This variable is contained in the following files:
SAS Name
MDCD_TOTAL_USE
This variable is the total count of Medicaid inpatient (IP), long-term care (LT), pharmacy (RX), and other services (OT) (header) claims for the beneficiary for during the year, after removing the managed care capitated payment claims from the OT file.
CCW filtered the OT claims header records to distinguish between claims for capitated payments and claims for services. Capitated payment claims are header claims where the claim type code (T-MSIS variable called CLM_TYPE_CD) is equal to '2' (Medicaid or expansion claim) 'B' (S-CHIP claim) or 'V' (Other Services claim).
The Medicaid payment information corresponding to this variable is in the MDCD_TOTAL_ NON_CAPTD_SPEND variable; however, due to CMS payment redaction requirements the dollar totals will not reflect the total managed care expenditures. MMLEADS may count claims (in this MDCD_ TOTAL_USE variable) for which there is no corresponding payment information.
Source: T-MSIS Claims file (derived)