FreestyleLibre3,2025-07-23,6,Humana,sensor,employer
+PT-1158,FreeStyle Libre 3,2025-09-06,1,Humana,sensor,employer

test-data/sample-batch-17-out_of_coverage.csv

@@ -1,4 +1,4 @@
-Patient_ID,Device,Ship_Date,Units,Plan,Type,Export Type
-PT-1161,fs libre 3,10/19/2024 00:00:00,3,CMS,sensor,CGM Only
-PT-1162,FSL3,01/09/2025 00:00:00,6,CMS,sensor,CGM Only
-PT-1163,FreeStyle Libre 3,12/22/2024 00:00:00,6,CMS,sensor,CGM Only
+Patient_ID,Device,Ship_Date,Units,Plan,Type,Export Type,payer_type
+PT-1161,fs libre 3,10/19/2024 00:00:00,3,CMS,sensor,CGM Only,employer
+PT-1162,FSL3,01/09/2025 00:00:00,6,CMS,sensor,CGM Only,employer
+PT-1163,FreeStyle Libre 3,12/22/2024 00:00:00,6,CMS,sensor,CGM Only,employer

test-data/sample-batch-17-refill_window.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1161,omnipod_5,2026-04-24,6,Medicaid - GA,pod
-PT-1162,omnipod_5,2026-04-22,6,Medicaid - GA,pod
-PT-1163,omnipod_5,2026-04-26,6,Medicaid - GA,pod
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1161,omnipod_5,2026-04-24,6,Medicaid - GA,pod,medicaid
+PT-1162,omnipod_5,2026-04-22,6,Medicaid - GA,pod,medicaid
+PT-1163,omnipod_5,2026-04-26,6,Medicaid - GA,pod,medicaid

test-data/sample-batch-17-visit_due.csv

@@ -1,6 +1,6 @@
-Patient_ID,Device,Ship_Date,Units,Plan,Type,Export Type
-PT-1161,Omnipod 5,06/05/2025 00:00:00,6,UnitedHealth,pod,CGM Only
-PT-1162,op5,05/05/2025 00:00:00,2,UnitedHealth,pod,CGM Only
-PT-1163,op5,06/16/2025 00:00:00,3,UnitedHealth,pod,CGM Only
-PT-1164,Omnipod,07/13/2025 00:00:00,2,UnitedHealth,pod,CGM Only
-PT-1165,Omnipod,05/01/2025 00:00:00,6,UnitedHealth,pod,CGM Only
+Patient_ID,Device,Ship_Date,Units,Plan,Type,Export Type,payer_type
+PT-1161,Omnipod 5,06/05/2025 00:00:00,6,UnitedHealth,pod,CGM Only,employer
+PT-1162,op5,05/05/2025 00:00:00,2,UnitedHealth,pod,CGM Only,employer
+PT-1163,op5,06/16/2025 00:00:00,3,UnitedHealth,pod,CGM Only,employer
+PT-1164,Omnipod,07/13/2025 00:00:00,2,UnitedHealth,pod,CGM Only,employer
+PT-1165,Omnipod,05/01/2025 00:00:00,6,UnitedHealth,pod,CGM Only,employer

test-data/sample-batch-18-out_of_coverage.csv

@@ -1,6 +1,6 @@
-patient id,item,dispense date,count,carrier,supply_type,Billing Staff,Auth Number
-PT-1171,FreestyleLibre3,2024-11-20,6,Medicare Part B,sensor,M. Jones,CGM-2026-001
-PT-1172,FreestyleLibre3,2025-01-02,3,Medicare Part B,sensor,M. Jones,CGM-2026-001
-PT-1173,FSL3,2024-10-05,2,Medicare Part B,sensor,M. Jones,CGM-2026-001
-PT-1174,FreeStyle Libre 3,2024-12-17,1,Medicare Part B,sensor,M. Jones,CGM-2026-001
-PT-1175,FSL3,2024-12-20,3,Medicare Part B,sensor,M. Jones,CGM-2026-001
+patient id,item,dispense date,count,carrier,supply_type,Billing Staff,Auth Number,payer_type
+PT-1171,FreestyleLibre3,2024-11-20,6,Medicare Part B,sensor,M. Jones,CGM-2026-001,Medicare Part B
+PT-1172,FreestyleLibre3,2025-01-02,3,Medicare Part B,sensor,M. Jones,CGM-2026-001,Medicare Part B
+PT-1173,FSL3,2024-10-05,2,Medicare Part B,sensor,M. Jones,CGM-2026-001,Medicare Part B
+PT-1174,FreeStyle Libre 3,2024-12-17,1,Medicare Part B,sensor,M. Jones,CGM-2026-001,Medicare Part B
+PT-1175,FSL3,2024-12-20,3,Medicare Part B,sensor,M. Jones,CGM-2026-001,Medicare Part B

test-data/sample-batch-18-refill_window.csv

@@ -1,4 +1,4 @@
-patient id,item,dispense date,count,carrier,supply_type,Billing Staff,Auth Number
-PT-1171,G6,2026-05-05,3,Medicare Part A,sensor,M. Jones,CGM-2026-001
-PT-1172,Dexcom G6 Pro,2026-04-28,9,Medicare Part A,sensor,M. Jones,CGM-2026-001
-PT-1173,Dexcom G6,2026-05-02,3,Medicare Part A,sensor,M. Jones,CGM-2026-001
+patient id,item,dispense date,count,carrier,supply_type,Billing Staff,Auth Number,Coverage Type
+PT-1171,G6,2026-05-05,3,Medicare Part A,sensor,M. Jones,CGM-2026-001,Medicare
+PT-1172,Dexcom G6 Pro,2026-04-28,9,Medicare Part A,sensor,M. Jones,CGM-2026-001,Medicare
+PT-1173,Dexcom G6,2026-05-02,3,Medicare Part A,sensor,M. Jones,CGM-2026-001,Medicare

