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TMSIS Dataguide Medicaid.gov

Version:

3.40.0

Data Quality Measures Directoryversion 4.1.0

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Measure ID Measure Name Priority File Type Claim Type Adjustment Type Crossover Indicator Category Focus Area
ALL-1-001-7 % of claim lines with BENEFIT-TYPE = 002 (outpatient hospital) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-002-8 % of claim lines with BENEFIT-TYPE = 010 (physician) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-003-1 # of unique Benefit Type values reported for mandatory ambulatory-only benefit (see DD Appendix H) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-004-2 # of unique Benefit Type values reported for mandatory institutional-only Long-Term Care benefit (see DD Appendix H) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-005-3 # of unique Benefit Type values reported for mandatory institutional-only non-Long-Term Care benefit (see DD Appendix H) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-006-4 # of unique Benefit Type values reported for optional ambulatory-only benefit (see DD Appendix H) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-007-5 # of unique Benefit Type values reported for optional institutional-only Long-Term Care benefit (see DD Appendix H) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-008-6 # of unique Benefit Type values reported for optional institutional-only non-Long-Term Care benefit (see DD Appendix H) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-009-9 % of claim lines with Benefit Type values representing a combination ambulatory/institutional benefit (see DD Appendix H) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-010-10 % of claim headers with Benefit Type values representing a combination ambulatory/institutional Long-Term Care benefit (see DD Appendix H) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-011-11 % of claim headers with Benefit Type values representing a combination ambulatory/institutional non-Long-Term Care benefit (see DD Appendix H) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-012-12 % of claim lines with Benefit Type values representing ambulatory-only benefit (see DD Appendix H) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-013-13 % of claim headers with Benefit Type values representing institutional-only Long-Term Care benefit (see DD Appendix H) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-1-014-14 % of claim headers with Benefit Type values representing institutional-only non-Long-Term Care benefit (see DD Appendix H) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover N/A N/A
ALL-2-001-1 # of unique HCBS Taxonomy valid values reported Medium COT Medicaid,FFS or Medicaid,Enc Original Non-Crossover Program participation N/A
ALL-2-002-2 % of MSIS IDs in Community First Choice (STATE-PLAN-OPTION-TYPE = '01') during the reporting period with any claim lines High Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover Program participation N/A
ALL-2-003-3 % of active 1915(i) MSIS IDs (STATE-PLAN-OPTION-TYPE = '02') during the reporting period with any claim lines Medium Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover Utilization N/A
ALL-2-004-4 % of active 1915(i) MSIS IDs (STATE-PLAN-OPTION-TYPE = '02') during the reporting period with 1915(i) claim lines (HCBS-SERVICE-CODE = '1') High Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover Program participation N/A
ALL-2-005-5 % of active 1915(j) MSIS IDs (STATE-PLAN-OPTION-TYPE = '03') during the reporting period with any claim lines Medium Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover Utilization N/A
ALL-2-006-6 % of active 1915(j) MSIS IDs (STATE-PLAN-OPTION-TYPE = '03') during the reporting period with 1915(j) claim lines (HCBS-SERVICE-CODE = '2') High Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover Program participation N/A
ALL-2-007-7 OT- % of active 1915(c) eligibles (WAIVER-TYPE = '06' - '20' or ‘33’) during the reporting period with 1915(c) claim records (HCBS-SERVICE-CODE = '5') N/A Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover N/A N/A
ALL-2-008-8 OT- % of 1915(c) or 1915(i) eligibles (WAIVER-TYPE = '06' - '20' or ‘33’ or STATE-PLAN-OPTION-TYPE = '02') with HCBS-TAXONOMY claims N/A Multiple Files Medicaid,FFS or Medicaid,Enc Original Non-Crossover N/A N/A
ALL-3-001-1 % of claim headers with Benefit Type values representing institutional-only non-Long-Term Care benefit (See DD Appendix H) N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-3-002-2 IP - % of records with TYPE-OF-HOSPITAL = 03, 04, 05, 07, 08 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EL-10-001-1 Index of dissimilarity - plan type Medium ELG N/A N/A N/A Program participation Managed care
EL-10-002-4 Average # of managed care plans per enrollee Medium ELG N/A N/A N/A Program participation Managed care
EL-10-003-2 # of managed care plan enrollees Medium ELG N/A N/A N/A Program participation Managed care
EL-10-004-5 % of MSIS IDs with restricted benefit (RESTRICTED-BENEFITS-CODE = 02, 03, or 06) enrolled in comprehensive managed care (MANAGED-CARE-PLAN-TYPE = 01) Medium ELG N/A N/A N/A Program participation Managed care
EL-10-005-6 % of MSIS IDs in CHIP enrolled in comprehensive managed care (MANAGED-CARE-PLAN-TYPE = 01) N/A ELG N/A N/A N/A N/A N/A
EL-10-006-3 % of MSIS IDs with more than one valid Managed Care Plan Type N/A ELG N/A N/A N/A N/A N/A
EL-1-001-1 % of MSIS IDs with SSN and MSIS ID Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-002-2 % of MSIS IDs with a verified SSN N/A ELG N/A N/A N/A N/A N/A
EL-1-004-3 # of SSNs with duplicate MSIS IDs N/A ELG N/A N/A N/A N/A N/A
EL-1-005-16 % of MSIS IDs with MSIS Case Number Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-006-4 Index of dissimilarity - county Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-007-5 Index of dissimilarity - ZIP code Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-008-7 Index of dissimilarity - race Medium ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-009-8 Index of dissimilarity - ethnicity Medium ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-010-9 % of MSIS IDs with unspecified, unknown, missing or invalid Ethnicity Code High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-011-10 % of MSIS IDs with unspecified, unknown, missing or invalid Race High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-012-11 % of Certified American Indian/Alaskan Natives with a self-identified race of American Indian or Alaskan Native (DD V2.0) N/A ELG N/A N/A N/A N/A N/A
EL-1-013-12 # of US citizens N/A ELG N/A N/A N/A N/A N/A
EL-1-014-13 % of MSIS IDs who are US citizens whose US citizenship has not been verified N/A ELG N/A N/A N/A N/A N/A
EL-1-015-14 % of MSIS IDs with a valid immigration status whose enrollment in Medicaid is pending immigration verification Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-016-17 % of MSIS IDs with age 0 Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-017-18 % of MSIS IDs with age 0 - 20 Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-018-19 % of MSIS IDs with age 65+ Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-019-6 % of MSIS IDs who are female Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-020-15 % of MSIS IDs that died in month Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-11-001-1 % of full duals (DUAL-ELIGIBLE-CODE = 02, 04, and 08) receiving private health insurance (TPL-HEALTH-INSURANCE = 1) Medium ELG N/A N/A N/A Program participation N/A
EL-2-001-1 Immigration Status values N/A ELG N/A N/A N/A N/A N/A
EL-3-001-1 # of MSIS IDs with a valid Eligibility Group Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-002-7 % of MSIS IDs in ELIGIBILITY-GROUP = 23 through 26 (QMB, QDWI, SLMB or QI) with valid DUAL-ELIGIBLE-CODE 01 through 10 N/A ELG N/A N/A N/A N/A N/A
EL-3-003-11 % of MSIS IDs with age 65+ that are duals High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-004-2 % of MSIS IDs with age 65+ that are enrolled in comprehensive managed care (MANAGED-CARE-PLAN-TYPE = 01) N/A ELG N/A N/A N/A N/A N/A
EL-3-005-6 Ticket to Work (TTW): % of ELIGIBILITY-GROUP = 48 or 49 (TTW Basic or TTW Medical Improvements) with Age 16-64 Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-006-3 # of MSIS IDs with a valid Disability Type Code N/A ELG N/A N/A N/A N/A N/A
EL-3-007-4 Pregnant Women (PW): % of MSIS IDs in ELIGIBILITY-GROUP = 05, 53, 67 or 68 (PW groups) with Age 13-64 Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-008-8 % of foster care children (ELIGIBILITY-GROUP = 08, 09 or 30) N/A ELG N/A N/A N/A N/A N/A
EL-3-009-5 Foster Care: % of MSIS IDs in ELIGIBILITY-GROUP = 08, 09 or 30 (Foster Care Children groups) with Age <26 Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-010-9 % of MSIS IDs in ELIGIBILITY-GROUP = 34 (BCCP) that are aged 16-65 Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-011-10 % of MSIS IDs in ELIGIBILITY-GROUP = 34 (BCCP) that are female Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-4-001-1 Enrollment Type values where CHIP-CODE = 2 (M-CHIP) N/A ELG N/A N/A N/A N/A N/A
EL-5-001-3 Index of dissimilarity - CHIP by age group for M-CHIP and S-CHIP (CHIP-CODE = 2, 3) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-5-002-1 # of MSIS IDs in M-CHIP (CHIP-CODE = 2) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-5-003-2 # of MSIS IDs in S-CHIP (CHIP-CODE = 3) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-001-1 Medicaid Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months) N/A ELG N/A N/A N/A N/A N/A
EL-6-002-2 S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled six months prior (continuous enrollment over 6 months) N/A ELG N/A N/A N/A N/A N/A
EL-6-003-3 Medicaid Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months) N/A ELG N/A N/A N/A N/A N/A
EL-6-004-4 S-CHIP Churn: % of eligibles enrolled in a month that were also enrolled 12 months prior (continuous enrollment over 12 months) N/A ELG N/A N/A N/A N/A N/A
EL-6-005-5 # of health home participants N/A ELG N/A N/A N/A N/A N/A
EL-6-006-6 # of MSIS IDs with a valid Health Home Chronic Condition N/A ELG N/A N/A N/A N/A N/A
EL-6-007-7 # of MSIS IDs with a valid HCBS Chronic Condition Non Health Home Code N/A ELG N/A N/A N/A N/A N/A
EL-6-008-8 # of MSIS IDs with an active provider lock-in period N/A ELG N/A N/A N/A N/A N/A
EL-6-009-9 # of LTSS eligibles N/A ELG N/A N/A N/A N/A N/A
EL-6-010-10 # of MFP participants N/A ELG N/A N/A N/A N/A N/A
EL-6-011-11 # of MFP participants also identified with a Restricted Benefits flag designating MFP participation (RESTRICTED-BENEFITS-CODE = D) N/A ELG N/A N/A N/A N/A N/A
EL-6-012-12 # of QMB only duals (DUAL-ELIGIBLE-CODE = 01) N/A ELG N/A N/A N/A N/A N/A
EL-6-013-13 # of QMB plus duals (DUAL-ELIGIBLE-CODE = 02) N/A ELG N/A N/A N/A N/A N/A
EL-6-014-14 # of SLMB only duals (DUAL-ELIGIBLE-CODE = 03) N/A ELG N/A N/A N/A N/A N/A
EL-6-015-15 # of SLMB plus duals (DUAL-ELIGIBLE-CODE = 04) N/A ELG N/A N/A N/A N/A N/A
EL-6-016-16 # of QDWI duals (DUAL-ELIGIBLE-CODE = 05) N/A ELG N/A N/A N/A N/A N/A
EL-6-017-17 # of QI-1 duals (DUAL-ELIGIBLE-CODE = 06) N/A ELG N/A N/A N/A N/A N/A
EL-6-018-18 # of Other duals (DUAL-ELIGIBLE-CODE = 08) N/A ELG N/A N/A N/A N/A N/A
EL-6-019-19 # of Other - specific CMS approval duals (DUAL-ELIGIBLE-CODE = 09) N/A ELG N/A N/A N/A N/A N/A
EL-6-020-20 # of MSIS IDs in S-CHIP entitled to Medicare (DUAL-ELIGIBLE-CODE = 10) N/A ELG N/A N/A N/A N/A N/A
EL-6-021-21 # of 1115A demonstration participants N/A ELG N/A N/A N/A N/A N/A
EL-10-007-7 % MSIS IDs with a valid plan type that are missing plan ID N/A ELG N/A N/A N/A N/A N/A
EL-7-001-1 Enrollment by waiver ID N/A ELG N/A N/A N/A N/A N/A
EL-8-001-1 Enrollment, capitation payments, and encounters by Plan Type N/A Multiple Files N/A N/A N/A N/A N/A
EL-8-002-2 Enrollment, capitation payments, capitation ratios, encounters (by claim file type) and encounter ratios (by claim file type) by plan ID with plan ID linking to MC file N/A Multiple Files N/A N/A N/A N/A N/A
EL-9-001-1 Enrollment by plan ID N/A ELG N/A N/A N/A N/A N/A
EL-S-001-1 Total # of MSIS IDs N/A ELG N/A N/A N/A N/A N/A
EL-S-002-2 Total # of duals Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EXP-10-001-25 Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-002-18 Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-003-19 Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-004-20 Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-005-21 Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-006-22 Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-007-23 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-008-24 Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-009-17 Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-010-10 Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-011-11 Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-1-001-14 Sum of Total Medicaid Paid Amount Medium CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-10-012-12 Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-013-13 Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-014-14 Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-015-15 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-016-16 Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-017-9 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-018-2 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-019-3 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-020-4 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-021-5 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-1-002-15 Total paid for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-10-022-6 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-023-7 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-024-8 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-10-025-1 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT CHIP,FFS Original All Indicators N/A N/A
EXP-1-003-17 Total paid for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-004-18 Total paid for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-005-19 Total paid for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-006-20 Total paid for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-007-21 Total paid for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-008-22 Total paid for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-009-23 Total paid for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-010-24 Total paid for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-011-16 Total paid for TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-012-3 % of claim headers with Total Medicaid Paid Amount > $2 million Medium CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-1-013-4 Average Total Medicaid Paid Amount (excludes outliers with Total Medicaid Paid Amount > $2 million) Medium CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-1-014-5 Average paid per record for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-015-6 Average paid per record for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-016-7 Average paid per record for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-017-8 Average paid per record for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-018-9 Average paid per record for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-019-10 Average paid per record for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-020-11 Average paid per record for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-021-12 Average paid per record for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-022-13 Average paid per record for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
EXP-1-023-1 % of claim headers with Total Billed Amount = $0 Medium CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-1-024-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-001-85 Sum of Medicaid Paid Amount Medium COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-002-84 Sum of Medicaid Paid Amount for HCBS Program N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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 Medium COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-004-98 Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-005-109 Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-006-118 Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-007-124 Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-008-133 Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-009-143 Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-010-154 Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-011-86 Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-012-87 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-013-89 Total paid for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-014-91 Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-015-92 Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-016-93 Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-017-94 Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-018-95 Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-022-100 Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-023-101 Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-024-102 Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-025-103 Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-026-104 Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-027-105 Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-028-106 Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-029-107 Total paid for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-030-108 Total paid for TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-031-110 Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-032-111 Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-033-112 Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-034-113 Total paid for TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-035-114 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-036-115 Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-037-116 Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-038-117 Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-039-119 Total paid for TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-040-120 Total paid for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-041-121 Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-042-122 Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-043-123 Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-044-125 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-045-126 Total paid for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-046-127 Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-047-128 Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-049-130 Total paid for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-050-131 Total paid for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-051-132 Total paid for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-052-134 Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-053-135 Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-054-136 Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-055-137 Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-056-138 Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-057-139 Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-058-140 Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-059-141 Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-061-144 Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-062-145 Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-063-146 Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-065-148 Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-066-149 Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-067-150 Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-068-151 Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-069-152 Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-070-153 Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-071-155 Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-072-156 Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-073-157 Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-074-158 Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-075-159 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-076-160 Total paid for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-078-162 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-079-88 Total paid for TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-080-90 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-081-3 % of claim lines with Medicaid Paid Amount > $100,000 Medium COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-082-5 Average Medicaid Paid Amount for HCBS Program (exclude outliers with Medicaid Paid Amount > $200,000) Medium COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-083-18 Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-084-29 Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-085-38 Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-086-44 Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-087-53 Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-088-63 Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-089-74 Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-090-6 Average paid per record for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-091-7 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-092-9 Average paid per record for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-093-11 Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-094-12 Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-095-13 Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-096-14 Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-097-15 Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-101-20 Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-102-21 Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-103-22 Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-104-23 Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-105-24 Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-106-25 Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-107-26 Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-108-27 Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-109-28 Average paid per record for TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-110-30 Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-111-31 Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-113-33 Average paid per record for TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-114-34 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-115-35 Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-116-36 Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-117-37 Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-118-39 Average paid per record for TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-119-40 Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-121-42 Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-122-43 Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-123-45 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-124-46 Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-125-47 Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-126-48 Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-128-50 Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-129-51 Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-130-52 Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-131-54 Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-132-55 Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-133-56 Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-134-57 Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-135-58 Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-136-59 Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-137-60 Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-138-61 Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-140-64 Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-141-65 Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-142-66 Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-144-68 Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-145-69 Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-146-70 Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-147-71 Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-148-72 Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-149-73 Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-150-75 Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-151-76 Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-152-77 Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-153-78 Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-154-79 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-155-80 Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-157-82 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-158-8 Average paid per record for TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-159-10 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-160-1 % of claim lines with Billed Amount = $0 N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-161-2 % of claim lines with Medicaid Paid Amount = $0 or missing N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-11-162-4 % of outpatient department claim lines with Medicaid Paid Amount = $0 N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-12-001-81 Sum of Medicaid Paid Amount N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-002-94 Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-003-105 Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-004-114 Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-005-120 Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-006-129 Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-007-139 Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-008-150 Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-009-82 Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-010-83 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-011-85 Total paid for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-012-87 Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-013-88 Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-014-89 Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-015-90 Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-016-91 Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-020-96 Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-021-97 Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-022-98 Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-023-99 Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-024-100 Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-025-101 Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-026-102 Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-027-103 Total paid for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-028-104 Total paid for TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-029-106 Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-030-107 Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-031-108 Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-032-109 Total paid for TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-033-110 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-034-111 Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-035-112 Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-036-113 Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-037-115 Total paid for TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-038-116 Total paid for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-039-117 Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-040-118 Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-041-119 Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-042-121 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-043-122 Total paid for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-044-123 Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-045-124 Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-047-126 Total paid for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-048-127 Total paid for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-049-128 Total paid for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-050-130 Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-051-131 Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-052-132 Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-053-133 Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-054-134 Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-055-135 Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-056-136 Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-057-137 Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-059-140 Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-060-141 Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-061-142 Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-063-144 Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-064-145 Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-065-146 Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-066-147 Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-067-148 Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-068-149 Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-069-151 Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-070-152 Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-071-153 Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-072-154 Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-073-155 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-074-156 Total paid for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-076-158 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-077-84 Total paid for TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-078-86 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-079-1 # of claim lines with Medicaid Paid Amount > $100,000 N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-080-3 Average Medicaid Amount Paid ($0 < Medicaid Amount Paid < $200,000) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-081-16 Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-082-27 Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-083-36 Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-084-42 Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-085-51 Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-086-61 Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-087-72 Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-088-4 Average paid per record for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-089-5 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-090-7 Average paid per record for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-091-9 Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-092-10 Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-093-11 Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-094-12 Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-095-13 Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-099-18 Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-100-19 Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-101-20 Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-102-21 Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-103-22 Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-104-23 Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-105-24 Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-106-25 Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-107-26 Average paid per record for TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-108-28 Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-109-29 Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
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)) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-111-31 Average paid per record for TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-112-32 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-113-33 Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-114-34 Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-115-35 Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-116-37 Average paid per record for TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-117-38 Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-119-40 Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-120-41 Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-121-43 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-122-44 Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-123-45 Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-124-46 Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-126-48 Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-127-49 Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-128-50 Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-129-52 Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-130-53 Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-131-54 Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-132-55 Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-133-56 Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-134-57 Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-135-58 Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-136-59 Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-138-62 Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-139-63 Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-140-64 Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-142-66 Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-143-67 Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-144-68 Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-145-69 Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-146-70 Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-147-71 Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-148-73 Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-149-74 Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-150-75 Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-151-76 Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-152-77 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-153-78 Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Crossover N/A N/A
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) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-155-80 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-156-6 Average paid per record for TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-157-8 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-12-158-2 % of records with Medicaid Amount Paid = $0 N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-13-001-5 Sum of Medicaid Paid Amount Medium COT CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-13-002-3 % of claim lines with Medicaid Paid Amount > $100,000 N/A COT CHIP,FFS Original Non-Crossover N/A N/A
EXP-13-003-1 % of claim lines with Billed Amount = $0 N/A COT CHIP,FFS Original Non-Crossover N/A N/A
EXP-13-004-2 % of claim lines with Medicaid Paid Amount = $0 or missing N/A COT CHIP,FFS Original Non-Crossover N/A N/A
EXP-13-005-4 % of outpatient department claim lines with Medicaid Paid Amount = $0 N/A COT CHIP,FFS Original Non-Crossover N/A N/A
EXP-14-001-4 Sum of Medicaid Paid Amount N/A COT CHIP,FFS Original Crossover N/A N/A
EXP-14-002-1 # of claim lines with Medicaid Paid Amount > $100,000 N/A COT CHIP,FFS Original Crossover N/A N/A
EXP-14-003-3 Average Medicaid Amount Paid ($0 < Medicaid Amount Paid < $200,000) N/A COT CHIP,FFS Original Crossover N/A N/A
EXP-14-004-2 % of records with Medicaid Amount Paid = $0 N/A COT CHIP,FFS Original Crossover N/A N/A
EXP-15-001-90 Total paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-002-101 Total paid for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-003-110 Total paid for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-004-116 Total paid for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-005-125 Total paid for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-006-135 Total paid for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-007-146 Total paid for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-008-78 Total paid for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-009-79 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-010-81 Total paid for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-011-83 Total paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-012-84 Total paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-013-85 Total paid for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-014-86 Total paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-015-87 Total paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-019-92 Total paid for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-020-93 Total paid for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-021-94 Total paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-022-95 Total paid for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-023-96 Total paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-024-97 Total paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-025-98 Total paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-026-99 Total paid for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-027-100 Total paid for TYPE-OF-SERVICE = 29 (Dental services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-028-102 Total paid for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-029-103 Total paid for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-030-104 Total paid for TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-031-105 Total paid for TYPE-OF-SERVICE = 35 (Dentures) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-032-106 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-033-107 Total paid for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-034-108 Total paid for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-035-109 Total paid for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-036-111 Total paid for TYPE-OF-SERVICE = 40 (Screening services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-037-112 Total paid for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-038-113 Total paid for TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-039-114 Total paid for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-040-115 Total paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-041-117 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-042-118 Total paid for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-043-119 Total paid for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-044-120 Total paid for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-046-122 Total paid for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-047-123 Total paid for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-048-124 Total paid for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-049-126 Total paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-050-127 Total paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-051-128 Total paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-052-129 Total paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-053-130 Total paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-054-131 Total paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-055-132 Total paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-056-133 Total paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-058-136 Total paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-059-137 Total paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-060-138 Total paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-062-140 Total paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-063-141 Total paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-064-142 Total paid for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-065-143 Total paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-066-144 Total paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-067-145 Total paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-068-147 Total paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-069-148 Total paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-070-149 Total paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-071-150 Total paid for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-072-151 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-073-152 Total paid for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-075-154 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-076-80 Total paid for TYPE-OF-SERVICE = 115 (Residential care) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-077-82 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-078-13 Average paid per record for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-079-24 Average paid per record for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-080-33 Average paid per record for TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-081-39 Average paid per record for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-082-48 Average paid per record for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-083-58 Average paid per record for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-084-69 Average paid per record for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-085-1 Average paid per record for TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-086-2 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-087-4 Average paid per record for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-088-6 Average paid per record for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-089-7 Average paid per record for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-090-8 Average paid per record for TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-091-9 Average paid per record for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-092-10 Average paid per record for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-096-15 Average paid per record for TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-097-16 Average paid per record for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-098-17 Average paid per record for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-099-18 Average paid per record for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-100-19 Average paid per record for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-101-20 Average paid per record for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-102-21 Average paid per record for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-103-22 Average paid per record for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-104-23 Average paid per record for TYPE-OF-SERVICE = 29 (Dental services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-105-25 Average paid per record for TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-106-26 Average paid per record for TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
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)) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-108-28 Average paid per record for TYPE-OF-SERVICE = 35 (Dentures) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-109-29 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-110-30 Average paid per record for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-111-31 Average paid per record for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-112-32 Average paid per record for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-113-34 Average paid per record for TYPE-OF-SERVICE = 40 (Screening services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-114-35 Average paid per record for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-116-37 Average paid per record for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-117-38 Average paid per record for TYPE-OF-SERVICE = 49 (Outpatient mental health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-118-40 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-119-41 Average paid per record for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-120-42 Average paid per record for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-121-43 Average paid per record for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-123-45 Average paid per record for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-124-46 Average paid per record for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-125-47 Average paid per record for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-126-49 Average paid per record for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-127-50 Average paid per record for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-128-51 Average paid per record for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-129-52 Average paid per record for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-130-53 Average paid per record for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-131-54 Average paid per record for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-132-55 Average paid per record for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-133-56 Average paid per record for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-135-59 Average paid per record for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-136-60 Average paid per record for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-137-61 Average paid per record for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-139-63 Average paid per record for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-140-64 Average paid per record for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-141-65 Average paid per record for TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-142-66 Average paid per record for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-143-67 Average paid per record for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-144-68 Average paid per record for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-145-70 Average paid per record for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-146-71 Average paid per record for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-147-72 Average paid per record for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-148-73 Average paid per record for TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-149-74 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-150-75 Average paid per record for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT CHIP,FFS Original All Indicators N/A N/A
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) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-151-77 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-153-3 Average paid per record for TYPE-OF-SERVICE = 115 (Residential care) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-15-154-5 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT CHIP,FFS Original All Indicators N/A N/A
EXP-16-001-13 Sum of Total Medicaid Paid Amount Medium CRX Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-16-002-14 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-003-16 Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-004-17 Total paid for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-005-18 Total paid for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-006-19 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-007-20 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-008-21 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-009-15 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-010-1 % of claim headers with Total Medicaid Paid Amount > $300,000 Medium CRX Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-16-011-4 Average Total Medicaid Paid Amount (excludes outliers with Total Medicaid Paid Amount > $300,000) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-012-5 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-013-7 Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-014-8 Average paid per record for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-015-9 Average paid per record for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-016-10 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-017-11 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-018-12 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-019-6 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
EXP-16-020-2 % of claim headers with Total Billed Amount = $0 Medium CRX Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-16-021-3 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CRX Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-17-001-9 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-002-11 Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-003-12 Total paid for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-004-13 Total paid for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-005-14 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-006-15 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-007-16 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-008-10 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-009-1 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-010-3 Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-011-4 Average paid per record for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-012-5 Average paid per record for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-013-6 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-014-7 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-015-8 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-17-016-2 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Crossover N/A N/A
