EXP-11-001-85
|
Sum of Medicaid Paid Amount
|
EXP-11-002-84
|
Sum of Medicaid Paid Amount for HCBS Program
|
EXP-11-003-83
|
% of amount paid for claim lines with HCBS Taxonomy values beginning with 02, 04, or 08 of the amount for all claim lines with HCBS Taxonomy
|
EXP-11-081-3
|
% of claim lines with Medicaid Paid Amount > $100,000
|
EXP-11-082-5
|
Average Medicaid Paid Amount for HCBS Program (exclude outliers with Medicaid Paid Amount > $200,000)
|
EXP-11-161-2
|
% of claim lines with Medicaid Paid Amount = $0 or missing
|
EXP-11-162-4
|
% of outpatient department claim lines with Medicaid Paid Amount = $0
|
EXP-12-001-81
|
Sum of Medicaid Paid Amount
|
EXP-12-079-1
|
# of claim lines with Medicaid Paid Amount > $100,000
|
EXP-13-001-5
|
Sum of Medicaid Paid Amount
|
EXP-13-002-3
|
% of claim lines with Medicaid Paid Amount > $100,000
|
EXP-13-004-2
|
% of claim lines with Medicaid Paid Amount = $0 or missing
|
EXP-14-001-4
|
Sum of Medicaid Paid Amount
|
EXP-14-002-1
|
# of claim lines with Medicaid Paid Amount > $100,000
|
EXP-20-001-1
|
Sum of Medicaid Paid Amount for other premium
|
EXP-20-002-2
|
Average Medicaid Paid Amount for other premium
|
EXP-21-001-1
|
Sum of Medicaid Paid Amount for other premium
|
EXP-21-002-2
|
Average Medicaid Paid Amount for other premium
|
EXP-22-001-2
|
Sum of Medicaid Paid Amount for HMOs, HIOs or PACE (TYPE-OF-SERVICE = 119)
|
EXP-22-001-8
|
Sum of Medicaid Paid Amount
|
EXP-22-003-4
|
Sum of Medicaid Paid Amount for PCCM (TYPE-OF-SERVICE = 120)
|
EXP-22-004-6
|
Sum of Medicaid Paid Amount for PHP (TYPE-OF-SERVICE = 122)
|
EXP-22-005-1
|
Average Medicaid Paid Amount
|
EXP-22-006-3
|
Average Medicaid Paid Amount for HMOs, HIOs or PACE (TYPE-OF-SERVICE = 119)
|
EXP-22-007-5
|
Average Medicaid Paid Amount for PCCM (TYPE-OF-SERVICE = 120)
|
EXP-22-008-7
|
Average Medicaid Paid Amount for PHP (TYPE-OF-SERVICE = 122)
|
EXP-23-001-2
|
Sum of Medicaid Paid Amount
|
EXP-23-002-1
|
Average absolute value of Medicaid Paid Amount
|
EXP-24-001-8
|
Sum of Medicaid Paid Amount
|
EXP-24-002-2
|
Sum of Medicaid Paid Amount for HMOs, HIOs or PACE (TYPE-OF-SERVICE = 119)
|
EXP-24-003-4
|
Sum of Medicaid Paid Amount for PCCM (TYPE-OF-SERVICE = 120)
|
EXP-24-004-6
|
Sum of Medicaid Paid Amount for PHP (TYPE-OF-SERVICE = 122)
|
EXP-24-005-1
|
Average Medicaid Paid Amount
|
EXP-24-006-3
|
Average Medicaid Paid Amount for HMOs, HIOs or PACE (TYPE-OF-SERVICE = 119)
|
EXP-24-007-5
|
Average Medicaid Paid Amount for PCCM (TYPE-OF-SERVICE = 120)
|
EXP-24-008-7
|
Average Medicaid Paid Amount for PHP (TYPE-OF-SERVICE = 122)
|
EXP-25-001-2
|
Sum of Medicaid Paid Amount
|
EXP-25-002-1
|
Average absolute value of Medicaid Paid Amount
|
EXP-37-001-1
|
% of claim lines with Medicaid Paid Amount = $0 or missing
|
EXP-39-001-1
|
% of claim lines with Medicaid Paid Amount = $0 or missing
|
EXP-S-002-5
|
Sum of Medicaid Paid Amount
|
EXP-S-006-6
|
Sum of Medicaid Paid Amount
|
FFS-10-002-3
|
% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
|
FFS-10-003-84
|
% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
|
FFS-10-004-4
|
% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
|
FFS-10-005-1
|
% of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0)
|
FFS-10-006-2
|
% of claim lines with Procedure Code or Revenue Code (Medicaid Paid Amount > $0)
|
FFS-12-002-1
|
% of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0)
|
FFS-12-003-2
|
% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
|
FFS-12-004-4
|
% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
|
FFS-12-005-3
|
% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
|
FFS-49-003-15
|
% 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-49-011-11
|
% of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount
|
MCR-11-002-3
|
% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
|
MCR-11-003-5
|
% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
|
MCR-11-004-4
|
% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
|
MCR-11-005-1
|
% of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0)
|
MCR-11-006-2
|
% of claim lines with Procedure Code or Revenue Code (Medicaid Paid Amount > $0)
|
MCR-15-002-2
|
% of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0)
|
MCR-15-003-4
|
% of claim lines with office Place of Service (Medicaid Paid Amount > $0)
|
MCR-15-004-3
|
% of claim lines with missing Place of Service (Medicaid Paid Amount > $0)
|
MCR-15-005-1
|
% of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0)
|
MCR-28-001-1
|
% of plan IDs with capitation payment ratios <0.9 or >1.1 (non-PCCM)
|
MCR-59-003-15
|
% 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-59-011-11
|
% of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount
|
MIS-7-016-16
|
% missing: MEDICAID-PAID-AMT (COT00003)
|
MIS-26-016-16
|
% missing: MEDICAID-PAID-AMT (COT00003)
|
MIS-84-015-15
|
% missing: MEDICAID-PAID-AMT (COT00003)
|
RULE-7562
|
% of denied claim lines where Medicaid Paid Amount is non-missing and non-zero
|
EXP-11-004-98
|
Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-11-005-109
|
Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-11-006-118
|
Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-11-007-124
|
Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-11-008-133
|
Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-11-009-143
|
Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-11-010-154
|
Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-11-011-86
|
Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
EXP-11-012-87
|
Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-11-013-89
|
Total paid for TYPE-OF-SERVICE = 12 (Physicians' services)
|
EXP-11-014-91
|
Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-11-015-92
|
Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-11-016-93
|
Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-11-017-94
|
Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-11-018-95
|
Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-11-019-96
|
Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-11-020-97
|
Total paid for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-11-021-99
|
Total paid for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-11-022-100
|
Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-11-023-101
|
Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-11-024-102
|
Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-11-025-103
|
Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-11-026-104
|
Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-11-027-105
|
Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-11-028-106
|
Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-11-029-107
|
Total paid for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-11-030-108
|
Total paid for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-11-031-110
|
Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-11-032-111
|
Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-11-033-112
|
Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-11-034-113
|
Total paid for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-11-035-114
|
Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-11-036-115
|
Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-11-037-116
|
Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-11-038-117
|
Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-11-039-119
|
Total paid for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-11-040-120
|
Total paid for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-11-041-121
|
Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-11-042-122
|
Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-11-043-123
|
Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services)
|
EXP-11-044-125
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-11-045-126
|
Total paid for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-11-046-127
|
Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-11-047-128
|
Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-11-048-129
|
Total paid for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-11-049-130
|
Total paid for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-11-050-131
|
Total paid for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-11-051-132
|
Total paid for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-11-052-134
|
Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-11-053-135
|
Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-11-054-136
|
Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-11-055-137
|
Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-11-056-138
|
Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-11-057-139
|
Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-11-058-140
|
Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-11-059-141
|
Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-11-060-142
|
Total paid for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness)
|
EXP-11-061-144
|
Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-11-062-145
|
Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-11-063-146
|
Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-11-064-147
|
Total paid for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-11-065-148
|
Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-11-066-149
|
Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-11-067-150
|
Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-11-068-151
|
Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-11-069-152
|
Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-11-070-153
|
Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-11-071-155
|
Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-11-072-156
|
Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-11-073-157
|
Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-11-074-158
|
Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-11-075-159
|
Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.)