test-data/sample-batch-19-ok.csv

@@ -1,7 +1,7 @@
-Acct No,Product Name,Last Ship Date,Qty Dispensed,Primary Payer,Component
-PT-1181,Libre 3,"May 23, 2026",2,Molina Healthcare,sensor
-PT-1182,fs libre 3,"May 26, 2026",2,Molina Healthcare,sensor
-PT-1183,FSL3,"May 28, 2026",6,Molina Healthcare,sensor
-PT-1184,FreeStyle Libre 3,"May 29, 2026",3,Molina Healthcare,sensor
-PT-1185,fs libre 3,"May 20, 2026",9,Molina Healthcare,sensor
-PT-1186,FSL3,"May 29, 2026",6,Molina Healthcare,sensor
+Acct No,Product Name,Last Ship Date,Qty Dispensed,Primary Payer,Component,LOB
+PT-1181,Libre 3,"May 23, 2026",2,Molina Healthcare,sensor,private
+PT-1182,fs libre 3,"May 26, 2026",2,Molina Healthcare,sensor,private
+PT-1183,FSL3,"May 28, 2026",6,Molina Healthcare,sensor,private
+PT-1184,FreeStyle Libre 3,"May 29, 2026",3,Molina Healthcare,sensor,private
+PT-1185,fs libre 3,"May 20, 2026",9,Molina Healthcare,sensor,private
+PT-1186,FSL3,"May 29, 2026",6,Molina Healthcare,sensor,private

test-data/sample-batch-19-visit_due.csv

@@ -1,4 +1,4 @@
-Acct No,Product Name,Last Ship Date,Qty Dispensed,Primary Payer,Component
-PT-1181,Omnipod,"Jul 31, 2025",3,Centene,pod
-PT-1182,op5,"May 06, 2025",1,Centene,pod
-PT-1183,Omnipod,"Sep 06, 2025",3,Centene,pod
+Acct No,Product Name,Last Ship Date,Qty Dispensed,Primary Payer,Component,payer_type
+PT-1181,Omnipod,"Jul 31, 2025",3,Centene,pod,employer
+PT-1182,op5,"May 06, 2025",1,Centene,pod,employer
+PT-1183,Omnipod,"Sep 06, 2025",3,Centene,pod,employer

test-data/sample-batch-20-out_of_coverage.csv

@@ -1,8 +1,8 @@
-Member ID,DME Description,DOS,QTY,Insurance,Item Type,Payer ID
-PT-1191,Omnipod,2024-12-07,1,Medicare,pod,00019
-PT-1192,OmniPod 5,2024-11-11,1,Medicare,pod,00019
-PT-1193,OmniPod 5,2025-01-07,2,Medicare,pod,00019
-PT-1194,Omnipod 5,2024-10-28,1,Medicare,pod,00019
-PT-1195,Omnipod 5,2024-11-05,6,Medicare,pod,00019
-PT-1196,Omnipod,2024-11-29,6,Medicare,pod,00019
-PT-1197,Omnipod,2024-12-07,2,Medicare,pod,00019
+Member ID,DME Description,DOS,QTY,Insurance,Item Type,Payer ID,payer_type
+PT-1191,Omnipod,2024-12-07,1,Medicare,pod,00019,Medicare Part B
+PT-1192,OmniPod 5,2024-11-11,1,Medicare,pod,00019,Medicare Part B
+PT-1193,OmniPod 5,2025-01-07,2,Medicare,pod,00019,Medicare Part B
+PT-1194,Omnipod 5,2024-10-28,1,Medicare,pod,00019,Medicare Part B
+PT-1195,Omnipod 5,2024-11-05,6,Medicare,pod,00019,Medicare Part B
+PT-1196,Omnipod,2024-11-29,6,Medicare,pod,00019,Medicare Part B
+PT-1197,Omnipod,2024-12-07,2,Medicare,pod,00019,Medicare Part B

test-data/sample-batch-20-refill_window.csv

@@ -1,8 +1,8 @@
-Member ID,DME Description,DOS,QTY,Insurance,Item Type,Payer ID
-PT-1191,Omnipod 5,2026-05-02,3,CMS,pod,00019
-PT-1192,op5,2026-05-01,3,CMS,pod,00019
-PT-1193,OmniPod 5,2026-05-03,9,CMS,pod,00019
-PT-1194,op5,2026-04-27,6,CMS,pod,00019
-PT-1195,Omnipod,2026-05-05,9,CMS,pod,00019
-PT-1196,op5,2026-05-01,9,CMS,pod,00019
-PT-1197,OmniPod 5,2026-04-27,2,CMS,pod,00019
+Member ID,DME Description,DOS,QTY,Insurance,Item Type,Payer ID,Coverage Type
+PT-1191,Omnipod 5,2026-05-02,3,CMS,pod,00019,Commercial
+PT-1192,op5,2026-05-01,3,CMS,pod,00019,Commercial
+PT-1193,OmniPod 5,2026-05-03,9,CMS,pod,00019,Commercial
+PT-1194,op5,2026-04-27,6,CMS,pod,00019,Commercial
+PT-1195,Omnipod,2026-05-05,9,CMS,pod,00019,Commercial
+PT-1196,op5,2026-05-01,9,CMS,pod,00019,Commercial
+PT-1197,OmniPod 5,2026-04-27,2,CMS,pod,00019,Commercial