EXP-18-001-5 Sum of Total Medicaid Paid Amount Medium CRX CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-18-002-1 % of claim headers with Total Medicaid Paid Amount > $300,000 N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
EXP-18-003-4 Average Total Medicaid Paid Amount (excludes outliers with Total Medicaid Paid Amount > $300,000) N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
EXP-18-004-2 % of claim headers with Total Billed Amount = $0 N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
EXP-18-005-3 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CRX CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-19-001-9 Total paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-002-11 Total paid for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-003-12 Total paid for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-004-13 Total paid for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-005-14 Total paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-006-15 Total paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-007-16 Total paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-008-10 Total paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-009-1 Average paid per record for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-010-3 Average paid per record for TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-011-4 Average paid per record for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-012-5 Average paid per record for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-013-6 Average paid per record for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-014-7 Average paid per record for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-015-8 Average paid per record for TYPE-OF-SERVICE = 89 (Disposable medical supplies) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-19-016-2 Average paid per record for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX CHIP,FFS Original All Indicators N/A N/A
EXP-20-001-1 Sum of Payment or Recoupment Amount for other premium N/A FTX N/A Original All Indicators N/A N/A
EXP-20-002-2 Average Payment or Recoupment Amount for other premium N/A FTX N/A Original All Indicators N/A N/A
EXP-2-001-1 % of claim headers with Total Medicaid Paid Amount > $2 million Medium CIP Medicaid,FFS Original Crossover Expenditures N/A
EXP-2-001-12 Total paid for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-002-14 Total paid for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-003-15 Total paid for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-004-16 Total paid for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-005-17 Total paid for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-006-18 Total paid for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-007-19 Total paid for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-008-20 Total paid for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-009-21 Total paid for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-010-13 Total paid for TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-011-3 Average paid per record for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-012-4 Average paid per record for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-013-5 Average paid per record for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-014-6 Average paid per record for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-015-7 Average paid per record for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-016-8 Average paid per record for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-017-9 Average paid per record for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-018-10 Average paid per record for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-019-11 Average paid per record for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
EXP-2-020-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP Medicaid,FFS Original Crossover Expenditures N/A
EXP-21-001-1 Sum of Payment or Recoupment Amount for other premium N/A FTX N/A Original All Indicators N/A N/A
EXP-21-002-2 Average Payment or Recoupment Amount for other premium N/A FTX N/A Original All Indicators N/A N/A
EXP-22-001-2 Sum of Payment or Recoupment Amount for HMOs, HIOs, or PACE N/A FTX N/A Original All Indicators N/A N/A
EXP-22-001-8 Sum of Medicaid Paid Amount N/A COT Medicaid,Cap Original All Indicators N/A N/A
EXP-22-003-4 Sum of Payment or Recoupment Amount for PCCM N/A FTX N/A Original All Indicators N/A N/A
EXP-22-004-6 Sum of Payment or Recoupment Amount for PHP N/A FTX N/A Original All Indicators N/A N/A
EXP-22-005-1 Average Medicaid Paid Amount N/A COT Medicaid,Cap Original All Indicators N/A N/A
EXP-22-006-3 Average Payment or Recoupment Amount for HMOs, HIOs, or PACE N/A FTX N/A Original All Indicators N/A N/A
EXP-22-007-5 Average Payment or Recoupment Amount for PCCM N/A FTX N/A Original All Indicators N/A N/A
EXP-22-008-7 Average Payment or Recoupment Amount for PHP N/A FTX N/A Original All Indicators N/A N/A
EXP-23-001-2 Sum of Payment or Recoupment Amount N/A FTX N/A All Adjustment Types All Indicators N/A N/A
EXP-23-002-1 Average absolute value of Payment or Recoupment Amount N/A FTX N/A All Adjustment Types All Indicators N/A N/A
EXP-24-001-8 Sum of Medicaid Paid Amount N/A COT CHIP,Cap Original All Indicators N/A N/A
EXP-24-002-2 Sum of Payment or Recoupment Amount for HMOs, HIOs, or PACE N/A FTX N/A Original All Indicators N/A N/A
EXP-24-003-4 Sum of Payment or Recoupment Amount for PCCM N/A FTX N/A Original All Indicators N/A N/A
EXP-24-004-6 Sum of Payment or Recoupment Amount for PHP N/A FTX N/A Original All Indicators N/A N/A
EXP-24-005-1 Average Medicaid Paid Amount N/A COT CHIP,Cap Original All Indicators N/A N/A
EXP-24-006-3 Average Payment or Recoupment Amount for HMOs, HIOs or PACE N/A FTX N/A Original All Indicators N/A N/A
EXP-24-007-5 Average Payment or Recoupment Amount for PCCM N/A FTX N/A Original All Indicators N/A N/A
EXP-24-008-7 Average Payment or Recoupment Amount for PHP N/A FTX N/A Original All Indicators N/A N/A
EXP-25-001-2 Sum of Payment or Recoupment Amount N/A FTX N/A All Adjustment Types All Indicators N/A N/A
EXP-25-002-1 Average absolute value of Payment or Recoupment Amount N/A FTX N/A All Adjustment Types All Indicators N/A N/A
EXP-26-001-1 Capitation payments by Plan ID (non-PCCM) N/A Multiple Files N/A N/A N/A N/A N/A
EXP-26-002-2 % of total capitation amount paid on Plan IDs not found in Managed Care file N/A Multiple Files N/A N/A N/A N/A N/A
EXP-26-003-3 % of total capitation amount paid with unknown or non-specified Plan IDs N/A Multiple Files N/A N/A N/A N/A N/A
EXP-3-001-5 Sum of Total Medicaid Paid Amount Medium CIP CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-3-002-3 % of claim headers with Total Medicaid Paid Amount > $2 million N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
EXP-3-003-4 Average Total Medicaid Paid Amount (excludes outliers with Total Medicaid Paid Amount > $2 million) N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
EXP-3-004-1 % of claim headers with Total Billed Amount = $0 N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
EXP-3-005-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-4-001-1 % of claim headers with Total Medicaid Paid Amount > $2 million N/A CIP CHIP,FFS Original Crossover N/A N/A
EXP-4-002-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP CHIP,FFS Original Crossover Expenditures N/A
EXP-5-001-10 Total paid for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-002-12 Total paid for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-003-13 Total paid for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-004-14 Total paid for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-005-15 Total paid for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-006-16 Total paid for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-007-17 Total paid for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-008-18 Total paid for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-009-19 Total paid for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-010-11 Total paid for TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-011-1 Average paid per record for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-012-2 Average paid per record for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-013-3 Average paid per record for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-014-4 Average paid per record for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-015-5 Average paid per record for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-016-6 Average paid per record for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-017-7 Average paid per record for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-018-8 Average paid per record for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-5-019-9 Average paid per record for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
EXP-6-001-21 Sum of Total Medicaid Paid Amount Medium CLT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-6-002-29 Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-003-22 Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-004-23 Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-005-24 Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-006-25 Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-007-26 Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-008-27 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-009-28 Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-010-3 % of claim headers with Total Medicaid Paid Amount > $20,000 N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-011-20 Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-012-13 Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-013-14 Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-014-15 Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-015-16 Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-016-17 Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-017-18 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-018-19 Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-019-12 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-020-5 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-021-6 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-022-7 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-023-8 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-024-9 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-025-10 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-026-11 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-027-4 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
EXP-6-028-2 % of claim headers with Total Billed Amount = $0 Medium CLT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-6-029-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-7-001-27 Total paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-002-20 Total paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-003-21 Total paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-004-22 Total paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-005-23 Total paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-006-24 Total paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-007-25 Total paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-008-26 Total paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-009-1 % of claim headers with Total Medicaid Paid Amount > $20,000 N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-010-19 Average paid per record for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-011-12 Average paid per record for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-012-13 Average paid per record for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-013-14 Average paid per record for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-014-15 Average paid per record for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-015-16 Average paid per record for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-016-17 Average paid per record for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-017-18 Average paid per record for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-018-11 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-019-4 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-020-5 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-021-6 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-022-7 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-023-8 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-024-9 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-025-10 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-026-3 Average paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT Medicaid,FFS Original Crossover N/A N/A
EXP-7-027-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT Medicaid,FFS Original Crossover Expenditures N/A
EXP-8-001-4 Sum of Total Medicaid Paid Amount Medium CLT CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-8-002-3 % of claim headers with Total Medicaid Paid Amount > $20,000 N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
EXP-8-003-2 % of claim headers with Total Billed Amount = $0 N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
EXP-8-004-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-9-001-1 % of claim headers with Total Medicaid Paid Amount > $20,000 N/A CLT CHIP,FFS Original Crossover N/A N/A
EXP-9-002-2 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT CHIP,FFS Original Crossover Expenditures N/A
EXP-S-001-1 Sum of Total Medicaid Paid Amount N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-002-5 Sum of Medicaid Paid Amount N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-003-3 Sum of Total Medicaid Paid Amount N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-004-7 Sum of Total Medicaid Paid Amount N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-005-2 Sum of Total Medicaid Paid Amount N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-006-6 Sum of Medicaid Paid Amount N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-007-4 Sum of Total Medicaid Paid Amount N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
EXP-S-008-8 Sum of Total Medicaid Paid Amount N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-10-001-85 Total # of claim lines N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-002-3 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0) Medium COT Medicaid,FFS Original Crossover Utilization N/A
FFS-10-003-84 % of claim lines with office Place of Service (Medicaid Paid Amount > $0) Medium COT Medicaid,FFS Original Crossover Utilization N/A
FFS-10-004-4 % of claim lines with missing Place of Service (Medicaid Paid Amount > $0) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-005-1 % of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0) Medium COT Medicaid,FFS Original Crossover Utilization N/A
FFS-10-006-2 % of claim lines with Procedure Code or Revenue Code (Medicaid Paid Amount > $0) Medium COT Medicaid,FFS Original Crossover Utilization N/A
FFS-10-007-5 % of claim lines with Revenue Code that also have a HCPCS Rate N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-008-19 % of records with TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-009-30 % of records with TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-010-39 % of records with TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-011-45 % of records with TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-012-54 % of records with TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-001-30 Total # of claim headers Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-013-64 % of records with TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-014-75 % of records with TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-015-6 % of records with TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-016-7 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-017-9 % of records with TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-018-11 % of records with TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-019-13 % of records with TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-020-14 % of records with TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-021-15 % of records with TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-022-16 % of records with TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-002-3 % of claim headers with Ending Date of Service within the past year Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-023-17 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-024-18 % of records with 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) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-025-20 % of records with 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) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-026-21 % of records with TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-027-22 % of records with TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-028-23 % of records with TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-029-24 % of records with TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-030-25 % of records with TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-031-26 % of records with TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-003-21 % of claim headers with diagnosis codes High CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-032-27 % of records with TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-033-28 % of records with TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-034-29 % of records with TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-035-31 % of records with TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-036-32 % of records with TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-037-33 % of records with TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-038-34 % of records with TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-039-35 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-040-36 % of records with TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-041-37 % of records with TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-042-38 % of records with TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-004-28 Average # of diagnoses High CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-043-40 % of records with TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-044-41 % of records with TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-045-42 % of records with TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-046-43 % of records with TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-047-44 % of records with TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-048-46 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-049-47 % of records with TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-050-48 % of records with TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-051-49 % of records with TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-005-22 % of claim headers with only 1 diagnosis code High CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-052-50 % of records with 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) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-053-51 % of records with TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-054-52 % of records with TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-055-53 % of records with TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-056-55 % of records with TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-057-56 % of records with TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-058-57 % of records with TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-059-58 % of records with TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-060-59 % of records with TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-061-60 % of records with TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-006-23 % of claim headers with principal Procedure Code High CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-062-61 % of records with TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-063-62 % of records with TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-064-63 % of records with 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) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-065-65 % of records with TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-066-66 % of records with TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-067-67 % of records with TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-068-68 % of records with TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-069-69 % of records with TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-070-70 % of records with TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-071-71 % of records with TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-072-72 % of records with TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-007-29 Average # of procedures Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-073-73 % of records with TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-074-74 % of records with TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-075-76 % of records with TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-076-77 % of records with TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-077-78 % of records with TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-078-79 % of records with TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-079-80 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-080-81 % of records with TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-008-1 % of claim headers with Admission Date within the past year Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-10-081-82 % of records with TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-082-83 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-083-8 % of records with TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-084-10 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-10-085-12 % of records with TYPE-OF-SERVICE = 131 (Drug Rebates) N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-1-009-4 % of claim headers with home Patient Status Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-010-17 % of claim headers with Patient Status of other institution Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-011-2 % of claim headers with deceased Patient Status Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-012-18 % of claim headers with Patient Status of still a patient Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-013-20 % of claim headers with DRG N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-014-19 % of records with CMS/MS-DRG N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-015-24 % of claim headers with any accommodation revenue codes Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-016-25 % of claim headers with any ancillary revenue codes Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-017-26 Mean # Accomm. Codes on claims with Accomm. Codes N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-018-27 Mean # Ancil. Codes on claims with Ancil. Codes N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-019-5 % of claim headers with TYPE-OF-SERVICE = 1 (inpatient hospital services, other than services in an institution for mental diseases) Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-020-9 % of records with TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-021-10 % of records with TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-022-11 % of records with TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-023-12 % of records with TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-024-13 % of records with TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-025-14 % of records with TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-026-15 % of records with TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-027-16 % of records with TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-028-6 % of records with TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-029-7 % of records with TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-030-8 % of records with TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-11-001-24 Total # of claim lines Medium COT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-11-002-23 % of records with Procedure Code N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-003-8 % of claim lines with Ending Date of Service within the past year N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-004-20 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 41, 14 with DX Codes N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-005-21 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61, 28, 41 with diagnosis codes High COT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-11-006-22 % of records with TYPE-OF-SERVICE = 12,2, 61, 28, 47 with DX Codes N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-007-9 % of claim lines with ER Place of Service N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-008-19 % of claim lines with office Place of Service N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-009-18 % of claim lines with missing Place of Service N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-010-3 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-011-4 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag and Procedure Code format 5n/4n1c N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-012-10 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-013-12 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 4n N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-014-11 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 1c3n N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-015-15 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 4n N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-016-14 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 1c3n N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-017-13 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and other Procedure Code format N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-018-16 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have ICD9CM (02) or ICD10CM (07) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-019-7 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS74 (03) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-020-6 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS69 (04) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-021-5 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS64 (05) Procedure Code Flag N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-022-17 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 with local service code indicator (PROCEDURE-CODE-FLAG = 10 - 87) N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-023-1 % of outpatient department claim lines that have accommodation codes N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-11-024-2 % of claim headers with SERVICE-QUANTITY-ACTUAL = 1 Medium COT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-12-001-5 Total # of crossover claim lines N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-12-002-1 % of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0) N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-12-003-2 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-12-004-4 % of claim lines with office Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-12-005-3 % of claim lines with missing Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-13-001-1 % of claim lines with Revenue Code that also have a HCPCS Rate N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-002-15 % of records with TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-003-26 % of records with TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-004-35 % of records with TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-005-41 % of records with TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-006-50 % of records with TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-007-60 % of records with TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-008-71 % of records with TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-009-2 % of records with TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-010-3 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-011-5 % of records with TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-012-7 % of records with TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-013-9 % of records with TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-014-10 % of records with TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-015-11 % of records with TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-016-12 % of records with TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-017-13 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-018-14 % of records with 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) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-019-16 % of records with 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) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-020-17 % of records with TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-021-18 % of records with TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-022-19 % of records with TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-023-20 % of records with TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-024-21 % of records with TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-025-22 % of records with TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-026-23 % of records with TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-027-24 % of records with TYPE-OF-SERVICE = 28 (Clinic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-028-25 % of records with TYPE-OF-SERVICE = 29 (Dental services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-029-27 % of records with TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-030-28 % of records with TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-031-29 % of records with TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-032-30 % of records with TYPE-OF-SERVICE = 35 (Dentures) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-033-31 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-034-32 % of records with TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-035-33 % of records with TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-036-34 % of records with TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-037-36 % of records with TYPE-OF-SERVICE = 40 (Screening services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-038-37 % of records with TYPE-OF-SERVICE = 41 (Preventive services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-039-38 % of records with TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-040-39 % of records with TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-041-40 % of records with TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-042-42 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-043-43 % of records with TYPE-OF-SERVICE = 51 (Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-044-44 % of records with TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-045-45 % of records with TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-046-46 % of records with 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) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-047-47 % of records with TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-048-48 % of records with TYPE-OF-SERVICE = 56 (Transportation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-049-49 % of records with TYPE-OF-SERVICE = 57 (Enabling services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-050-51 % of records with TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-051-52 % of records with TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-052-53 % of records with TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-053-54 % of records with TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-054-55 % of records with TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-055-56 % of records with TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-056-57 % of records with TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-057-58 % of records with TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-058-59 % of records with 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) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-059-61 % of records with TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-060-62 % of records with TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-061-63 % of records with TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-062-64 % of records with TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-063-65 % of records with TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-064-66 % of records with TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-065-67 % of records with TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-066-68 % of records with TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-067-69 % of records with TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-068-70 % of records with TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-069-72 % of records with TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-070-73 % of records with TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-071-74 % of records with TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-072-75 % of records with TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-073-76 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-074-77 % of records with TYPE-OF-SERVICE = 87 (Hospice services) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-075-78 % of records with TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-076-79 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-077-4 % of records with TYPE-OF-SERVICE = 115 (Residential care) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-078-6 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-13-079-8 % of records with TYPE-OF-SERVICE = 131 (Drug Rebates) N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-14-001-15 Total # of claim headers Medium CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-002-7 % of claim headers with Prescription Fill Date within the past year Medium CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-003-6 % of claim headers with Prescription Fill Date = Date Prescribed Medium CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-004-5 % of claim headers with Days Supply > 30 Medium CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-005-1 % of claim headers with missing Days Supply N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-006-3 % of claim headers with NDC (11 numeric) High CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-007-4 % of claim headers with PRESCRIPTION-QUANTITY-ACTUAL = 1 Medium CRX Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-14-008-2 % of claim headers with missing Prescription Quantity Actual N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-009-9 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-010-10 % of records with TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-011-11 % of records with TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-012-12 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-013-13 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-014-14 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-14-015-8 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
FFS-15-001-1 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-002-3 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-003-4 % of records with TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-004-5 % of records with TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-005-6 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-006-7 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-007-8 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-15-008-2 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,FFS Original Crossover N/A N/A
FFS-16-001-8 Total # of claim headers Medium CRX CHIP,FFS Original Non-Crossover Utilization N/A
FFS-16-002-7 % of claim headers with Prescription Fill Date within the past year N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
FFS-16-003-6 % of claim headers with Prescription Fill Date = Date Prescribed N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
FFS-16-004-5 % of claim headers with Days Supply > 30 N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
FFS-16-005-1 % of claim headers with missing Days Supply N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
FFS-16-006-3 % of claim headers with NDC (11 numeric) High CRX CHIP,FFS Original Non-Crossover Utilization N/A
FFS-16-007-4 % of claim headers with PRESCRIPTION-QUANTITY-ACTUAL = 1 Medium CRX CHIP,FFS Original Non-Crossover Utilization N/A
FFS-16-008-2 % of claim headers with missing Prescription Quantity Actual N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
FFS-17-001-1 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-002-3 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-003-4 % of records with TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-004-5 % of records with TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-005-6 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-006-7 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-007-8 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-17-008-2 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-18-001-3 % of claim lines with Servicing Provider Num N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-002-2 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-18-003-1 % of physician claim lines with Servicing Provider Specialty Medium COT Medicaid,FFS Original Non-Crossover Provider information N/A
FFS-18-004-4 IP - Average # of PROV-LOCATION-ID per beneficiary N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-005-6 OT - Average # of PROV-LOCATION-ID per beneficiary N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-006-5 LT - Average # of PROV-LOCATION-ID per beneficiary N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-007-7 IP - Average # of PROV-LOCATION-ID per billing NPI N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-008-8 OT - Average # of PROV-LOCATION-ID per billing NPI N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-009-9 IP - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-18-010-10 OT - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-19-001-2 % of claim lines with Servicing Provider Num N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-19-002-1 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number Medium COT Medicaid,FFS Original Crossover Utilization N/A
FFS-19-003-3 IP - Average # of PROV-LOCATION-ID per beneficiary N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-19-004-5 OT - Average # of PROV-LOCATION-ID per beneficiary N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-19-005-4 LT - Average # of PROV-LOCATION-ID per beneficiary N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-19-006-6 IP - Average # of PROV-LOCATION-ID per billing NPI N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-19-007-7 OT - Average # of PROV-LOCATION-ID per billing NPI N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-19-008-8 IP - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-19-009-9 OT - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A COT Medicaid,FFS Original Crossover N/A N/A
FFS-20-001-1 IP - Average # of PROV-LOCATION-ID per beneficiary N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-20-002-2 OT - Average # of PROV-LOCATION-ID per beneficiary N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-20-003-3 RX - Average # of PROV-LOCATION-ID per beneficiary N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-20-004-4 IP - Average # of PROV-LOCATION-ID per billing NPI N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-20-005-5 OT - Average # of PROV-LOCATION-ID per billing NPI N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-20-006-6 RX - Average # of PROV-LOCATION-ID per billing NPI N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-20-007-8 IP - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-20-008-9 OT - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-20-009-7 RX - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per dispensing NPI N/A CRX CHIP,FFS Original All Indicators N/A N/A
FFS-2-001-13 Total # of claim headers N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-002-1 % of claim headers with TYPE-OF-SERVICE = 1 (inpatient hospital services, other than services in an institution for mental diseases) Medium CIP Medicaid,FFS Original Crossover Utilization N/A
FFS-2-003-5 % of records with TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-004-6 % of records with TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-005-7 % of records with TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-006-8 % of records with TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-007-9 % of records with TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-008-10 % of records with TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-009-11 % of records with TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-010-12 % of records with TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-011-2 % of records with TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-012-3 % of records with TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-2-013-4 % of records with TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP Medicaid,FFS Original Crossover N/A N/A
FFS-21-001-1 RX - Average # of PROV-LOCATION-ID per beneficiary N/A CRX Medicaid,FFS Original All Indicators N/A N/A
FFS-21-002-2 RX - Average # of PROV-LOCATION-ID per billing NPI N/A CRX Medicaid,FFS Original All Indicators N/A N/A
FFS-21-003-3 RX - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per dispensing NPI N/A CRX Medicaid,FFS Original All Indicators N/A N/A
FFS-22-001-3 % of claim lines with Servicing Provider Num N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-22-002-2 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-22-003-1 % of physician claim lines with Servicing Provider Specialty N/A COT CHIP,FFS Original Non-Crossover N/A N/A
FFS-23-001-2 % of claim lines with Servicing Provider Num N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-23-002-1 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number N/A COT CHIP,FFS Original Crossover N/A N/A
FFS-3-001-18 Total # of claim headers Medium CIP CHIP,FFS Original Non-Crossover Utilization N/A
FFS-3-002-3 % of claim headers with Ending Date of Service within the past year N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-003-9 % of claim headers with diagnosis codes High CIP CHIP,FFS Original Non-Crossover Utilization N/A
FFS-3-004-16 Average # of diagnoses High CIP CHIP,FFS Original Non-Crossover Utilization N/A
FFS-3-005-10 % of claim headers with only 1 diagnosis code High CIP CHIP,FFS Original Non-Crossover Utilization N/A
FFS-3-006-11 % of claim headers with principal Procedure Code High CIP CHIP,FFS Original Non-Crossover Utilization N/A
FFS-3-007-17 Average # of procedures N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-008-1 % of claim headers with Admission Date within the past year N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-009-4 % of claim headers with home Patient Status N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-010-5 % of claim headers with Patient Status of other institution N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-011-2 % of claim headers with deceased Patient Status N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-012-6 % of claim headers with Patient Status of still a patient N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-013-8 % of claim headers with DRG N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-014-7 % of records with CMS/MS-DRG N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-015-12 % of claim headers with any accommodation revenue codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-016-13 % of claim headers with any ancillary revenue codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-017-14 Mean # Accomm. Codes on claims with Accomm. Codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-018-15 Mean # Ancil. Codes on claims with Ancil. Codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-4-001-13 Total # of crossover claim headers N/A CIP CHIP,FFS Original Crossover N/A N/A
FFS-4-002-1 % of records with TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-003-5 % of records with TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-004-6 % of records with TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-005-7 % of records with TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-006-8 % of records with TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-007-9 % of records with TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-008-10 % of records with TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-009-11 % of records with TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-010-12 % of records with TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-011-2 % of records with TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-012-3 % of records with TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-4-013-4 % of records with TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-5-001-30 Total # of claim headers Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-002-10 % of claim headers with Ending Date of Service within the past year Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-003-27 % of claim headers with diagnosis codes High CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-004-28 Average # of diagnoses High CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-005-25 % of claim headers with Patient Status of still a patient Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-006-11 % of claim headers with home Patient Status Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-007-9 % of claim headers with deceased Patient Status Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-008-13 % of claim headers with 28-31 long-term care days N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-009-26 % of claim headers with 6-8 long term care days N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-010-23 % of claim headers that do not have 6-8 or 28-31 long-term care days N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-011-29 Average # of long-term care days, exclude 0 Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-012-12 % of claim headers with Leave Days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-013-24 % of claim headers with patient liability Medium CLT Medicaid,FFS Original Non-Crossover Expenditures N/A
FFS-5-014-22 % of records with TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-015-1 % of claim headers with TYPE-OF-SERVICE = 09 (nursing facility services age 21+) without nursing facility days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-016-15 % of records with TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-017-2 % of claim headers with TYPE-OF-SERVICE = 44 (inpatient hospital services for individuals age 65 or older for mental diseases) without inpatient days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-018-16 % of records with TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-019-3 % of claim headers with TYPE-OF-SERVICE = 45 (nursing facility services for individuals aged 65+ in institutions for mental diseases) without nursing facility days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-020-17 % of records with TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-021-4 % of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-022-18 % of records with TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-023-5 % of claim headers with TYPE-OF-SERVICE = 47 (nursing facility services other than mental diseases) without nursing facility days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-024-19 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-025-6 % of claim headers with TYPE-OF-SERVICE = 48 (inpatient psychiatric services for individuals under age 21) without inpatient days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-026-20 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-027-7 % of claim headers with TYPE-OF-SERVICE = 50 (inpatient and residential substance abuse) without inpatient days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-028-21 % of records with TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-5-029-8 % of claim headers with TYPE-OF-SERVICE = 59 (skilled nursing facility services for individuals under age 21) without nursing facility days Medium CLT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-5-030-14 % of records with TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-6-001-10 Total # of claim headers N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-002-9 % of records with TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-003-2 % of records with TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-004-3 % of records with TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-005-4 % of records with TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-006-5 % of records with TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-007-6 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-008-7 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-009-8 % of records with TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-6-010-1 % of records with TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT Medicaid,FFS Original Crossover N/A N/A
