This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
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 payments (refer to MMLEADS variable MDCR_MC_PTA_PTB_CAPTD_SPEND_01-12) for the beneficiary for each month.
Values: $
Source: Medicare Claims files and MARx file (derived)
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 payments (refer to MMLEADS variable MDCR_MC_PTA_PTB_CAPTD_SPEND_01-12) for the beneficiary for each month.
Values: $
Source: Medicare Claims files and MARx file (derived)