test-data/sample-batch-20-visit_due.csv

@@ -1,7 +1,7 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1191,dexcom_g7,2025-09-19,9,UnitedHealth,sensor
-PT-1192,dexcom_g7,2025-09-18,9,UnitedHealth,sensor
-PT-1193,dexcom_g7,2025-09-14,3,UnitedHealth,sensor
-PT-1194,dexcom_g7,2025-09-12,3,UnitedHealth,sensor
-PT-1195,dexcom_g7,2025-09-12,3,UnitedHealth,sensor
-PT-1196,dexcom_g7,2025-09-15,2,UnitedHealth,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1191,dexcom_g7,2025-09-19,9,UnitedHealth,sensor,commercial
+PT-1192,dexcom_g7,2025-09-18,9,UnitedHealth,sensor,commercial
+PT-1193,dexcom_g7,2025-09-14,3,UnitedHealth,sensor,commercial
+PT-1194,dexcom_g7,2025-09-12,3,UnitedHealth,sensor,commercial
+PT-1195,dexcom_g7,2025-09-12,3,UnitedHealth,sensor,commercial
+PT-1196,dexcom_g7,2025-09-15,2,UnitedHealth,sensor,commercial

test-data/sample-batch-21-ok.csv

@@ -1,7 +1,7 @@
-pt id,device_type,service date,quantity,payer,component
-PT-1201,dexcom g7,05/19/2026,1,Blue Cross Blue Shield,sensor
-PT-1202,Dexcom G7,05/24/2026,6,Blue Cross Blue Shield,sensor
-PT-1203,dexcom g7,05/23/2026,9,Blue Cross Blue Shield,sensor
-PT-1204,Dexcom G7 CGM,05/27/2026,6,Blue Cross Blue Shield,sensor
-PT-1205,dexcom g7,05/30/2026,9,Blue Cross Blue Shield,sensor
-PT-1206,dexcom g7,05/23/2026,6,Blue Cross Blue Shield,sensor
+pt id,device_type,service date,quantity,payer,component,plan_type
+PT-1201,dexcom g7,05/19/2026,1,Blue Cross Blue Shield,sensor,commercial
+PT-1202,Dexcom G7,05/24/2026,6,Blue Cross Blue Shield,sensor,commercial
+PT-1203,dexcom g7,05/23/2026,9,Blue Cross Blue Shield,sensor,commercial
+PT-1204,Dexcom G7 CGM,05/27/2026,6,Blue Cross Blue Shield,sensor,commercial
+PT-1205,dexcom g7,05/30/2026,9,Blue Cross Blue Shield,sensor,commercial
+PT-1206,dexcom g7,05/23/2026,6,Blue Cross Blue Shield,sensor,commercial

test-data/sample-batch-21-out_of_coverage.csv

@@ -1,9 +1,9 @@
-pt id,device_type,service date,quantity,payer,component
-PT-1201,op5,11/15/2024,6,Aetna Commercial,pod
-PT-1202,op5,12/28/2024,2,Aetna Commercial,pod
-PT-1203,OmniPod 5,12/25/2024,9,Aetna Commercial,pod
-PT-1204,OmniPod 5,12/30/2024,1,Aetna Commercial,pod
-PT-1205,OmniPod 5,01/07/2025,2,Aetna Commercial,pod
-PT-1206,Omnipod 5,10/28/2024,1,Aetna Commercial,pod
-PT-1207,Omnipod 5,11/05/2024,6,Aetna Commercial,pod
-PT-1208,Omnipod,11/29/2024,6,Aetna Commercial,pod
+pt id,device_type,service date,quantity,payer,component,plan_type
+PT-1201,op5,11/15/2024,6,Aetna Commercial,pod,commercial
+PT-1202,op5,12/28/2024,2,Aetna Commercial,pod,commercial
+PT-1203,OmniPod 5,12/25/2024,9,Aetna Commercial,pod,commercial
+PT-1204,OmniPod 5,12/30/2024,1,Aetna Commercial,pod,commercial
+PT-1205,OmniPod 5,01/07/2025,2,Aetna Commercial,pod,commercial
+PT-1206,Omnipod 5,10/28/2024,1,Aetna Commercial,pod,commercial
+PT-1207,Omnipod 5,11/05/2024,6,Aetna Commercial,pod,commercial
+PT-1208,Omnipod,11/29/2024,6,Aetna Commercial,pod,commercial

test-data/sample-batch-22-out_of_coverage.csv

@@ -1,9 +1,9 @@
-acct_no,product,fill date,units,insurance name,type,Branch Code
-PT-1211,Omnipod 5,2024-12-29,6,Medicare,pod,GA-02
-PT-1212,op5,2024-10-31,1,Medicare,pod,GA-02
-PT-1213,Omnipod 5,2024-12-13,6,Medicare,pod,GA-02
-PT-1214,op5,2024-10-25,9,Medicare,pod,GA-02
-PT-1215,OmniPod 5,2024-12-16,6,Medicare,pod,GA-02
-PT-1216,op5,2024-12-25,9,Medicare,pod,GA-02
-PT-1217,op5,2024-11-29,6,Medicare,pod,GA-02
-PT-1218,Omnipod,2024-11-10,3,Medicare,pod,GA-02
+acct_no,product,fill date,units,insurance name,type,Branch Code,payer_type
+PT-1211,Omnipod 5,2024-12-29,6,Medicare,pod,GA-02,Medicare Part B
+PT-1212,op5,2024-10-31,1,Medicare,pod,GA-02,Medicare Part B
+PT-1213,Omnipod 5,2024-12-13,6,Medicare,pod,GA-02,Medicare Part B
+PT-1214,op5,2024-10-25,9,Medicare,pod,GA-02,Medicare Part B
+PT-1215,OmniPod 5,2024-12-16,6,Medicare,pod,GA-02,Medicare Part B
+PT-1216,op5,2024-12-25,9,Medicare,pod,GA-02,Medicare Part B
+PT-1217,op5,2024-11-29,6,Medicare,pod,GA-02,Medicare Part B
+PT-1218,Omnipod,2024-11-10,3,Medicare,pod,GA-02,Medicare Part B