|
EXP-11-076-160
|
Total paid for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-11-077-161
|
Total paid for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.)
|
EXP-11-078-162
|
Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.)
|
EXP-11-079-88
|
Total paid for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-11-080-90
|
Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-11-083-18
|
Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-11-084-29
|
Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-11-085-38
|
Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-11-086-44
|
Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-11-087-53
|
Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-11-088-63
|
Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-11-089-74
|
Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-11-091-7
|
Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-11-093-11
|
Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-11-094-12
|
Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-11-095-13
|
Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-11-096-14
|
Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-11-097-15
|
Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-11-098-16
|
Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-11-099-17
|
Average paid per record for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-11-100-19
|
Average paid per record for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-11-101-20
|
Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-11-102-21
|
Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-11-103-22
|
Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-11-104-23
|
Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-11-105-24
|
Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-11-106-25
|
Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-11-107-26
|
Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-11-108-27
|
Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-11-109-28
|
Average paid per record for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-11-110-30
|
Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-11-111-31
|
Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-11-112-32
|
Average paid per record for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-11-113-33
|
Average paid per record for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-11-114-34
|
Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-11-115-35
|
Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-11-116-36
|
Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-11-117-37
|
Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-11-118-39
|
Average paid per record for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-11-119-40
|
Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-11-120-41
|
Average paid per record for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-11-121-42
|
Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-11-122-43
|
Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services)
|
EXP-11-123-45
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-11-124-46
|
Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-11-125-47
|
Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-11-126-48
|
Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-11-127-49
|
Average paid per record for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-11-128-50
|
Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-11-129-51
|
Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-11-130-52
|
Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-11-131-54
|
Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-11-132-55
|
Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-11-133-56
|
Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-11-134-57
|
Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-11-135-58
|
Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-11-136-59
|
Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-11-137-60
|
Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-11-138-61
|
Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-11-139-62
|
Average paid per record for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services)
|
EXP-11-140-64
|
Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-11-141-65
|
Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-11-142-66
|
Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-11-143-67
|
Average paid per record for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-11-144-68
|
Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-11-145-69
|
Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-11-146-70
|
Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-11-147-71
|
Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-11-148-72
|
Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-11-149-73
|
Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-11-150-75
|
Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-11-151-76
|
Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-11-152-77
|
Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-11-153-78
|
Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-11-154-79
|
Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies)
|
EXP-11-155-80
|
Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-11-156-81
|
Average paid per record for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations)
|
EXP-11-157-82
|
Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies)
|
EXP-11-158-8
|
Average paid per record for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-11-159-10
|
Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-12-002-94
|
Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-12-003-105
|
Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-12-004-114
|
Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-12-005-120
|
Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-12-006-129
|
Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-12-007-139
|
Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-12-008-150
|
Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-12-009-82
|
Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
EXP-12-010-83
|
Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-12-011-85
|
Total paid for TYPE-OF-SERVICE = 12 (Physicians' services)
|
EXP-12-012-87
|
Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-12-013-88
|
Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-12-014-89
|
Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-12-015-90
|
Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-12-016-91
|
Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-12-017-92
|
Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-12-018-93
|
Total paid for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-12-019-95
|
Total paid for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-12-020-96
|
Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-12-021-97
|
Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-12-022-98
|
Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-12-023-99
|
Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-12-024-100
|
Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-12-025-101
|
Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-12-026-102
|
Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-12-027-103
|
