Medicare Payment Amount — Total

This variable is contained in the following files:

Medicare-Medicaid Linked Enrollee Analytic Data Source 3.0

SAS Name

MDCR_TOTAL_SPEND

This variable is the total Medicare payment amount for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary during the year.

Comments

CCW calculates this variable as the sum of all CLM_PMT_AMT from the IP, SNF, HHA, Hospice, HOP, Carrier, and DME claims, plus the TOT_RX_CST_AMT for all PDEs, plus the MA capitated premium payments (MAPMT_AMT from the source MARx data) for the beneficiary for the year.

Within MMLEADS, there are five variables that also sum to this MDCR_TOTAL_ SPEND: MDCR_PTA_TOTAL_FFS_SPEND, MDCR_HOP_TOTAL_FFS_SPEND, MDCR_PTBNI_TOTAL_FFS_SPEND, MDCR_PTD_TOTAL_SPEND and MDCR_MC_PTA_PTB_CAPTD_SPEND.

Values: $

Source: Medicare Claims files and MARx file (derived)