FFS-7-001-20 Total # of claim headers Medium CLT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-7-002-10 % of claim headers with Ending Date of Service within the past year N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-003-17 % of claim headers with diagnosis codes High CLT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-7-004-18 Average # of diagnoses High CLT CHIP,FFS Original Non-Crossover Utilization N/A
FFS-7-005-15 % of claim headers with Patient Status of still a patient N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-006-11 % of claim headers with home Patient Status N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-007-9 % of claim headers with deceased Patient Status N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-008-13 % of claim headers with 28-31 long-term care days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-009-16 % of claim headers with 6-8 long term care days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-010-14 % of claim headers that do not have 6-8 or 28-31 long-term care days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-011-19 Average # of long-term care days, exclude 0 N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-012-12 % of claim headers with Leave Days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-013-1 % of records with TYPE-OF-SERVICE = 09 (Nursing Facility Services age 21+) without NF days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-014-2 % of records with TYPE-OF-SERVICE = 44 (Inpatient Hospital Services for Individuals age 65+ for mental diseases) without IP days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-015-3 % of records with TYPE-OF-SERVICE = 45 (Nursing Facility Services for 65+ for mental diseases) without NF Days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-016-4 % of records with TYPE-OF-SERVICE = 46 (Intermediate Care Facility Services) without ICF Days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-017-5 % of records with TYPE-OF-SERVICE = 47 (Nursing Facility services other than mental Diseases) without NF days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-018-6 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services under 21) without IP days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-019-7 % of records with TYPE-OF-SERVICE = 50 (Inpatient and residential substance abuse) without IP days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-7-020-8 % of records with TYPE-OF-SERVICE = 59 (Skilled Nursing Facility services under 21) without NF days N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
FFS-8-001-10 Total # of crossover claim headers N/A CLT CHIP,FFS Original Crossover N/A N/A
FFS-8-002-9 % of records with TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-003-2 % of records with TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-004-3 % of records with TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-005-4 % of records with TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-006-5 % of records with TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-007-6 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-008-7 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-009-8 % of records with TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-8-010-1 % of records with TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT CHIP,FFS Original All Indicators N/A N/A
FFS-9-001-103 Total # of claim lines Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-002-102 % of records with Procedure Code N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-003-8 % of claim lines with Ending Date of Service within the past year Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-004-100 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61, 28, 41 with diagnosis codes High COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-005-99 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 41, 14 with DX Codes N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-006-101 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 45 with DX Codes N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-007-9 % of claim lines with ER Place of Service Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-008-98 % of claim lines with office Place of Service Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-009-18 % of claim lines with missing Place of Service N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-010-3 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-011-4 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag and Procedure Code format 5n/4n1c N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-012-19 % of claim lines with Revenue Code that also have a HCPCS Rate N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-013-10 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-014-12 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 4n N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-015-11 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 1c3n N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-016-15 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 4n N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-017-14 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 1c3n N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-018-13 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and other Procedure Code format N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-019-16 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have ICD9CM (02) or ICD10CM (07) Procedure Code Flag Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-020-7 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS74 (03) Procedure Code Flag Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-021-6 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS69 (04) Procedure Code Flag Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-022-5 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS64 (05) Procedure Code Flag Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-023-17 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 with local service code indicator (PROCEDURE-CODE-FLAG = 10 - 87) Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-024-1 % of outpatient department claim lines that have accommodation codes Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-025-2 % of claim headers with SERVICE-QUANTITY-ACTUAL = 1 Medium COT Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-9-026-33 % of records with TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-027-44 % of records with TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-028-53 % of records with TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-029-59 % of records with TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-030-68 % of records with TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-031-78 % of records with TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-032-89 % of records with TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-033-20 % of records with TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-034-21 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-035-23 % of records with TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-036-25 % of records with TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-037-27 % of records with TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-038-28 % of records with TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-039-29 % of records with TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-040-30 % of records with TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-041-31 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-042-32 % of records with 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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-043-34 % of records with 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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-044-35 % of records with TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-045-36 % of records with TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-046-37 % of records with TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-047-38 % of records with TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-048-39 % of records with TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-049-40 % of records with TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-050-41 % of records with TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-051-42 % of records with TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-052-43 % of records with TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-053-45 % of records with TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-054-46 % of records with TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-055-47 % of records with TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-056-48 % of records with TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-057-49 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-058-50 % of records with TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-059-51 % of records with TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-060-52 % of records with TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-061-54 % of records with TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-062-55 % of records with TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-063-56 % of records with TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-064-57 % of records with TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-065-58 % of records with TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-066-60 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-067-61 % of records with TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-068-62 % of records with TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-069-63 % of records with TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-070-64 % of records with 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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-071-65 % of records with TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-072-66 % of records with TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-073-67 % of records with TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-074-69 % of records with TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-075-70 % of records with TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-076-71 % of records with TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-077-72 % of records with TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-078-73 % of records with TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-079-74 % of records with TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-080-75 % of records with TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-081-76 % of records with TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-082-77 % of records with 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) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-083-79 % of records with TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-084-80 % of records with TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-085-81 % of records with TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-086-82 % of records with TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-087-83 % of records with TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-088-84 % of records with TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-089-85 % of records with TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-090-86 % of records with TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-091-87 % of records with TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-092-88 % of records with TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-093-90 % of records with TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-094-91 % of records with TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-095-92 % of records with TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-096-93 % of records with TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-097-94 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-098-95 % of records with TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-099-96 % of records with TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-100-97 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-101-22 % of records with TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-102-24 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-9-103-26 % of records with TYPE-OF-SERVICE = 131 (Drug Rebates) N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
FFS-S-001-3 Total # of claim headers N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-002-9 Total # of claim lines N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-003-6 Total # of claim headers N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-004-11 Total # of claim headers N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-005-14 Total # of claim headers N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-006-20 Total # of claim lines N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-007-17 Total # of claim headers N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-008-22 Total # of claim headers N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-009-2 % of claim headers that are original Medium CIP Medicaid,FFS All Adjustment Types All Indicators Expenditures N/A
FFS-S-010-8 % of claim lines that are original Medium COT Medicaid,FFS All Adjustment Types All Indicators Expenditures N/A
FFS-S-011-5 % of claim headers that are original Medium CLT Medicaid,FFS All Adjustment Types All Indicators Expenditures N/A
FFS-S-012-10 % of claim headers that are original Medium CRX Medicaid,FFS All Adjustment Types All Indicators Expenditures N/A
FFS-S-013-13 % of claim headers that are original N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-014-19 % of claim lines that are original N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-015-16 % of claim headers that are original N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-016-21 % of claim headers that are original N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-S-017-1 % of total original claim headers that are crossover claims N/A CIP Medicaid,FFS Original All Indicators N/A N/A
FFS-S-018-7 % of total original claim lines that are crossover claims N/A COT Medicaid,FFS Original All Indicators N/A N/A
FFS-S-019-4 % of total original claim headers that are crossover claims N/A CLT Medicaid,FFS Original All Indicators N/A N/A
FFS-S-020-12 % of total original claim headers that are crossover claims N/A CIP CHIP,FFS Original All Indicators N/A N/A
FFS-S-021-18 % of total original claim lines that are crossover claims N/A COT CHIP,FFS Original All Indicators N/A N/A
FFS-S-022-15 % of total original claim headers that are crossover claims N/A CLT CHIP,FFS Original All Indicators N/A N/A
MCR-10-001-24 Total # of claim lines Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-002-23 % of records with Procedure Code N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-003-8 % of claim lines with Ending Date of Service within the past year Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-004-20 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 41, 14 with DX Codes N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-005-21 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61, 28, 41 with diagnosis codes High COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-006-22 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 46 with DX Codes N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-007-9 % of claim lines with ER Place of Service Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-008-19 % of claim lines with office Place of Service Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-009-18 % of claim lines with missing Place of Service N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-010-3 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-011-4 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag and Procedure Code format 5n/4n1c N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-001-18 Total # of claim headers Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-012-10 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-013-12 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 4n N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-014-11 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 1c3n N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-015-15 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 4n N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-016-14 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 1c3n N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-017-13 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and other Procedure Code format N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-018-16 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have ICD9CM (02) or ICD10CM (07) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-019-7 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS74 (03) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-020-6 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS69 (04) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-021-5 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS64 (05) Procedure Code Flag N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-10-022-17 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 with local service code indicator (PROCEDURE-CODE-FLAG = 10 - 87) Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-002-3 % of claim headers with Ending Date of Service within the past year Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-023-1 % of outpatient department claim lines that have accommodation codes Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-10-024-2 % of claim headers with SERVICE-QUANTITY-ACTUAL = 1 Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-003-9 % of claim headers with diagnosis codes High CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-004-16 Average # of diagnoses High CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-005-10 % of claim headers with only 1 diagnosis code High CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-006-11 % of claim headers with principal Procedure Code High CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-007-17 Average # of procedures N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-008-1 % of claim headers with Admission Date within the past year Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-009-4 % of claim headers with home Patient Status Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-010-2 % of claim headers with deceased Patient Status Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-010-5 % of claim headers with Patient Status of other institution Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-011-6 % of claim headers with Patient Status of still a patient Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-012-8 % of claim headers with DRG N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-013-7 % of records with CMS/MS-DRG N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-014-12 % of claim headers with any accommodation revenue codes Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-015-13 % of claim headers with any ancillary revenue codes Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-016-14 Mean # Accomm. Codes on claims with Accomm. Codes N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-017-15 Mean # Ancil. Codes on claims with Ancil. Codes N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-11-001-6 Total # of crossover claim lines N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-11-002-3 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0) N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-11-003-5 % of claim lines with office Place of Service (Medicaid Paid Amount > $0) N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-11-004-4 % of claim lines with missing Place of Service (Medicaid Paid Amount > $0) N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-11-005-1 % of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0) N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-11-006-2 % of claim lines with Procedure Code or Revenue Code (Medicaid Paid Amount > $0) N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-12-001-1 % of claim lines with Revenue Code that also have a HCPCS Rate N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-002-14 % of records with TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-003-25 % of records with TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-004-34 % of records with TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-005-40 % of records with TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-006-49 % of records with TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-007-59 % of records with TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-008-70 % of records with TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-009-2 % of records with TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-010-3 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-011-5 % of records with TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-012-7 % of records with TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-013-8 % of records with TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-014-9 % of records with TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-015-10 % of records with TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-016-11 % of records with TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-017-12 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-018-13 % of records with 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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-019-15 % of records with 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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-020-16 % of records with TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-021-17 % of records with TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-022-18 % of records with TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-023-19 % of records with TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-024-20 % of records with TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-025-21 % of records with TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-026-22 % of records with TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-027-23 % of records with TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-028-24 % of records with TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-029-26 % of records with TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-030-27 % of records with TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-031-28 % of records with TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-032-29 % of records with TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-033-30 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-034-31 % of records with TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-035-32 % of records with TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-036-33 % of records with TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-037-35 % of records with TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-038-36 % of records with TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-039-37 % of records with TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-040-38 % of records with TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-041-39 % of records with TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-042-41 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-043-42 % of records with TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-044-43 % of records with TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-045-44 % of records with TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-046-45 % of records with 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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-047-46 % of records with TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-048-47 % of records with TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-049-48 % of records with TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-050-50 % of records with TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-051-51 % of records with TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-052-52 % of records with TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-053-53 % of records with TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-054-54 % of records with TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-055-55 % of records with TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-056-56 % of records with TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-057-57 % of records with TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-058-58 % of records with 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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-059-60 % of records with TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-060-61 % of records with TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-061-62 % of records with TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-062-63 % of records with TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-063-64 % of records with TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-064-65 % of records with TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-065-66 % of records with TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-066-67 % of records with TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-067-68 % of records with TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-068-69 % of records with TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-069-71 % of records with TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-070-72 % of records with TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-071-73 % of records with TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-072-74 % of records with TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-073-75 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-074-76 % of records with TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-075-77 % of records with TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-076-78 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-077-4 % of records with TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-078-6 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-079-91 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-080-102 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-082-117 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-083-126 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-084-136 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-085-147 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-088-82 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-089-84 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-090-85 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-092-87 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-093-88 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-098-94 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-099-95 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-100-96 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-101-97 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-102-98 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-103-99 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-104-100 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 28 (Clinic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-105-101 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 29 (Dental services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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)) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-109-106 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 35 (Dentures) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-110-107 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-111-108 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-112-109 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-113-110 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-114-112 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 40 (Screening services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-115-113 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 41 (Preventive services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-117-115 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-118-116 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 49 (Outpatient mental health services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-120-119 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 51 (Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-121-120 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-122-121 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-124-123 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-125-124 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 56 (Transportation services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-126-125 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 57 (Enabling services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-127-127 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-128-128 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-129-129 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-130-130 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-131-131 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-132-132 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-133-133 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-134-134 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-136-137 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-137-138 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-138-139 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-140-141 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-141-142 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-143-144 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-144-145 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-145-146 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-146-148 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-147-149 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-148-150 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-151-153 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 87 (Hospice services) N/A COT Medicaid,Enc Original All Indicators N/A N/A
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.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-153-155 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-154-81 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 115 (Residential care) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-155-83 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-13-001-17 Total # of capitation payments N/A FTX N/A Original All Indicators N/A N/A
MCR-13-002-1 # of records with capitated payments to HMOs, HIOs or PACE plans N/A FTX N/A Original All Indicators N/A N/A
MCR-13-003-3 # of records with capitated payments to PHPs N/A FTX N/A Original All Indicators N/A N/A
MCR-13-004-2 # of records with capitated payments for PCCM N/A FTX N/A Original All Indicators N/A N/A
MCR-13-005-4 % of records with plan ID N/A FTX N/A Original All Indicators N/A N/A
MCR-13-006-7 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-007-6 # of capitated payments to PHPs with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-008-5 # of capitated payments for PCCM with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-009-16 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-010-15 # of capitated payments to PHPs with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-011-14 # of capitated payments for PCCM with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-012-13 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-013-12 # of capitated payments to PHPs with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-014-11 # of capitated payments for PCCM with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-015-10 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-016-9 # of capitated payments to PHPs with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-13-017-8 # of capitated payments for PCCM with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-14-001-24 Total # of claim lines Medium COT CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-14-002-23 % of records with Procedure Code N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-003-8 % of claim lines with Ending Date of Service within the past year N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-004-21 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61, 28, 41 with diagnosis codes High COT CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-14-005-20 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 41, 14 with DX Codes N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-006-22 % of records with TYPE-OF-SERVICE = 12, 2, 61, 28, 48 with DX Codes N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-007-9 % of claim lines with ER Place of Service N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-008-19 % of claim lines with office Place of Service N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-009-18 % of claim lines with missing Place of Service N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-010-3 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-011-4 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have CPT (01) Procedure Code Flag and Procedure Code format 5n/4n1c N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-012-10 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-013-12 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 4n N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-014-11 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format A-V + 1c3n N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-015-15 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 4n N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-016-14 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and Procedure Code format W-Z + 1c3n N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-017-13 % of records with TYPE-OF-SERVICE = 12, 25, 26 that have HCPCS (06) Procedure Code Flag and other Procedure Code format N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-018-16 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have ICD9CM (02) or ICD10CM (07) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-019-7 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS74 (03) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-020-6 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS69 (04) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-021-5 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 that have CRVS64 (05) Procedure Code Flag N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-022-17 % of claim lines with TYPE-OF-SERVICE = 12, 25, 26 with local service code indicator (PROCEDURE-CODE-FLAG = 10 - 87) N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-023-1 % of outpatient department claim lines that have accommodation codes N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-14-024-2 % of claim headers with SERVICE-QUANTITY-ACTUAL = 1 Medium COT CHIP,Enc Original Non-Crossover Utilization N/A
MCR-15-001-5 Total # of crossover claim lines N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-15-002-2 % of claim lines with TYPE-OF-SERVICE = 12, 2, 61 with ER Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-15-003-4 % of claim lines with office Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-15-004-3 % of claim lines with missing Place of Service (Medicaid Paid Amount > $0) N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-15-005-1 % of claim lines with Procedure Code Flag (Medicaid Paid Amount > $0) N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-16-001-1 % of claim lines with Revenue Code that also have a HCPCS Rate N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-002-14 % of records with TYPE-OF-SERVICE = 2 (Outpatient hospital services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-003-25 % of records with TYPE-OF-SERVICE = 3 (Rural health clinic services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-004-34 % of records with TYPE-OF-SERVICE = 4 (Other ambulatory services furnished by a rural health clinic) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-005-40 % of records with TYPE-OF-SERVICE = 5 (Professional laboratory services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-006-49 % of records with TYPE-OF-SERVICE = 6 (Technical laboratory services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-007-59 % of records with TYPE-OF-SERVICE = 7 (Professional radiological services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-008-70 % of records with TYPE-OF-SERVICE = 8 (Technical radiological services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-009-2 % of records with TYPE-OF-SERVICE = 10 (Early and periodic screening and diagnosis and treatment (EPSDT) services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-010-3 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-011-5 % of records with TYPE-OF-SERVICE = 12 (Physicians' services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-012-7 % of records with TYPE-OF-SERVICE = 13 (Medical and surgical services of a dentist) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-013-8 % of records with TYPE-OF-SERVICE = 14 (Outpatient substance abuse treatment services.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-014-9 % of records with TYPE-OF-SERVICE = 15 (Medical or other remedial care or services, other than physicians' services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-015-10 % of records with TYPE-OF-SERVICE = 16 (Home health services - Nursing services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-016-11 % of records with TYPE-OF-SERVICE = 17 (Home health services - Home health aide services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-017-12 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-018-13 % of records with 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) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-019-15 % of records with 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) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-020-16 % of records with TYPE-OF-SERVICE = 21 (Home health services - Speech pathology and audiology services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-021-17 % of records with TYPE-OF-SERVICE = 22 (Private duty nursing services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-022-18 % of records with TYPE-OF-SERVICE = 23 (Advanced practice nurse services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-023-19 % of records with TYPE-OF-SERVICE = 24 (Pediatric nurse) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-024-20 % of records with TYPE-OF-SERVICE = 25 (Nurse-midwife service) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-025-21 % of records with TYPE-OF-SERVICE = 26 (Nurse practitioner services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-026-22 % of records with TYPE-OF-SERVICE = 27 (Respiratory care for ventilator-dependent individuals) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-027-23 % of records with TYPE-OF-SERVICE = 28 (Clinic services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-028-24 % of records with TYPE-OF-SERVICE = 29 (Dental services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-029-26 % of records with TYPE-OF-SERVICE = 30 (Physical therapy services (when not provided under home health services)) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-030-27 % of records with TYPE-OF-SERVICE = 31 (Occupational therapy services (when not provided under home health services)) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-031-28 % of records with TYPE-OF-SERVICE = 32 (Speech, hearing, and language disorders services (when not provided under home health services)) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-032-29 % of records with TYPE-OF-SERVICE = 35 (Dentures) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-033-30 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-034-31 % of records with TYPE-OF-SERVICE = 37 (Eyeglasses) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-035-32 % of records with TYPE-OF-SERVICE = 38 (Hearing Aids) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-036-33 % of records with TYPE-OF-SERVICE = 39 (Diagnostic services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-037-35 % of records with TYPE-OF-SERVICE = 40 (Screening services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-038-36 % of records with TYPE-OF-SERVICE = 41 (Preventive services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-039-37 % of records with TYPE-OF-SERVICE = 42 (Well-baby and well-child care services as defined by the State.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-040-38 % of records with TYPE-OF-SERVICE = 43 (Rehabilitative services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-041-39 % of records with TYPE-OF-SERVICE = 49 (Outpatient mental health services, other than substance abuse treatment services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-042-41 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-043-42 % of records with TYPE-OF-SERVICE = 51 (Personal care services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-044-43 % of records with TYPE-OF-SERVICE = 52 (Primary care case management services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-045-44 % of records with TYPE-OF-SERVICE = 53 (Targeted case management services ) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-046-45 % of records with 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) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-047-46 % of records with TYPE-OF-SERVICE = 55 (Care coordination services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-048-47 % of records with TYPE-OF-SERVICE = 56 (Transportation services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-049-48 % of records with TYPE-OF-SERVICE = 57 (Enabling services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-050-50 % of records with TYPE-OF-SERVICE = 61 (Critical access hospital services - OT) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-051-51 % of records with TYPE-OF-SERVICE = 62 (HCBS - Case management services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-052-52 % of records with TYPE-OF-SERVICE = 63 (HCBS - Homemaker services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-053-53 % of records with TYPE-OF-SERVICE = 64 (HCBS - Home health aide services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-054-54 % of records with TYPE-OF-SERVICE = 65 (HCBS - Personal care services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-055-55 % of records with TYPE-OF-SERVICE = 66 (HCBS - Adult day health services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-056-56 % of records with TYPE-OF-SERVICE = 67 (HCBS - Habilitation services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-057-57 % of records with TYPE-OF-SERVICE = 68 (HCBS - Respite care services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-058-58 % of records with 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) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-059-60 % of records with TYPE-OF-SERVICE = 70 (HCBS - Day Care) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-060-61 % of records with TYPE-OF-SERVICE = 71 (HCBS - Training for family members) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-061-62 % of records with TYPE-OF-SERVICE = 72 (HCBS - Minor modification to the home) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-062-63 % of records with TYPE-OF-SERVICE = 73 (HCBS - Other services requested by the agency and approved by CMS as cost effective and necessary to avoid institutionalization) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-063-64 % of records with TYPE-OF-SERVICE = 74 (HCBS - Expanded habilitation services - Prevocational services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-064-65 % of records with TYPE-OF-SERVICE = 75 (HCBS - Expanded habilitation services - Educational services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-065-66 % of records with TYPE-OF-SERVICE = 76 (HCBS - Expanded habilitation services - Supported employment services, which facilitate paid employment) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-066-67 % of records with TYPE-OF-SERVICE = 77 (HCBS-65-plus - Case management services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-067-68 % of records with TYPE-OF-SERVICE = 78 (HCBS-65-plus - Homemaker services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-068-69 % of records with TYPE-OF-SERVICE = 79 (HCBS-65-plus - Home health aide services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-069-71 % of records with TYPE-OF-SERVICE = 80 (HCBS-65-plus - Personal care services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-070-72 % of records with TYPE-OF-SERVICE = 81 (HCBS-65-plus - Adult day health services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-071-73 % of records with TYPE-OF-SERVICE = 82 (HCBS-65-plus - Respite care services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-072-74 % of records with TYPE-OF-SERVICE = 83 (HCBS-65-plus - Other medical and social services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-073-75 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-074-76 % of records with TYPE-OF-SERVICE = 87 (Hospice services) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-075-77 % of records with TYPE-OF-SERVICE = 88 (Any other health care services or items specified by the Secretary and not excluded under regulations.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-076-78 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-077-4 % of records with TYPE-OF-SERVICE = 115 (Residential care) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-16-078-6 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-17-001-8 Total # of claim headers Medium CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-002-7 % of claim headers with Prescription Fill Date within the past year Medium CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-003-6 % of claim headers with Prescription Fill Date = Date Prescribed Medium CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-004-5 % of claim headers with Days Supply > 30 Medium CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-005-1 % of claim headers with missing Days Supply N/A CRX Medicaid,Enc Original Non-Crossover N/A N/A
MCR-17-006-3 % of claim headers with NDC (11 numeric) High CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-007-4 % of claim headers with PRESCRIPTION-QUANTITY-ACTUAL = 1 Medium CRX Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-17-008-2 % of claim headers with missing Prescription Quantity Actual N/A CRX Medicaid,Enc Original Non-Crossover N/A N/A
MCR-18-001-1 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-002-3 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-003-4 % of records with TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-004-5 % of records with TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-005-6 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-006-7 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-007-8 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-008-2 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-009-9 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-010-11 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) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-011-12 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-012-13 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-013-14 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-014-15 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-015-16 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-18-016-10 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-19-001-8 Total # of claim headers Medium CRX CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-19-002-7 % of claim headers with Prescription Fill Date within the past year N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