Total paid for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-12-028-104
|
Total paid for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-12-029-106
|
Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-12-030-107
|
Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-12-031-108
|
Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-12-032-109
|
Total paid for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-12-033-110
|
Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-12-034-111
|
Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-12-035-112
|
Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-12-036-113
|
Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-12-037-115
|
Total paid for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-12-038-116
|
Total paid for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-12-039-117
|
Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-12-040-118
|
Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-12-041-119
|
Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services)
|
EXP-12-042-121
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-12-043-122
|
Total paid for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-12-044-123
|
Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-12-045-124
|
Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-12-046-125
|
Total paid for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-12-047-126
|
Total paid for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-12-048-127
|
Total paid for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-12-049-128
|
Total paid for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-12-050-130
|
Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-12-051-131
|
Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-12-052-132
|
Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-12-053-133
|
Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-12-054-134
|
Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-12-055-135
|
Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-12-056-136
|
Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-12-057-137
|
Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-12-058-138
|
Total paid for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness)
|
EXP-12-059-140
|
Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-12-060-141
|
Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-12-061-142
|
Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-12-062-143
|
Total paid for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-12-063-144
|
Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-12-064-145
|
Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-12-065-146
|
Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-12-066-147
|
Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-12-067-148
|
Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-12-068-149
|
Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-12-069-151
|
Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-12-070-152
|
Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-12-071-153
|
Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-12-072-154
|
Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-12-073-155
|
Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.)
|
EXP-12-074-156
|
Total paid for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-12-075-157
|
Total paid for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.)
|
EXP-12-076-158
|
Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.)
|
EXP-12-077-84
|
Total paid for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-12-078-86
|
Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-12-080-3
|
Average Medicaid Amount Paid ($0 < Medicaid Amount Paid < $200,000)
|
EXP-12-081-16
|
Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-12-082-27
|
Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-12-083-36
|
Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-12-084-42
|
Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-12-085-51
|
Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-12-086-61
|
Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-12-087-72
|
Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-12-088-4
|
Average paid per record for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
EXP-12-089-5
|
Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-12-090-7
|
Average paid per record for TYPE-OF-SERVICE = 12 (Physicians' services)
|
EXP-12-091-9
|
Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-12-092-10
|
Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-12-093-11
|
Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-12-094-12
|
Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-12-095-13
|
Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-12-096-14
|
Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-12-097-15
|
Average paid per record for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-12-098-17
|
Average paid per record for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-12-099-18
|
Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-12-100-19
|
Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-12-101-20
|
Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-12-102-21
|
Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-12-103-22
|
Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-12-104-23
|
Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-12-105-24
|
Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-12-106-25
|
Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-12-107-26
|
Average paid per record for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-12-108-28
|
Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-12-109-29
|
Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-12-110-30
|
Average paid per record for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-12-111-31
|
Average paid per record for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-12-112-32
|
Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-12-113-33
|
Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-12-114-34
|
Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-12-115-35
|
Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-12-116-37
|
Average paid per record for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-12-117-38
|
Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-12-118-39
|
Average paid per record for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-12-119-40
|
Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-12-120-41
|
Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services)
|
EXP-12-121-43
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-12-122-44
|
Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-12-123-45
|
Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-12-124-46
|
Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-12-125-47
|
Average paid per record for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-12-126-48
|
Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-12-127-49
|
Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-12-128-50
|
Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-12-129-52
|
Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-12-130-53
|
Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-12-131-54
|
Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-12-132-55