test-data/sample-batch-22-refill_window.csv

@@ -1,8 +1,8 @@
-acct_no,product,fill date,units,insurance name,type,Branch Code
-PT-1211,Libre 3,2026-05-03,3,UHC,sensor,GA-02
-PT-1212,FSL3,2026-04-28,2,UHC,sensor,GA-02
-PT-1213,FSL3,2026-04-29,9,UHC,sensor,GA-02
-PT-1214,Libre 3,2026-04-26,2,UHC,sensor,GA-02
-PT-1215,Libre 3,2026-05-03,2,UHC,sensor,GA-02
-PT-1216,fs libre 3,2026-04-28,3,UHC,sensor,GA-02
-PT-1217,fs libre 3,2026-05-02,1,UHC,sensor,GA-02
+acct_no,product,fill date,units,insurance name,type,Branch Code,Coverage Type
+PT-1211,Libre 3,2026-05-03,3,UHC,sensor,GA-02,Commercial
+PT-1212,FSL3,2026-04-28,2,UHC,sensor,GA-02,Commercial
+PT-1213,FSL3,2026-04-29,9,UHC,sensor,GA-02,Commercial
+PT-1214,Libre 3,2026-04-26,2,UHC,sensor,GA-02,Commercial
+PT-1215,Libre 3,2026-05-03,2,UHC,sensor,GA-02,Commercial
+PT-1216,fs libre 3,2026-04-28,3,UHC,sensor,GA-02,Commercial
+PT-1217,fs libre 3,2026-05-02,1,UHC,sensor,GA-02,Commercial

test-data/sample-batch-22-visit_due.csv

@@ -1,4 +1,4 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1211,freestyle_libre_3,2025-08-24,3,Medicaid - GA,sensor
-PT-1212,freestyle_libre_3,2025-08-25,2,Medicaid - GA,sensor
-PT-1213,freestyle_libre_3,2025-08-28,9,Medicaid - GA,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1211,freestyle_libre_3,2025-08-24,3,Medicaid - GA,sensor,medicaid
+PT-1212,freestyle_libre_3,2025-08-25,2,Medicaid - GA,sensor,medicaid
+PT-1213,freestyle_libre_3,2025-08-28,9,Medicaid - GA,sensor,medicaid

test-data/sample-batch-23-out_of_coverage.csv

@@ -1,6 +1,6 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1221,dexcom_g7,2024-12-23,1,Cigna,sensor
-PT-1222,dexcom_g7,2024-12-15,3,Cigna,sensor
-PT-1223,dexcom_g7,2024-12-14,1,Cigna,sensor
-PT-1224,dexcom_g7,2024-12-21,2,Cigna,sensor
-PT-1225,dexcom_g7,2024-12-17,3,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1221,dexcom_g7,2024-12-23,1,Cigna,sensor,commercial
+PT-1222,dexcom_g7,2024-12-15,3,Cigna,sensor,commercial
+PT-1223,dexcom_g7,2024-12-14,1,Cigna,sensor,commercial
+PT-1224,dexcom_g7,2024-12-21,2,Cigna,sensor,commercial
+PT-1225,dexcom_g7,2024-12-17,3,Cigna,sensor,commercial

test-data/sample-batch-23-refill_window.csv

@@ -1,7 +1,7 @@
-External Patient Ref,Item Description,Dispense Date,Quantity,Plan Name,Supply Type
-PT-1221,OmniPod 5,04/30/2026 00:00:00,2,Molina Healthcare,pod
-PT-1222,OmniPod 5,04/29/2026 00:00:00,9,Molina Healthcare,pod
-PT-1223,Omnipod,04/26/2026 00:00:00,2,Molina Healthcare,pod
-PT-1224,Omnipod,05/03/2026 00:00:00,2,Molina Healthcare,pod
-PT-1225,op5,04/28/2026 00:00:00,3,Molina Healthcare,pod
-PT-1226,op5,05/02/2026 00:00:00,1,Molina Healthcare,pod
+External Patient Ref,Item Description,Dispense Date,Quantity,Plan Name,Supply Type,Coverage Type
+PT-1221,OmniPod 5,04/30/2026 00:00:00,2,Molina Healthcare,pod,Commercial
+PT-1222,OmniPod 5,04/29/2026 00:00:00,9,Molina Healthcare,pod,Commercial
+PT-1223,Omnipod,04/26/2026 00:00:00,2,Molina Healthcare,pod,Commercial
+PT-1224,Omnipod,05/03/2026 00:00:00,2,Molina Healthcare,pod,Commercial
+PT-1225,op5,04/28/2026 00:00:00,3,Molina Healthcare,pod,Commercial
+PT-1226,op5,05/02/2026 00:00:00,1,Molina Healthcare,pod,Commercial

test-data/sample-batch-23-visit_due.csv

@@ -1,8 +1,8 @@
-External Patient Ref,Item Description,Dispense Date,Quantity,Plan Name,Supply Type
-PT-1221,dexcom g6,05/01/2025 00:00:00,6,Humana,sensor
-PT-1222,Dexcom G6 Pro,04/23/2025 00:00:00,6,Humana,sensor
-PT-1223,G6,08/09/2025 00:00:00,6,Humana,sensor
-PT-1224,dexcom g6,06/17/2025 00:00:00,6,Humana,sensor
-PT-1225,Dexcom G6 Pro,04/30/2025 00:00:00,6,Humana,sensor
-PT-1226,dexcom g6,06/07/2025 00:00:00,2,Humana,sensor
-PT-1227,dexcom g6,09/03/2025 00:00:00,9,Humana,sensor
+External Patient Ref,Item Description,Dispense Date,Quantity,Plan Name,Supply Type,payer_type
+PT-1221,dexcom g6,05/01/2025 00:00:00,6,Humana,sensor,employer
+PT-1222,Dexcom G6 Pro,04/23/2025 00:00:00,6,Humana,sensor,employer
+PT-1223,G6,08/09/2025 00:00:00,6,Humana,sensor,employer
+PT-1224,dexcom g6,06/17/2025 00:00:00,6,Humana,sensor,employer
+PT-1225,Dexcom G6 Pro,04/30/2025 00:00:00,6,Humana,sensor,employer
+PT-1226,dexcom g6,06/07/2025 00:00:00,2,Humana,sensor,employer
+PT-1227,dexcom g6,09/03/2025 00:00:00,9,Humana,sensor,employer