MCR-19-003-6 % of claim headers with Prescription Fill Date = Date Prescribed N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
MCR-19-004-5 % of claim headers with Days Supply > 30 N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
MCR-19-005-1 % of claim headers with missing Days Supply N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
MCR-19-006-4 % of claim headers with PRESCRIPTION-QUANTITY-ACTUAL = 1 Medium CRX CHIP,Enc Original Non-Crossover Utilization N/A
MCR-19-007-3 % of claim headers with NDC (11 numeric) High CRX CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-19-008-2 % of claim headers with missing Prescription Quantity Actual N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
MCR-20-001-1 % of records with TYPE-OF-SERVICE = 11 (Family planning services and supplies for individuals of child-bearing age) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-002-3 % of records with TYPE-OF-SERVICE = 18 (Home health services - Medical supplies, equipment, and appliances suitable for use in the home) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-003-4 % of records with TYPE-OF-SERVICE = 33 (Prescribed drugs) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-004-5 % of records with TYPE-OF-SERVICE = 34 (Over-the-counter medications.) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-005-6 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-006-7 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-007-8 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-008-2 % of records with TYPE-OF-SERVICE = 127 (Indian Health Service (IHS) - Family Plan) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-2-001-25 Total # of crossover claim headers N/A CIP Medicaid,Enc Original Crossover N/A N/A
MCR-2-002-1 % of records with TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-003-5 % of records with TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-004-6 % of records with TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-005-7 % of records with TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-006-8 % of records with TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-007-9 % of records with TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-008-10 % of records with TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-009-11 % of records with TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-010-12 % of records with TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-011-2 % of records with TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-012-3 % of records with TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-013-4 % of records with TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-014-13 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-015-17 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-016-18 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-017-19 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-018-20 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-019-21 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-020-22 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-021-23 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-022-24 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-023-14 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-024-15 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-2-025-16 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-21-001-3 % of claim lines with Billing Provider ID N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-21-002-4 % of claim lines with Servicing Provider Num N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-21-003-2 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number Medium COT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-21-004-1 % of physician claim lines with Servicing Provider Specialty Medium COT Medicaid,Enc Original Non-Crossover Provider information Managed care
MCR-22-001-2 % of claim lines with Servicing Provider Num N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-22-002-1 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number N/A COT Medicaid,Enc Original Crossover N/A N/A
MCR-23-001-1 IP - Average # of PROV-LOCATION-ID per beneficiary N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-23-002-5 OT - Average # of PROV-LOCATION-ID per beneficiary N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-23-003-4 LT - Average # of PROV-LOCATION-ID per beneficiary N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-23-004-8 RX - Average # of PROV-LOCATION-ID per beneficiary N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-23-005-2 IP - Average # of PROV-LOCATION-ID per billing NPI N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-23-006-6 OT - Average # of PROV-LOCATION-ID per billing NPI N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-23-007-9 RX - Average # of PROV-LOCATION-ID per billing NPI N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-23-008-3 IP - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-23-009-7 OT - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-23-010-10 RX - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per dispensing NPI N/A CRX Medicaid,Enc Original All Indicators N/A N/A
MCR-24-001-3 % of claim lines with Billing Provider ID N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-24-002-4 % of claim lines with Servicing Provider Num N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-24-003-2 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-24-004-1 % of physician claim lines with Servicing Provider Specialty N/A COT CHIP,Enc Original Non-Crossover N/A N/A
MCR-25-001-2 % of claim lines with Servicing Provider Num N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-25-002-1 % of claim lines with TYPE-OF-SERVICE = 12, 29, 15, 2, 61, 28, 41 where Servicing Provider Number = Billing Provider Number N/A COT CHIP,Enc Original Crossover N/A N/A
MCR-26-001-1 IP - Average # of PROV-LOCATION-ID per beneficiary N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-26-002-4 OT - Average # of PROV-LOCATION-ID per beneficiary N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-26-003-7 RX - Average # of PROV-LOCATION-ID per beneficiary N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-26-004-2 IP - Average # of PROV-LOCATION-ID per billing NPI N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-26-005-5 OT - Average # of PROV-LOCATION-ID per billing NPI N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-26-006-8 RX - Average # of PROV-LOCATION-ID per billing NPI N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-26-007-3 IP - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-26-008-6 OT - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per servicing NPI N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-26-009-9 RX - Average # of unique combinations of PROV-LOCATION-ID and billing NPI per dispensing NPI N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-27-001-1 Encounters (by Claim File Type) N/A Multiple Files N/A N/A N/A N/A N/A
MCR-27-002-2 Encounters (by Claims file type) by Plan ID (non-PCCM) N/A Multiple Files N/A N/A N/A N/A N/A
MCR-28-001-1 % of plan IDs with capitation payment ratios <0.9 or >1.1 (non-PCCM) N/A Multiple Files N/A N/A N/A N/A N/A
MCR-29-001-1 Plan Type comparison with MMCDCS N/A MCR N/A N/A N/A N/A N/A
MCR-29-002-2 Operating Authority comparison with MMCDCS N/A MCR N/A N/A N/A N/A N/A
MCR-3-001-18 Total # of claim headers Medium CIP CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-3-002-3 % of claim headers with Ending Date of Service within the past year N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-003-9 % of claim headers with diagnosis codes High CIP CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-3-004-16 Average # of diagnoses High CIP CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-3-005-10 % of claim headers with only 1 diagnosis code High CIP CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-3-006-11 % of claim headers with principal Procedure Code High CIP CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-3-007-17 Average # of procedures N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-008-1 % of claim headers with Admission Date within the past year N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-009-4 % of claim headers with home Patient Status N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-010-5 % of claim headers with Patient Status of other institution N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-011-2 % of claim headers with deceased Patient Status N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-012-6 % of claim headers with Patient Status of still a patient N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-013-8 % of claim headers with DRG N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-014-7 % of records with CMS/MS-DRG N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-015-12 % of claim headers with any accommodation revenue codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-016-13 % of claim headers with any ancillary revenue codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-017-14 Mean # Accomm. Codes on claims with Accomm. Codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-018-15 Mean # Ancil. Codes on claims with Ancil. Codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-4-001-13 Total # of crossover claim headers N/A CIP CHIP,Enc Original Crossover N/A N/A
MCR-4-002-1 % of records with TYPE-OF-SERVICE = 1 (Inpatient hospital services, other than services in an institution for mental diseases) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-003-5 % of records with TYPE-OF-SERVICE = 58 (Services furnished in a religious nonmedical health care institution) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-004-6 % of records with TYPE-OF-SERVICE = 60 (Emergency hospital services) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-005-7 % of records with TYPE-OF-SERVICE = 84 (Sterilizations) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-006-8 % of records with TYPE-OF-SERVICE = 86 (Other Pregnancy-related Procedures) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-007-9 % of records with TYPE-OF-SERVICE = 90 (Critical access hospital services – IP) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-008-10 % of records with TYPE-OF-SERVICE = 91 (Skilled care – hospital residing) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-009-11 % of records with TYPE-OF-SERVICE = 92 (Exceptional care – hospital residing) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-010-12 % of records with TYPE-OF-SERVICE = 93 (Non-acute care – hospital residing) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-011-2 % of records with TYPE-OF-SERVICE = 123 (Disproportionate share hospital (DSH) payments) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-012-3 % of records with TYPE-OF-SERVICE = 132 (Supplemental payment - inpatient) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-4-013-4 % of records with TYPE-OF-SERVICE = 135 (EHR payments to provider) N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-5-001-21 Total # of claim headers Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-002-10 % of claim headers with Ending Date of Service within the past year Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-003-18 % of claim headers with diagnosis codes High CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-004-19 Average # of diagnoses High CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-005-16 % of claim headers with Patient Status of still a patient Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-006-11 % of claim headers with home Patient Status Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-007-9 % of claim headers with deceased Patient Status Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-008-13 % of claim headers with 28-31 long-term care days N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-5-009-17 % of claim headers with 6-8 long term care days N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-5-010-14 % of claim headers that do not have 6-8 or 28-31 long-term care days N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-5-011-20 Average # of long-term care days, exclude 0 Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-012-12 % of claim headers with Leave Days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-013-15 % of claim headers with patient liability N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
MCR-5-014-1 % of claim headers with TYPE-OF-SERVICE = 09 (nursing facility services age 21+) without nursing facility days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-015-2 % of claim headers with TYPE-OF-SERVICE = 44 (inpatient hospital services for individuals aged 65+ for mental diseases) without inpatient days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-016-3 % of claim headers with TYPE-OF-SERVICE = 45 (nursing facility services for individuals aged 65+ in institutions for mental diseases) without nursing facility days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-017-4 % of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-018-5 % of claim headers with TYPE-OF-SERVICE = 47 (nursing facility services other than mental diseases) without nursing facility days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-019-6 % of claim headers with TYPE-OF-SERVICE = 48 (inpatient psychiatric services for individuals under age 21) without inpatient days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-020-7 % of claim headers with TYPE-OF-SERVICE = 50 (inpatient and residential substance abuse) without inpatient days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-5-021-8 % of claim headers with TYPE-OF-SERVICE = 59 (skilled nursing facility services for individuals under age 21) without nursing facility days Medium CLT Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-6-001-26 Total # of crossover claim headers N/A CLT Medicaid,Enc Original Crossover N/A N/A
MCR-6-002-8 % of records with TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-003-1 % of records with TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-004-2 % of records with TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-005-3 % of records with TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-006-4 % of records with TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-007-5 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-008-6 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-009-7 % of records with TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-010-16 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-011-9 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-012-10 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-013-11 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-014-12 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-015-13 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-016-14 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-017-15 Ratio of Average FFS Equivalent to Average Paid for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-018-17 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-019-19 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-020-20 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-021-21 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-022-22 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-023-23 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-024-24 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-025-25 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-6-026-18 Ratio of Average Medicaid FFS equivalent amount per Long-Term Care day to Average Amount Paid per Long-Term Care day for TYPE-OF-SERVICE = 133 (Supplemental payment - nursing) N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-7-001-20 Total # of claim headers Medium CLT CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-7-002-10 % of claim headers with Ending Date of Service within the past year N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-003-17 % of claim headers with diagnosis codes High CLT CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-7-004-18 Average # of diagnoses High CLT CHIP,Enc Original Non-Crossover Utilization Managed care
MCR-7-005-15 % of claim headers with Patient Status of still a patient N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-006-11 % of records with Home Patient Status N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-007-9 % of claim headers with deceased Patient Status N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-008-13 % of claim headers with 28-31 long-term care days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-009-16 % of claim headers with 6-8 long term care days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-010-14 % of claim headers that do not have 6-8 or 28-31 long-term care days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-011-19 Average # of long-term care days, exclude 0 N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-012-12 % of claim headers with Leave Days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-013-1 % of claim headers with TYPE-OF-SERVICE = 09 (nursing facility services age 21+) without nursing facility days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-014-2 % of claim headers with TYPE-OF-SERVICE = 44 (inpatient hospital services for individuals aged 65+ for mental diseases) without inpatient days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-015-3 % of claim headers with TYPE-OF-SERVICE = 45 (nursing facility services for individuals aged 65+ in institutions for mental diseases) without nursing facility days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-016-4 % of claim headers with TYPE-OF-SERVICE = 46 (intermediate care facility (ICF/IIDICF/IID) services) without intermediate care facility days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-017-5 % of claim headers with TYPE-OF-SERVICE = 47 (nursing facility services other than mental diseases) without nursing facility days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-018-6 % of claim headers with TYPE-OF-SERVICE = 48 (inpatient psychiatric services for individuals under age 21) without inpatient days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-019-7 % of claim headers with TYPE-OF-SERVICE = 50 (inpatient and residential substance abuse) without inpatient days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-7-020-8 % of claim headers with TYPE-OF-SERVICE = 59 (skilled nursing facility services for individuals under age 21) without nursing facility days N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
MCR-8-001-9 Total # of crossover claim headers N/A CLT CHIP,Enc Original Crossover N/A N/A
MCR-8-002-8 % of records with TYPE-OF-SERVICE = 9 (Nursing facility services; age 21 or older) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-003-1 % of records with TYPE-OF-SERVICE = 44 (Inpatient hospital services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-004-2 % of records with TYPE-OF-SERVICE = 45 (Nursing facility services for individuals age 65 or older in institutions for mental diseases) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-005-3 % of records with TYPE-OF-SERVICE = 46 (Intermediate care facility (ICF/IIDICF/IID) services) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-006-4 % of records with TYPE-OF-SERVICE = 47 (Nursing facility services, other than in institutions for mental diseases) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-007-5 % of records with TYPE-OF-SERVICE = 48 (Inpatient psychiatric services for individuals under age 21) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-008-6 % of records with TYPE-OF-SERVICE = 50 (Inpatient substance abuse treatment services and residential substance abuse treatment services.) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-8-009-7 % of records with TYPE-OF-SERVICE = 59 (Skilled nursing facility services for individuals under age 21) N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-9-001-17 Total # of capitation payments N/A FTX N/A Original All Indicators N/A N/A
MCR-9-002-1 # of records with capitated payments to HMOs, HIOs or PACE plans N/A FTX N/A Original All Indicators N/A N/A
MCR-9-003-3 # of records with capitated payments to PHPs N/A FTX N/A Original All Indicators N/A N/A
MCR-9-004-2 # of records with capitated payments for PCCM N/A FTX N/A Original All Indicators N/A N/A
MCR-9-005-4 % of records with plan ID N/A FTX N/A Original All Indicators N/A N/A
MCR-9-006-7 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-007-6 # of capitated payments to PHPs with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-008-5 # of capitated payments for PCCM with Capitation Period End Date in the current month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-009-16 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-010-15 # of capitated payments to PHPs with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-011-14 # of capitated payments for PCCM with Capitation Period End Date in the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-012-13 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-013-12 # of capitated payments to PHPs with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-014-11 # of capitated payments for PCCM with Capitation Period End Date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-015-10 # of capitated payments to HMOs, HIOs or PACE plans with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-016-9 # of capitated payments to PHPs with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-9-017-8 # of capitated payments for PCCM with Capitation Period End Date in a future month N/A FTX N/A Original All Indicators N/A N/A
MCR-S-001-27 # of unique plan IDs N/A MCR N/A N/A N/A N/A N/A
MCR-S-002-25 # of Plan Types that are found in T-MSIS or MMCDCS but not both N/A MCR N/A N/A N/A N/A N/A
MCR-S-003-26 # of Operating Authorities that are found in T-MSIS or MMCDCS but not both N/A MCR N/A N/A N/A N/A N/A
MCR-S-004-3 Total # of claim headers N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-005-9 Total # of claim lines N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-006-6 Total # of claim headers N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-007-11 Total # of claim headers N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-008-14 Total # of claim headers N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-009-20 Total # of claim lines N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-010-17 Total # of claim headers N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-011-22 Total # of claim headers N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-012-2 % of claim headers that are original Medium CIP Medicaid,Enc All Adjustment Types All Indicators Expenditures Managed care
MCR-S-013-8 % of claim lines that are original Medium COT Medicaid,Enc All Adjustment Types All Indicators Expenditures Managed care
MCR-S-014-5 % of claim headers that are original Medium CLT Medicaid,Enc All Adjustment Types All Indicators Expenditures Managed care
MCR-S-015-10 % of claim headers that are original Medium CRX Medicaid,Enc All Adjustment Types All Indicators Expenditures Managed care
MCR-S-016-13 % of claim headers that are original N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-017-19 % of claim lines that are original N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-018-16 % of claim headers that are original N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-019-21 % of claim headers that are original N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-S-020-1 % of total original claim headers that are crossover claims N/A CIP Medicaid,Enc Original All Indicators N/A N/A
MCR-S-021-7 % of total original claim lines that are crossover claims N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-S-022-4 % of total original claim headers that are crossover claims N/A CLT Medicaid,Enc Original All Indicators N/A N/A
MCR-S-023-12 % of total original claim headers that are crossover claims N/A CIP CHIP,Enc Original All Indicators N/A N/A
MCR-S-024-18 % of Total original claim lines that are crossover claims N/A COT CHIP,Enc Original All Indicators N/A N/A
MCR-S-025-15 % of total original claim headers that are crossover claims N/A CLT CHIP,Enc Original All Indicators N/A N/A
MCR-S-026-23 Total # of capitation payments N/A FTX N/A All Adjustment Types All Indicators N/A N/A
MCR-S-027-24 Total # of capitation payments N/A FTX N/A All Adjustment Types All Indicators N/A N/A
PRV-1-001-12 Average # of PROV-ADDR-TYPE = 1 (Provider Billing) per Provider N/A PRV N/A N/A N/A N/A N/A
PRV-1-002-11 % of records with PROV-ADDR-TYPE = 1 (Provider Billing) N/A PRV N/A N/A N/A N/A N/A
PRV-1-003-14 Average # of PROV-ADDR-TYPE = 3 (Provider Practice) per Provider N/A PRV N/A N/A N/A N/A N/A
PRV-1-004-13 % of records with PROV-ADDR-TYPE = 3 (Provider Practice) N/A PRV N/A N/A N/A N/A N/A
PRV-1-005-16 Average # of PROV-ADDR-TYPE = 4 (Service Location) per Provider N/A PRV N/A N/A N/A N/A N/A
PRV-1-006-15 % of records with PROV-ADDR-TYPE = 4 (Service Location) N/A PRV N/A N/A N/A N/A N/A
PRV-1-007-1 % of provider records that have all practice and service locations (PROV-LOCATION-IDs) represented in the claims files N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-008-2 % of unique combinations of SUBMITTING-STATE-PROV-ID and PROV-LOCATION-ID for practice and service locations (provider records) that are represented in claims files N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-009-8 IP - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-010-9 LT - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-011-7 OT - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-012-10 RX - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-013-4 IP - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-014-5 LT - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-015-3 OT - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations N/A Multiple Files N/A N/A N/A N/A N/A
PRV-1-016-6 RX - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations N/A Multiple Files N/A N/A N/A N/A N/A
PRV-2-001-1 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 1 (state-specific Medicaid provider ID) N/A PRV N/A N/A N/A N/A N/A
PRV-2-002-2 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 2 (NPI) Medium PRV N/A N/A N/A Provider identifiers N/A
PRV-2-003-3 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 3 (Medicare ID) N/A PRV N/A N/A N/A N/A N/A
PRV-2-004-4 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 4 (NCPDP ID) N/A PRV N/A N/A N/A N/A N/A
PRV-2-005-5 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 5 (federal tax ID) N/A PRV N/A N/A N/A N/A N/A
PRV-2-006-6 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 6 (state tax ID) N/A PRV N/A N/A N/A N/A N/A
PRV-2-007-7 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 7 (SSN) N/A PRV N/A N/A N/A N/A N/A
PRV-2-008-8 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 8 (other) N/A PRV N/A N/A N/A N/A N/A
PRV-3-001-3 % of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 1 (Medicaid) N/A PRV N/A N/A N/A N/A N/A
PRV-3-002-4 % of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 2 (CHIP) N/A PRV N/A N/A N/A N/A N/A
PRV-3-003-5 % of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 3 (both Medicaid and CHIP) N/A PRV N/A N/A N/A N/A N/A
PRV-3-004-6 % of Submitting State Provider IDs with STATE-PLAN-ENROLLMENT = 4 (not state plan affiliated) N/A PRV N/A N/A N/A N/A N/A
PRV-3-005-1 % of Submitting State Provider IDs with PROV-MEDICAID-ENROLLMENT-STATUS-CODE of 20-24 (denied) N/A PRV N/A N/A N/A N/A N/A
PRV-3-006-2 % of Submitting State Provider IDs with PROV-MEDICAID-ENROLLMENT-STATUS-CODE of 60-83 (termed) N/A PRV N/A N/A N/A N/A N/A
PRV-4-001-1 # of providers by Provider Classification Type N/A PRV N/A N/A N/A N/A N/A
PRV-S-001-1 Total # of facilities N/A PRV N/A N/A N/A N/A N/A
PRV-S-002-2 Total # of individual providers N/A PRV N/A N/A N/A N/A N/A
PRV-S-003-3 Total # of group providers N/A PRV N/A N/A N/A N/A N/A
TPL-1-001-1 # of MSIS IDs N/A TPL N/A N/A N/A N/A N/A
TPL-1-002-4 # of MSIS IDs with TPL coverage (health insurance or other) N/A TPL N/A N/A N/A N/A N/A
TPL-1-003-2 # of MSIS IDs with a valid Coverage Type N/A TPL N/A N/A N/A N/A N/A
TPL-1-004-3 # of MSIS IDs with a valid Insurance Plan Type N/A TPL N/A N/A N/A N/A N/A
TPL-2-001-1 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CIP Medicaid,FFS Original Non-Crossover Expenditures N/A
TPL-2-002-5 % of claim lines with OTHER-INSURANCE-IND = 1 Medium COT Medicaid,FFS Original Non-Crossover Expenditures N/A
TPL-2-003-3 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CLT Medicaid,FFS Original Non-Crossover Expenditures N/A
TPL-2-004-7 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CRX Medicaid,FFS Original Non-Crossover Expenditures N/A
TPL-2-005-2 % of claim headers with any valid Other TPL Collection code N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
TPL-2-006-6 % of claim lines with any valid Other TPL Collection code N/A COT Medicaid,FFS Original Non-Crossover N/A N/A
TPL-2-007-4 % of claim headers with any valid Other TPL Collection code N/A CLT Medicaid,FFS Original Non-Crossover N/A N/A
TPL-2-008-8 % of claim headers with any valid Other TPL Collection code N/A CRX Medicaid,FFS Original Non-Crossover N/A N/A
TPL-3-001-1 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CIP Medicaid,Enc Original Non-Crossover Expenditures N/A
TPL-3-002-5 % of claim lines with OTHER-INSURANCE-IND = 1 Medium COT Medicaid,Enc Original Non-Crossover Expenditures N/A
TPL-3-003-3 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CLT Medicaid,Enc Original Non-Crossover Expenditures N/A
TPL-3-004-7 % of claim headers with OTHER-INSURANCE-IND = 1 Medium CRX Medicaid,Enc Original Non-Crossover Expenditures N/A
TPL-3-005-2 % of claim headers with any valid Other TPL Collection code N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
TPL-3-006-6 % of claim lines with any valid Other TPL Collection code N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
TPL-3-007-4 % of claim headers with any valid Other TPL Collection code N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
TPL-3-008-8 % of claim headers with any valid Other TPL Collection code N/A CRX Medicaid,Enc Original Non-Crossover N/A N/A
TPL-4-001-1 % of claim headers with OTHER-INSURANCE-IND = 1 N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-002-5 % of claim lines with OTHER-INSURANCE-IND = 1 N/A COT CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-003-3 % of claim headers with OTHER-INSURANCE-IND = 1 N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-004-7 % of claim headers with OTHER-INSURANCE-IND = 2 N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-005-2 % of claim headers with any valid Other TPL Collection code N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-006-6 % of claim lines with any valid Other TPL Collection code N/A COT CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-007-4 % of claim headers with any valid Other TPL Collection code N/A CLT CHIP,FFS Original Non-Crossover N/A N/A
TPL-4-008-8 % of claim headers with any valid Other TPL Collection code N/A CRX CHIP,FFS Original Non-Crossover N/A N/A
TPL-5-001-1 % of claim headers with OTHER-INSURANCE-IND = 1 N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-002-5 % of claim lines with OTHER-INSURANCE-IND = 1 N/A COT CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-003-3 % of claim headers with OTHER-INSURANCE-IND = 1 N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-004-7 % of claim headers with OTHER-INSURANCE-IND = 1 N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-005-2 % of claim headers with any valid Other TPL Collection code N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-006-6 % of claim lines with any valid Other TPL Collection code N/A COT CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-007-4 % of claim headers with any valid Other TPL Collection code N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
TPL-5-008-8 % of claim headers with any valid Other TPL Collection code N/A CRX CHIP,Enc Original Non-Crossover N/A N/A
TPL-6-001-1 # of records with private health insurance premium with end date in the current month N/A FTX N/A Original All Indicators N/A N/A
TPL-6-002-4 # of records with private health insurance premium with end date in the previous month N/A FTX N/A Original All Indicators N/A N/A
TPL-6-003-3 # of records with private health insurance premium with end date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
TPL-6-004-2 # of records with private health insurance premium with end date in future month N/A FTX N/A Original All Indicators N/A N/A
TPL-7-001-1 # of records with private health insurance premium with end date in the current month N/A FTX N/A Original All Indicators N/A N/A
TPL-7-002-4 # of records with private health insurance premium with end date in the previous month N/A FTX N/A Original All Indicators N/A N/A
TPL-7-003-3 # of records with private health insurance premium with end date prior to the previous month N/A FTX N/A Original All Indicators N/A N/A
TPL-7-004-2 # of records with private health insurance premium with end date in future month N/A FTX N/A Original All Indicators N/A N/A
ALL-4-001-1 % of billing and servicing provider numbers on claims that are not found in the provider file High Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider identifiers N/A
ALL-4-002-2 % of billing and servicing provider numbers on claims that are not found in the provider file High Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider identifiers N/A
ALL-4-003-3 % of billing and servicing provider numbers on claims that are not found in the provider file High Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider identifiers N/A
ALL-4-004-4 % of billing and dispensing provider numbers on claims that are not found in the provider file High Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider identifiers N/A
ALL-5-001-1 % of duplicate claim headers N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-002-2 % of duplicate claim headers N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-003-3 % of duplicate claim headers N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-004-4 % of duplicate claim headers N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-005-5 % of duplicate claim lines N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-006-6 % of duplicate claim lines N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-007-7 % of duplicate claim lines N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-5-008-8 % of duplicate claim lines N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EL-12-001-1 Eligibility Group values N/A ELG N/A N/A N/A N/A N/A
EL-10-008-8 % of MSIS IDs with a non-missing plan ID that are missing plan type N/A ELG N/A N/A N/A N/A N/A
FFS-24-001-1 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-002-2 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-003-3 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-004-4 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-005-5 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-006-6 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-007-7 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-24-008-8 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-001-1 % of MSIS IDs enrolled on Admission Date N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-002-2 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-003-3 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-004-4 % of MSIS IDs enrolled on Prescription Fill Date N/A Multiple Files Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-005-5 % of MSIS IDs enrolled on Admission Date N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-006-6 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-007-7 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-25-008-8 % of MSIS IDs enrolled on Prescription Fill Date N/A Multiple Files CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-001-1 % of claim headers with a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-002-2 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-003-3 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-004-4 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-005-5 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-006-6 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-007-7 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-008-8 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-009-9 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-010-10 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-011-11 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-012-12 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-013-13 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-014-14 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-015-15 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-26-016-16 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-27-001-1 Adjustment Indicator values N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-28-001-1 Adjustment Indicator values N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-29-001-1 Adjustment Indicator values N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-30-001-1 Adjustment Indicator values N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-31-001-1 Line Adjustment Indicator values N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-32-001-1 Line Adjustment Indicator values N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-33-001-1 Line Adjustment Indicator values N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-34-001-1 Line Adjustment Indicator values N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-35-001-1 Adjustment Indicator values N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-36-001-1 Adjustment Indicator values N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-37-001-1 Adjustment Indicator values N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-38-001-1 Adjustment Indicator values N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-39-001-1 Line Adjustment Indicator values N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-40-001-1 Line Adjustment Indicator values N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-41-001-1 Line Adjustment Indicator values N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-42-001-1 Line Adjustment Indicator values N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
MCR-30-001-1 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-002-2 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-003-3 % of MSIS IDs with any enrollment time span N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-30-004-4 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-005-5 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-006-6 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-007-7 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-008-8 % of MSIS IDs with any enrollment time span N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-30-009-9 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-30-010-10 % of MSIS IDs with any enrollment time span N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-001-1 % of MSIS IDs enrolled on Admission Date N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-002-2 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-003-3 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files Medicaid,Cap All Adjustment Types All Indicators N/A N/A
MCR-31-004-4 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-005-5 % of MSIS IDs enrolled on Prescription Fill Date N/A Multiple Files Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-006-6 % of MSIS IDs enrolled on Admission Date N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-007-7 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-008-8 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files CHIP,Cap All Adjustment Types All Indicators N/A N/A
MCR-31-009-9 % of MSIS IDs enrolled on Beginning Date of Service N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-31-010-10 % of MSIS IDs enrolled on Prescription Fill Date N/A Multiple Files CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-001-1 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-002-2 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-003-3 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-004-4 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-005-5 % of capitation payments without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A FTX N/A All Adjustment Types All Indicators N/A N/A
MCR-32-006-6 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-007-7 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT Medicaid,Cap All Adjustment Types All Indicators N/A N/A
MCR-32-008-8 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-009-9 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-010-10 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-010-20 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-011-11 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-012-12 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-013-13 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-014-14 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-015-15 % of capitation payments without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A FTX N/A All Adjustment Types All Indicators N/A N/A
MCR-32-016-16 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-017-17 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT CHIP,Cap All Adjustment Types All Indicators N/A N/A
MCR-32-018-18 % of claim lines without a valid Line Adjustment Indicator (LINE-ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-32-019-19 % of claim headers without a valid Adjustment Indicator (ADJ-IND is 2, 3, 9, other invalid value, or missing) N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-33-001-1 Adjustment Indicator values N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-34-001-1 Adjustment Indicator values N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-35-001-1 Adjustment Indicator values N/A FTX N/A All Adjustment Types All Indicators N/A N/A
MCR-36-001-1 Adjustment Indicator values N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-37-001-1 Adjustment Indicator values N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-38-001-1 Line Adjustment Indicator values N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-39-001-1 Line Adjustment Indicator values N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-40-001-1 Line Adjustment Indicator values N/A COT Medicaid,Cap All Adjustment Types All Indicators N/A N/A
MCR-41-001-1 Line Adjustment Indicator values N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-42-001-1 Line Adjustment Indicator values N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-43-001-1 Adjustment Indicator values N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-44-001-1 Adjustment Indicator values N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-45-001-1 Adjustment Indicator values N/A FTX N/A All Adjustment Types All Indicators N/A N/A
MCR-46-001-1 Adjustment Indicator values N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-47-001-1 Line Adjustment Indicator values N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-48-001-1 Adjustment Indicator values N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-49-001-1 Line Adjustment Indicator values N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-50-001-1 Line Adjustment Indicator values N/A COT CHIP,Cap All Adjustment Types All Indicators N/A N/A
MCR-51-001-1 Line Adjustment Indicator values N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-52-001-1 Line Adjustment Indicator values N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
TPL-1-005-5 % of MSIS IDs with any enrollment time span N/A Multiple Files N/A N/A N/A N/A N/A
EL-1-005_1-20 % of SSNs with more than one MSIS ID Medium ELG N/A N/A N/A Beneficiary demographics N/A
EL-3-001_1-13 # of distinct mandatory eligibility group values High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-1-021-21 % of MSIS IDs with age over 120 or less than -1 N/A ELG N/A N/A N/A N/A N/A
EL-14-001-1 Ratio of errors for overlapping segment eff/end dates [RULE-2028] to all active PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-3-003_1-15 % of MSIS IDs that are duals High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-S-003-3 Total # of MSIS IDs in CHIP (CHIP-CODE = 2 + CHIP-CODE = 3) N/A ELG N/A N/A N/A N/A N/A
MCR-13-006_1-18 % of PCCM capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation PCCM plan Medium Multiple Files N/A Original All Indicators Expenditures Managed care
MCR-13-006_2-19 % of PCCM capitated payments with a non-missing plan ID where plan ID number equals the Billing Provider Number or Billing Provider NPI Number N/A COT CHIP,Cap Original All Indicators N/A N/A
MCR-53-001-1 Total # of managed care enrollments High ELG N/A N/A N/A Program participation Managed care
MCR-53-002-2 Total # of managed care capitations High FTX N/A N/A N/A Expenditures Managed care
MCR-53-003-3 Total # of managed care encounters High COT N/A N/A N/A Utilization Managed care
MCR-54-001-1 # of plans with at least 100 enrollments, 0 capitations, 0 encounters High ELG N/A N/A N/A Program participation Managed care
MCR-54-002-2 # of plans with at least 100 enrollments or 100 capitations, 0 encounters High FTX N/A N/A N/A Utilization Managed care
MCR-54-003-3 # of plans with at least 100 enrollments or 100 encounters, 0 capitations High FTX N/A N/A N/A Expenditures Managed care
MCR-54-004-4 # of plans with at least 100 enrollments and some capitations that have capitation ratios outside of the expected range (0.7 - 1.3) High FTX N/A N/A N/A Expenditures Managed care
MCR-54-005-5 # of plans with at least 100 capitations or 100 encounters, 0 enrollments High ELG N/A N/A N/A Program participation Managed care
MCR-54-006-6 # of plans with at least 100 enrollments and some encounters that have IP ratios outside of the expected range (0.01 - 2) Medium Multiple Files N/A N/A N/A Utilization Managed care
MCR-54-007-7 # of plans with at least 100 enrollments and some encounters that have OT ratios outside of the expected range (0.1 - 20) Medium Multiple Files N/A N/A N/A Utilization Managed care
MCR-54-008-8 # of plans with at least 100 enrollments and some encounters that have RX ratios outside of the expected range (0.02 - 5) Medium Multiple Files N/A N/A N/A Utilization Managed care
MCR-54-009-9 # of plans with at least 100 enrollments, capitations, or encounters, that do not have a managed care record N/A MCR N/A N/A N/A N/A N/A
MCR-54-010-10 # of plans where MC plan type does not match EL plan type High ELG N/A N/A N/A Program participation Managed care
MCR-54-011-11 # of PCCM plan IDs Medium Multiple Files N/A N/A N/A Managed care file Managed care
MCR-54-012-12 # of PCCM plans with at least 100 enrollments, capitations, or encounters, that do not have a managed care record Medium Multiple Files N/A N/A N/A Managed care file Managed care
MCR-55-001-1 Traditional PCCM capitation ratio High FTX N/A N/A N/A Expenditures Managed care
MCR-55-002-2 Enhanced PCCM capitation ratio High FTX N/A N/A N/A Expenditures Managed care
MCR-55-003-3 PACE capitation ratio High FTX N/A N/A N/A Expenditures Managed care
MCR-55-004-4 Health home capitation ratio N/A Multiple Files N/A N/A N/A N/A N/A
MCR-9-006_1-18 % of PCCM capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation PCCM plan Medium Multiple Files N/A Original All Indicators Expenditures Managed care
MCR-9-006_2-19 % of PCCM capitated payments with a non-missing plan ID where plan ID number equals the Billing Provider Number or Billing Provider NPI Number N/A COT Medicaid,Cap Original All Indicators N/A N/A
MIS-10-001-1 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-MAIN-REC-EFF-DATE (MCR00002) Critical MCR N/A N/A N/A File integrity N/A
MIS-10-002-2 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-PLAN-TYPE (MCR00002) Medium MCR N/A N/A N/A Managed care file N/A
MIS-10-003-3 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-PROGRAM (MCR00002) Medium MCR N/A N/A N/A Managed care file N/A
MIS-10-004-4 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: REIMBURSEMENT-ARRANGEMENT (MCR00002) Medium MCR N/A N/A N/A Managed care file N/A
MIS-10-006-6 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-ADDR-TYPE (MCR00003) N/A MCR N/A N/A N/A N/A N/A
MIS-10-007-7 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-LOCATION-AND-CONTACT-INFO-EFF-DATE (MCR00003) N/A MCR N/A N/A N/A N/A N/A
MIS-10-008-8 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-LOCATION-ID (MCR00003) N/A MCR N/A N/A N/A N/A N/A
EL-14-002-2 Ratio of errors for overlapping segment eff/end dates [RULE-2071] to all active VARIABLE-DEMOGRAPHICS-ELIGIBILITY (ELG00003) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
MIS-10-011-11 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-SERVICE-AREA-EFF-DATE (MCR00004) High MCR N/A N/A N/A Managed care file N/A