|
Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-12-133-56
|
Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-12-134-57
|
Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-12-135-58
|
Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-12-136-59
|
Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-12-137-60
|
Average paid per record for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services)
|
EXP-12-138-62
|
Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-12-139-63
|
Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-12-140-64
|
Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-12-141-65
|
Average paid per record for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-12-142-66
|
Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-12-143-67
|
Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-12-144-68
|
Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-12-145-69
|
Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-12-146-70
|
Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-12-147-71
|
Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-12-148-73
|
Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-12-149-74
|
Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-12-150-75
|
Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-12-151-76
|
Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-12-152-77
|
Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies)
|
EXP-12-153-78
|
Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-12-154-79
|
Average paid per record for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations)
|
EXP-12-155-80
|
Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies)
|
EXP-12-156-6
|
Average paid per record for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-12-157-8
|
Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-12-158-2
|
% of records with Medicaid Amount Paid = $0
|
EXP-14-003-3
|
Average Medicaid Amount Paid ($0 < Medicaid Amount Paid < $200,000)
|
EXP-14-004-2
|
% of records with Medicaid Amount Paid = $0
|
EXP-15-001-90
|
Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-15-002-101
|
Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-15-003-110
|
Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-15-004-116
|
Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-15-005-125
|
Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-15-006-135
|
Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-15-007-146
|
Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-15-008-78
|
Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
EXP-15-009-79
|
Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-15-010-81
|
Total paid for TYPE-OF-SERVICE = 12 (Physicians' services)
|
EXP-15-011-83
|
Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-15-012-84
|
Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-15-013-85
|
Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-15-014-86
|
Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-15-015-87
|
Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-15-016-88
|
Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-15-017-89
|
Total paid for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-15-018-91
|
Total paid for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-15-019-92
|
Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-15-020-93
|
Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-15-021-94
|
Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-15-022-95
|
Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-15-023-96
|
Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-15-024-97
|
Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-15-025-98
|
Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-15-026-99
|
Total paid for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-15-027-100
|
Total paid for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-15-028-102
|
Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-15-029-103
|
Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-15-030-104
|
Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-15-031-105
|
Total paid for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-15-032-106
|
Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-15-033-107
|
Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-15-034-108
|
Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-15-035-109
|
Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-15-036-111
|
Total paid for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-15-037-112
|
Total paid for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-15-038-113
|
Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-15-039-114
|
Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-15-040-115
|
Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services)
|
EXP-15-041-117
|
Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-15-042-118
|
Total paid for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-15-043-119
|
Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-15-044-120
|
Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-15-045-121
|
Total paid for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-15-046-122
|
Total paid for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-15-047-123
|
Total paid for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-15-048-124
|
Total paid for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-15-049-126
|
Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-15-050-127
|
Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-15-051-128
|
Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-15-052-129
|
Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-15-053-130
|
Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-15-054-131
|
Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-15-055-132
|
Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-15-056-133
|
Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-15-057-134
|
Total paid for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services (whether or not furnished in a facility) for individuals with chronic mental illness)
|
EXP-15-058-136
|
Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-15-059-137
|
Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-15-060-138
|
Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-15-061-139
|
Total paid for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-15-062-140
|
Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-15-063-141
|
Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-15-064-142
|
Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-15-065-143
|
Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-15-066-144
|
Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-15-067-145
|
Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-15-068-147
|
Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-15-069-148
|
Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-15-070-149
|
Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-15-071-150
|
Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-15-072-151
|
Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.)
|
EXP-15-073-152
|
Total paid for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-15-074-153
|
Total paid for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.)
|
EXP-15-075-154
|
Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.)