test-data/sample-batch-24-out_of_coverage.csv

@@ -1,5 +1,5 @@
-patient_id,device_type,shipment_date,quantity,payer,component,Internal Code,Region,Staff ID
-PT-1231,Dexcom G7,2024-12-01,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001
-PT-1232,G7,2024-11-21,6,Medicare Part A,sensor,DME-99,Northeast,STAFF-001
-PT-1233,dexcom g7,2024-11-14,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001
-PT-1234,dexcom g7,2025-01-12,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001
+patient_id,device_type,shipment_date,quantity,payer,component,Internal Code,Region,Staff ID,plan_type
+PT-1231,Dexcom G7,2024-12-01,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001,medicare
+PT-1232,G7,2024-11-21,6,Medicare Part A,sensor,DME-99,Northeast,STAFF-001,medicare
+PT-1233,dexcom g7,2024-11-14,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001,medicare
+PT-1234,dexcom g7,2025-01-12,3,Medicare Part A,sensor,DME-99,Northeast,STAFF-001,medicare

test-data/sample-batch-24-visit_due.csv

@@ -1,6 +1,6 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1231,dexcom_g6,2025-07-18,6,Cigna,sensor
-PT-1232,dexcom_g6,2025-07-14,1,Cigna,sensor
-PT-1233,dexcom_g6,2025-07-11,6,Cigna,sensor
-PT-1234,dexcom_g6,2025-07-14,1,Cigna,sensor
-PT-1235,dexcom_g6,2025-07-10,3,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1231,dexcom_g6,2025-07-18,6,Cigna,sensor,commercial
+PT-1232,dexcom_g6,2025-07-14,1,Cigna,sensor,commercial
+PT-1233,dexcom_g6,2025-07-11,6,Cigna,sensor,commercial
+PT-1234,dexcom_g6,2025-07-14,1,Cigna,sensor,commercial
+PT-1235,dexcom_g6,2025-07-10,3,Cigna,sensor,commercial

test-data/sample-batch-25-ok.csv

@@ -1,4 +1,4 @@
-Acct #,Device,Order Date,Qty,Insurance,Component,Supplier Code
-PT-1241,Dexcom G7,"May 21, 2026",1,Medicare Part B - CGM,sensor,STTIL-01
-PT-1242,G7,"May 16, 2026",1,Medicare Part B - CGM,sensor,STTIL-01
-PT-1243,G7,"May 25, 2026",2,Medicare Part B - CGM,sensor,STTIL-01
+Acct #,Device,Order Date,Qty,Insurance,Component,Supplier Code,LOB
+PT-1241,Dexcom G7,"May 21, 2026",1,Medicare Part B - CGM,sensor,STTIL-01,medicare ffs
+PT-1242,G7,"May 16, 2026",1,Medicare Part B - CGM,sensor,STTIL-01,medicare ffs
+PT-1243,G7,"May 25, 2026",2,Medicare Part B - CGM,sensor,STTIL-01,medicare ffs

test-data/sample-batch-25-visit_due.csv

@@ -1,8 +1,8 @@
-patient_id,device_type,shipment_date,quantity,payer,component
-PT-1241,dexcom_g6,2025-06-26,9,Cigna,sensor
-PT-1242,dexcom_g6,2025-06-20,1,Cigna,sensor
-PT-1243,dexcom_g6,2025-06-21,2,Cigna,sensor
-PT-1244,dexcom_g6,2025-06-28,1,Cigna,sensor
-PT-1245,dexcom_g6,2025-06-25,9,Cigna,sensor
-PT-1246,dexcom_g6,2025-06-28,2,Cigna,sensor
-PT-1247,dexcom_g6,2025-06-26,2,Cigna,sensor
+patient_id,device_type,shipment_date,quantity,payer,component,plan_type
+PT-1241,dexcom_g6,2025-06-26,9,Cigna,sensor,commercial
+PT-1242,dexcom_g6,2025-06-20,1,Cigna,sensor,commercial
+PT-1243,dexcom_g6,2025-06-21,2,Cigna,sensor,commercial
+PT-1244,dexcom_g6,2025-06-28,1,Cigna,sensor,commercial
+PT-1245,dexcom_g6,2025-06-25,9,Cigna,sensor,commercial
+PT-1246,dexcom_g6,2025-06-28,2,Cigna,sensor,commercial
+PT-1247,dexcom_g6,2025-06-26,2,Cigna,sensor,commercial

test-data/sample-green.csv

@@ -1,2 +1,2 @@
-patient_id,device_type,shipment_date,quantity,payer,visit_date,swo_status,pecos_verified,pa_status,diagnosis_on_file
-PT-GREEN-1,dexcom_g7,2026-06-10,3,Medicare Part B,2026-04-15,On File,Yes,Not Required,Yes
+patient_id,device_type,shipment_date,quantity,payer,visit_date,swo_status,pecos_verified,pa_status,diagnosis_on_file,plan_type
+PT-GREEN-1,dexcom_g7,2026-06-10,3,Medicare Part B,2026-04-15,On File,Yes,Not Required,Yes,medicare