MIS-10-012-12 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-SERVICE-AREA-NAME (MCR00004) High MCR N/A N/A N/A Managed care file N/A
MIS-10-014-14 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-OP-AUTHORITY-EFF-DATE (MCR00005) High MCR N/A N/A N/A Managed care file N/A
MIS-10-015-15 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: OPERATING-AUTHORITY (MCR00005) High MCR N/A N/A N/A Managed care file N/A
MIS-10-017-17 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: WAIVER-ID (MCR00005) N/A MCR N/A N/A N/A N/A N/A
MIS-10-018-18 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-PLAN-POP (MCR00006) N/A MCR N/A N/A N/A N/A N/A
MIS-10-019-19 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: MANAGED-CARE-PLAN-POP-EFF-DATE (MCR00006) High MCR N/A N/A N/A Managed care file N/A
MIS-10-021-21 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: ACCREDITATION-ORGANIZATION (MCR00007) N/A MCR N/A N/A N/A N/A N/A
MIS-1-002-2 % distinct MSIS IDs with only missing values in any active segment: DATE-OF-DEATH (ELG00002) N/A ELG N/A N/A N/A N/A N/A
MIS-10-022-22 % distinct STATE-PLAN-ID-NUMs with only missing values in any active segment: DATE-ACCREDITATION-ACHIEVED (MCR00007) N/A MCR N/A N/A N/A N/A N/A
MIS-1-004-4 % distinct MSIS IDs with only missing values in any active segment: PRIMARY-DEMOGRAPHIC-ELEMENT-EFF-DATE (ELG00002) High ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-005-5 % distinct MSIS IDs with only missing values in any active segment: PRIMARY-DEMOGRAPHIC-ELEMENT-END-DATE (ELG00002) High ELG N/A N/A N/A Beneficiary demographics N/A
EL-14-003-3 Ratio of errors for overlapping segment eff/end dates [RULE-2105] to all active ELIGIBLE-CONTACT-INFORMATION (ELG00004) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
MIS-1-007-7 % distinct MSIS IDs with only missing values in any active segment: CHIP-CODE (ELG00003) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-1-008-8 % distinct MSIS IDs with only missing values in any active segment: CITIZENSHIP-IND (ELG00003) N/A ELG N/A N/A N/A N/A N/A
MIS-1-009-9 % distinct MSIS IDs with only missing values in any active segment: HOUSEHOLD-SIZE (ELG00003) Medium ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-010-10 % distinct MSIS IDs with only missing values in any active segment: IMMIGRATION-STATUS (ELG00003) N/A ELG N/A N/A N/A N/A N/A
MIS-1-011-11 % distinct MSIS IDs with only missing values in any active segment: INCOME-CODE (ELG00003) Medium ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-012-12 % distinct MSIS IDs with only missing values in any active segment: MARITAL-STATUS (ELG00003) Medium ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-014-14 % distinct MSIS IDs with only missing values in any active segment: SSN (ELG00003) N/A ELG N/A N/A N/A N/A N/A
MIS-1-015-15 % distinct MSIS IDs with only missing values in any active segment: SSN-VERIFICATION-FLAG (ELG00003) Medium ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-016-16 % distinct MSIS IDs with only missing values in any active segment: VARIABLE-DEMOGRAPHIC-ELEMENT-EFF-DATE (ELG00003) High ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-017-17 % distinct MSIS IDs with only missing values in any active segment: VETERAN-IND (ELG00003) N/A ELG N/A N/A N/A N/A N/A
MIS-1-018-18 % distinct MSIS IDs with only missing values in any active segment: ELIGIBLE-ADDR-TYPE (ELG00004) High ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-019-19 % distinct MSIS IDs with only missing values in any active segment: ELIGIBLE-ADDR-EFF-DATE (ELG00004) High ELG N/A N/A N/A Beneficiary demographics N/A
EL-14-004-4 Ratio of errors for overlapping segment eff/end dates [RULE-2165] to all active ELIGIBILITY-DETERMINANTS (ELG00005) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-005-5 Ratio of errors for overlapping segment eff/end dates [RULE-2188] to all active HEALTH-HOME-SPA-PARTICIPATION-INFORMATION (ELG00006) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
MIS-1-023-23 % distinct MSIS IDs with only missing values in any active segment: DUAL-ELIGIBLE-CODE (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-024-24 % distinct MSIS IDs with only missing values in any active segment: ELIGIBILITY-DETERMINANT-EFF-DATE (ELG00005) High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-1-025-25 % distinct MSIS IDs with only missing values in any active segment: ELIGIBILITY-DETERMINANT-END-DATE (ELG00005) High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-1-026-26 % distinct MSIS IDs with only missing values in any active segment: ELIGIBILITY-GROUP (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-027-27 % distinct MSIS IDs with only missing values in any active segment: MAINTENANCE-ASSISTANCE-STATUS (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-028-28 % distinct MSIS IDs with only missing values in any active segment: MEDICAID-BASIS-OF-ELIGIBILITY (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-029-29 % distinct MSIS IDs with only missing values in any active segment: MSIS-CASE-NUM (ELG00005) High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-1-031-31 % distinct MSIS IDs with only missing values in any active segment: PRIMARY-ELIGIBILITY-GROUP-IND (ELG00005) Critical ELG N/A N/A N/A File integrity N/A
EL-14-006-6 Ratio of errors for overlapping segment eff/end dates [RULE-2217] to all active HEALTH-HOME-SPA-PROVIDERS (ELG00007) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
MIS-1-033-33 % distinct MSIS IDs with only missing values in any active segment: SSDI-IND (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-034-34 % distinct MSIS IDs with only missing values in any active segment: SSI-IND (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-035-35 % distinct MSIS IDs with only missing values in any active segment: SSI-STATE-SUPPLEMENT-STATUS-CODE (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-036-36 % distinct MSIS IDs with only missing values in any active segment: TANF-CASH-CODE (ELG00005) Medium ELG N/A N/A N/A Beneficiary demographics N/A
MIS-1-037-37 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-ENTITY-NAME (ELG00006) N/A ELG N/A N/A N/A N/A N/A
MIS-1-038-38 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-SPA-NAME (ELG00006) N/A ELG N/A N/A N/A N/A N/A
MIS-1-039-39 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-SPA-PARTICIPATION-EFF-DATE (ELG00006) N/A ELG N/A N/A N/A N/A N/A
MIS-1-040-40 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-SPA-PARTICIPATION-END-DATE (ELG00006) N/A ELG N/A N/A N/A N/A N/A
MIS-1-042-42 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-ENTITY-NAME (ELG00007) N/A ELG N/A N/A N/A N/A N/A
MIS-1-043-43 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-PROV-NUM (ELG00007) N/A ELG N/A N/A N/A N/A N/A
MIS-1-044-44 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-SPA-NAME (ELG00007) N/A ELG N/A N/A N/A N/A N/A
MIS-1-045-45 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-SPA-PROVIDER-EFF-DATE (ELG00007) N/A ELG N/A N/A N/A N/A N/A
MIS-1-047-47 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-CHRONIC-CONDITION (ELG00008) N/A ELG N/A N/A N/A N/A N/A
MIS-1-048-48 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-CHRONIC-CONDITION-EFF-DATE (ELG00008) N/A ELG N/A N/A N/A N/A N/A
MIS-1-049-49 % distinct MSIS IDs with only missing values in any active segment: HEALTH-HOME-CHRONIC-CONDITION-OTHER-EXPLANATION (ELG00008) N/A ELG N/A N/A N/A N/A N/A
MIS-1-051-51 % distinct MSIS IDs with only missing values in any active segment: LOCKED-IN-SRVCS (ELG00009) N/A ELG N/A N/A N/A N/A N/A
MIS-1-052-52 % distinct MSIS IDs with only missing values in any active segment: LOCKIN-EFF-DATE (ELG00009) N/A ELG N/A N/A N/A N/A N/A
MIS-1-053-53 % distinct MSIS IDs with only missing values in any active segment: LOCKIN-PROV-NUM (ELG00009) N/A ELG N/A N/A N/A N/A N/A
MIS-1-055-55 % distinct MSIS IDs with only missing values in any active segment: MFP-ENROLLMENT-EFF-DATE (ELG00010) N/A ELG N/A N/A N/A N/A N/A
MIS-1-056-56 % distinct MSIS IDs with only missing values in any active segment: MFP-ENROLLMENT-END-DATE (ELG00010) N/A ELG N/A N/A N/A N/A N/A
MIS-1-059-59 % distinct MSIS IDs with only missing values in any active segment: STATE-PLAN-OPTION-EFF-DATE (ELG00011) N/A ELG N/A N/A N/A N/A N/A
MIS-1-060-60 % distinct MSIS IDs with only missing values in any active segment: STATE-PLAN-OPTION-TYPE (ELG00011) N/A ELG N/A N/A N/A N/A N/A
MIS-1-062-62 % distinct MSIS IDs with only missing values in any active segment: WAIVER-ENROLLMENT-EFF-DATE (ELG00012) N/A ELG N/A N/A N/A N/A N/A
MIS-1-063-63 % distinct MSIS IDs with only missing values in any active segment: WAIVER-ID (ELG00012) N/A ELG N/A N/A N/A N/A N/A
MIS-1-064-64 % distinct MSIS IDs with only missing values in any active segment: WAIVER-TYPE (ELG00012) N/A ELG N/A N/A N/A N/A N/A
MIS-1-065-65 % distinct MSIS IDs with only missing values in any active segment: LTSS-ELIGIBILITY-EFF-DATE (ELG00013) N/A ELG N/A N/A N/A N/A N/A
MIS-1-066-66 % distinct MSIS IDs with only missing values in any active segment: LTSS-LEVEL-CARE (ELG00013) N/A ELG N/A N/A N/A N/A N/A
MIS-1-067-67 % distinct MSIS IDs with only missing values in any active segment: LTSS-PROV-NUM (ELG00013) N/A ELG N/A N/A N/A N/A N/A
MIS-1-069-69 % distinct MSIS IDs with only missing values in any active segment: MANAGED-CARE-PLAN-TYPE (ELG00014) N/A ELG N/A N/A N/A N/A N/A
MIS-1-070-70 % distinct MSIS IDs with only missing values in any active segment: MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE (ELG00014) N/A ELG N/A N/A N/A N/A N/A
MIS-1-071-71 % distinct MSIS IDs with only missing values in any active segment: MANAGED-CARE-PLAN-ID (ELG00014) N/A ELG N/A N/A N/A N/A N/A
MIS-1-073-73 % distinct MSIS IDs with only missing values in any active segment: ETHNICITY-CODE (ELG00015) N/A ELG N/A N/A N/A N/A N/A
MIS-1-074-74 % distinct MSIS IDs with only missing values in any active segment: ETHNICITY-DECLARATION-EFF-DATE (ELG00015) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
MIS-1-076-76 % distinct MSIS IDs with only missing values in any active segment: AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR (ELG00016) N/A ELG N/A N/A N/A N/A N/A
MIS-1-078-78 % distinct MSIS IDs with only missing values in any active segment: RACE (ELG00016) N/A ELG N/A N/A N/A N/A N/A
MIS-1-079-79 % distinct MSIS IDs with only missing values in any active segment: RACE-DECLARATION-EFF-DATE (ELG00016) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
MIS-1-080-80 % distinct MSIS IDs with only missing values in any active segment: RACE-OTHER (ELG00016) N/A ELG N/A N/A N/A N/A N/A
MIS-1-081-81 % distinct MSIS IDs with only missing values in any active segment: DISABILITY-TYPE-CODE (ELG00017) N/A ELG N/A N/A N/A N/A N/A
MIS-1-082-82 % distinct MSIS IDs with only missing values in any active segment: DISABILITY-TYPE-EFF-DATE (ELG00017) N/A ELG N/A N/A N/A N/A N/A
MIS-1-084-84 % distinct MSIS IDs with only missing values in any active segment: 1115A-DEMONSTRATION-IND (ELG00018) N/A ELG N/A N/A N/A N/A N/A
MIS-1-085-85 % distinct MSIS IDs with only missing values in any active segment: 1115A-EFF-DATE (ELG00018) N/A ELG N/A N/A N/A N/A N/A
MIS-1-087-87 % distinct MSIS IDs with only missing values in any active segment: HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-CODE (ELG00020) N/A ELG N/A N/A N/A N/A N/A
MIS-1-088-88 % distinct MSIS IDs with only missing values in any active segment: HCBS-CHRONIC-CONDITION-NON-HEALTH-HOME-EFF-DATE (ELG00020) N/A ELG N/A N/A N/A N/A N/A
MIS-1-090-90 % distinct MSIS IDs with only missing values in any active segment: ENROLLMENT-EFF-DATE (ELG00021) Critical ELG N/A N/A N/A File integrity N/A
MIS-1-091-91 % distinct MSIS IDs with only missing values in any active segment: ENROLLMENT-END-DATE (ELG00021) Critical ELG N/A N/A N/A File integrity N/A
EL-14-007-7 Ratio of errors for overlapping segment eff/end dates [RULE-2241] to all active HEALTH-HOME-CHRONIC-CONDITIONS (ELG00008) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
MIS-11-001-1 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: DATE-OF-BIRTH (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-002-2 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: DATE-OF-DEATH (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-003-3 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: FACILITY-GROUP-INDIVIDUAL-CODE (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-004-4 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-ATTRIBUTES-EFF-DATE (PRV00002) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-005-5 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-ATTRIBUTES-END-DATE (PRV00002) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-006-6 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-DOING-BUSINESS-AS-NAME (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-007-7 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-FIRST-NAME (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-008-8 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LAST-NAME (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-009-9 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LEGAL-NAME (PRV00002) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-010-10 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-ORGANIZATION-NAME (PRV00002) N/A PRV N/A N/A N/A N/A N/A
MIS-11-012-12 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-CITY (PRV00003) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-013-13 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-COUNTY (PRV00003) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-014-14 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-EMAIL (PRV00003) N/A PRV N/A N/A N/A N/A N/A
MIS-11-015-15 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-LN1 (PRV00003) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-016-16 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-STATE (PRV00003) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-017-17 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-ADDR-TYPE (PRV00003) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-018-18 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: ADDR-ZIP-CODE (PRV00003) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-11-019-19 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-AND-CONTACT-INFO-EFF-DATE (PRV00003) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-020-20 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-AND-CONTACT-INFO-END-DATE (PRV00003) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-021-21 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-ID (PRV00003) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-024-24 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: LICENSE-ISSUING-ENTITY-ID (PRV00004) N/A PRV N/A N/A N/A N/A N/A
MIS-11-025-25 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: LICENSE-OR-ACCREDITATION-NUMBER (PRV00004) N/A PRV N/A N/A N/A N/A N/A
MIS-11-026-26 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: LICENSE-TYPE (PRV00004) N/A PRV N/A N/A N/A N/A N/A
MIS-11-027-27 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LICENSE-EFF-DATE (PRV00004) Medium PRV N/A N/A N/A Provider characteristics N/A
MIS-11-028-28 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LICENSE-END-DATE (PRV00004) Medium PRV N/A N/A N/A Provider characteristics N/A
MIS-11-029-29 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-ID (PRV00004) N/A PRV N/A N/A N/A N/A N/A
MIS-11-031-31 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-IDENTIFIER (PRV00005) N/A PRV N/A N/A N/A N/A N/A
MIS-11-032-32 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-IDENTIFIER-EFF-DATE (PRV00005) N/A PRV N/A N/A N/A N/A N/A
MIS-11-033-33 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-IDENTIFIER-END-DATE (PRV00005) High PRV N/A N/A N/A Provider identifiers N/A
MIS-11-034-34 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-IDENTIFIER-ISSUING-ENTITY-ID (PRV00005) N/A PRV N/A N/A N/A N/A N/A
MIS-11-035-35 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-IDENTIFIER-TYPE (PRV00005) N/A PRV N/A N/A N/A N/A N/A
MIS-11-036-36 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-ID (PRV00005) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-038-38 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-CLASSIFICATION-CODE (PRV00006) N/A PRV N/A N/A N/A N/A N/A
MIS-11-039-39 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-CLASSIFICATION-TYPE (PRV00006) N/A PRV N/A N/A N/A N/A N/A
MIS-11-040-40 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-TAXONOMY-CLASSIFICATION-EFF-DATE (PRV00006) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-041-41 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-TAXONOMY-CLASSIFICATION-END-DATE (PRV00006) High PRV N/A N/A N/A Provider characteristics N/A
MIS-11-043-43 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-MEDICAID-EFF-DATE (PRV00007) High PRV N/A N/A N/A Provider enrollment N/A
MIS-11-044-44 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-MEDICAID-END-DATE (PRV00007) High PRV N/A N/A N/A Provider enrollment N/A
MIS-11-045-45 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-MEDICAID-ENROLLMENT-STATUS-CODE (PRV00007) High PRV N/A N/A N/A Provider enrollment N/A
MIS-11-046-46 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: STATE-PLAN-ENROLLMENT (PRV00007) Medium PRV N/A N/A N/A Provider enrollment N/A
MIS-11-048-48 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-AFFILIATED-GROUP-EFF-DATE (PRV00008) N/A PRV N/A N/A N/A N/A N/A
MIS-11-050-50 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: SUBMITTING-STATE-PROV-ID-OF-AFFILIATED-ENTITY (PRV00008) N/A PRV N/A N/A N/A N/A N/A
MIS-11-051-51 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: AFFILIATED-PROGRAM-ID (PRV00009) N/A PRV N/A N/A N/A N/A N/A
MIS-11-052-52 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: AFFILIATED-PROGRAM-TYPE (PRV00009) N/A PRV N/A N/A N/A N/A N/A
MIS-11-053-53 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-AFFILIATED-PROGRAM-EFF-DATE (PRV00009) N/A PRV N/A N/A N/A N/A N/A
MIS-11-055-55 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: BED-TYPE-CODE (PRV00010) N/A PRV N/A N/A N/A N/A N/A
MIS-11-056-56 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: BED-TYPE-EFF-DATE (PRV00010) N/A PRV N/A N/A N/A N/A N/A
MIS-11-057-57 % distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-LOCATION-ID (PRV00010) Medium PRV N/A N/A N/A Provider identifiers N/A
MIS-12-002-2 % distinct MSIS IDs with only missing values in any active segment: TPL-HEALTH-INSURANCE-COVERAGE-IND (TPL00002) N/A TPL N/A N/A N/A N/A N/A
MIS-12-003-3 % distinct MSIS IDs with only missing values in any active segment: TPL-OTHER-COVERAGE-IND (TPL00002) N/A TPL N/A N/A N/A N/A N/A
MIS-2-001-1 % missing: ADJUDICATION-DATE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-003-3 % missing: ADMISSION-DATE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-004-4 % missing: ADMISSION-TYPE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-005-5 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-006-6 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-007-7 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-008-8 % missing: BILLING-PROV-NPI-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-009-9 % missing: BILLING-PROV-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-010-10 % missing: BILLING-PROV-TYPE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-011-11 % missing: CLAIM-LINE-COUNT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-012-12 % missing: CROSSOVER-INDICATOR (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-013-13 % missing: DIAGNOSIS-CODE-1 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-014-14 % missing: DIAGNOSIS-CODE-10 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-015-15 % missing: DIAGNOSIS-CODE-11 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-016-16 % missing: DIAGNOSIS-CODE-12 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-017-17 % missing: DIAGNOSIS-CODE-2 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-018-18 % missing: DIAGNOSIS-CODE-3 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-019-19 % missing: DIAGNOSIS-CODE-4 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-020-20 % missing: DIAGNOSIS-CODE-5 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-021-21 % missing: DIAGNOSIS-CODE-6 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-022-22 % missing: DIAGNOSIS-CODE-7 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-023-23 % missing: DIAGNOSIS-CODE-8 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-024-24 % missing: DIAGNOSIS-CODE-9 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-025-25 % missing: DIAGNOSIS-POA-FLAG-1 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-026-26 % missing: DISCHARGE-DATE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-027-27 % missing: FIXED-PAYMENT-IND (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-028-28 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-029-29 % missing: ICN-ADJ (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-030-30 % missing: ICN-ORIG (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-031-31 % missing: MEDICAID-AMOUNT-PAID-DSH (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-032-32 % missing: MEDICAID-COV-INPATIENT-DAYS (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-033-33 % missing: MEDICARE-PAID-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-034-34 % missing: MEDICARE-REIM-TYPE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-035-35 % missing: MSIS-IDENTIFICATION-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-036-36 % missing: NON-COV-CHARGES (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-037-37 % missing: OTHER-INSURANCE-IND (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-038-38 % missing: OTHER-TPL-COLLECTION (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-039-39 % missing: PATIENT-STATUS (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-040-40 % missing: PLAN-ID-NUMBER (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-041-41 % missing: PROCEDURE-CODE-1 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-042-42 % missing: PROCEDURE-CODE-2 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-043-43 % missing: PROCEDURE-CODE-DATE-1 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-044-44 % missing: PROCEDURE-CODE-DATE-2 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-045-45 % missing: PROCEDURE-CODE-FLAG-1 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-046-46 % missing: PROCEDURE-CODE-FLAG-2 (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-047-47 % missing: PROGRAM-TYPE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-048-48 % missing: TOT-ALLOWED-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-049-49 % missing: TOT-BILLED-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-050-50 % missing: TOT-COPAY-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-051-51 % missing: TOT-MEDICAID-PAID-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-052-52 % missing: TOT-OTHER-INSURANCE-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-053-53 % missing: TOT-TPL-AMT (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-054-54 % missing: TYPE-OF-BILL (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-055-55 % missing: TYPE-OF-CLAIM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-056-56 % missing: TYPE-OF-HOSPITAL (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-001-1 % missing: ADJUDICATION-DATE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-002-2 % missing: BEGINNING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-003-3 % missing: ENDING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-004-4 % missing: ICN-ADJ (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-005-5 % missing: ICN-ORIG (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-007-7 % missing: LINE-NUM-ADJ (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-008-8 % missing: LINE-NUM-ORIG (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-009-9 % missing: MEDICAID-PAID-AMT (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-010-10 % missing: PROV-FACILITY-TYPE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-011-11 % missing: REVENUE-CHARGE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-012-12 % missing: REVENUE-CODE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-013-13 % missing: SERVICING-PROV-NPI-NUM (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-014-14 % missing: SERVICING-PROV-NUM (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-015-15 % missing: SERVICING-PROV-SPECIALTY (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-016-16 % missing: SERVICING-PROV-TYPE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-017-17 % missing: TYPE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-001-1 % missing: ADJUDICATION-DATE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-003-3 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-004-4 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-005-5 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-006-6 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-007-7 % missing: BILLING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-008-8 % missing: BILLING-PROV-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-009-9 % missing: BILLING-PROV-TYPE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-010-10 % missing: CLAIM-LINE-COUNT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-011-11 % missing: CROSSOVER-INDICATOR (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-012-12 % missing: DIAGNOSIS-CODE-1 (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-013-13 % missing: DIAGNOSIS-CODE-2 (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-014-14 % missing: DIAGNOSIS-CODE-FLAG-1 (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-015-15 % missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-016-16 % missing: DIAGNOSIS-POA-FLAG-1 (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-017-17 % missing: ENDING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-018-18 % missing: FIXED-PAYMENT-IND (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-019-19 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-020-20 % missing: ICF-IID-DAYS (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-021-21 % missing: ICN-ADJ (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-022-22 % missing: ICN-ORIG (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-023-23 % missing: LEAVE-DAYS (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-024-24 % missing: LTC-RCP-LIAB-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-025-25 % missing: MEDICAID-COV-INPATIENT-DAYS (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-026-26 % missing: MEDICARE-PAID-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-027-27 % missing: MEDICARE-REIM-TYPE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-028-28 % missing: MSIS-IDENTIFICATION-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-029-29 % missing: NURSING-FACILITY-DAYS (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-030-30 % missing: OTHER-INSURANCE-IND (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-031-31 % missing: OTHER-TPL-COLLECTION (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-032-32 % missing: PATIENT-STATUS (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-033-33 % missing: PLAN-ID-NUMBER (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-034-34 % missing: PROGRAM-TYPE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-035-35 % missing: TOT-ALLOWED-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-036-36 % missing: TOT-BILLED-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-037-37 % missing: TOT-MEDICAID-PAID-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-038-38 % missing: TOT-MEDICARE-COINS-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-039-39 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-040-40 % missing: TOT-OTHER-INSURANCE-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-041-41 % missing: TOT-TPL-AMT (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-042-42 % missing: TYPE-OF-BILL (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-043-43 % missing: TYPE-OF-CLAIM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-001-1 % missing: ADJUDICATION-DATE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-002-2 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-003-3 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-004-4 % missing: ENDING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-005-5 % missing: ICN-ADJ (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-006-6 % missing: ICN-ORIG (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-008-8 % missing: LINE-NUM-ADJ (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-009-9 % missing: LINE-NUM-ORIG (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-010-10 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-011-11 % missing: MEDICAID-PAID-AMT (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-012-12 % missing: PROV-FACILITY-TYPE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-013-13 % missing: REVENUE-CHARGE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-014-14 % missing: REVENUE-CODE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-015-15 % missing: SERVICING-PROV-NPI-NUM (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-016-16 % missing: SERVICING-PROV-NUM (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-017-17 % missing: SERVICING-PROV-SPECIALTY (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-018-18 % missing: SERVICING-PROV-TYPE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-019-19 % missing: TYPE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-001-1 % missing: ADJUDICATION-DATE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-003-3 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-004-4 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-005-5 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-006-6 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-007-7 % missing: BILLING-PROV-NPI-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-008-8 % missing: BILLING-PROV-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-009-9 % missing: BILLING-PROV-TYPE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-010-10 % missing: CLAIM-LINE-COUNT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-011-11 % missing: CROSSOVER-INDICATOR (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-012-12 % missing: DIAGNOSIS-CODE-1 (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-013-13 % missing: DIAGNOSIS-CODE-2 (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-014-14 % missing: DIAGNOSIS-CODE-FLAG-1 (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-015-15 % missing: DIAGNOSIS-CODE-FLAG-2 (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-016-16 % missing: DIAGNOSIS-POA-FLAG-1 (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-017-17 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-018-18 % missing: FIXED-PAYMENT-IND (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-019-19 % missing: HEALTH-HOME-PROV-IND (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-020-20 % missing: ICN-ADJ (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-021-21 % missing: ICN-ORIG (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-022-22 % missing: MSIS-IDENTIFICATION-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-023-23 % missing: OTHER-INSURANCE-IND (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-024-24 % missing: OTHER-TPL-COLLECTION (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-025-25 % missing: PLACE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-026-26 % missing: PLAN-ID-NUMBER (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-027-27 % missing: PROGRAM-TYPE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-028-28 % missing: TOT-MEDICAID-PAID-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-029-29 % missing: TOT-MEDICARE-COINS-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-030-30 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-031-31 % missing: TOT-OTHER-INSURANCE-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-032-32 % missing: TOT-TPL-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-033-33 % missing: TYPE-OF-BILL (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-034-34 % missing: TYPE-OF-CLAIM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-001-1 % missing: ADJUDICATION-DATE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-002-2 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-003-3 % missing: BENEFIT-TYPE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-004-4 % missing: BILLED-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-005-5 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-006-6 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-007-7 % missing: HCBS-SERVICE-CODE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-008-8 % missing: HCBS-TAXONOMY (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-009-9 % missing: HCPCS-RATE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-010-10 % missing: ICN-ADJ (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-011-11 % missing: ICN-ORIG (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-013-13 % missing: LINE-NUM-ADJ (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-014-14 % missing: LINE-NUM-ORIG (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-015-15 % missing: MEDICAID-FFS-EQUIVALENT-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-016-16 % missing: MEDICAID-PAID-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-017-17 % missing: MEDICARE-PAID-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-018-18 % missing: MSIS-IDENTIFICATION-NUM (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-019-19 % missing: OTHER-INSURANCE-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-020-20 % missing: SERVICE-QUANTITY-ACTUAL (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-021-21 % missing: PROCEDURE-CODE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-022-22 % missing: PROCEDURE-CODE-FLAG (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-023-23 % missing: PROCEDURE-CODE-MOD-1 (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-024-24 % missing: PROCEDURE-CODE-MOD-2 (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-025-25 % missing: REVENUE-CODE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-026-26 % missing: SERVICING-PROV-NPI-NUM (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-027-27 % missing: SERVICING-PROV-NUM (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-028-28 % missing: SERVICING-PROV-SPECIALTY (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-029-29 % missing: SERVICING-PROV-TYPE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-030-30 % missing: TPL-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-030-31 % missing: TYPE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-001-1 % missing: ADJUDICATION-DATE (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-003-3 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-004-4 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-005-5 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-006-6 % missing: BILLING-PROV-NPI-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-007-7 % missing: BILLING-PROV-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-008-8 % missing: CLAIM-LINE-COUNT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-009-9 % missing: COMPOUND-DRUG-IND (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-010-10 % missing: CROSSOVER-INDICATOR (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-011-11 % missing: DATE-PRESCRIBED (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-012-12 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NPI (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-013-13 % missing: FIXED-PAYMENT-IND (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-014-14 % missing: ICN-ADJ (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-015-15 % missing: ICN-ORIG (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-016-16 % missing: MSIS-IDENTIFICATION-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-017-17 % missing: OTHER-INSURANCE-IND (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-018-18 % missing: OTHER-TPL-COLLECTION (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-019-19 % missing: PAYMENT-LEVEL-IND (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-020-20 % missing: PLAN-ID-NUMBER (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-021-21 % missing: PRESCRIBING-PROV-NPI-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-022-22 % missing: PRESCRIBING-PROV-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-023-23 % missing: PRESCRIPTION-FILL-DATE (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-024-24 % missing: PROGRAM-TYPE (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-025-25 % missing: TOT-ALLOWED-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-026-26 % missing: TOT-BILLED-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-027-27 % missing: TOT-COPAY-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-028-28 % missing: TOT-MEDICAID-PAID-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-029-29 % missing: TOT-MEDICARE-COINS-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-030-30 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-031-31 % missing: TOT-OTHER-INSURANCE-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-032-32 % missing: TOT-TPL-AMT (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-033-33 % missing: TYPE-OF-CLAIM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-001-1 % missing: ADJUDICATION-DATE (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-002-2 % missing: ALLOWED-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-003-3 % missing: BILLED-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-004-4 % missing: BRAND-GENERIC-IND (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-005-5 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-006-6 % missing: DAYS-SUPPLY (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-007-7 % missing: DISPENSE-FEE-SUBMITTED (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-008-8 % missing: ICN-ADJ (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-009-9 % missing: ICN-ORIG (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-011-11 % missing: LINE-NUM-ADJ (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-012-12 % missing: LINE-NUM-ORIG (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-013-13 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-014-14 % missing: MEDICAID-PAID-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-015-15 % missing: MEDICARE-PAID-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-016-16 % missing: NATIONAL-DRUG-CODE (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-017-17 % missing: NEW-REFILL-IND (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-018-18 % missing: OTHER-INSURANCE-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-019-19 % missing: PRESCRIPTION-QUANTITY-ACTUAL (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-020-20 % missing: REBATE-ELIGIBLE-INDICATOR (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-021-21 % missing: TPL-AMT (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-9-022-22 % missing: TYPE-OF-SERVICE (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
ALL-10-001-1 % of claim headers that are crossover claims N/A CLT CHIP,FFS or CHIP,Enc Original All Indicators N/A N/A
ALL-11-001-1 % of claim lines that are crossover claims N/A COT CHIP,FFS or CHIP,Enc Original All Indicators N/A N/A
ALL-6-001-1 % of claim headers that are crossover claims Medium CIP Medicaid,FFS or Medicaid,Enc Original All Indicators Expenditures N/A
ALL-7-001-1 % of claim headers that are crossover claims Medium CLT Medicaid,FFS or Medicaid,Enc Original All Indicators Expenditures N/A
ALL-8-001-1 % of claim lines that are crossover claims Medium COT Medicaid,FFS or Medicaid,Enc Original All Indicators Expenditures N/A
ALL-9-001-1 % of claim headers that are crossover claims N/A CIP CHIP,FFS or CHIP,Enc Original All Indicators N/A N/A
EL-13-001-1 % of MC enrollments with a plan ID that does not link to a health plan affiliated with any provider in the provider file N/A ELG N/A N/A N/A N/A N/A
EL-14-008-8 Ratio of errors for overlapping segment eff/end dates [RULE-2263] to all active LOCK-IN-INFORMATION (ELG00009) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-009-9 Ratio of errors for overlapping segment eff/end dates [RULE-2289] to all active MFP-INFORMATION (ELG00010) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-010-10 Ratio of errors for overlapping segment eff/end dates [RULE-2313] to all active STATE-PLAN-OPTION-PARTICIPATION (ELG00011) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-011-11 Ratio of errors for overlapping segment eff/end dates [RULE-2338] to all active WAIVER-PARTICIPATION (ELG00012) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-012-12 Ratio of errors for overlapping segment eff/end dates [RULE-2361] to all active LTSS-PARTICIPATION (ELG00013) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-013-13 Ratio of errors for overlapping segment eff/end dates [RULE-2392] to all active MANAGED-CARE-PARTICIPATION (ELG00014) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-014-14 Ratio of errors for overlapping segment eff/end dates [RULE-2413] to all active ETHNICITY-INFORMATION (ELG00015) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-015-15 Ratio of errors for overlapping segment eff/end dates [RULE-2438] to all active RACE-INFORMATION (ELG00016) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-016-16 Ratio of errors for overlapping segment eff/end dates [RULE-2458] to all active DISABILITY-INFORMATION (ELG00017) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-017-17 Ratio of errors for overlapping segment eff/end dates [RULE-2478] to all active 1115A-DEMONSTRATION-INFORMATION (ELG00018) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-018-18 Ratio of errors for overlapping segment eff/end dates [RULE-2498] to all active HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME (ELG00020) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-14-019-19 Ratio of errors for overlapping segment eff/end dates [RULE-2519] to all active ENROLLMENT-TIME-SPAN-SEGMENT (ELG00021) segments across all reporting and coverage periods N/A ELG N/A N/A N/A N/A N/A
EL-16-001-1 % of ELG00002 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-002-2 % of ELG00003 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-003-3 % of ELG00004 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-004-4 % of ELG00005 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-005-5 % of ELG00012 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-006-6 % of ELG00014 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-007-7 % of ELG00015 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-15-001-1 % difference between full-benefit T-MSIS enrollment count (EL-6-023-23) and PI enrollment count (Medicaid + CHIP) High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
EL-15-002-2 % difference between T-MSIS CHIP count (EL-S-003-3) and PI CHIP count (M-CHIP + S-CHIP) High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
EL-6-023-23 # of full-benefit enrollees N/A ELG N/A N/A N/A N/A N/A
EL-6-024-24 Restricted Benefit Code values N/A ELG N/A N/A N/A N/A N/A
EXP-27-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High COT Medicaid,FFS Original Crossover Expenditures N/A
EXP-27-002-2 Average Total Medicaid Paid Amount ($0 < Total Medicaid Paid Amount < $200,000) N/A COT Medicaid,FFS Original Crossover N/A N/A
EXP-28-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High COT CHIP,FFS Original Crossover Expenditures N/A
EXP-28-002-2 Average Total Medicaid Paid Amount ($0 < Total Medicaid Paid Amount < $200,000) N/A COT CHIP,FFS Original Crossover N/A N/A
EXP-29-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP Medicaid,Enc Original Non-Crossover Expenditures Managed care
EXP-30-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP Medicaid,Enc Original Crossover Expenditures Managed care
EXP-31-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP CHIP,Enc Original Non-Crossover Expenditures Managed care
EXP-32-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CIP CHIP,Enc Original Crossover Expenditures Managed care
EXP-33-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT Medicaid,Enc Original Non-Crossover Expenditures Managed care
EXP-34-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT Medicaid,Enc Original Crossover Expenditures Managed care
EXP-35-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT CHIP,Enc Original Non-Crossover Expenditures Managed care
EXP-36-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CLT CHIP,Enc Original Crossover Expenditures Managed care
EXP-37-001-1 % of claim lines with Medicaid Paid Amount = $0 or missing N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
EXP-38-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High COT Medicaid,Enc Original Crossover Expenditures Managed care
EXP-39-001-1 % of claim lines with Medicaid Paid Amount = $0 or missing N/A COT CHIP,Enc Original Non-Crossover N/A N/A
EXP-40-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High COT CHIP,Enc Original Crossover Expenditures Managed care
EXP-41-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CRX Medicaid,Enc Original Non-Crossover Expenditures Managed care
EXP-42-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing High CRX CHIP,Enc Original Non-Crossover Expenditures Managed care
FFS-1-014-31 % of claim headers with CMS/MS-DRG N/A CIP Medicaid,FFS Original Non-Crossover N/A N/A
FFS-1-017-32 Average # accommodation codes on claims with accommodation codes Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-1-018-33 Average # ancillary codes on claims with ancillary codes Medium CIP Medicaid,FFS Original Non-Crossover Utilization N/A
FFS-3-014-19 % of claim headers with CMS/MS-DRG N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-017-20 Average # accommodation codes on claims with accommodation codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-3-018-21 Average # ancillary codes on claims with ancillary codes N/A CIP CHIP,FFS Original Non-Crossover N/A N/A
FFS-43-001-1 % of crossover claim headers where Total Medicare Deductible Amount and Total Medicare Coinsurance Amount do not sum to Total Medicaid Paid Amount Medium CIP Medicaid,FFS All Adjustment Types Crossover Expenditures N/A
FFS-44-001-1 % of crossover claim headers where Total Medicare Deductible Amount and Total Medicare Coinsurance Amount do not sum to Total Medicaid Paid Amount Medium CLT Medicaid,FFS All Adjustment Types Crossover Expenditures N/A
FFS-45-001-1 % of crossover claim headers where Total Medicare Deductible Amount and Total Medicare Coinsurance Amount do not sum to Total Medicaid Paid Amount Medium COT Medicaid,FFS All Adjustment Types Crossover Expenditures N/A
FFS-46-001-1 % of crossover claim headers where Total Medicare Deductible Amount and Total Medicare Coinsurance Amount do not sum to Total Medicaid Paid Amount N/A CRX Medicaid,FFS All Adjustment Types Crossover N/A N/A
FFS-47-001-1 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-48-001-1 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
MCR-1-013-19 % of claim headers with CMS/MS-DRG N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
MCR-1-016-20 Average # accommodation codes on claims with accommodation codes Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-1-017-21 Average # ancillary codes on claims with ancillary codes Medium CIP Medicaid,Enc Original Non-Crossover Utilization Managed care
MCR-3-014-19 % of claim headers with CMS/MS-DRG N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-017-20 Average # accommodation codes on claims with accommodation codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-3-018-21 Average # ancillary codes on claims with ancillary codes N/A CIP CHIP,Enc Original Non-Crossover N/A N/A
MCR-56-001-1 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date Critical CIP Medicaid,Enc All Adjustment Types All Indicators File integrity Managed care
MCR-57-001-1 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date Critical CIP CHIP,Enc All Adjustment Types All Indicators File integrity Managed care
MCR-58-001-1 Ratio of errors for overlapping segment eff/end dates [RULE-2578] to all active MANAGED-CARE-MAIN (MCR00002) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-002-2 Ratio of errors for overlapping segment eff/end dates [RULE-2598] to all active MANAGED-CARE-LOCATION-AND-CONTACT-INFO (MCR00003) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-003-3 Ratio of errors for overlapping segment eff/end dates [RULE-2636] to all active MANAGED-CARE-SERVICE-AREA (MCR00004) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-004-4 Ratio of errors for overlapping segment eff/end dates [RULE-2659] to all active MANAGED-CARE-OPERATING-AUTHORITY (MCR00005) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-005-5 Ratio of errors for overlapping segment eff/end dates [RULE-2680] to all active MANAGED-CARE-PLAN-POPULATION-ENROLLED (MCR00006) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-006-6 Ratio of errors for overlapping segment eff/end dates [RULE-2701] to all active MANAGED-CARE-ACCREDITATION-ORGANIZATION (MCR00007) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-007-7 Ratio of errors for overlapping segment eff/end dates [RULE-2726] to all active NATIONAL-HEALTH-CARE-ENTITY-ID-INFO (MCR00008) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