|
EXP-15-076-80
|
Total paid for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-15-077-82
|
Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-15-078-13
|
Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
EXP-15-079-24
|
Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
EXP-15-080-33
|
Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
EXP-15-081-39
|
Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
EXP-15-082-48
|
Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
EXP-15-083-58
|
Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
EXP-15-084-69
|
Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
EXP-15-085-1
|
Average paid per record for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
EXP-15-086-2
|
Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
EXP-15-087-4
|
Average paid per record for TYPE-OF-SERVICE = 12 (Physicians' services)
|
EXP-15-088-6
|
Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
EXP-15-089-7
|
Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
EXP-15-090-8
|
Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
EXP-15-091-9
|
Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
EXP-15-092-10
|
Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
EXP-15-093-11
|
Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
EXP-15-094-12
|
Average paid per record for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-15-095-14
|
Average paid per record for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
EXP-15-096-15
|
Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
EXP-15-097-16
|
Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
EXP-15-098-17
|
Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
EXP-15-099-18
|
Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
EXP-15-100-19
|
Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
EXP-15-101-20
|
Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
EXP-15-102-21
|
Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
EXP-15-103-22
|
Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services)
|
EXP-15-104-23
|
Average paid per record for TYPE-OF-SERVICE = 29 (Dental services)
|
EXP-15-105-25
|
Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
EXP-15-106-26
|
Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
EXP-15-107-27
|
Average paid per record for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
EXP-15-108-28
|
Average paid per record for TYPE-OF-SERVICE = 35 (Dentures)
|
EXP-15-109-29
|
Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
EXP-15-110-30
|
Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
EXP-15-111-31
|
Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
EXP-15-112-32
|
Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
EXP-15-113-34
|
Average paid per record for TYPE-OF-SERVICE = 40 (Screening services)
|
EXP-15-114-35
|
Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services)
|
EXP-15-115-36
|
Average paid per record for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
EXP-15-116-37
|
Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
EXP-15-117-38
|
Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services)
|
EXP-15-118-40
|
Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
EXP-15-119-41
|
Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services)
|
EXP-15-120-42
|
Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
EXP-15-121-43
|
Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
EXP-15-122-44
|
Average paid per record for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
EXP-15-123-45
|
Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services)
|
EXP-15-124-46
|
Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services)
|
EXP-15-125-47
|
Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services)
|
EXP-15-126-49
|
Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
EXP-15-127-50
|
Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
EXP-15-128-51
|
Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
EXP-15-129-52
|
Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
EXP-15-130-53
|
Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
EXP-15-131-54
|
Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
EXP-15-132-55
|
Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
EXP-15-133-56
|
Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
EXP-15-134-57
|
Average paid per record for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services)
|
EXP-15-135-59
|
Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
EXP-15-136-60
|
Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
EXP-15-137-61
|
Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
EXP-15-138-62
|
Average paid per record for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
EXP-15-139-63
|
Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
EXP-15-140-64
|
Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
EXP-15-141-65
|
Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
EXP-15-142-66
|
Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
EXP-15-143-67
|
Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
EXP-15-144-68
|
Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
EXP-15-145-70
|
Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
EXP-15-146-71
|
Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
EXP-15-147-72
|
Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
EXP-15-148-73
|
Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
EXP-15-149-74
|
Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies)
|
EXP-15-150-75
|
Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services)
|
EXP-15-151-76
|
Average paid per record for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations)
|
EXP-15-151-77
|
Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies)
|
EXP-15-153-3
|
Average paid per record for TYPE-OF-SERVICE = 115 (Residential care)
|
EXP-15-154-5
|
Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
EXP-26-001-1
|
Capitation payments by Plan ID (non-PCCM)
|
EXP-26-002-2
|
% of total capitation amount paid on Plan IDs not found in Managed Care file
|
EXP-26-003-3
|
% of total capitation amount paid with unknown or non-specified Plan IDs
|
FFS-49-003-3
|
% of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
MCR-12-079-91
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services)
|
MCR-12-080-102
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 3 (Rural health clinic services)
|
MCR-12-081-111
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic)
|
MCR-12-082-117
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 5 (Professional laboratory services)
|
MCR-12-083-126
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 6 (Technical laboratory services)
|
MCR-12-084-136
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 7 (Professional radiological services)
|
MCR-12-085-147
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 8 (Technical radiological services)
|
MCR-12-086-79
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services)
|
MCR-12-087-80
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age)
|
MCR-12-088-82
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 12 (Physicians' services)
|
MCR-12-089-84
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist)
|
MCR-12-090-85
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.)
