Medicaid Use (Claim Count) — Rx

SAS Name
MDCD_RX_TOTAL_USE

This variable is the total count of Medicaid Pharmacy (RX) (header) claims for the beneficiary during the year.

Comments

The corresponding Medicaid payment information for RX is in the MDCD_RX_TOTAL_SPEND variable; however, due to CMS payment redaction requirements the dollar totals will not reflect the (redacted) managed care expenditures. MMLEADS counts all claims in the MDCD_RX_TOTAL_USE variable. Use caution when calculating average spend per claim. There may be claims (i.e., use) for which there is no corresponding payment information.

Source: T-MSIS Pharmacy Claims file (derived)