MCR-58-008-8 Ratio of errors for overlapping segment eff/end dates [RULE-2750] to all active CHPID-SHPID-RELATIONSHIPS (MCR00009) segments across all reporting and coverage periods N/A MCR N/A N/A N/A N/A N/A
PRV-5-001-1 Ratio of errors for overlapping segment eff/end dates [RULE-2793] to all active PROV-ATTRIBUTES-MAIN (PRV00002) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-002-2 Ratio of errors for overlapping segment eff/end dates [RULE-2841] to all active PROV-LOCATION-AND-CONTACT-INFO (PRV00003) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-003-3 Ratio of errors for overlapping segment eff/end dates [RULE-2878] to all active PROV-LICENSING-INFO (PRV00004) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-004-4 Ratio of errors for overlapping segment eff/end dates [RULE-2911] to all active PROV-IDENTIFIERS (PRV00005) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-005-5 Ratio of errors for overlapping segment eff/end dates [RULE-2932] to all active PROV-TAXONOMY-CLASSIFICATION (PRV00006) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-006-6 Ratio of errors for overlapping segment eff/end dates [RULE-2950] to all active PROV-MEDICAID-ENROLLMENT (PRV00007) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-007-7 Ratio of errors for overlapping segment eff/end dates [RULE-2974] to all active PROV-AFFILIATED-GROUPS (PRV00008) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-008-8 Ratio of errors for overlapping segment eff/end dates [RULE-2996] to all active PROV-AFFILIATED-PROGRAMS (PRV00009) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
PRV-5-009-9 Ratio of errors for overlapping segment eff/end dates [RULE-3016] to all active PROV-BED-TYPE-INFO (PRV00010) segments across all reporting and coverage periods N/A PRV N/A N/A N/A N/A N/A
TPL-8-001-1 Ratio of errors for overlapping segment eff/end dates [RULE-3070] to all active TPL-MEDICAID-ELIGIBLE-PERSON-MAIN (TPL00002) segments across all reporting and coverage periods N/A TPL N/A N/A N/A N/A N/A
TPL-8-002-2 Ratio of errors for overlapping segment eff/end dates [RULE-3103] to all active TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO (TPL00003) segments across all reporting and coverage periods N/A TPL N/A N/A N/A N/A N/A
TPL-8-003-3 Ratio of errors for overlapping segment eff/end dates [RULE-3127] to all active TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES (TPL00004) segments across all reporting and coverage periods N/A TPL N/A N/A N/A N/A N/A
TPL-8-004-4 Ratio of errors for overlapping segment eff/end dates [RULE-3148] to all active TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION (TPL00005) segments across all reporting and coverage periods N/A TPL N/A N/A N/A N/A N/A
TPL-8-005-5 Ratio of errors for overlapping segment eff/end dates [RULE-3176] to all active TPL-ENTITY-CONTACT-INFORMATION (TPL00006) segments across all reporting and coverage periods N/A TPL N/A N/A N/A N/A N/A
ALL-12-001-1 % of claim headers with PROGRAM TYPE = 01, 02, or 04 (EPSDT, family planning, or FQHC) Medium COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original Non-Crossover Utilization N/A
ALL-13-001-1 % of MSIS IDs limited to family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning services (PROGRAM-TYPE not equal 2) High Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Beneficiary eligibility N/A
ALL-13-002-2 % of MSIS IDs limited to family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning services (PROGRAM-TYPE not equal 2) High Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Beneficiary eligibility N/A
ALL-13-003-3 % of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services N/A Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators N/A N/A
ALL-13-004-4 % of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with non-emergency room services N/A Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators N/A N/A
EL-16-008-8 % of ELG00016 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-16-009-9 % of ELG00021 record segments with a missing MSIS ID N/A ELG N/A N/A N/A N/A N/A
EL-17-001-1 % of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on PRIMARY-DEMOGRAPHICS-ELIGIBILITY-ELG00002 for the same month N/A ELG N/A N/A N/A N/A N/A
EL-17-002-2 % of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on VARIABLE-DEMOGRAPHICS-ELIGIBILITY-ELG00003 for the same month N/A ELG N/A N/A N/A N/A N/A
EL-17-003-3 % of MSIS IDs reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on ELIGIBLITY-DETERMINANTS-ELG00005 for the same month N/A ELG N/A N/A N/A N/A N/A
EL-3-000-12 % of MSIS IDs without a valid Eligibility Group N/A ELG N/A N/A N/A N/A N/A
EL-3-001_2-14 % of MSIS IDs with more than one primary segment (PRIMARY-ELIGIBILITY-GROUP-IND = 1) N/A ELG N/A N/A N/A N/A N/A
EL-3-002_2-31 % of MSIS IDs with CHIP-CODE = 1 (Medicaid) that have ENROLLMENT-TYPE = 2 (Separate Title XXI CHIP) N/A ELG N/A N/A N/A N/A N/A
EL-3-002_3-16 % of MSIS IDs with CHIP-CODE = 2 (M-CHIP) that have ENROLLMENT-TYPE = 2 (Separate Title XXI CHIP) N/A ELG N/A N/A N/A N/A N/A
EL-3-002_4-32 % of MSIS IDs with CHIP-CODE = 3 (S-CHIP) that have ENROLLMENT-TYPE = 1 (Medicaid or M-CHIP) N/A ELG N/A N/A N/A N/A N/A
EL-6-022-22 Family Planning (FP): % MSIS IDs with FP-waivers (WAIVER TYPE = 24) that have RESTRICTED-BENEFIT-CODE = 6 (FP) N/A ELG N/A N/A N/A N/A N/A
EL-6-025-25 % family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning eligibility group N/A ELG N/A N/A N/A N/A N/A
EL-3-012-17 % of M-CHIP and S-CHIP eligibles with a non-CHIP eligibility group N/A ELG N/A N/A N/A N/A N/A
EL-3-013-18 % of Medicaid MSIS IDs with a CHIP Eligibility Group High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-028-28 % of record segments with an invalid waiver ID format for 1115 waivers (WAIVER-TYPE = 01 or 21 - 30) N/A ELG N/A N/A N/A N/A N/A
EXP-22-009-9 01/30/2026 % of records with Payment or Recoupment Amount = $0 or missing High FTX N/A Original All Indicators Expenditures N/A
EXP-24-009-9 01/30/2026 % of records with Payment or Recoupment Amount = $0 or missing High FTX N/A Original All Indicators Expenditures N/A
FFS-49-001-1 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CIP Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-002-2 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CLT Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
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 N/A COT Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-004-4 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CRX Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-005-5 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High CIP Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
FFS-49-006-6 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High CLT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
FFS-49-007-7 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High COT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
FFS-49-008-8 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount N/A CRX Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-009-9 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount Medium CIP Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
FFS-49-010-10 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount Medium CLT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
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 High COT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
FFS-49-012-12 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount N/A CRX Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
MCR-59-001-1 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CIP Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59-002-2 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CLT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
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 N/A COT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59-004-4 % of claim headers where the sum of Medicaid Paid Amount from the lines does not equal Total Medicaid Paid Amount from the header N/A CRX Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59-005-5 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High CIP Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-006-6 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High CLT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-007-7 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount High COT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-008-8 % of claim headers that have Total Medicaid Paid Amount greater than a non-zero Total Allowed Amount N/A CRX Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59-009-9 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount Medium CIP Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-010-10 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount Medium CLT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
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 High COT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-012-12 % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount N/A CRX Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MIS-13-001-1 % missing: TYPE-OF-CLAIM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
MIS-15-001-1 % missing: TYPE-OF-CLAIM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
MIS-17-001-1 % missing: TYPE-OF-CLAIM (COT00002) N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
MIS-19-001-1 % missing: TYPE-OF-CLAIM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
MIS-2-039_1-57 % missing: PAYMENT-LEVEL-IND (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-22-001-1 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-001-1 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-001-1 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-001-1 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-29-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
MIS-29-002-2 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
MIS-30-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
MIS-30-002-2 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
MIS-30-003-3 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
MIS-4-032_1-44 % missing: PAYMENT-LEVEL-IND (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-002-20 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-024_1-35 % missing: PAYMENT-LEVEL-IND (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-027_1-36 % missing: TOT-BILLED-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-002-32 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
ALL-13-003-5 % of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related Medium Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Beneficiary eligibility N/A
ALL-13-004-6 % of MSIS IDs with alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) with services that are not emergency room or pregnancy-related N/A Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators N/A N/A
ALL-14-001-1 % of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Admission Date High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-002-2 % of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Beginning Date of Service High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-003-3 % of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Beginning Date of Service High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-004-4 % of MSIS IDs on crossover claim headers not enrolled as duals (QMB, QMB Plus, SLMB Plus, Other) on Prescription Fill Date High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-005-5 % of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Admission Date High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-006-6 % of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Beginning Date of Service High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-007-7 % of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Beginning Date of Service High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-14-008-8 % of MSIS IDs on crossover claim headers enrolled as premium only dual groups (SLMB, QI, QDWI) on Prescription Fill Date High Multiple Files Medicaid,FFS or Medicaid,Enc All Adjustment Types Crossover Beneficiary eligibility N/A
ALL-15-001-1 % of claim lines with non-missing Place of Service that have missing Procedure Code N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-15-002-2 % of claim lines with both Type of Bill and Place of Service non-missing High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
ALL-16-001-1 % of claim header record segments missing ADJUDICATION-DATE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-002-2 % of claim line record segments missing ADJUDICATION-DATE (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-003-3 % of claim header record segments missing ADJUDICATION-DATE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-004-4 % of claim line record segments missing ADJUDICATION-DATE (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-005-5 % of claim header record segments missing ADJUDICATION-DATE (COT00002) N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-006-6 % of claim line record segments missing ADJUDICATION-DATE (COT00003) N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-007-7 % of claim header record segments missing ADJUDICATION-DATE (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-008-8 % of claim line record segments missing ADJUDICATION-DATE (CRX00003) N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EL-3-014-19 % of MSIS IDs with ELIGIBILITY-GROUP = 72 (adult group - newly eligible for all states) if the state reported MBES enrollment for this group High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-015-20 % of MSIS IDs with ELIGIBILITY-GROUP = 73 (adult group - not newly eligible for non 1905z(3) states) if the state reported MBES enrollment for this group N/A ELG N/A N/A N/A N/A N/A
EL-3-016-21 % of MSIS IDs with ELIGIBILITY-GROUP = 74 or 75 (adult group - not newly eligible in 1905z(3) states) if the state reported MBES enrollment for these groups N/A ELG N/A N/A N/A N/A N/A
EL-3-017-22 % of MSIS IDs with ELIGIBILITY-GROUP = 72 (adult group - newly eligible for all states) if the state did not report MBES enrollment for this group High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
EL-3-018-23 % of MSIS IDs with ELIGIBILITY-GROUP = 73 (adult group - not newly eligible for non 1905z(3) states) if the state did not report MBES enrollment for this group N/A ELG N/A N/A N/A N/A N/A
EL-3-019-24 % of MSIS IDs with ELIGIBILITY-GROUP = 74 or 75 (adult group - not newly eligible in 1905z(3) states) if the state did not report MBES enrollment for these groups N/A ELG N/A N/A N/A N/A N/A
EL-6-026-26 % of RBC duals (RESTRICTED-BENEFITS-CODE = 3 or G) without a partial dual code (DUAL-ELIGIBLE-CODE not 01, 03, 05, 06) N/A ELG N/A N/A N/A N/A N/A
EL-6-027-27 % of partial duals (DUAL-ELIGIBLE-CODE = 01, 03, 05, 06) without an RBC of dual (RESTRICTED-BENEFITS-CODE not 3 or G) N/A ELG N/A N/A N/A N/A N/A
FFS-50-001-1 % of claim headers that have an invalid Billing Provider Taxonomy N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-002-2 % of claim headers that have an invalid Billing Provider Taxonomy N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-003-3 % of claim headers that have an invalid Billing Provider Taxonomy N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-004-4 % of records that have an invalid BILLING-PROV-TAXONOMY N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-005-5 % of claim headers with Billing Provider NPI Number in an invalid format N/A CIP Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-006-6 % of claim headers with Billing Provider NPI Number in an invalid format N/A CLT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-007-7 % of claim headers with Billing Provider NPI Number in an invalid format N/A COT Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-50-008-8 % of claim headers with Billing Provider NPI Number in an invalid format N/A CRX Medicaid,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-001-1 % of claim headers that have an invalid Billing Provider Taxonomy N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-002-2 % of claim headers that have an invalid Billing Provider Taxonomy N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-003-3 % of claim headers that have an invalid Billing Provider Taxonomy N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-004-4 % of records that have an invalid BILLING-PROV-TAXONOMY N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-005-5 % of claim headers with Billing Provider NPI Number in an invalid format N/A CIP CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-006-6 % of claim headers with Billing Provider NPI Number in an invalid format N/A CLT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-007-7 % of claim headers with Billing Provider NPI Number in an invalid format N/A COT CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-51-008-8 % of claim headers with Billing Provider NPI Number in an invalid format N/A CRX CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-52-001-1 % of claim headers where BILLING-PROV-TAXONOMY does not begin with 27 or 28 High CIP Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
FFS-52-002-2 % of claim headers where BILLING-PROV-TAXONOMY does not begin with 283Q, 283X, 282E, 31, 32, 385H, or 281P High CLT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
FFS-52-003-3 % of claims where BILLING-PROV-TAXONOMY does not begin with 18 OR 33 N/A CRX Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators N/A N/A
FFS-52-004-4 % of claim lines with revenue codes that are accommodation revenue codes High COT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Utilization N/A
FFS-52-005-5 % of claim headers where TYPE-OF-BILL does not begin with 011 (inpatient hospital) High CIP Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Utilization N/A
FFS-52-006-6 % of claim headers where TYPE-OF-BILL does not begin with 02 (nursing facility) or 06 (ICF) High CLT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Utilization N/A
FFS-52-007-7 % of claim lines where TYPE-OF-BILL does not begin with 03, 07, 08, 012, 013, 014, 022, 023, 024 High COT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Utilization N/A
MCR-60-001-1 % of claim headers that have an invalid Billing Provider Taxonomy N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-002-2 % of claim headers that have an invalid Billing Provider Taxonomy N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-003-3 % of claim headers that have an invalid Billing Provider Taxonomy N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-004-4 % of records that have an invalid BILLING-PROV-TAXONOMY N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-005-5 % of claim headers with Billing Provider NPI Number in an invalid format N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-006-6 % of claim headers with Billing Provider NPI Number in an invalid format N/A CLT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-007-7 % of claim headers with Billing Provider NPI Number in an invalid format N/A COT Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-60-008-8 % of claim headers with Billing Provider NPI Number in an invalid format N/A CRX Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-001-1 % of claim headers that have an invalid Billing Provider Taxonomy N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-002-2 % of claim headers that have an invalid Billing Provider Taxonomy N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-003-3 % of claim headers that have an invalid Billing Provider Taxonomy N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-004-4 % of records that have an invalid BILLING-PROV-TAXONOMY N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-005-5 % of claim headers with Billing Provider NPI Number in an invalid format N/A CIP CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-006-6 % of claim headers with Billing Provider NPI Number in an invalid format N/A CLT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-007-7 % of claim headers with Billing Provider NPI Number in an invalid format N/A COT CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-61-008-8 % of claim headers with Billing Provider NPI Number in an invalid format N/A CRX CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-62-001-1 % of claim headers where BILLING-PROV-TAXONOMY does not begin with 27 or 28 High CIP Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
MCR-62-002-2 % of claim headers where BILLING-PROV-TAXONOMY does not begin with 283Q, 283X, 282E, 31, 32, 385H, or 281P High CLT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
MCR-62-003-3 % of claims where BILLING-PROV-TAXONOMY does not begin with 18 or 33 N/A CRX Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators N/A N/A
MCR-62-004-4 % of claim lines with revenue codes that are accommodation revenue codes High COT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Utilization Managed care
MCR-62-005-5 % of claim headers where TYPE-OF-BILL does not begin with 011 (inpatient hospital) High CIP Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Utilization Managed care
MCR-62-006-6 % of claim headers where TYPE-OF-BILL does not begin with 02 (nursing facility) or 06 (ICF) High CLT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Utilization Managed care
MCR-62-007-7 % of claim lines where TYPE-OF-BILL does not begin with 03, 07, 08, 012, 013, 014, 022, 023, 024 High COT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Utilization Managed care
MIS-2-009_1-59 % missing: BILLING-PROV-TAXONOMY (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-032_1-58 % missing: MEDICAID-PAID-DATE (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-40-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS Original and Replacement All Indicators N/A N/A
MIS-4-008_1-46 % missing: BILLING-PROV-TAXONOMY (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-025_1-45 % missing: MEDICAID-PAID-DATE (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-42-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS Original and Replacement All Indicators N/A N/A
MIS-44-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT Medicaid,FFS Original and Replacement All Indicators N/A N/A
MIS-46-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX Medicaid,FFS Original and Replacement All Indicators N/A N/A
MIS-48-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-50-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-52-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-54-001-1 % missing: MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-6-008_1-38 % missing: BILLING-PROV-TAXONOMY (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-021_1-37 % missing: MEDICAID-PAID-DATE (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-015_1-34 % missing: MEDICAID-PAID-DATE (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
PRV-2-009-9 % of Submitting State Provider IDs with PROV-IDENTIFIER-TYPE = 2 (NPI) that don't have any PROV-CLASSIFICATION-TYPE = 1 (taxonomy) High PRV N/A N/A N/A Provider characteristics N/A
MCR-20-005-9 % of records with TYPE-OF-SERVICE = 36 (Medical equipment/prosthetic devices) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-006-10 % of records with TYPE-OF-SERVICE = 85 (Prenatal care and pre-pregnancy family planning services and supplies.) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-20-007-11 % of records with TYPE-OF-SERVICE = 89 (Disposable medical supplies.) N/A CRX CHIP,Enc Original All Indicators N/A N/A
MCR-7-006-21 % of claim headers with home Patient Status N/A CLT CHIP,Enc Original Non-Crossover N/A N/A
ALL-15-003-3 % of claim lines missing Type of Bill and Place of Service N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-15-004-4 % of claim lines with non-missing Type of Bill that have missing Revenue Code N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-15-005-5 % of claim lines with non-missing Revenue Code that have missing Type of Bill N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-15-006-6 % of claim lines missing Procedure Code and Revenue Code N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-17-001-1 % of claim headers that have no corresponding claim lines N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-002-2 % of claim headers that have no corresponding claim lines N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-003-3 % of claim headers that have no corresponding claim lines N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-004-4 % of claim headers that have no corresponding claim lines N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-005-5 % of claim lines that have no corresponding claim header N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-006-6 % of claim lines that have no corresponding claim header N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-007-7 % of claim lines that have no corresponding claim header N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-17-008-8 % of claim lines that have no corresponding claim header N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-18-001-1 # of claim headers with TYPE-OF-CLAIM = U, V, W, X or Y that aren’t MFP (PROGRAM-TYPE = 08) High CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
ALL-18-002-2 # of claim headers with TYPE-OF-CLAIM = U, V, W, X or Y that aren’t MFP (PROGRAM-TYPE = 08) High CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
ALL-18-003-3 # of claim headers with TYPE-OF-CLAIM = U, V, W, X or Y that aren’t MFP (PROGRAM-TYPE = 08) High COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
ALL-18-004-4 # of claim headers with TYPE-OF-CLAIM = U, V, W, X or Y that aren’t MFP (PROGRAM-TYPE = 08) High CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
ALL-2-009-9 % of 1915(c) waiver enrollees (WAIVER-TYPE = 06 - 20 or 33) that do not have any claim headers with the corresponding waiver ID High Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Program participation N/A
ALL-2-010-10 % of 1915(c) waiver enrollees (WAIVER-TYPE = 06 - 20 or 33) that do not have any claim headers with PROGRAM-TYPE = 07 High Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Program participation N/A
ALL-2-011-11 % of 1915(c) waiver enrollees (WAIVER-TYPE = 06 - 20 or 33) that do not have any claim headers with HCBS-SERVICE-CODE = 4 High Multiple Files Medicaid,FFS or Medicaid,Enc Original All Indicators Program participation N/A
EL-6-029-29 % of record segments with an invalid waiver ID format for 1915(b) and 1915(c) waivers (WAIVER-TYPE = 02 - 20, 32, or 33) N/A ELG N/A N/A N/A N/A N/A
MIS-1-001-1 % distinct MSIS IDs with only missing values in any active segment: DATE-OF-BIRTH (ELG00002) N/A ELG N/A N/A N/A N/A N/A
MIS-1-006-6 % distinct MSIS IDs with only missing values in any active segment: SEX (ELG00002) High ELG N/A N/A N/A Beneficiary demographics N/A
EL-3-020-25 % of MSIS IDs in M-CHIP reported without an M-CHIP Eligibility Group High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-021-26 % of MSIS IDs in S-CHIP reported without an S-CHIP Eligibility Group High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-022-27 # of distinct mandatory eligibility group values populated for children, pregnant women, caretakers, and foster children (ELIGIBILITY-GROUP = 01, 05, 06, 07, 08 or 09) High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-023-28 # of distinct mandatory eligibility group values populated for transitional medical assistance (ELIGIBILITY-GROUP = 02 or 03) High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-024-29 # of distinct mandatory eligibility group values populated for duals (ELIGIBILITY-GROUP = 23, 24, 25, 26) High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-025-30 # of distinct mandatory eligibility group values for SSI or ABD individuals (ELIGIBILITY-GROUP = 11 or 12) High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-1-020-20 % distinct MSIS IDs with only missing values in any active segment: ELIGIBLE-COUNTY-CODE (ELG00004) N/A ELG N/A N/A N/A N/A N/A
MIS-1-021-21 % distinct MSIS IDs with only missing values in any active segment: ELIGIBLE-ZIP-CODE (ELG00004) N/A ELG N/A N/A N/A N/A N/A
ALL-19-001-1 % of claim headers with HCBS-SERVICE-CODE = 4 that are missing Waiver ID N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-20-001-1 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
ALL-20-002-2 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
ALL-20-003-3 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
ALL-20-004-4 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
EL-1-012_1-27 % of MSIS IDs with AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = 1 but do not have RACE = 003 (American Indian or Alaskan Native) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-015_1-25 % of MSIS IDs with an IMMIGRATION-STATUS = 8 (U.S. Citizen) but CITIZENSHIP-IND does not equal 1 N/A ELG N/A N/A N/A N/A N/A
EL-1-015_2-26 % of MSIS IDs with CITIZENSHIP-IND = 1 but IMMIGRATION-STATUS does not equal 8 (U.S. Citizen) N/A ELG N/A N/A N/A N/A N/A
EL-1-022-22 % of MSIS IDs without a primary address (ELIGIBLE-ADDR-TYPE not equal 1) High ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-023-23 % of MSIS IDs in which the primary home address county code, zip code, or state is not in-state High ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-024-24 % of MSIS IDs in which a non-primary home address county code, zip code, or state is not in-state N/A ELG N/A N/A N/A N/A N/A
EL-1-025-28 % of MSIS IDs where county code or zip code does not align with address state N/A ELG N/A N/A N/A N/A N/A
MIS-1-032-32 % distinct MSIS IDs with only missing values in any active segment: RESTRICTED-BENEFITS-CODE (ELG00005) N/A ELG N/A N/A N/A N/A N/A
MIS-1-092-92 % distinct MSIS IDs with only missing values in any active segment: ENROLLMENT-TYPE (ELG00021) N/A ELG N/A N/A N/A N/A N/A
EL-6-030-30 % of MSIS IDs with S-CHIP dental coverage (RESTRICTED-BENEFITS-CODE = C) that are not S-CHIP (CHIP-CODE not 3) High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-031-31 % of MFP participants that do not have restricted benefits code designating MFP participation (RESTRICTED-BENEFITS-CODE not D) High ELG N/A N/A N/A Program participation N/A
EL-6-032-32 % of MSIS IDs with restricted benefits code designating MFP participation (RESTRICTED-BENEFITS-CODE = D) that are not found on MFP-INFORMATION-ELG00010 for the same month N/A ELG N/A N/A N/A N/A N/A
EL-6-033-33 % of MSIS IDs with an alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) but a non-qualified alien immigration status (IMMIGRATION-STATUS not 1, 2, or 3) N/A ELG N/A N/A N/A N/A N/A
EL-6-034-34 % of MSIS IDs with an alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) but CITIZENSHIP-IND = 1 N/A ELG N/A N/A N/A N/A N/A
FFS-53-001-1 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CIP Medicaid,FFS or CHIP,FFS All Adjustment Types Non-Crossover N/A N/A
FFS-53-002-2 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CLT Medicaid,FFS or CHIP,FFS All Adjustment Types Non-Crossover N/A N/A
FFS-53-003-3 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A COT Medicaid,FFS or CHIP,FFS All Adjustment Types Non-Crossover N/A N/A
FFS-53-004-4 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CRX Medicaid,FFS or CHIP,FFS All Adjustment Types Non-Crossover N/A N/A
FFS-54-001-1 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CIP Medicaid,FFS or CHIP,FFS All Adjustment Types Crossover N/A N/A
FFS-54-002-2 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CLT Medicaid,FFS or CHIP,FFS All Adjustment Types Crossover N/A N/A
FFS-54-003-3 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A COT Medicaid,FFS or CHIP,FFS All Adjustment Types Crossover N/A N/A
FFS-54-004-4 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CRX Medicaid,FFS or CHIP,FFS All Adjustment Types Crossover N/A N/A
MCR-63-001-1 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CIP Medicaid,Enc or CHIP,Enc All Adjustment Types Non-Crossover N/A N/A
MCR-63-002-2 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CLT Medicaid,Enc or CHIP,Enc All Adjustment Types Non-Crossover N/A N/A
MCR-63-003-3 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A COT Medicaid,Enc or CHIP,Enc All Adjustment Types Non-Crossover N/A N/A
MCR-63-004-4 % of non-crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement Non-Crossover N/A N/A
MCR-64-001-1 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CIP Medicaid,Enc or CHIP,Enc All Adjustment Types Crossover N/A N/A
MCR-64-002-2 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CLT Medicaid,Enc or CHIP,Enc All Adjustment Types Crossover N/A N/A
MCR-64-003-3 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A COT Medicaid,Enc or CHIP,Enc All Adjustment Types Crossover N/A N/A
MCR-64-004-4 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CRX Medicaid,Enc or CHIP,Enc All Adjustment Types Crossover N/A N/A
MIS-2-004_1-60 % missing: ADMITTING-PROV-NPI-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-004_2-61 % missing: ADMITTING-PROV-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-047_1-62 % missing: REFERRING-PROV-NPI-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-2-047_2-63 % missing: REFERRING-PROV-NUM (CIP00002) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-001_1-18 % missing: ALLOWED-AMT (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-3-009_1-19 % missing: OPERATING-PROV-NPI-NUM (CIP00003) N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-002_1-47 % missing: ADMITTING-PROV-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-002-2 % missing: ADMITTING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-034_1-48 % missing: REFERRING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-4-034_2-49 % missing: REFERRING-PROV-NUM (CLT00002) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-5-001_1-21 % missing: ALLOWED-AMT (CLT00003) N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-027_2-39 % missing: TOT-ALLOWED-AMT (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-027_3-40 % missing: REFERRING-PROV-NPI-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-027_4-41 % missing: REFERRING-PROV-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-7-001_1-33 % missing: ALLOWED-AMT (COT00003) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-8-012_1-35 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NUM (CRX00002) N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
ALL-21-001-1 % of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Admission Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-002-2 % of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-003-3 % of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-004-4 % of BILLING-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Prescription Fill Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-005-5 % of SERVICING-PROV-NUM on claim lines that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-006-6 % of SERVICING-PROV-NUM on claim lines that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-007-7 % of SERVICING-PROV-NUM on claim lines that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-21-008-8 % of DISPENSING-PRESCRIPTION-DRUG-PROV-NUM on claim headers that do not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Prescription Fill Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-22-001-1 Type of Claim values N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-23-001-1 Type of Claim values N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-24-001-1 Type of Claim values N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-25-001-1 Type of Claim values N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EXP-43-001-1 # of non-service tracking claim headers with non-missing Service Tracking Type N/A CIP N/A All Adjustment Types All Indicators N/A N/A
EXP-43-002-2 # of non-service tracking claim headers with non-missing Service Tracking Type N/A CLT N/A All Adjustment Types All Indicators N/A N/A
EXP-43-003-3 # of non-service tracking claim headers with non-missing Service Tracking Type N/A COT N/A All Adjustment Types All Indicators N/A N/A
EXP-43-004-4 # of non-service tracking claim headers with non-missing Service Tracking Type N/A CRX N/A All Adjustment Types All Indicators N/A N/A
EXP-43-005-5 # of non-service tracking claim headers with non-missing Service Tracking Payment Amount N/A CIP N/A All Adjustment Types All Indicators N/A N/A
EXP-43-006-6 # of non-service tracking claim headers with non-missing Service Tracking Payment Amount N/A CLT N/A All Adjustment Types All Indicators N/A N/A
EXP-43-007-7 # of non-service tracking claim headers with non-missing Service Tracking Payment Amount N/A COT N/A All Adjustment Types All Indicators N/A N/A
EXP-43-008-8 # of non-service tracking claim headers with non-missing Service Tracking Payment Amount N/A CRX N/A All Adjustment Types All Indicators N/A N/A
EXP-44-001-1 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
EXP-44-002-2 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
EXP-44-003-3 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
EXP-44-004-4 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CRX Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
EXP-45-001-1 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A CIP Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EXP-45-002-2 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A CLT Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EXP-45-003-3 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A COT Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EXP-45-004-4 01/30/2026 % of MSIS IDs with any enrollment time span Critical Multiple Files Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
EXP-45-005-5 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EXP-45-006-6 % of MSIS IDs with any enrollment time span N/A Multiple Files Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
MIS-55-001-1 % missing: ADMISSION-DATE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-55-002-2 % missing: DISCHARGE-DATE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-55-003-3 % missing: SERVICE-TRACKING-PAYMENT-AMT (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-55-004-4 % missing: SERVICE-TRACKING-TYPE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-57-001-1 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-57-002-2 % missing: ENDING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-57-003-3 % missing: SERVICE-TRACKING-PAYMENT-AMT (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-57-004-4 % missing: SERVICE-TRACKING-TYPE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-58-001-1 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-58-002-2 % missing: ENDING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-59-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-59-002-2 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-59-003-3 % missing: SERVICE-TRACKING-PAYMENT-AMT (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-59-004-4 % missing: SERVICE-TRACKING-TYPE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-60-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-60-002-2 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-61-001-1 % missing: SERVICE-TRACKING-PAYMENT-AMT (CRX00002) N/A CRX Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-61-002-2 % missing: SERVICE-TRACKING-TYPE (CRX00002) N/A CRX Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
MIS-64-001-1 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP Medicaid,Serv Non-void All Indicators N/A N/A
MIS-66-001-1 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv Non-void All Indicators N/A N/A
MIS-68-001-1 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT Medicaid,Serv Non-void All Indicators N/A N/A
MIS-70-001-1 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX Medicaid,Serv Non-void All Indicators N/A N/A
MIS-72-001-1 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP CHIP,Serv Non-void All Indicators N/A N/A
MIS-74-001-1 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT CHIP,Serv Non-void All Indicators N/A N/A
MIS-76-001-1 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT CHIP,Serv Non-void All Indicators N/A N/A
MIS-78-001-1 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX CHIP,Serv Non-void All Indicators N/A N/A
PRV-2-010-10 % of Submitting State Provider IDs (FACILITY-GROUP-INDIVIDUAL-CODE = 03) with more than one NPI (PROV-IDENTIFIER-TYPE = 2) (across all time) N/A PRV N/A N/A N/A N/A N/A
RULE-1337 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service N/A Multiple Files N/A Non-void All Indicators N/A N/A
RULE-1341 % of claim headers with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1343 % of claim headers with invalid Diagnosis Code 1 N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators N/A N/A
RULE-1347 % of claim headers with invalid Diagnosis Code 2 N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators N/A N/A
RULE-1371 % of claim headers with invalid Type of Bill Medium COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators Utilization N/A
RULE-1634 % of claim lines with invalid Procedure Code Medium COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators Utilization N/A
RULE-2135 % of record segments with an invalid Eligibility Group Critical ELG N/A N/A N/A File integrity Enrollment monitoring
RULE-2806 % of PRV00002 segments for individuals (FACILITY-GROUP-INDIVIDUAL-CODE = 03) with missing or invalid Provider First Name Medium PRV N/A N/A N/A Provider identifiers N/A
RULE-2809 % of PRV00002 segments for non-individuals (FACILITY-GROUP-INDIVIDUAL-CODE <> 03) with non-missing Provider Middle Name Medium PRV N/A N/A N/A Provider identifiers N/A
RULE-2810 % of PRV00002 segments for individuals (FACILITY-GROUP-INDIVIDUAL-CODE = 03) with missing or invalid Provider Last Name Medium PRV N/A N/A N/A Provider identifiers N/A
RULE-2813 % of PRV00002 segments for individuals (FACILITY-GROUP-INDIVIDUAL-CODE = 03) with missing or invalid Sex Medium PRV N/A N/A N/A Provider identifiers N/A
RULE-2928 % of PRV00006 segments with invalid Provider Classification Code for Provider Classification Type Medium PRV N/A N/A N/A Provider identifiers N/A
RULE-347 % of claim headers with invalid Diagnosis Code 1 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-351 % of claim headers with invalid Diagnosis Code 2 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-357 % of claim headers with invalid Diagnosis Code 3 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-405 % of claim headers with invalid Diagnosis Code 12 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-896 % of claim headers with invalid Diagnosis Code 2 N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-26-001-1 % of claim headers with PAYMENT-LEVEL-IND = 1 N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-26-002-2 % of claim headers with PAYMENT-LEVEL-IND = 1 N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-26-003-3 % of claim headers with PAYMENT-LEVEL-IND = 1 N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-26-004-4 % of claim headers with PAYMENT-LEVEL-IND = 1 N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-27-001-1 # of Medicaid service tracking claim headers (TYPE-OF-CLAIM = 4) N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-27-002-2 # of Medicaid supplemental claim headers (TYPE-OF-CLAIM = 5) N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-28-001-1 Type of Service values N/A CIP Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-29-001-1 Type of Service values N/A CLT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-30-001-1 Type of Service values N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-31-001-1 Type of Service values N/A CRX Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-32-001-1 Type of Bill values N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
ALL-33-001-1 Billing Provider Taxonomy values N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-2028 Ratio of errors for overlapping segment eff/end dates [RULE-2028] to all active PRIMARY-DEMOGRAPHICS-ELIGIBILITY (ELG00002) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2071 Ratio of errors for overlapping segment eff/end dates [RULE-2071] to all active VARIABLE-DEMOGRAPHICS-ELIGIBILITY (ELG00003) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2105 Ratio of errors for overlapping segment eff/end dates [RULE-2105] to all active ELIGIBLE-CONTACT-INFORMATION (ELG00004) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2165 Ratio of errors for overlapping segment eff/end dates [RULE-2165] to all active ELIGIBILITY-DETERMINANTS (ELG00005) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2188 Ratio of errors for overlapping segment eff/end dates [RULE-2188] to all active HEALTH-HOME-SPA-PARTICIPATION-INFORMATION (ELG00006) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2217 Ratio of errors for overlapping segment eff/end dates [RULE-2217] to all active HEALTH-HOME-SPA-PROVIDERS (ELG00007) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2241 Ratio of errors for overlapping segment eff/end dates [RULE-2241] to all active HEALTH-HOME-CHRONIC-CONDITIONS (ELG00008) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2263 Ratio of errors for overlapping segment eff/end dates [RULE-2263] to all active LOCK-IN-INFORMATION (ELG00009) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2289 Ratio of errors for overlapping segment eff/end dates [RULE-2289] to all active MFP-INFORMATION (ELG00010) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2313 Ratio of errors for overlapping segment eff/end dates [RULE-2313] to all active STATE-PLAN-OPTION-PARTICIPATION (ELG00011) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2338 Ratio of errors for overlapping segment eff/end dates [RULE-2338] to all active WAIVER-PARTICIPATION (ELG00012) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2361 Ratio of errors for overlapping segment eff/end dates [RULE-2361] to all active LTSS-PARTICIPATION (ELG00013) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2392 Ratio of errors for overlapping segment eff/end dates [RULE-2392] to all active MANAGED-CARE-PARTICIPATION (ELG00014) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2413 Ratio of errors for overlapping segment eff/end dates [RULE-2413] to all active ETHNICITY-INFORMATION (ELG00015) segments Critical ELG N/A N/A N/A File integrity Race/ethnicity
RULE-2438 Ratio of errors for overlapping segment eff/end dates [RULE-2438] to all active RACE-INFORMATION (ELG00016) segments Critical ELG N/A N/A N/A File integrity Race/ethnicity
RULE-2458 Ratio of errors for overlapping segment eff/end dates [RULE-2458] to all active DISABILITY-INFORMATION (ELG00017) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2478 Ratio of errors for overlapping segment eff/end dates [RULE-2478] to all active 1115A-DEMONSTRATION-INFORMATION (ELG00018) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2498 Ratio of errors for overlapping segment eff/end dates [RULE-2498] to all active HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME (ELG00020) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2519 Ratio of errors for overlapping segment eff/end dates [RULE-2519] to all active ENROLLMENT-TIME-SPAN-SEGMENT (ELG00021) segments Critical ELG N/A N/A N/A File integrity N/A
RULE-2578 Ratio of errors for overlapping segment eff/end dates [RULE-2578] to all active MANAGED-CARE-MAIN (MCR00002) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2598 Ratio of errors for overlapping segment eff/end dates [RULE-2598] to all active MANAGED-CARE-LOCATION-AND-CONTACT-INFO (MCR00003) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2636 Ratio of errors for overlapping segment eff/end dates [RULE-2636] to all active MANAGED-CARE-SERVICE-AREA (MCR00004) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2659 Ratio of errors for overlapping segment eff/end dates [RULE-2659] to all active MANAGED-CARE-OPERATING-AUTHORITY (MCR00005) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2680 Ratio of errors for overlapping segment eff/end dates [RULE-2680] to all active MANAGED-CARE-PLAN-POPULATION-ENROLLED (MCR00006) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2701 Ratio of errors for overlapping segment eff/end dates [RULE-2701] to all active MANAGED-CARE-ACCREDITATION-ORGANIZATION (MCR00007) segments Critical MCR N/A N/A N/A File integrity Managed care
RULE-2793 Ratio of errors for overlapping segment eff/end dates [RULE-2793] to all active PROV-ATTRIBUTES-MAIN (PRV00002) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2841 Ratio of errors for overlapping segment eff/end dates [RULE-2841] to all active PROV-LOCATION-AND-CONTACT-INFO (PRV00003) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2878 Ratio of errors for overlapping segment eff/end dates [RULE-2878] to all active PROV-LICENSING-INFO (PRV00004) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2911 Ratio of errors for overlapping segment eff/end dates [RULE-2911] to all active PROV-IDENTIFIERS (PRV00005) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2932 Ratio of errors for overlapping segment eff/end dates [RULE-2932] to all active PROV-TAXONOMY-CLASSIFICATION (PRV00006) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2950 Ratio of errors for overlapping segment eff/end dates [RULE-2950] to all active PROV-MEDICAID-ENROLLMENT (PRV00007) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2974 Ratio of errors for overlapping segment eff/end dates [RULE-2974] to all active PROV-AFFILIATED-GROUPS (PRV00008) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-2996 Ratio of errors for overlapping segment eff/end dates [RULE-2996] to all active PROV-AFFILIATED-PROGRAMS (PRV00009) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-3016 Ratio of errors for overlapping segment eff/end dates [RULE-3016] to all active PROV-BED-TYPE-INFO (PRV00010) segments Critical PRV N/A N/A N/A File integrity N/A
