This variable is contained in the following files:
SAS Name
MDCR_TOTAL_FFS_USE_12
This variable is the total count of claims for each month for all Medicare fee-for-service (FFS) claims and Part D events (PDEs) for the beneficiary. Note that only fee-for-service (FFS) claims for services and PDEs are included.
CCW calculates this variable as the count of all claims from the monthly Inpatient, Skilled Nursing Facility, Home Health, Hospice, Hospital Outpatient, Carrier, and DME claims as well as the count of Part D Prescription Drug Events for the beneficiary.
Within MMLEADS, there are monthly variables that sum the total payments (the CLM_PMT_AMT field) for capitated payments (the MDCR_MC_PTA_PTB_CAPTD_SPEND_01–12). There are monthly totals that include the sum of the FFS claims (these claims) and capitated payments (MDCR_TOTAL_SPEND_01–12).
Source: Medicare Claims files (derived)