tests/test_overrides.py

@@ -0,0 +1,311 @@
+"""
+Tests for device-keyed staff overrides (build plan 02, P4).
+
+Locked semantics (phase-2 design Item 4 / brief section 6):
+- visit overrides are patient-scoped and fan out to ALL the patient's lines
+  (they ride the confirmed_visits path by construction);
+- swo/pa overrides apply only to lines whose device_type matches;
+- device_type '' marks a legacy patient-scoped row and matches all devices;
+- staff knowledge wins over the CSV cell;
+- after a write, the recompute returns {lines, rollup} from the same engine.
+
+PHI CONTRACT: synthetic patient_ids only; overrides carry hashes.
+"""
+
+import hashlib
+import io
+import sys
+from datetime import date, timedelta
+from pathlib import Path
+
+import pytest
+
+sys.path.insert(0, str(Path(__file__).parent.parent / "python-backend"))
+
+from core.coverage_calculator import ShipmentRecord  # noqa: E402
+from core.overrides import (  # noqa: E402
+    Override,
+    OverrideKey,
+    apply_overrides,
+    overrides_from_saved,
+)
+from core.worklist_readiness import build_readiness_index  # noqa: E402
+
+TODAY = date.today()
+
+
+def _hash(pid: str) -> str:
+    return hashlib.sha256(pid.encode()).hexdigest()
+
+
+def _record(**kwargs) -> ShipmentRecord:
+    defaults = dict(
+        patient_id="PT-OV-1",
+        device_type="dexcom_g7",
+        shipment_date=TODAY - timedelta(days=5),
+        quantity=3,
+        payer="Medicare Part B",
+        component="sensor",
+        plan_type="medicare",
+        csv_visit_date=TODAY - timedelta(days=30),
+        csv_pecos_verified="Yes",
+        csv_diagnosis_on_file="Yes",
+    )
+    defaults.update(kwargs)
+    return ShipmentRecord(**defaults)
+
+
+def _swo_override(pid="PT-OV-1", device="dexcom_g7", status="on_file"):
+    return Override(
+        key=OverrideKey(
+            org_id="org", patient_hash=_hash(pid), device_type=device,
+            doc_type="swo",
+        ),
+        status=status,
+    )
+
+
+def test_override_swo_applies_only_to_one_device():
+    # Two devices, both missing SWO -> Action Needed. Override device A only.
+    g7 = _record(device_type="dexcom_g7")
+    libre = _record(device_type="freestyle_libre_2")
+    index = build_readiness_index(
+        [g7, libre], overrides=[_swo_override(device="dexcom_g7")]
+    )
+    assert index.by_line[("PT-OV-1", "dexcom_g7", "medicare")].line_status.value == "Clear to Ship"
+    assert index.by_line[("PT-OV-1", "freestyle_libre_2", "medicare")].line_status.value == "Action Needed"
+
+
+def test_legacy_blank_device_row_applies_patient_wide():
+    g7 = _record(device_type="dexcom_g7")
+    libre = _record(device_type="freestyle_libre_2")
+    index = build_readiness_index(
+        [g7, libre], overrides=[_swo_override(device="")]
+    )
+    for key, verdict in index.by_line.items():
+        assert verdict.line_status.value == "Clear to Ship", key
+
+
+def test_device_scoped_row_wins_over_legacy_row():
+    g7 = _record(device_type="dexcom_g7")
+    index = build_readiness_index(
+        [g7],
+        overrides=[
+            _swo_override(device="", status="on_file"),
+            _swo_override(device="dexcom_g7", status="pending"),
+        ],
+    )
+    verdict = index.by_line[("PT-OV-1", "dexcom_g7", "medicare")]
+    swo = next(i for i in verdict.doc_items if i.doc_type == "swo")
+    assert swo.quality.value == "PENDING"  # device-scoped Pending won
+
+
+def test_override_triggers_recompute_to_better_status():
+    # SWO missing is the last open required item; the override flips the line.
+    rec = _record()
+    base = build_readiness_index([rec])
+    assert base.by_line[("PT-OV-1", "dexcom_g7", "medicare")].line_status.value == "Action Needed"
+    fixed = build_readiness_index([rec], overrides=[_swo_override()])
+    assert fixed.by_line[("PT-OV-1", "dexcom_g7", "medicare")].line_status.value == "Clear to Ship"
+
+
+def test_override_visit_applies_to_all_patient_lines():
+    # Visit rides confirmed_visits: patient-scoped fan-out by construction.
+    g7 = _record(device_type="dexcom_g7", csv_visit_date=None,
+                 csv_swo_status="On File")
+    libre = _record(device_type="freestyle_libre_2", csv_visit_date=None,
+                    csv_swo_status="On File")
+    confirmed = {_hash("PT-OV-1"): TODAY - timedelta(days=10)}
+    index = build_readiness_index([g7, libre], confirmed_visits=confirmed)
+    for key, verdict in index.by_line.items():
+        visit = next(i for i in verdict.doc_items if i.doc_type == "visit")
+        assert visit.satisfied, key
+
+
+def test_overrides_from_saved_shape():
+    saved = {
+        _hash("PT-OV-1"): {
+            "": {"swo": {"status": "on_file"}},
+            "dexcom_g7": {"pa": {"status": "approved"}},
+        }
+    }
+    overrides = overrides_from_saved(saved)
+    assert len(overrides) == 2
+    kinds = {(o.key.device_type, o.key.doc_type, o.status) for o in overrides}
+    assert kinds == {("", "swo", "on_file"), ("dexcom_g7", "pa", "approved")}
+
+
+def test_apply_overrides_returns_touched_patients():
+    g7 = _record()
+    other = _record(patient_id="PT-OV-2")
+    index_lines = build_readiness_index([g7, other]).lines
+    touched = apply_overrides(index_lines, [_swo_override()])
+    assert touched == {"PT-OV-1"}
+
+
+# --- API level ---------------------------------------------------------------
+
+httpx = pytest.importorskip("httpx", reason="httpx required for TestClient")
+from fastapi.testclient import TestClient  # noqa: E402
+
+import api.main as api_main  # noqa: E402
+
+client = TestClient(api_main.app)
+
+
+def test_doc_status_put_accepts_device_and_returns_line_and_rollup(monkeypatch):
+    saved_writes = {}
+
+    def fake_upsert(org_id, patient_hash, doc_type, status,
+                    status_date=None, expiry_date=None, device_type=""):
+        saved_writes[(patient_hash, doc_type, device_type)] = status
+        return True
