TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THE RECIPIENT DURING THE CALENDAR YEAR (FEE-FOR-SERVICE AND PREMIUM PAYMENTS), FOR ALL TYPES OF SERVICE AND ANY TYPE OF CLAIM.
(SAS USERS: ZONED DECIMAL - ZD8)
Comments
USER NOTES: THIS IS A SUM OF THE AMOUNTS IN 'RECIPIENT TOTAL MEDICAID FEE-FOR-SERVICE PAYMENT AMOUNT' AND 'RECIPIENT TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT AMOUNT'. ENCOUNTER RECORDS (TYPE OF CLAIM = 3) HAVE $0 PAYMENT AMOUNTS. MSIS RECORDS WITH TYPE OF CLAIM = 4 (SERVICE TRACKING CLAIM) ARE EXCLUDED FROM ALL MAX FILES.
USER NOTES: THIS IS A SUM OF THE AMOUNTS IN 'RECIPIENT TOTAL MEDICAID FEE-FOR-SERVICE PAYMENT AMOUNT' AND 'RECIPIENT TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT AMOUNT'. ENCOUNTER RECORDS (TYPE OF CLAIM = 3) HAVE $0 PAYMENT AMOUNTS. MSIS RECORDS WITH TYPE OF CLAIM = 4 (SERVICE TRACKING CLAIM) ARE EXCLUDED FROM ALL MAX FILES.
SOURCE: MSIS CLAIMS FILES.