|
MCR-12-091-86
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services)
|
MCR-12-092-87
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services)
|
MCR-12-093-88
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services)
|
MCR-12-094-89
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home)
|
MCR-12-095-90
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 19 (Home health services - Physical therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
MCR-12-096-92
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 20 (Home health services - Occupational therapy provided by a home health agency or by a facility licensed by the State to provide medical rehabilitation services)
|
MCR-12-097-93
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services)
|
MCR-12-098-94
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 22 (Private duty nursing services)
|
MCR-12-099-95
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services)
|
MCR-12-100-96
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 24 (Pediatric nurse)
|
MCR-12-101-97
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service)
|
MCR-12-102-98
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services)
|
MCR-12-103-99
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals)
|
MCR-12-104-100
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 28 (Clinic services)
|
MCR-12-105-101
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 29 (Dental services)
|
MCR-12-106-103
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services))
|
MCR-12-107-104
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services))
|
MCR-12-108-105
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services))
|
MCR-12-109-106
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 35 (Dentures)
|
MCR-12-110-107
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices)
|
MCR-12-111-108
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 37 (Eyeglasses)
|
MCR-12-112-109
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 38 (Hearing Aids)
|
MCR-12-113-110
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 39 (Diagnostic services)
|
MCR-12-114-112
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 40 (Screening services)
|
MCR-12-115-113
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 41 (Preventive services)
|
MCR-12-116-114
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.)
|
MCR-12-117-115
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 43 (Rehabilitative services)
|
MCR-12-118-116
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services)
|
MCR-12-119-118
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.)
|
MCR-12-120-119
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 51 (Personal care services)
|
MCR-12-121-120
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 52 (Primary care case management services)
|
MCR-12-122-121
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 53 (Targeted case management services )
|
MCR-12-123-122
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 54 (Case Management services other than those that meet the definition of primary care case management services or targeted case management services)
|
MCR-12-124-123
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 55 (Care coordination services)
|
MCR-12-125-124
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 56 (Transportation services)
|
MCR-12-126-125
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 57 (Enabling services)
|
MCR-12-127-127
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT)
|
MCR-12-128-128
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services)
|
MCR-12-129-129
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services)
|
MCR-12-130-130
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services)
|
MCR-12-131-131
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services)
|
MCR-12-132-132
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services)
|
MCR-12-133-133
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services)
|
MCR-12-134-134
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services)
|
MCR-12-135-135
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 69 (HCBS - Day treatment or other partial hospitalization services, psychosocial rehabilitation services and clinic services)
|
MCR-12-136-137
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care)
|
MCR-12-137-138
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members)
|
MCR-12-138-139
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home)
|
MCR-12-139-140
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization)
|
MCR-12-140-141
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services)
|
MCR-12-141-142
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services)
|
MCR-12-142-143
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment)
|
MCR-12-143-144
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services)
|
MCR-12-144-145
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services)
|
MCR-12-145-146
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services)
|
MCR-12-146-148
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services)
|
MCR-12-147-149
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services)
|
MCR-12-148-150
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services)
|
MCR-12-149-151
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services)
|
MCR-12-150-152
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.)
|
MCR-12-151-153
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 87 (Hospice services)
|
MCR-12-152-154
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.)
|
MCR-12-153-155
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.)
|
MCR-12-154-81
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 115 (Residential care)
|
MCR-12-155-83
|
Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan)
|
MCR-59-003-3
|
% of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header
|
EXP-11-161_1-164
|
% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing
|
EXP-37-001_1-2
|
% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing
|
EXP-39-001_1-2
|
% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing
|
EXP-13-004_1-7
|
% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing
|
EXP-37P-001-1-2
|
% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing, by Plan ID
|
MCR-59P-003-15
|
% 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-37R-001-1-2
|
% of Plan IDs over the threshold for EXP-37P-001-1-2 (% of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing, by Plan ID)
|
MCR-59R-003-15
|
% of Plan IDs over the threshold for MCR-59P-003-15 (% 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-7792
|
% 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
|