+
+    def fake_load(org_id):
+        # Echo the persisted write back, as a fresh load would.
+        out = {}
+        for (ph, dt, dev), status in saved_writes.items():
+            out.setdefault(ph, {}).setdefault(dev, {})[dt] = {"status": status}
+        return out
+
+    monkeypatch.setattr(api_main, "get_or_create_org", lambda **kw: "org-test")
+    monkeypatch.setattr(api_main, "upsert_doc_status", fake_upsert)
+    monkeypatch.setattr(api_main, "load_doc_statuses_for_org", fake_load)
+    monkeypatch.setattr(
+        api_main, "load_confirmed_visits_for_org", lambda org: {}
+    )
+
+    resp = client.put(
+        "/api/doc-status",
+        json={
+            "patient_id": "PT-API-1",
+            "doc_type": "swo",
+            "status": "on_file",
+            "device_type": "dexcom_g7",
+            "lines": [
+                {
+                    "device_type": "dexcom_g7",
+                    "plan_type": "medicare",
+                    "csv_visit_date": (TODAY - timedelta(days=20)).isoformat(),
+                    "csv_pecos_verified": "Yes",
+                    "csv_diagnosis_on_file": "Yes",
+                },
+                {
+                    "device_type": "freestyle_libre_2",
+                    "plan_type": "medicare",
+                    "csv_visit_date": (TODAY - timedelta(days=20)).isoformat(),
+                    "csv_pecos_verified": "Yes",
+                    "csv_diagnosis_on_file": "Yes",
+                },
+            ],
+        },
+    )
+    assert resp.status_code == 200
+    body = resp.json()
+    assert body["device_type"] == "dexcom_g7"
+    by_dev = {l["device_type"]: l for l in body["lines"]}
+    # The override satisfied G7's SWO; the Libre line is untouched (no leak).
+    assert by_dev["dexcom_g7"]["line_status"] == "Clear to Ship"
+    assert by_dev["freestyle_libre_2"]["line_status"] == "Action Needed"
+    assert body["rollup_status"] == "Action Needed"  # worst line
+
+
+def test_doc_status_put_without_lines_keeps_legacy_shape(monkeypatch):
+    monkeypatch.setattr(api_main, "get_or_create_org", lambda **kw: "org-test")
+    monkeypatch.setattr(
+        api_main, "upsert_doc_status", lambda *a, **kw: True
+    )
+    resp = client.put(
+        "/api/doc-status",
+        json={"patient_id": "PT-API-2", "doc_type": "pa", "status": "approved"},
+    )
+    assert resp.status_code == 200
+    body = resp.json()
+    assert body["display"] == "Approved"
+    assert "lines" not in body
+
+
+def test_confirm_visit_with_lines_returns_rerolled_patient(monkeypatch):
+    monkeypatch.setattr(api_main, "get_or_create_org", lambda **kw: "org-test")
+    monkeypatch.setattr(
+        api_main, "upsert_confirmed_visit", lambda *a, **kw: True
+    )
+    monkeypatch.setattr(
+        api_main, "load_doc_statuses_for_org", lambda org: {}
+    )
+    ship = (TODAY - timedelta(days=5)).isoformat()
+    resp = client.post(
+        "/api/confirm-visit",
+        json={
+            "patient_id": "PT-API-3",
+            "confirmed_date": (TODAY - timedelta(days=15)).isoformat(),
+            "shipment_date": ship,
+            "payer": "Medicare Part B",
+            "device_type": "dexcom_g7",
+            "quantity": 3,
+            "csv_swo_status": "On File",
+            "csv_pecos_verified": "Yes",
+            "csv_diagnosis_on_file": "Yes",
+            "plan_type": "medicare",
+            "lines": [
+                {
+                    "device_type": "dexcom_g7",
+                    "plan_type": "medicare",
+                    "csv_swo_status": "On File",
+                    "csv_pecos_verified": "Yes",
+                    "csv_diagnosis_on_file": "Yes",
+                },
+                {
+                    "device_type": "freestyle_libre_2",
+                    "plan_type": "medicare",
+                    "csv_swo_status": "On File",
+                    "csv_pecos_verified": "Yes",
+                    "csv_diagnosis_on_file": "Yes",
+                },
+            ],
+        },
+    )
+    assert resp.status_code == 200
+    body = resp.json()
+    # Legacy record fields still present
+    assert body["readiness_status"] == "Clear to Ship"
+    # The confirmed visit fanned out to BOTH echoed lines
+    assert all(l["line_status"] == "Clear to Ship" for l in body["lines"])
+    assert body["rollup_status"] == "Clear to Ship"
+
+
+def test_upload_grades_with_saved_device_scoped_override(monkeypatch):
+    """An SWO override saved for device A feeds the verdict for A's line only."""
+    pid_hash = hashlib.sha256("PT-UP-1".encode()).hexdigest()
+    monkeypatch.setattr(
+        api_main,
+        "load_doc_statuses_for_org",
+        lambda org: {
+            pid_hash: {"dexcom_g7": {"swo": {"status": "on_file"}}}
+        },
+    )
+    monkeypatch.setattr(api_main, "get_or_create_org", lambda **kw: "org-test")
+    monkeypatch.setattr(
+        api_main, "load_confirmed_visits_for_org", lambda org: {}
+    )
+    ship = (TODAY - timedelta(days=5)).isoformat()
+    visit = (TODAY - timedelta(days=30)).isoformat()
+    header = (
+        "patient_id,device_type,shipment_date,quantity,payer,plan_type,"
+        "visit_date,pecos_verified,diagnosis_on_file"
+    )
+    csv_text = (
+        header
+        + f"\nPT-UP-1,Dexcom G7,{ship},3,Medicare Part B,medicare,{visit},Yes,Yes"
+        + f"\nPT-UP-1,Libre 2,{ship},1,Medicare Part B,medicare,{visit},Yes,Yes"
+    )
+    resp = client.post(
+        "/api/upload",
+        files={"file": ("f.csv", io.BytesIO(csv_text.encode()), "text/csv")},
+    )
+    assert resp.status_code == 200
+    recs = {r["device_type"]: r for r in resp.json()["records"]}
+    assert recs["dexcom_g7"]["readiness_status"] == "Clear to Ship"
+    assert recs["freestyle_libre_2"]["readiness_status"] == "Action Needed"
+    # Display follows the same device scope
+    assert recs["dexcom_g7"]["doc_state"]["swo"] == "On File"