RULE-3070 Ratio of errors for overlapping segment eff/end dates [RULE-3070] to all active TPL-MEDICAID-ELIGIBLE-PERSON-MAIN (TPL00002) segments Critical TPL N/A N/A N/A File integrity N/A
RULE-3103 Ratio of errors for overlapping segment eff/end dates [RULE-3103] to all active TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO (TPL00003) segments Critical TPL N/A N/A N/A File integrity N/A
RULE-3127 Ratio of errors for overlapping segment eff/end dates [RULE-3127] to all active TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES (TPL00004) segments Critical TPL N/A N/A N/A File integrity N/A
RULE-3148 Ratio of errors for overlapping segment eff/end dates [RULE-3148] to all active TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION (TPL00005) segments Critical TPL N/A N/A N/A File integrity N/A
RULE-3176 Ratio of errors for overlapping segment eff/end dates [RULE-3176] to all active TPL-ENTITY-CONTACT-INFORMATION (TPL00006) segments Critical TPL N/A N/A N/A File integrity N/A
RULE-7183 % of duplicate claim headers Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7184 % of duplicate claim headers Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7185 % of duplicate claim headers Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7186 % of duplicate claim headers Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7187 % of duplicate claim lines Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7188 % of duplicate claim lines Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7189 % of duplicate claim lines Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7190 % of duplicate claim lines Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7447 % of record segments with missing Eligibility Group Critical ELG N/A N/A N/A File integrity Enrollment monitoring
RULE-1126 % of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-1211 % of claim lines with an invalid Line Adjustment Indicator (LINE-ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1246 % of claim headers with a Servicing Provider Number that is not found on the provider file during the dates of service Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-1540 % of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-1616 % of claim lines with an invalid Line Adjustment Indicator (LINE-ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1663 % of claim headers with a Servicing Provider Number that is not found on the provider file during the dates of service Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-1758 % of claim headers with an MSIS ID not enrolled on Prescription Fill Date N/A Multiple Files N/A Non-void All Indicators N/A N/A
RULE-1762 % of claim headers with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1845 % of claim headers with a Billing Provider Number that is not found on the provider file on the Prescription Fill Date Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-1916 % of claim lines with an invalid Line Adjustment Indicator (LINE-ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1964 % of claim headers with a Dispensing Provider Number that is not found on the provider file on the Prescription Fill Date Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-335 % of claim headers with an MSIS ID not enrolled on Admission Date N/A Multiple Files N/A Non-void All Indicators N/A N/A
RULE-340 % of claim headers with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-689 % of claim headers with a Billing Provider Number that is not found on the provider file during the dates of service Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-7464 % of claim headers with a missing Adjustment Indicator Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7465 % of claim headers with a missing Adjustment Indicator Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7466 % of claim headers with a missing Adjustment Indicator Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7467 % of claim headers with a missing Adjustment Indicator Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7468 % of claim lines with a missing Line Adjustment Indicator Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7469 % of claim lines with a missing Line Adjustment Indicator Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7470 % of claim lines with a missing Line Adjustment Indicator Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7471 % of claim lines with a missing Line Adjustment Indicator Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-774 % of claim lines with an invalid Line Adjustment Indicator (LINE-ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-810 % of claim headers with a Servicing Provider Number that is not found on the provider file during the dates of service Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Provider information N/A
RULE-884 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service N/A Multiple Files N/A Non-void All Indicators N/A N/A
RULE-888 % of claim headers with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1204 % of claim lines that have no corresponding claim header Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1610 % of claim lines that have no corresponding claim header Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1909 % of claim lines that have no corresponding claim header Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7431 % of claim headers that have no corresponding claim lines Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7432 % of claim headers that have no corresponding claim lines Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7433 % of claim headers that have no corresponding claim lines Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7434 % of claim headers that have no corresponding claim lines Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-768 % of claim lines that have no corresponding claim header Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-1948 % of claim lines with invalid Reason for Service component of the Drug Utilization Code Medium CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators Utilization N/A
RULE-2614 % of MCR00003 segments with an invalid Managed Care State Medium MCR N/A N/A N/A Managed care file Managed care
RULE-346 % of claim headers with invalid Admitting Diagnosis Code Flag N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-363 % of claim headers with invalid Diagnosis Code 4 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-369 % of claim headers with invalid Diagnosis Code 5 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-375 % of claim headers with invalid Diagnosis Code 6 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-380 % of claim headers with invalid Diagnosis Code 7 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-385 % of claim headers with invalid Diagnosis Code 8 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-390 % of claim headers with invalid Diagnosis Code 9 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-395 % of claim headers with invalid Diagnosis Code 10 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-400 % of claim headers with invalid Diagnosis Code 11 N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-7294 % of claim lines with Procedure Code that are missing Procedure Code Flag Medium COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Utilization N/A
ALL-34-001-1 % of claim lines with non-missing HCBS Service Code that have missing HCBS Taxonomy Medium COT Medicaid,FFS or Medicaid,Enc Original and Replacement All Indicators Utilization N/A
ALL-34-002-2 % of claim lines with non-missing Procedure Code and either HCBS Service Code or HCBS Taxonomy that have a Procedure Code format that indicates a CPT or CDT code Medium COT Medicaid,FFS or Medicaid,Enc Original and Replacement All Indicators Utilization N/A
ALL-35-001-1 % of claim lines with a Procedure Code indicating a sealant, filling, or root canal that are missing Tooth Number Medium COT Medicaid,FFS or Medicaid,Enc Original and Replacement All Indicators Utilization N/A
ALL-35-002-2 % of claim lines with a Procedure Code indicating a sealant, filling, or root canal that are missing Tooth Number Medium COT CHIP,FFS or CHIP,Enc Original and Replacement All Indicators Utilization N/A
ALL-35-003-3 % of claim lines with non-missing Tooth Number that do not have a Procedure Code format that indicates a CDT code Medium COT Medicaid,FFS or Medicaid,Enc Original and Replacement All Indicators Utilization N/A
ALL-35-004-4 % of claim lines with non-missing Tooth Number that do not have a Procedure Code format that indicates a CDT code Medium COT CHIP,FFS or CHIP,Enc Original and Replacement All Indicators Utilization N/A
ALL-36-001-1 # of service tracking claim lines with TYPE-OF-SERVICE = 123 (DSH), 131 (Drug Rebates), 135 (EHR) N/A Multiple Files Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
EL-1-011_1-29 % of MSIS IDs with more than one valid, specified race value High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-024-30 % of MSIS IDs in which a non-primary home address county code, zip code, or state is not in-state and not missing High ELG N/A N/A N/A Beneficiary demographics N/A
EL-18-001-1 Race values N/A ELG N/A N/A N/A N/A N/A
EL-19-001-1 % of MSIS IDs enrolled any day in the previous month but not any day in the current month, with missing, invalid, unknown, or other ELIGIBILITY-TERMINATION-REASON High ELG N/A N/A N/A Beneficiary eligibility N/A
FFS-49-001-13 % 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 N/A CIP Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-002-14 % 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 N/A CLT Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
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 N/A COT Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
FFS-49-004-16 % 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 N/A CRX Medicaid,FFS or CHIP,FFS Original All Indicators N/A N/A
MCR-59-001-13 % 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 High CIP Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-002-14 % 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 High CLT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
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 High COT Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
MCR-59-004-16 % 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 High CRX Medicaid,Enc or CHIP,Enc Original All Indicators Expenditures Managed care
PRV-6-001-1 % of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 01, 02 (facility or group) that do not have a Provider Classification Code that indicates a facility or group Medium PRV N/A N/A N/A Provider identifiers N/A
PRV-6-002-2 % of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 03 (individual) that do not have a Provider Classification Code that indicates an individual Medium PRV N/A N/A N/A Provider identifiers N/A
PRV-6-003-3 % of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 01, 02 (facility or group) that are missing Provider Classification Code N/A PRV N/A N/A N/A N/A N/A
PRV-6-004-4 % of Submitting State Provider IDs with FACILITY-GROUP-INDIVIDUAL-CODE = 03 (individual) that are missing Provider Classification Code N/A PRV N/A N/A N/A N/A N/A
RULE-7372 % of claim lines on non-zero paid claims with Title XIX funding with missing XIX-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP N/A Non-void All Indicators N/A N/A
RULE-7373 % of claim lines on non-zero paid claims with Title XIX funding with missing XIX-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT N/A Non-void All Indicators N/A N/A
RULE-7374 % of claim lines on non-zero paid claims with Title XIX funding with missing XIX-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT N/A Non-void All Indicators N/A N/A
RULE-7375 % of claim lines on non-zero paid claims with Title XIX funding with missing XIX-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX N/A Non-void All Indicators N/A N/A
RULE-7376 % of claim lines on non-zero paid claims with Title XXI funding with missing XXI-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP N/A Non-void All Indicators N/A N/A
RULE-7377 % of claim lines on non-zero paid claims with Title XXI funding with missing XXI-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT N/A Non-void All Indicators N/A N/A
RULE-7378 % of claim lines on non-zero paid claims with Title XXI funding with missing XXI-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT N/A Non-void All Indicators N/A N/A
RULE-7379 % of claim lines on non-zero paid claims with Title XXI funding with missing XXI-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX N/A Non-void All Indicators N/A N/A
RULE-7533 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CIP N/A Non-void All Indicators N/A N/A
RULE-7534 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CLT N/A Original and Replacement All Indicators N/A N/A
RULE-7535 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A COT N/A Non-void All Indicators N/A N/A
RULE-7536 % of claim lines with both XIX and XXI MBESCBES Category of Service N/A CRX N/A Non-void All Indicators N/A N/A
RULE-7578 % of record segments with more than one primary segment (PRIMARY-ELIGIBILITY-GROUP-IND = 1) High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-21-001-1 % missing: ADMISSION-DATE (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-002-2 % missing: ADMITTING-PROV-NPI-NUM (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-003-3 % missing: ADMITTING-PROV-NUM (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-004-4 % missing: ADMISSION-TYPE (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-21-005-5 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-006-6 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-007-7 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-008-8 % missing: BILLING-PROV-NPI-NUM (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-009-9 % missing: BILLING-PROV-TAXONOMY (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-010-10 % missing: BILLING-PROV-NUM (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-011-11 % missing: BILLING-PROV-TYPE (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-012-12 % missing: CLAIM-LINE-COUNT (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-21-013-13 % missing: CROSSOVER-INDICATOR (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-014-14 % missing: DIAGNOSIS-CODE-1 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-015-15 % missing: DIAGNOSIS-CODE-10 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-016-16 % missing: DIAGNOSIS-CODE-11 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-017-17 % missing: DIAGNOSIS-CODE-12 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-018-18 % missing: DIAGNOSIS-CODE-2 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-019-19 % missing: DIAGNOSIS-CODE-3 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-020-20 % missing: DIAGNOSIS-CODE-4 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-021-21 % missing: DIAGNOSIS-CODE-5 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-022-22 % missing: DIAGNOSIS-CODE-6 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-023-23 % missing: DIAGNOSIS-CODE-7 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-024-24 % missing: DIAGNOSIS-CODE-8 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-025-25 % missing: DIAGNOSIS-CODE-9 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-026-26 % missing: DIAGNOSIS-POA-FLAG-1 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-027-27 % missing: DISCHARGE-DATE (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-028-28 % missing: FIXED-PAYMENT-IND (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-029-29 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-030-30 % missing: ICN-ADJ (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-031-31 % missing: ICN-ORIG (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-032-32 % missing: MEDICAID-AMOUNT-PAID-DSH (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-033-33 % missing: MEDICAID-PAID-DATE (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-034-34 % missing: MEDICAID-COV-INPATIENT-DAYS (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-21-035-35 % missing: MEDICARE-PAID-AMT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-036-36 % missing: MEDICARE-REIM-TYPE (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-037-37 % missing: MSIS-IDENTIFICATION-NUM (CIP00002) Critical CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
MIS-21-038-38 % missing: NON-COV-CHARGES (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-039-39 % missing: OTHER-INSURANCE-IND (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-040-40 % missing: OTHER-TPL-COLLECTION (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-041-41 % missing: PAYMENT-LEVEL-IND (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-21-042-42 % missing: PATIENT-STATUS (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-21-043-43 % missing: PLAN-ID-NUMBER (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-044-44 % missing: PROCEDURE-CODE-1 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-045-45 % missing: PROCEDURE-CODE-2 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-046-46 % missing: PROCEDURE-CODE-DATE-1 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-047-47 % missing: PROCEDURE-CODE-DATE-2 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-048-48 % missing: PROCEDURE-CODE-FLAG-1 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-049-49 % missing: PROCEDURE-CODE-FLAG-2 (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-050-50 % missing: REFERRING-PROV-NPI-NUM (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-051-51 % missing: REFERRING-PROV-NUM (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-21-052-52 % missing: PROGRAM-TYPE (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-053-53 % missing: TOT-ALLOWED-AMT (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-21-054-54 % missing: TOT-BILLED-AMT (CIP00002) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-21-055-55 % missing: TOT-COPAY-AMT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-056-56 % missing: TOT-MEDICAID-PAID-AMT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-057-57 % missing: TOT-OTHER-INSURANCE-AMT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-058-58 % missing: TOT-TPL-AMT (CIP00002) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-21-059-59 % missing: TYPE-OF-BILL (CIP00002) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-21-060-60 % missing: TYPE-OF-HOSPITAL (CIP00002) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-22-002-2 % missing: ALLOWED-AMT (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-003-3 % missing: BEGINNING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-004-4 % missing: ENDING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-005-5 % missing: ICN-ADJ (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-006-6 % missing: ICN-ORIG (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-007-7 % missing: LINE-NUM-ADJ (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-008-8 % missing: LINE-NUM-ORIG (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-009-9 % missing: OPERATING-PROV-NPI-NUM (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-010-10 % missing: MEDICAID-PAID-AMT (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-011-11 % missing: PROV-FACILITY-TYPE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-012-12 % missing: REVENUE-CHARGE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-013-13 % missing: REVENUE-CODE (CIP00003) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-22-014-14 % missing: SERVICING-PROV-NPI-NUM (CIP00003) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-22-015-15 % missing: SERVICING-PROV-NUM (CIP00003) Medium CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-22-016-16 % missing: SERVICING-PROV-SPECIALTY (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-017-17 % missing: SERVICING-PROV-TYPE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-22-018-18 % missing: TYPE-OF-SERVICE (CIP00003) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-001-1 % missing: ADMITTING-PROV-NUM (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-002-2 % missing: ADMITTING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-003-3 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-004-4 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-005-5 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-006-6 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-007-7 % missing: BILLING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-008-8 % missing: BILLING-PROV-TAXONOMY (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-23-009-9 % missing: BILLING-PROV-NUM (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-010-10 % missing: BILLING-PROV-TYPE (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-23-011-11 % missing: CLAIM-LINE-COUNT (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-23-012-12 % missing: CROSSOVER-INDICATOR (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-013-13 % missing: DIAGNOSIS-CODE-1 (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-014-14 % missing: DIAGNOSIS-CODE-2 (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-015-15 % missing: DIAGNOSIS-CODE-FLAG-1 (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-016-16 % missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-017-17 % missing: DIAGNOSIS-POA-FLAG-1 (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-018-18 % missing: ENDING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-019-19 % missing: FIXED-PAYMENT-IND (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-020-20 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-021-21 % missing: ICF-IID-DAYS (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-022-22 % missing: ICN-ADJ (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-023-23 % missing: ICN-ORIG (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-024-24 % missing: LEAVE-DAYS (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-025-25 % missing: LTC-RCP-LIAB-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-026-26 % missing: MEDICAID-PAID-DATE (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-027-27 % missing: MEDICAID-COV-INPATIENT-DAYS (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-028-28 % missing: MEDICARE-PAID-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-029-29 % missing: MEDICARE-REIM-TYPE (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-030-30 % missing: MSIS-IDENTIFICATION-NUM (CLT00002) Critical CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
MIS-23-031-31 % missing: NURSING-FACILITY-DAYS (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-032-32 % missing: OTHER-INSURANCE-IND (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-033-33 % missing: OTHER-TPL-COLLECTION (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-034-34 % missing: PAYMENT-LEVEL-IND (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-23-035-35 % missing: PATIENT-STATUS (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-23-036-36 % missing: PLAN-ID-NUMBER (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-037-37 % missing: REFERRING-PROV-NPI-NUM (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-23-038-38 % missing: REFERRING-PROV-NUM (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-23-039-39 % missing: PROGRAM-TYPE (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-040-40 % missing: TOT-ALLOWED-AMT (CLT00002) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-23-041-41 % missing: TOT-BILLED-AMT (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-23-042-42 % missing: TOT-MEDICAID-PAID-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-043-43 % missing: TOT-MEDICARE-COINS-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-044-44 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-045-45 % missing: TOT-OTHER-INSURANCE-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-046-46 % missing: TOT-TPL-AMT (CLT00002) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-23-047-47 % missing: TYPE-OF-BILL (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-24-001-10 % missing: MEDICAID-PAID-AMT (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-002-2 % missing: ALLOWED-AMT (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-003-3 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-004-4 % missing: ENDING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-005-5 % missing: ICN-ADJ (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-006-6 % missing: ICN-ORIG (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-007-7 % missing: LINE-NUM-ADJ (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-008-8 % missing: LINE-NUM-ORIG (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-009-9 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-011-11 % missing: PROV-FACILITY-TYPE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-012-12 % missing: REVENUE-CHARGE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-013-13 % missing: REVENUE-CODE (CLT00003) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-24-014-14 % missing: SERVICING-PROV-NPI-NUM (CLT00003) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-24-015-15 % missing: SERVICING-PROV-NUM (CLT00003) Medium CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-24-016-16 % missing: SERVICING-PROV-SPECIALTY (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-017-17 % missing: SERVICING-PROV-TYPE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-24-018-18 % missing: TYPE-OF-SERVICE (CLT00003) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-001-10 % missing: CROSSOVER-INDICATOR (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-002-2 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-002-20 % missing: MEDICAID-PAID-DATE (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-003-3 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-003-30 % missing: REFERRING-PROV-NPI-NUM (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-25-004-4 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-005-5 % missing: BILLING-PROV-NPI-NUM (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-25-006-6 % missing: BILLING-PROV-TAXONOMY (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-25-007-7 % missing: BILLING-PROV-NUM (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-008-8 % missing: BILLING-PROV-TYPE (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-25-009-9 % missing: CLAIM-LINE-COUNT (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-25-011-11 % missing: DIAGNOSIS-CODE-1 (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-012-12 % missing: DIAGNOSIS-CODE-2 (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-013-13 % missing: DIAGNOSIS-CODE-FLAG-1 (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-014-14 % missing: DIAGNOSIS-CODE-FLAG-2 (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-015-15 % missing: DIAGNOSIS-POA-FLAG-1 (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-016-16 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-017-17 % missing: FIXED-PAYMENT-IND (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-018-18 % missing: HEALTH-HOME-PROV-IND (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-019-19 % missing: ICN-ADJ (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-021-21 % missing: ICN-ORIG (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-022-22 % missing: MSIS-IDENTIFICATION-NUM (COT00002) Critical COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
MIS-25-023-23 % missing: OTHER-INSURANCE-IND (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-024-24 % missing: PAYMENT-LEVEL-IND (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-25-025-25 % missing: OTHER-TPL-COLLECTION (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-026-26 % missing: PLACE-OF-SERVICE (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-027-27 % missing: PLAN-ID-NUMBER (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-028-28 % missing: TOT-BILLED-AMT (COT00002) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-25-029-29 % missing: TOT-ALLOWED-AMT (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-25-031-31 % missing: REFERRING-PROV-NUM (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-25-032-32 % missing: PROGRAM-TYPE (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-25-033-33 % missing: TOT-MEDICAID-PAID-AMT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-034-34 % missing: TOT-MEDICARE-COINS-AMT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-035-35 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-036-36 % missing: TOT-OTHER-INSURANCE-AMT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-037-37 % missing: TOT-TPL-AMT (COT00002) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-25-038-38 % missing: TYPE-OF-BILL (COT00002) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-26-001-10 % missing: HCPCS-RATE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-002-2 % missing: ALLOWED-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-002-20 % missing: SERVICE-QUANTITY-ACTUAL (COT00003) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-26-003-3 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-003-30 % missing: TPL-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-004-4 % missing: BENEFIT-TYPE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-005-5 % missing: BILLED-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-006-6 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-007-7 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-008-8 % missing: HCBS-SERVICE-CODE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-009-9 % missing: HCBS-TAXONOMY (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-011-11 % missing: ICN-ADJ (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-012-12 % missing: ICN-ORIG (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-013-13 % missing: LINE-NUM-ADJ (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-014-14 % missing: LINE-NUM-ORIG (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-015-15 % missing: MEDICAID-FFS-EQUIVALENT-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-016-16 % missing: MEDICAID-PAID-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-017-17 % missing: MEDICARE-PAID-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-018-18 % missing: MSIS-IDENTIFICATION-NUM (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-019-19 % missing: OTHER-INSURANCE-AMT (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-021-21 % missing: PROCEDURE-CODE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-022-22 % missing: PROCEDURE-CODE-FLAG (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-023-23 % missing: PROCEDURE-CODE-MOD-1 (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-024-24 % missing: PROCEDURE-CODE-MOD-2 (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-025-25 % missing: REVENUE-CODE (COT00003) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-26-026-26 % missing: SERVICING-PROV-NPI-NUM (COT00003) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-26-027-27 % missing: SERVICING-PROV-NUM (COT00003) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-26-028-28 % missing: SERVICING-PROV-SPECIALTY (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-26-029-29 % missing: SERVICING-PROV-TYPE (COT00003) Medium COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-26-031-31 % missing: TYPE-OF-SERVICE (COT00003) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-001-1 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-001-10 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NUM (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-27-002-2 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-002-20 % missing: PLAN-ID-NUMBER (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-003-3 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-003-30 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-004-4 % missing: BILLING-PROV-NPI-NUM (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-005-5 % missing: BILLING-PROV-NUM (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-006-6 % missing: CLAIM-LINE-COUNT (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-27-007-7 % missing: COMPOUND-DRUG-IND (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-27-008-8 % missing: CROSSOVER-INDICATOR (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-009-9 % missing: DATE-PRESCRIBED (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-27-011-11 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NPI (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-27-012-12 % missing: FIXED-PAYMENT-IND (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-013-13 % missing: ICN-ADJ (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-014-14 % missing: MEDICAID-PAID-DATE (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-015-15 % missing: ICN-ORIG (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-016-16 % missing: MSIS-IDENTIFICATION-NUM (CRX00002) Critical CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
MIS-27-017-17 % missing: OTHER-INSURANCE-IND (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-018-18 % missing: OTHER-TPL-COLLECTION (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-019-19 % missing: PAYMENT-LEVEL-IND (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-27-021-21 % missing: PRESCRIBING-PROV-NPI-NUM (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-27-022-22 % missing: PRESCRIBING-PROV-NUM (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
MIS-27-023-23 % missing: PRESCRIPTION-FILL-DATE (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-024-24 % missing: PROGRAM-TYPE (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-025-25 % missing: TOT-ALLOWED-AMT (CRX00002) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-27-026-26 % missing: TOT-BILLED-AMT (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
MIS-27-027-27 % missing: TOT-COPAY-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-028-28 % missing: TOT-MEDICAID-PAID-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-029-29 % missing: TOT-MEDICARE-COINS-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-031-31 % missing: TOT-OTHER-INSURANCE-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-27-032-32 % missing: TOT-TPL-AMT (CRX00002) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-001-10 % missing: LINE-NUM-ADJ (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-002-2 % missing: ALLOWED-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-003-3 % missing: BILLED-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-004-4 % missing: BRAND-GENERIC-IND (CRX00003) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-28-005-5 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-006-6 % missing: DAYS-SUPPLY (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-007-7 % missing: DISPENSE-FEE-SUBMITTED (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-008-8 % missing: ICN-ADJ (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-009-9 % missing: ICN-ORIG (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-011-11 % missing: LINE-NUM-ORIG (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-012-12 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-013-13 % missing: MEDICAID-PAID-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-014-14 % missing: MEDICARE-PAID-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-015-15 % missing: NATIONAL-DRUG-CODE (CRX00003) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-28-016-16 % missing: NEW-REFILL-IND (CRX00003) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-28-017-17 % missing: OTHER-INSURANCE-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-018-18 % missing: PRESCRIPTION-QUANTITY-ACTUAL (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-019-19 % missing: REBATE-ELIGIBLE-INDICATOR (CRX00003) Medium CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
MIS-28-020-20 % missing: TPL-AMT (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-28-021-21 % missing: TYPE-OF-SERVICE (CRX00003) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-79-001-1 % missing: ADMISSION-DATE (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-002-2 % missing: ADMITTING-PROV-NPI-NUM (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-003-3 % missing: ADMITTING-PROV-NUM (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-004-4 % missing: ADMISSION-TYPE (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-79-005-5 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-006-6 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-007-7 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-008-8 % missing: BILLING-PROV-NPI-NUM (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-009-9 % missing: BILLING-PROV-TAXONOMY (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-010-10 % missing: BILLING-PROV-NUM (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-011-11 % missing: BILLING-PROV-TYPE (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-012-12 % missing: CLAIM-LINE-COUNT (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-79-013-13 % missing: CROSSOVER-INDICATOR (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-014-14 % missing: DIAGNOSIS-CODE-1 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-015-15 % missing: DIAGNOSIS-CODE-10 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-016-16 % missing: DIAGNOSIS-CODE-11 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-017-17 % missing: DIAGNOSIS-CODE-12 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-018-18 % missing: DIAGNOSIS-CODE-2 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-019-19 % missing: DIAGNOSIS-CODE-3 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-020-20 % missing: DIAGNOSIS-CODE-4 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-021-21 % missing: DIAGNOSIS-CODE-5 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-022-22 % missing: DIAGNOSIS-CODE-6 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-023-23 % missing: DIAGNOSIS-CODE-7 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-024-24 % missing: DIAGNOSIS-CODE-8 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-025-25 % missing: DIAGNOSIS-CODE-9 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-026-26 % missing: DIAGNOSIS-POA-FLAG-1 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-027-27 % missing: DISCHARGE-DATE (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-028-28 % missing: FIXED-PAYMENT-IND (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-029-29 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-030-30 % missing: ICN-ADJ (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-031-31 % missing: ICN-ORIG (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-032-32 % missing: MEDICAID-AMOUNT-PAID-DSH (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-033-33 % missing: MEDICAID-PAID-DATE (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-034-34 % missing: MEDICAID-COV-INPATIENT-DAYS (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-79-035-35 % missing: MEDICARE-PAID-AMT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-036-36 % missing: MEDICARE-REIM-TYPE (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-037-37 % missing: MSIS-IDENTIFICATION-NUM (CIP00002) Critical CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
MIS-79-038-38 % missing: NON-COV-CHARGES (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-039-39 % missing: OTHER-INSURANCE-IND (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-040-40 % missing: OTHER-TPL-COLLECTION (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-041-41 % missing: PAYMENT-LEVEL-IND (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-79-042-42 % missing: PATIENT-STATUS (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-79-043-43 % missing: PLAN-ID-NUMBER (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-044-44 % missing: PROCEDURE-CODE-1 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-045-45 % missing: PROCEDURE-CODE-2 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-046-46 % missing: PROCEDURE-CODE-DATE-1 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-047-47 % missing: PROCEDURE-CODE-DATE-2 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-048-48 % missing: PROCEDURE-CODE-FLAG-1 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-049-49 % missing: PROCEDURE-CODE-FLAG-2 (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-050-50 % missing: REFERRING-PROV-NPI-NUM (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-051-51 % missing: REFERRING-PROV-NUM (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-79-052-52 % missing: PROGRAM-TYPE (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-053-53 % missing: TOT-ALLOWED-AMT (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-79-054-54 % missing: TOT-BILLED-AMT (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-79-055-55 % missing: TOT-COPAY-AMT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-056-56 % missing: TOT-MEDICAID-PAID-AMT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-057-57 % missing: TOT-OTHER-INSURANCE-AMT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-058-58 % missing: TOT-TPL-AMT (CIP00002) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-79-059-59 % missing: TYPE-OF-BILL (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-79-060-60 % missing: TYPE-OF-HOSPITAL (CIP00002) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-80-001-1 % missing: ALLOWED-AMT (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-002-2 % missing: BEGINNING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-003-3 % missing: ENDING-DATE-OF-SERVICE (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-004-4 % missing: ICN-ADJ (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-005-5 % missing: ICN-ORIG (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-006-6 % missing: LINE-NUM-ADJ (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-007-7 % missing: LINE-NUM-ORIG (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-008-8 % missing: OPERATING-PROV-NPI-NUM (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-009-9 % missing: MEDICAID-PAID-AMT (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-010-10 % missing: PROV-FACILITY-TYPE (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-011-11 % missing: REVENUE-CHARGE (CIP00003) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-80-012-12 % missing: REVENUE-CODE (CIP00003) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-80-013-13 % missing: SERVICING-PROV-NPI-NUM (CIP00003) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-80-014-14 % missing: SERVICING-PROV-NUM (CIP00003) Medium CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-80-015-15 % missing: SERVICING-PROV-SPECIALTY (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-016-16 % missing: SERVICING-PROV-TYPE (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-80-017-17 % missing: TYPE-OF-SERVICE (CIP00003) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-001-1 % missing: ADMITTING-PROV-NUM (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-002-2 % missing: ADMITTING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-003-3 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-004-4 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-005-5 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-006-6 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-007-7 % missing: BILLING-PROV-NPI-NUM (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-008-8 % missing: BILLING-PROV-TAXONOMY (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-81-009-9 % missing: BILLING-PROV-NUM (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-010-10 % missing: BILLING-PROV-TYPE (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-81-011-11 % missing: CLAIM-LINE-COUNT (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-81-012-12 % missing: CROSSOVER-INDICATOR (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-013-13 % missing: DIAGNOSIS-CODE-1 (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-014-14 % missing: DIAGNOSIS-CODE-2 (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-015-15 % missing: DIAGNOSIS-CODE-FLAG-1 (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-016-16 % missing: DIAGNOSIS-CODE-FLAG-2 (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-017-17 % missing: DIAGNOSIS-POA-FLAG-1 (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-018-18 % missing: ENDING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-019-19 % missing: FIXED-PAYMENT-IND (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-020-20 % missing: HEALTH-CARE-ACQUIRED-CONDITION-IND (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-021-21 % missing: ICF-IID-DAYS (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-022-22 % missing: ICN-ADJ (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-023-23 % missing: ICN-ORIG (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-024-24 % missing: LEAVE-DAYS (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-025-25 % missing: LTC-RCP-LIAB-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-026-26 % missing: MEDICAID-PAID-DATE (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-027-27 % missing: MEDICAID-COV-INPATIENT-DAYS (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-028-28 % missing: MEDICARE-PAID-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-029-29 % missing: MEDICARE-REIM-TYPE (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-030-30 % missing: MSIS-IDENTIFICATION-NUM (CLT00002) Critical CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
MIS-81-031-31 % missing: NURSING-FACILITY-DAYS (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-032-32 % missing: OTHER-INSURANCE-IND (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-033-33 % missing: OTHER-TPL-COLLECTION (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-034-34 % missing: PAYMENT-LEVEL-IND (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-81-035-35 % missing: PATIENT-STATUS (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-81-036-36 % missing: PLAN-ID-NUMBER (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-037-37 % missing: REFERRING-PROV-NPI-NUM (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-81-038-38 % missing: REFERRING-PROV-NUM (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-81-039-39 % missing: PROGRAM-TYPE (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-040-40 % missing: TOT-ALLOWED-AMT (CLT00002) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-81-041-41 % missing: TOT-BILLED-AMT (CLT00002) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-81-042-42 % missing: TOT-MEDICAID-PAID-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-043-43 % missing: TOT-MEDICARE-COINS-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-044-44 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-045-45 % missing: TOT-OTHER-INSURANCE-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-046-46 % missing: TOT-TPL-AMT (CLT00002) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-81-047-47 % missing: TYPE-OF-BILL (CLT00002) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-82-001-1 % missing: ALLOWED-AMT (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-002-2 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-003-3 % missing: ENDING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-004-4 % missing: ICN-ADJ (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-005-5 % missing: ICN-ORIG (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-006-6 % missing: LINE-NUM-ADJ (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-007-7 % missing: LINE-NUM-ORIG (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-008-8 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-009-9 % missing: MEDICAID-PAID-AMT (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-010-10 % missing: PROV-FACILITY-TYPE (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-011-11 % missing: REVENUE-CHARGE (CLT00003) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-82-012-12 % missing: REVENUE-CODE (CLT00003) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-82-013-13 % missing: SERVICING-PROV-NPI-NUM (CLT00003) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-82-014-14 % missing: SERVICING-PROV-NUM (CLT00003) Medium CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-82-015-15 % missing: SERVICING-PROV-SPECIALTY (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-016-16 % missing: SERVICING-PROV-TYPE (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-82-017-17 % missing: TYPE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-001-1 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-002-2 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-003-3 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-004-4 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-005-5 % missing: BILLING-PROV-NPI-NUM (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-83-006-6 % missing: BILLING-PROV-TAXONOMY (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-83-007-7 % missing: BILLING-PROV-NUM (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-008-8 % missing: BILLING-PROV-TYPE (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-83-009-9 % missing: CLAIM-LINE-COUNT (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-83-010-10 % missing: CROSSOVER-INDICATOR (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-011-11 % missing: DIAGNOSIS-CODE-1 (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-012-12 % missing: DIAGNOSIS-CODE-2 (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-013-13 % missing: DIAGNOSIS-CODE-FLAG-1 (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-014-14 % missing: DIAGNOSIS-CODE-FLAG-2 (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-015-15 % missing: DIAGNOSIS-POA-FLAG-1 (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-016-16 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-017-17 % missing: FIXED-PAYMENT-IND (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-018-18 % missing: HEALTH-HOME-PROV-IND (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-019-19 % missing: ICN-ADJ (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-020-20 % missing: MEDICAID-PAID-DATE (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-021-21 % missing: ICN-ORIG (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-022-22 % missing: MSIS-IDENTIFICATION-NUM (COT00002) Critical COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
