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This variable is contained in the following files:
SAS Name
OUD_ANY_MEDICARE
This variable is the Overarching Opioid Use Disorder (OUD) indicator, which identifies whether a beneficiary met any of the three opioid-related sub-Indicators as of the end of the calendar year. Beneficiaries who were identified as meeting the criteria for any of the following, also meet the criteria for this overarching indicator: OUD_DX_MEDICARE, OUD_HOSP_MEDICARE, or OUD_MAT_MEDICARE.
| Code | Code value |
|---|---|
| 0 | Beneficiary did not meet claims criteria or have sufficient fee-for-service (FFS) coverage |
| 1 | Beneficiary met claims criteria but did not have sufficient FFS coverage |
| 2 | Beneficiary did not meet claims criteria but had sufficient FFS coverage |
| 3 | Beneficiary met claims criteria and had sufficient FFS coverage |
The condition variable requires beneficiaries to satisfy both claims criteria (a minimum number/type of Medicare claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (Medicare FFS Part A and Part B coverage during the entire specified time period).
For the overarching opioid use disorder indicator, beneficiaries must have met the criteria for at least one of the three opioid-use disorder sub-category conditions:
You can find more detailed information on the criteria on the CCW website.
Source: CCW (derived)