tests/test_worklist_readiness.py

@@ -609,3 +609,110 @@ def test_upload_readiness_items_carry_rule_ids():
     assert items["pecos"]["rule_id"] == "R004"
     assert items["pa"]["rule_id"] == "R003"
     assert items["swo"]["rule_id"] == "R100"
+
+
+# ---------------------------------------------------------------------------
+# P5: plan-type enforcement in the live path (plan 02)
+# ---------------------------------------------------------------------------
+
+
+def test_plan_type_value_normalization():
+    """Synonyms canonicalize; the same string in a PAYER column changes
+    nothing about readiness."""
+    from api.normalizer import _normalize_plan_type
+
+    for raw, want in [
+        ("Medicare Part B", "medicare"), ("FFS", "medicare"),
+        ("Original Medicare", "medicare"), ("MA", "medicare_advantage"),
+        ("Part C", "medicare_advantage"), ("state medicaid", "medicaid"),
+        ("Private", "commercial"), ("Employer", "commercial"),
+        ("", None), ("  ", None), ("Tricare Select", None),
+    ]:
+        assert _normalize_plan_type(raw) == want, raw
+
+
+def test_payer_name_never_sets_plan_type():
+    """A payer of 'Medicare Part B' with NO plan_type column yields
+    Plan Type Needed — never a guess from the payer name."""
+    header = (
+        "patient_id,device_type,shipment_date,quantity,payer,"
+        "swo_status,visit_date,pecos_verified,pa_status,diagnosis_on_file"
+    )
+    csv_text = (
+        header
+        + f"\nPT-NG-1,Dexcom G7,{SHIP},3,Medicare Part B,"
+        + f"On File,{VISIT},Yes,,Yes"
+    )
+    resp = _upload(csv_text)
+    rec = resp.json()["records"][0]
+    assert rec["plan_type"] is None
+    assert rec["readiness_status"] == "Plan Type Needed"
+
+
+def test_plan_type_synonym_flows_end_to_end():
+    csv_text = (
+        HEADER
+        + f"\nPT-SYN-1,Dexcom G7,{SHIP},3,Medicare Part B,Medicare Part B,"
+        + f"On File,{VISIT},Yes,,Yes"
+    )
+    resp = _upload(csv_text)
+    rec = resp.json()["records"][0]
+    assert rec["plan_type"] == "medicare"  # value map canonicalized it
+    assert rec["readiness_status"] == "Clear to Ship"
+
+
+def test_unknown_plan_type_value_yields_plan_type_needed():
+    csv_text = (
+        HEADER
+        + f"\nPT-UNK-1,Dexcom G7,{SHIP},3,Tricare,Tricare Select,"
+        + f"On File,{VISIT},Yes,,Yes"
+    )
+    resp = _upload(csv_text)
+    rec = resp.json()["records"][0]
+    assert rec["plan_type"] is None
+    assert rec["readiness_status"] == "Plan Type Needed"
+
+
+def test_default_config_never_reaches_readiness():
+    """'default' is not a known plan type; it must grade Plan Type Needed,
+    never through the default payer_rules entry."""
+    from core.readiness import evaluate_readiness
+
+    v = evaluate_readiness(
+        "default",
+        csv_swo_status="On File",
+        csv_pecos_verified="Yes",
+        csv_diagnosis_on_file="Yes",
+    )
+    assert v.line_status.value == "Plan Type Needed"
+
+
+def test_deprecation_warning_logged_once_per_batch(caplog):
+    header = (
+        "patient_id,device_type,shipment_date,quantity,payer,"
+        "swo_status,visit_date,pecos_verified,pa_status,diagnosis_on_file"
+    )
+    csv_text = (
+        header
+        + f"\nPT-DW-1,Dexcom G7,{SHIP},3,Medicare Part B,On File,{VISIT},Yes,,Yes"
+        + f"\nPT-DW-2,Libre 3,{SHIP},1,Aetna,On File,{VISIT},,,Yes"
+    )
+    with caplog.at_level("WARNING"):
+        resp = _upload(csv_text)
+    assert resp.status_code == 200
+    hits = [r for r in caplog.records if "plan_type not provided" in r.getMessage()]
+    assert len(hits) == 1  # once per batch, not per record
+    assert "2/2 records" in hits[0].getMessage()
+
+
+def test_unrecognized_plan_value_warning_hashes_patient(caplog):
+    csv_text = (
+        HEADER
+        + f"\nPT-RAW-SECRET,Dexcom G7,{SHIP},3,Tricare,Tricare Select,"
+        + f"On File,{VISIT},Yes,,Yes"
+    )
+    with caplog.at_level("WARNING"):
+        _upload(csv_text)
+    hits = [r for r in caplog.records if "Unrecognized plan_type" in r.getMessage()]
+    assert len(hits) == 1
+    assert "PT-RAW-SECRET" not in hits[0].getMessage()