EXP-33-001-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-34-001-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-35-001-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-36-001-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-44-002-2
|
% of service tracking claim headers with a non-zero Total Medicaid Paid Amount
|
EXP-45-002-2
|
% of header claims with Total Medicaid Paid Amount = $0 or missing
|
EXP-6-001-21
|
Sum of Total Medicaid Paid Amount
|
EXP-6-010-3
|
% of claim headers with Total Medicaid Paid Amount > $20,000
|
EXP-6-029-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-7-009-1
|
% of claim headers with Total Medicaid Paid Amount > $20,000
|
EXP-7-027-2
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-8-001-4
|
Sum of Total Medicaid Paid Amount
|
EXP-8-002-3
|
% of claim headers with Total Medicaid Paid Amount > $20,000
|
EXP-8-004-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-9-001-1
|
% of claim headers with Total Medicaid Paid Amount > $20,000
|
EXP-9-002-2
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing
|
EXP-S-003-3
|
Sum of Total Medicaid Paid Amount
|
EXP-S-007-4
|
Sum of Total Medicaid Paid Amount
|
FFS-44-001-1
|
% of crossover claim headers where Total Medicare Deductible Amount and Total Medicare Coinsurance Amount do not sum to Total Medicaid Paid Amount
|
FFS-49-002-14
|
% of claim headers with PAYMENT-LEVEL-IND = 2 where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
FFS-49-006-6
|
% of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount
|
MCR-59-002-14
|
% of claim headers with PAYMENT-LEVEL-IND = 2 where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
MCR-59-006-6
|
% of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount
|
MIS-4-037-37
|
% missing: TOT-MEDICAID-PAID-AMT (CLT00002)
|
MIS-23-042-42
|
% missing: TOT-MEDICAID-PAID-AMT (CLT00002)
|
MIS-81-042-42
|
% missing: TOT-MEDICAID-PAID-AMT (CLT00002)
|
RULE-7523
|
% of header claims with Total Medicaid Paid Amount = $0 or missing
|
RULE-7436
|
% of service tracking claim headers with a non-zero Total Medicaid Paid Amount
|
RULE-7566
|
% of denied claim headers where Total Medicaid Paid Amount is non-missing and non-zero
|
EXP-10-001-25
|
Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-10-002-18
|
Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-003-19
|
Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-004-20
|
Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-10-005-21
|
Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-10-006-22
|
Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-10-007-23
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-10-008-24
|
Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-10-009-17
|
Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-10-010-10
|
Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-011-11
|
Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-012-12
|
Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-10-013-13
|
Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-10-014-14
|
Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-10-015-15
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-10-016-16
|
Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-10-017-9
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-10-018-2
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-019-3
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-10-020-4
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-10-021-5
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-10-022-6
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-10-023-7
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-10-024-8
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-10-025-1
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing)
|
EXP-6-002-29
|
Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-6-003-22
|
Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-004-23
|
Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-005-24
|
Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-6-006-25
|
Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-6-007-26
|
Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-6-008-27
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-6-009-28
|
Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-6-011-20
|
Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-6-012-13
|
Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-013-14
|
Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-014-15
|
Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-6-015-16
|
Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-6-016-17
|
Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-6-017-18
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-6-018-19
|
Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-6-019-12
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-6-020-5
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-021-6
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-6-022-7
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-6-023-8
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-6-024-9
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-6-025-10
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-6-026-11
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-6-027-4
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing)
|
EXP-7-001-27
|
Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-7-002-20
|
Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-003-21
|
Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-004-22
|
Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-7-005-23
|
Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-7-006-24
|
Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-7-007-25
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-7-008-26
|
Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-7-010-19
|
Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-7-011-12
|
Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-012-13
|
Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-013-14
|
Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-7-014-15
|
Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-7-015-16
|
Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-7-016-17
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-7-017-18
|
Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-7-018-11
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older)
|
EXP-7-019-4
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-020-5
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases)
|
EXP-7-021-6
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services)
|
EXP-7-022-7
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases)
|
EXP-7-023-8
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21)
|
EXP-7-024-9
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-7-025-10
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21)
|
EXP-7-026-3
|
Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing)
|
FFS-49-002-2
|
% of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
MCR-59-002-2
|
% of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
EXP-33P-001-1
|
% of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID
|
MCR-59P-002-14
|
% of claim headers with PAYMENT-LEVEL-IND = 2 where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header, by Plan ID
|
EXP-33R-001-1
|
% of Plan IDs over the threshold for EXP-33P-001-1 (% of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID)
|
MCR-59R-002-14
|
% of Plan IDs over the threshold for MCR-59P-002-14 (% of claim headers with PAYMENT-LEVEL-IND = 2 where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header, by Plan ID)
|
RULE-7791
|
% of claim headers with PAYMENT-LEVEL-IND = 2 where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|