MIS-83-023-23 % missing: OTHER-INSURANCE-IND (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-024-24 % missing: PAYMENT-LEVEL-IND (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-83-025-25 % missing: OTHER-TPL-COLLECTION (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-026-26 % missing: PLACE-OF-SERVICE (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-027-27 % missing: PLAN-ID-NUMBER (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-028-28 % missing: TOT-BILLED-AMT (COT00002) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-83-029-29 % missing: TOT-ALLOWED-AMT (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-83-030-30 % missing: REFERRING-PROV-NPI-NUM (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-83-031-31 % missing: REFERRING-PROV-NUM (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-83-032-32 % missing: PROGRAM-TYPE (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-83-033-33 % missing: TOT-MEDICAID-PAID-AMT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-034-34 % missing: TOT-MEDICARE-COINS-AMT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-035-35 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-036-36 % missing: TOT-OTHER-INSURANCE-AMT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-037-37 % missing: TOT-TPL-AMT (COT00002) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-83-038-38 % missing: TYPE-OF-BILL (COT00002) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-84-001-1 % missing: ALLOWED-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-002-2 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-003-3 % missing: BENEFIT-TYPE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-004-4 % missing: BILLED-AMT (COT00003) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-84-005-5 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-006-6 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-007-7 % missing: HCBS-SERVICE-CODE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-008-8 % missing: HCBS-TAXONOMY (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-009-9 % missing: HCPCS-RATE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-010-10 % missing: ICN-ADJ (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-011-11 % missing: ICN-ORIG (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-012-12 % missing: LINE-NUM-ADJ (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-013-13 % missing: LINE-NUM-ORIG (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-014-14 % missing: MEDICAID-FFS-EQUIVALENT-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-015-15 % missing: MEDICAID-PAID-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-016-16 % missing: MEDICARE-PAID-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-017-17 % missing: MSIS-IDENTIFICATION-NUM (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-018-18 % missing: OTHER-INSURANCE-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-019-19 % missing: SERVICE-QUANTITY-ACTUAL (COT00003) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-84-020-20 % missing: PROCEDURE-CODE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-021-21 % missing: PROCEDURE-CODE-FLAG (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-022-22 % missing: PROCEDURE-CODE-MOD-1 (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-023-23 % missing: PROCEDURE-CODE-MOD-2 (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-024-24 % missing: REVENUE-CODE (COT00003) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization N/A
MIS-84-025-25 % missing: SERVICING-PROV-NPI-NUM (COT00003) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-84-026-26 % missing: SERVICING-PROV-NUM (COT00003) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-84-027-27 % missing: SERVICING-PROV-SPECIALTY (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-028-28 % missing: SERVICING-PROV-TYPE (COT00003) Medium COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-84-029-29 % missing: TPL-AMT (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-84-030-30 % missing: TYPE-OF-SERVICE (COT00003) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-001-1 % missing: TOT-BENEFICIARY-COINSURANCE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-002-2 % missing: TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-003-3 % missing: TOT-BENEFICIARY-DEDUCTIBLE-PAID-AMOUNT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-004-4 % missing: BILLING-PROV-NPI-NUM (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-005-5 % missing: BILLING-PROV-NUM (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-006-6 % missing: CLAIM-LINE-COUNT (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-85-007-7 % missing: COMPOUND-DRUG-IND (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-85-008-8 % missing: CROSSOVER-INDICATOR (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-009-9 % missing: DATE-PRESCRIBED (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-85-010-10 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NUM (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-85-011-11 % missing: DISPENSING-PRESCRIPTION-DRUG-PROV-NPI (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-85-012-12 % missing: FIXED-PAYMENT-IND (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-013-13 % missing: ICN-ADJ (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-014-14 % missing: MEDICAID-PAID-DATE (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-015-15 % missing: ICN-ORIG (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-016-16 % missing: MSIS-IDENTIFICATION-NUM (CRX00002) Critical CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
MIS-85-017-17 % missing: OTHER-INSURANCE-IND (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-018-18 % missing: OTHER-TPL-COLLECTION (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-019-19 % missing: PAYMENT-LEVEL-IND (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-85-020-20 % missing: PLAN-ID-NUMBER (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-021-21 % missing: PRESCRIBING-PROV-NPI-NUM (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-85-022-22 % missing: PRESCRIBING-PROV-NUM (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
MIS-85-023-23 % missing: PRESCRIPTION-FILL-DATE (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-024-24 % missing: PROGRAM-TYPE (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-025-25 % missing: TOT-ALLOWED-AMT (CRX00002) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-85-026-26 % missing: TOT-BILLED-AMT (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-85-027-27 % missing: TOT-COPAY-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-028-28 % missing: TOT-MEDICAID-PAID-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-029-29 % missing: TOT-MEDICARE-COINS-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-030-30 % missing: TOT-MEDICARE-DEDUCTIBLE-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-031-31 % missing: TOT-OTHER-INSURANCE-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-85-032-32 % missing: TOT-TPL-AMT (CRX00002) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-001-1 % missing: ALLOWED-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-002-2 % missing: BILLED-AMT (CRX00003) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-86-003-3 % missing: BRAND-GENERIC-IND (CRX00003) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-86-004-4 % missing: BENEFICIARY-COPAYMENT-PAID-AMOUNT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-005-5 % missing: DAYS-SUPPLY (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-006-6 % missing: DISPENSE-FEE-SUBMITTED (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-007-7 % missing: ICN-ADJ (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-008-8 % missing: ICN-ORIG (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-009-9 % missing: LINE-NUM-ADJ (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-010-10 % missing: LINE-NUM-ORIG (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-011-11 % missing: MEDICAID-FFS-EQUIVALENT-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-012-12 % missing: MEDICAID-PAID-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-013-13 % missing: MEDICARE-PAID-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-014-14 % missing: NATIONAL-DRUG-CODE (CRX00003) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-86-015-15 % missing: NEW-REFILL-IND (CRX00003) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-86-016-16 % missing: OTHER-INSURANCE-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-017-17 % missing: PRESCRIPTION-QUANTITY-ACTUAL (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-018-18 % missing: REBATE-ELIGIBLE-INDICATOR (CRX00003) Medium CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
MIS-86-019-19 % missing: TPL-AMT (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-86-020-20 % missing: TYPE-OF-SERVICE (CRX00003) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
EL-15-003-3 % difference between total T-MSIS duals count and total MMA duals count High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-004-4 % difference between T-MSIS QMB-only duals count and MMA QMB-only duals count (Dual Code=01) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-005-5 % difference between T-MSIS QMB-plus duals count and MMA QMB-plus duals count (Dual Code=02) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-006-6 % difference between T-MSIS SLMB-only duals count and MMA SLMB-only duals count (Dual Code=03) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-007-7 % difference between T-MSIS SLMB-plus duals count and MMA SLMB-plus duals count (Dual Code=04) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-008-8 % difference between T-MSIS QDWI duals count and MMA QDWI duals count (Dual Code=05) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-009-9 % difference between T-MSIS QI duals count and MMA QI duals count (Dual Code=06) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-010-10 % difference between T-MSIS Other duals count and MMA Other duals count (Dual Code=08) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-15-011-11 % difference between T-MSIS Other - specific CMS approval duals and MMA Other - specific CMS approval duals (Dual Code=09) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-1-025-31 % of MSIS IDs where county code or zip code does not align with address state and is not missing N/A ELG N/A N/A N/A N/A N/A
EL-6-032-35 % of MSIS IDs with restricted benefits code designating MFP participation (RESTRICTED-BENEFITS-CODE = D) that are not found on MFP-INFORMATION-ELG00010 for the same month Medium ELG N/A N/A N/A Program participation N/A
EL-6-036-36 % of duals missing Medicare Beneficiary Identifier High ELG N/A N/A N/A Beneficiary eligibility N/A
MIS-88-001-1 % missing: TYPE-OF-SERVICE (COT00003) N/A COT Medicaid,Cap Original and Replacement All Indicators N/A N/A
MIS-90-001-1 % missing: TYPE-OF-SERVICE (COT00003) N/A COT CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-2382 % of record segments that do not have a managed care record Critical Multiple Files N/A N/A N/A File integrity Managed care
RULE-7191 % of record segments with ENROLLMENT-TYPE=1 that do not have a CHIP-CODE=1 or 2 High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7192 % of record segments with ENROLLMENT-TYPE=2 that do not have a CHIP-CODE=3 High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7382 % missing: ADMISSION-DATE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7383 % missing: DISCHARGE-DATE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7384 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP Medicaid,Serv Non-void All Indicators N/A N/A
RULE-7385 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CIP00003) N/A CIP CHIP,Serv Non-void All Indicators N/A N/A
RULE-7386 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv Non-void All Indicators N/A N/A
RULE-7387 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT Medicaid,Serv Non-void All Indicators N/A N/A
RULE-7388 % missing: XIX-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX Medicaid,Serv Non-void All Indicators N/A N/A
RULE-7389 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CLT00003) N/A CLT CHIP,Serv Non-void All Indicators N/A N/A
RULE-7390 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (COT00003) N/A COT CHIP,Serv Non-void All Indicators N/A N/A
RULE-7391 % missing: XXI-MBESCBES-CATEGORY-OF-SERVICE (CRX00003) N/A CRX CHIP,Serv Non-void All Indicators N/A N/A
RULE-7392 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7393 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7394 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7395 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7396 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7397 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7398 % missing: ENDING-DATE-OF-SERVICE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7399 % missing: ENDING-DATE-OF-SERVICE (CLT00003) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7400 % missing: SERVICE-TRACKING-PAYMENT-AMT (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7401 % missing: SERVICE-TRACKING-PAYMENT-AMT (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7402 % missing: SERVICE-TRACKING-PAYMENT-AMT (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7403 % missing: SERVICE-TRACKING-PAYMENT-AMT (CRX00002) N/A CRX Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7404 % missing: SERVICE-TRACKING-TYPE (CLT00002) N/A CLT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7405 % missing: SERVICE-TRACKING-TYPE (COT00002) N/A COT Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7406 % missing: SERVICE-TRACKING-TYPE (CRX00002) N/A CRX Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7435 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CIP Medicaid,Serv or CHIP,Serv All Adjustment Types All Indicators N/A N/A
RULE-7436 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CLT Medicaid,Serv or CHIP,Serv All Adjustment Types All Indicators N/A N/A
RULE-7437 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A COT Medicaid,Serv or CHIP,Serv All Adjustment Types All Indicators N/A N/A
RULE-7438 % of service tracking claim headers with a non-zero Total Medicaid Paid Amount N/A CRX Medicaid,Serv or CHIP,Serv All Adjustment Types All Indicators N/A N/A
RULE-7521 % missing: SERVICE-TRACKING-TYPE (CIP00002) N/A CIP Medicaid,Serv or CHIP,Serv Non-void All Indicators N/A N/A
RULE-7522 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A CIP Medicaid,Supp or CHIP,Supp Non-void All Indicators N/A N/A
RULE-7523 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A CLT Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-7524 % of header claims with Total Medicaid Paid Amount = $0 or missing N/A COT Medicaid,Supp or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EL-1-014-32 % of MSIS IDs with CITIZENSHIP-IND = 1 (U.S. Citizen) whose enrollment in Medicaid is pending citizenship verification Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-016_1-33 % of MSIS IDs with ELIGIBILITY-GROUP = 73, 74, or 75 (adult group - not newly eligible) if the state reported MBES enrollment for this group High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-019_1-34 % of MSIS IDs with ELIGIBILITY-GROUP = 73, 74, or 75 (adult group - not newly eligible) if the state did not report MBES enrollment for this group High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
EL-3-026-35 % of MSIS IDs with ELIGIBILITY-GROUP = 11 (Individuals Receiving SSI) if the state is not a 1634 or SSI criteria state High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-027-36 % of MSIS IDs with ELIGIBILITY-GROUP = 12 (Aged, Blind and Disabled Individuals in 209(b) States) if the state is not a 209(b) state High ELG N/A N/A N/A Beneficiary eligibility N/A
FFS-54-001_1-5 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CIP Medicaid,FFS or CHIP,FFS Non-void Crossover N/A N/A
FFS-54-002_1-6 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CLT Medicaid,FFS or CHIP,FFS Non-void Crossover N/A N/A
FFS-54-003_1-7 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A COT Medicaid,FFS or CHIP,FFS Non-void Crossover N/A N/A
FFS-54-004_1-8 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing N/A CRX Medicaid,FFS or CHIP,FFS Non-void Crossover N/A N/A
MCR-64-001_1-5 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing Medium CIP Medicaid,Enc or CHIP,Enc Non-void Crossover Expenditures Managed care
MCR-64-002_1-6 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing Medium CLT Medicaid,Enc or CHIP,Enc Non-void Crossover Expenditures Managed care
MCR-64-003_1-7 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing Medium COT Medicaid,Enc or CHIP,Enc Non-void Crossover Expenditures Managed care
MCR-64-004_1-8 % of crossover claim headers where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing Medium CRX Medicaid,Enc or CHIP,Enc Non-void Crossover Expenditures Managed care
RULE-7553 % of record segments with DUAL-ELIGIBLE-CODE = 1 (QMB only) that do not have ELIGIBILITY-GROUP = 23 (Qualified Medicare Beneficiaries) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7554 % of record segments with DUAL-ELIGIBLE-CODE = 5 (QDWI) that do not have ELIGIBILITY-GROUP = 24 (Qualified Disabled and Working Individuals) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7555 % of record segments with DUAL-ELIGIBLE-CODE = 3 (SLMB only) that do not have ELIGIBILITY-GROUP = 25 (Specified Low Income Medicare Beneficiaries) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7556 % of record segments with DUAL-ELIGIBLE-CODE = 6 (QI) that do not have ELIGIBILITY-GROUP = 26 (Qualifying Individuals) Medium ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7557 % of record segments with CITIZENSHIP-IND = 1 (U.S. Citizen) that have missing Citizenship Verification Flag Medium ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7558 % of record segments with primary home address and contact information that have missing Eligible Phone Number Medium ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7559 % of record segments with Dual Eligible Code indicating dual status where Medicare Beneficiary Identifier and Medicare HIC Number are missing N/A ELG N/A N/A N/A N/A N/A
RULE-7560 % of denied claim lines where Medicaid Paid Amount is non-missing and non-zero Medium CIP N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7561 % of denied claim lines where Medicaid Paid Amount is non-missing and non-zero Medium CLT N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7562 % of denied claim lines where Medicaid Paid Amount is non-missing and non-zero Medium COT N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7563 % of denied claim lines where Medicaid Paid Amount is non-missing and non-zero Medium CRX N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7564 % of claim headers with a Procedure Code indicating a dental claim and non-missing Diagnosis Code Flag 1 that have a missing Diagnosis Code 1 N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
RULE-7565 % of denied claim headers where Total Medicaid Paid Amount is non-missing and non-zero Medium CIP N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7566 % of denied claim headers where Total Medicaid Paid Amount is non-missing and non-zero Medium CLT N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7567 % of denied claim headers where Total Medicaid Paid Amount is non-missing and non-zero Medium COT N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7568 % of denied claim headers where Total Medicaid Paid Amount is non-missing and non-zero Medium CRX N/A All Adjustment Types All Indicators Expenditures N/A
RULE-7570 % of denied claim headers that have no corresponding claim lines Critical CIP N/A All Adjustment Types All Indicators File integrity N/A
RULE-7571 % of denied claim headers that have no corresponding claim lines Critical CLT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7572 % of denied claim headers that have no corresponding claim lines Critical COT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7573 % of denied claim headers that have no corresponding claim lines Critical CRX N/A All Adjustment Types All Indicators File integrity N/A
RULE-7574 % of denied claim lines that have no corresponding claim header Critical CIP N/A All Adjustment Types All Indicators File integrity N/A
RULE-7575 % of denied claim lines that have no corresponding claim header Critical CLT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7576 % of denied claim lines that have no corresponding claim header Critical COT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7577 % of denied claim lines that have no corresponding claim header Critical CRX N/A All Adjustment Types All Indicators File integrity N/A
RULE-7579 % of service tracking claim headers where Medicaid Amount Paid DSH is non-missing and non-zero N/A CIP N/A All Adjustment Types All Indicators N/A N/A
RULE-7580 % of claim lines with TYPE-OF-SERVICE = 132 (Supplemental payment – inpatient) that are not on a service tracking claim Medium CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
RULE-7581 % of claim lines with TYPE-OF-SERVICE = 133 (Supplemental payment – nursing) that are not on a service tracking claim Medium CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
RULE-7582 % of claim lines with TYPE-OF-SERVICE = 134 (Supplemental payment outpatient) that are not on a service tracking claim Medium COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Expenditures N/A
RULE-7593 % of claim lines where TYPE-OF-SERVICE is missing or is not for a beneficiary-level payment N/A COT N/A All Adjustment Types All Indicators N/A N/A
RULE-7642 % of claim headers with an MSIS ID not enrolled on Admission Date High Multiple Files Medicaid,Enc or CHIP,Enc Non-void All Indicators File integrity Managed care
RULE-7643 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Non-void All Indicators File integrity Managed care
RULE-7644 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Non-void All Indicators File integrity Managed care
RULE-7645 % of claim headers with an MSIS ID not enrolled on Prescription Fill Date High Multiple Files Medicaid,Enc or CHIP,Enc Non-void All Indicators File integrity Managed care
RULE-7646 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service N/A COT Medicaid,Cap or CHIP,Cap Non-void All Indicators N/A Managed care
EL-1-026-33 % of MSIS IDs that have White race (RACE = 001) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-027-34 % of MSIS IDs that have Black or African American race (RACE = 002) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
EL-1-028-35 % of MSIS IDs that have American Indian or Alaska Native race (RACE = 003) N/A ELG N/A N/A N/A N/A N/A
EL-1-029-36 % of MSIS IDs that have Asian race (RACE = 004, 005, 006, 007, 008, 009, 010, 011) N/A ELG N/A N/A N/A N/A N/A
EL-1-030-37 % of MSIS IDs that have Native Hawaiian or Other Pacific Islander race (RACE = 012, 013, 014, 015, 016) N/A ELG N/A N/A N/A N/A N/A
EL-1-031-38 % of MSIS IDs that have Other race (RACE = 018) High ELG N/A N/A N/A Beneficiary demographics Race/ethnicity
MCR-65-001-1 01/30/2026 % of Comprehensive MCO (MANAGED-CARE-PLAN-TYPE = 01, 04) enrollees with no capitation payments for comprehensive MCO High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-002-2 01/30/2026 % of PACE plan (MANAGED-CARE-PLAN-TYPE = 17) enrollees with no capitation payments for PACE High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-003-3 01/30/2026 % of Transportation PAHP (MANAGED-CARE-PLAN-TYPE = 15) enrollees with no capitation payments for Transportation PAHPs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-004-4 01/30/2026 % of Dental PAHP (MANAGED-CARE-PLAN-TYPE = 14) enrollees with no capitation payments for Dental PAHPs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-005-5 01/30/2026 % of Pharmacy PAHP (MANAGED-CARE-PLAN-TYPE = 18) enrollees with no capitation payments for Pharmacy PAHPs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-006-6 01/30/2026 % of Mental Health PIHP (MANAGED-CARE-PLAN-TYPE = 08, 10, 12) enrollees with no capitation payments for Mental Health PIHPs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-007-7 01/30/2026 % of Mental Health PAHP (MANAGED-CARE-PLAN-TYPE = 09, 11, 13) enrollees with no capitation payments for Mental Health PAHPs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-008-8 01/30/2026 % of LTSS (MANAGED-CARE-PLAN-TYPE = 07, 19) enrollees with no capitation payments for LTSS High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-009-9 01/30/2026 % of Disease Management (MANAGED-CARE-PLAN-TYPE = 02, 03, 16) enrollees with no capitation payments for Disease Management High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-010-10 01/30/2026 % of ACO (MANAGED-CARE-PLAN-TYPE = 60) enrollees with no capitation payments for ACOs High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-011-11 01/30/2026 % of Health/Medical Home (MANAGED-CARE-PLAN-TYPE = 70) enrollees with no capitation payments for Health/Medical Home High Multiple Files N/A N/A N/A Program participation Managed care
MCR-65-012-12 01/30/2026 % of Integrated Care for Dual Eligibles (MANAGED-CARE-PLAN-TYPE = 80) enrollees with no capitation payments for Integrated Care for Dual Eligibles High Multiple Files N/A N/A N/A Program participation Managed care
EL-1-032-39 % MSIS IDs with White race (RACE = 001) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
EL-1-033-40 % MSIS IDs with Black or African American race (RACE = 002) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
EL-1-034-41 % of MSIS IDs with American Indian or Alaska Native race (RACE = 003) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
EL-1-035-42 % of MSIS IDs with Asian race (RACE = 004, 005, 006, 007, 008, 009, 010, 011) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
EL-1-036-43 % of MSIS IDs with Native Hawaiian or Other Pacific Islander race (RACE = 012, 013, 014, 015, 016) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
EL-1-037-44 % of MSIS IDs with Other race (RACE = 018) where ETHNICITY-CODE is missing, unspecified, or invalid N/A ELG N/A N/A N/A N/A N/A
PRV-2-011-11 % of providers that require NPI (non-atypical) that are missing NPI (PROV-IDENTIFIER-TYPE=2) Medium PRV N/A N/A N/A Provider classification N/A
RULE-7220 % of record segments with an invalid value for Eligible Identifier Type High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7239 % of record segments with an invalid value for Reason for Change High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7439 % of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Admission Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7440 % of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7441 % of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7442 % of claim headers with a BILLING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Prescription Fill Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7443 % of claim lines with a of SERVICING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7444 % of claim lines that have a SERVICING-PROV-NUM does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7445 % of claim lines that have a SERVICING-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Beginning Date of Service N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7446 % of claim headers that have a DISPENSING-PRESCRIPTION-DRUG-PROV-NUM that does not have a match in PRV00007 with active provider enrollment status (PROV-MEDICAID-ENROLLMENT-STATUS-CODE in (1, 2, 3, 4, 5, 6) on Prescription Fill Date N/A Multiple Files Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7458 % of record segments with an invalid waiver ID format for 1115 waivers (WAIVER-TYPE = 01 or 21 - 30) High ELG N/A N/A N/A Program participation N/A
RULE-7459 % of record segments with an invalid waiver ID format for 1915(b) and 1915(c) waivers (WAIVER-TYPE = 02 - 20, 32, or 33) High ELG N/A N/A N/A Program participation N/A
RULE-7460 % of claim headers with HCBS-SERVICE-CODE = 4 that are missing Waiver ID N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators N/A N/A
RULE-7569 % of Provider Attributes Main segments for individual providers (FACILITY-GROUP-INDIVIDUAL-CODE = 03) with more than one NPI (PROV-IDENTIFIER-TYPE = 2) (across all time) High PRV N/A N/A N/A Provider identifiers N/A
EL-1-038-45 % of MSIS IDs with English as a primary language (PREFERRED-LANGUAGE-CODE = ENG)    High ELG N/A N/A N/A Beneficiary demographics N/A
EL-1-039-46 % of MSIS IDs with Spanish as a primary language (PREFERRED-LANGUAGE-CODE = SPA) N/A ELG N/A N/A N/A N/A N/A
EL-1-040-47 % of MSIS IDs with a primary language other than English or Spanish (PREFERRED-LANGUAGE-CODE<> ENG, SPA) N/A ELG N/A N/A N/A N/A N/A
EL-6-037-37 % of MSIS IDs with an IMMIGRATION-STATUS = 3 (Eligible only for payment for emergency services) but RESTRICTED-BENEFITS-CODE does not equal 2 or 4 Medium ELG N/A N/A N/A Beneficiary demographics N/A
EXP-11-160_1-163 % of claim lines on claims where Payment Level Indicator = 2 with Billed Amount = $0 High COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-11-161_1-164 % of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing High COT Medicaid,FFS Original Non-Crossover Expenditures N/A
EXP-37-001_1-2 % of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing High COT Medicaid,Enc Original Non-Crossover Expenditures Managed care
EXP-39-001_1-2 % of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing High COT CHIP,Enc Original Non-Crossover Expenditures Managed care
MIS-1-013-13 % distinct MSIS IDs with only missing values in any active segment: PREFERRED-LANGUAGE-CODE (ELG00003) High ELG N/A N/A N/A Beneficiary demographics N/A
EL-20-001-1 Eligibility Termination Reason N/A ELG N/A N/A N/A N/A N/A
MCR-13-018-20 % of PHP capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation PHP plan N/A Multiple Files N/A Original All Indicators N/A N/A
MCR-13-019-21 % of Comprehensive MCO capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation Comprehensive MCO plan N/A Multiple Files N/A Original All Indicators N/A N/A
MCR-9-018-20 % of PHP capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation PHP plan N/A Multiple Files N/A Original All Indicators N/A N/A
MCR-9-019-21 % of Comprehensive MCO capitation payment records with a non-missing plan ID that do not have a corresponding managed care participation Comprehensive MCO plan N/A Multiple Files N/A Original All Indicators N/A N/A
RULE-7182 % of Variable Demographics segments where SSN is non-missing and invalid High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7194 % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7195 % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7196 % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc Non-void All Indicators Program participation Managed care
RULE-7197 % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7198 % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7199 % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7200 % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7201 % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Program participation Managed care
RULE-7427 Family Planning (FP): % of FP-waiver segments (WAIVER TYPE = 24) that do not have RESTRICTED-BENEFITS-CODE = 6 (FP) High ELG N/A N/A N/A Program participation N/A
RULE-7538 % of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on PRIMARY-DEMOGRAPHICS-ELIGIBILITY-ELG00002 for the same month Critical ELG N/A N/A N/A File integrity N/A
RULE-7539 % of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on VARIABLE-DEMOGRAPHICS-ELIGIBILITY-ELG00003 for the same month Critical ELG N/A N/A N/A File integrity N/A
RULE-7540 % of segments reported on ENROLLMENT-TIME-SPAN-SEGMENT-ELG00021 that are not found on ELIGIBLITY-DETERMINANTS-ELG00005 for the same month Critical ELG N/A N/A N/A File integrity N/A
RULE-7662 % of non-crossover encounter claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CIP Medicaid,Enc or CHIP,Enc Original and Replacement Non-Crossover Expenditures Managed care
RULE-7663 % of non-crossover encounter claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CLT Medicaid,Enc or CHIP,Enc Original and Replacement Non-Crossover Expenditures Managed care
RULE-7664 % of non-crossover encounter claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High COT Medicaid,Enc or CHIP,Enc Original and Replacement Non-Crossover Expenditures Managed care
RULE-7665 % of non-crossover encounter claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CRX Medicaid,Enc or CHIP,Enc Original and Replacement Non-Crossover Expenditures Managed care
RULE-7666 % of non-crossover capitation claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement Non-Crossover N/A N/A
RULE-7702 % of claim headers with a valid value for Plan ID Number that do not have a corresponding MCR Managed Care Main segment for the same time period N/A Multiple Files N/A Non-void All Indicators N/A Managed care
RULE-7706 % of claim headers with a valid value for Plan ID Number that do not have a corresponding ELG Managed Care Participation segment for the same time period N/A Multiple Files N/A Non-void All Indicators N/A Managed care
RULE-7728 % of individual providers where Provider Last Name is missing High PRV N/A N/A N/A Provider identifiers N/A
RULE-7729 % of Provider Location and Contact Info segments with a missing Address Line 1 High PRV N/A N/A N/A Provider identifiers N/A
RULE-7731 % of Provider Location and Contact Info segments with a non-missing Address Line 1 that have a missing Address City High PRV N/A N/A N/A Provider identifiers N/A
RULE-7732 % of Provider Location and Contact Info segments with a non-missing Address Line 1 that have a missing Address State High PRV N/A N/A N/A Provider identifiers N/A
RULE-7733 % of Provider Location and Contact Info segments with a non-missing Address Line 1 that have a missing Address Zip Code High PRV N/A N/A N/A Provider identifiers N/A
RULE-7734 % of Provider Location and Contact Info segments with a non-missing Address Line 1 that have a missing Address County High PRV N/A N/A N/A Provider identifiers N/A
RULE-7735 % of providers without a corresponding Provider Location and Contact Information segment Critical PRV N/A N/A N/A File integrity N/A
RULE-7774 % of crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing High CIP Medicaid,FFS or CHIP,FFS Original and Replacement Crossover Expenditures N/A
RULE-7775 % of crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing High CLT Medicaid,FFS or CHIP,FFS Original and Replacement Crossover Expenditures N/A
RULE-7776 % of crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing High COT Medicaid,FFS or CHIP,FFS Original and Replacement Crossover Expenditures N/A
RULE-7777 % of crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, and TOT-MEDICARE-DEDUCTIBLE-AMT are 0 or missing High CRX Medicaid,FFS or CHIP,FFS Original and Replacement Crossover Expenditures N/A
RULE-7778 % of non-crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CIP Medicaid,FFS or CHIP,FFS Original and Replacement Non-Crossover Expenditures N/A
RULE-7779 % of non-crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CLT Medicaid,FFS or CHIP,FFS Original and Replacement Non-Crossover Expenditures N/A
RULE-7780 % of non-crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High COT Medicaid,FFS or CHIP,FFS Original and Replacement Non-Crossover Expenditures N/A
RULE-7781 % of non-crossover claims where MEDICARE-PAID-AMT, TOT-MEDICARE-COINS-AMT, or TOT-MEDICARE-DEDUCTIBLE-AMT is non-zero High CRX Medicaid,FFS or CHIP,FFS Original and Replacement Non-Crossover Expenditures N/A
EXP-13-003_1-6 % of claim lines on claims where Payment Level Indicator = 2 with Billed Amount = $0 High COT CHIP,FFS Original Non-Crossover Expenditures N/A
EXP-13-004_1-7 % of claim lines on claims where Payment Level Indicator = 2 with Medicaid Paid Amount = $0 or missing High COT CHIP,FFS Original Non-Crossover Expenditures N/A
EL-3-028-37 % of MSIS IDs with PREGNANCY-INDICATOR= 1 that have SEX = “M” High ELG N/A N/A N/A Beneficiary demographics N/A
EL-3-029-38 % of MSIS IDs with RESTRICTED-BENEFITS-CODE = "4" that have SEX = “M” High ELG N/A N/A N/A Beneficiary eligibility N/A
ALL-16-009-9 % of claim lines with TYPE-OF-SERVICE= “086” (IP) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-010-10 % of claim lines with TYPE-OF-SERVICE= “086” (RX) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-011-11 % of claim lines with TYPE-OF-SERVICE= “025” or “085” (OT) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-012-12 % of claim lines in MBESCBES-FORM-GROUP 1 with MBESCBES-CATEGORY-OF-SERVICE = “14”, “35”, “42” or “44” (IP) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-013-13 % of claim lines in MBESCBES-FORM-GROUP 1 with MBESCBES-CATEGORY-OF-SERVICE = “14”, “35”, “42” or “44” (LT) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-014-14 % of claim lines in MBESCBES-FORM-GROUP 1 with MBESCBES-CATEGORY-OF-SERVICE = “14”, “35”, “42” or “44” (OT) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-015-15 % of claim lines in MBESCBES-FORM-GROUP 1 with MBESCBES-CATEGORY-OF-SERVICE = “14”, “35”, “42” or “44” (RX) linked to an MSIS ID where SEX = “M” N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-7243 % of ELG00002 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7244 % of ELG00003 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7245 % of ELG00004 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7246 % of ELG00005 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7248 % of ELG00012 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7249 % of ELG00014 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7250 % of ELG00015 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7251 % of ELG00016 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7247 % of ELG00021 record segments with a missing MSIS ID Critical ELG N/A N/A N/A File integrity N/A
RULE-7641 % of record segments with a valid Dual Eligible Code that have a missing value for Medicare HIC Number and Medicare Beneficiary Identifier for the same period of time High ELG N/A N/A N/A Beneficiary eligibility N/A
EXP-29P-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
EXP-33P-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
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 N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
EXP-22P-009-9 % of records with Payment or Recoupment Amount = $0 or missing, by Plan ID N/A FTX N/A Original All Indicators N/A N/A
EXP-41P-001-1 % of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID N/A CRX Medicaid,Enc Original Non-Crossover N/A N/A
MCR-56P-001-1 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-59P-001-13 % 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 N/A CIP Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59P-002-14 % 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 N/A CLT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
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 N/A COT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59P-004-16 % 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 N/A CRX Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
EXP-29R-001-1 % of Plan IDs over the threshold for EXP-29P-001-1 (% of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID) N/A CIP Medicaid,Enc Original Non-Crossover N/A N/A
EXP-33R-001-1 % of Plan IDs over the threshold for EXP-33P-001-1 (% of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID) N/A CLT Medicaid,Enc Original Non-Crossover N/A N/A
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) N/A COT Medicaid,Enc Original Non-Crossover N/A N/A
EXP-22R-009-9 % of Plan IDs over the threshold for EXP-22P-009-9 (% of records with Payment or Recoupment Amount = $0 or missing, by Plan ID) N/A FTX N/A Original All Indicators N/A N/A
EXP-41R-001-1 % of Plan IDs over the threshold for EXP-41P-001-1 (% of claim headers with Total Medicaid Paid Amount = $0 or missing, by Plan ID) N/A CRX Medicaid,Enc Original Non-Crossover N/A N/A
MCR-56R-001-1 % of Plan IDs over the threshold for MCR-56P-001-1 (% of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date, by Plan ID) N/A CIP Medicaid,Enc All Adjustment Types All Indicators N/A N/A
MCR-59R-001-13 % of Plan IDs over the threshold for MCR-59P-001-13 (% 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) N/A CIP Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59R-002-14 % of Plan IDs over the threshold for MCR-59P-002-14 (% 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) N/A CLT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
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) N/A COT Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MCR-59R-004-16 % of Plan IDs over the threshold for MCR-59P-004-16 (% 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) N/A CRX Medicaid,Enc or CHIP,Enc Original All Indicators N/A N/A
MIS-11-010_10-58 % distinct SUBMITTING-STATE-PROV-IDs where FACILITY-GROUP-INDIVIDUAL-CODE <> 03 with only missing values in any active segment: PROV-ORGANIZATION-NAME (PRV00002) Medium PRV N/A N/A N/A Provider identifiers N/A
MCR-12-156-156 # of records indicating a sub-capitation payment (SUBCAPITATION-IND = 2) N/A FTX N/A Original All Indicators N/A N/A
MCR-12-157-157 # of records indicating a sub-capitation payment (SUBCAPITATION-IND = 2) N/A FTX N/A Original All Indicators N/A N/A
MCR-12-158-158 # of claim headers indicating sub-capitated encounter records from sub-capitated entities that are not sub-capitated network providers (SOURCE-LOCATION = 22) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-159-159 # of claim headers indicating sub-capitated encounter records from sub-capitated entities that are not sub-capitated network providers (SOURCE-LOCATION = 22) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-160-160 # of claim headers indicating sub-capitated encounter records from sub-capitated network providers (SOURCE-LOCATION = 23) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-161-161 # of claim headers indicating sub-capitated encounter records from sub-capitated network providers (SOURCE-LOCATION = 23) N/A COT Medicaid,Enc Original All Indicators N/A N/A
MCR-12-162-162 # of records where the source location indicates a sub-capitation payment (SOURCE-LOCATION = 20) N/A FTX N/A Original All Indicators N/A N/A
MCR-12-163-163 # of records where the source location indicates a sub-capitation payment (SOURCE-LOCATION = 20) N/A FTX N/A Original All Indicators N/A N/A
ALL-37-001-1 Source Location N/A CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-38-001-1 Source Location N/A CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-39-001-1 Source Location N/A COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-40-001-1 Source Location N/A CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
RULE-7423 % of segments associated with an MSIS-ID with age over 120 or less than -1 High ELG N/A N/A N/A Beneficiary demographics Enrollment monitoring
RULE-7366 % of segments with missing DATE-OF-BIRTH (ELG00002) High ELG N/A N/A N/A Beneficiary demographics Enrollment monitoring
RULE-7367 % of segments with missing SEX (ELG00002) N/A ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7368 % of segments with missing ELIGIBLE-COUNTY-CODE (ELG00004) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7369 % of segments with missing ELIGIBLE-ZIP-CODE (ELG00004) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7370 % of segments missing RESTRICTED-BENEFITS-CODE (ELG00005) High ELG N/A N/A N/A Beneficiary demographics Enrollment monitoring
RULE-7371 % of segments missing ENROLLMENT-TYPE (ELG00021) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7407 % of segments with a valid plan type that are missing plan ID High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7408 % of segments with a non-missing plan ID that are missing plan type High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7411 % of segments indicating family planning (RESTRICTED-BENEFITS-CODE = 6) with non-family planning eligibility group High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7790 % 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 High CIP Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
RULE-7791 % 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 High CLT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
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 High COT Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
RULE-7793 % 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 High CRX Medicaid,FFS or CHIP,FFS Original All Indicators Expenditures N/A
RULE-7805 % of claims for which Patient Status is NOT "still a patient" but are missing Discharge Date Critical CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7806 % missing: ADMISSION-DATE (CIP00002) Critical CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7807 % missing: BEGINNING-DATE-OF-SERVICE (CIP00003) Critical CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7808 % missing: ENDING-DATE-OF-SERVICE (CIP00003) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7800 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7799 % missing: ENDING-DATE-OF-SERVICE (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7798 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) Critical CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7797 % missing: ENDING-DATE-OF-SERVICE (CLT00003) Critical CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7804 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) Critical COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7803 % missing: ENDING-DATE-OF-SERVICE (COT00002) Critical COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7802 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7801 % missing: ENDING-DATE-OF-SERVICE (COT00003) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7809 % missing: PRESCRIPTION-FILL-DATE (CRX00002) Critical CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators File integrity N/A
RULE-7726 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-7725 % missing: ENDING-DATE-OF-SERVICE (COT00002) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-7724 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-7723 % missing: ENDING-DATE-OF-SERVICE (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-7715 % missing: ADMISSION-DATE (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7716 % missing: BEGINNING-DATE-OF-SERVICE (CIP00003) Critical CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7717 % missing: ENDING-DATE-OF-SERVICE (CIP00003) Critical CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7712 % missing: BEGINNING-DATE-OF-SERVICE (CLT00002) Critical CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7713 % missing: ENDING-DATE-OF-SERVICE (CLT00002) Critical CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7710 % missing: BEGINNING-DATE-OF-SERVICE (CLT00003) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7711 % missing: ENDING-DATE-OF-SERVICE (CLT00003) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7722 % missing: BEGINNING-DATE-OF-SERVICE (COT00002) Critical COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7721 % missing: ENDING-DATE-OF-SERVICE (COT00002) Critical COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7720 % missing: BEGINNING-DATE-OF-SERVICE (COT00003) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7719 % missing: ENDING-DATE-OF-SERVICE (COT00003) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7718 % missing: PRESCRIPTION-FILL-DATE (CRX00002) Critical CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators File integrity Managed care
RULE-7893 % missing: TYPE-OF-SERVICE (CIP00003) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7737 % missing: TYPE-OF-SERVICE (CIP00003) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7894 % missing: TYPE-OF-SERVICE (CLT00003) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7738 % missing: TYPE-OF-SERVICE (CLT00003) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7895 % missing: TYPE-OF-SERVICE (COT00003) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7739 % missing: TYPE-OF-SERVICE (COT00003) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7896 % missing: TYPE-OF-SERVICE (CRX00003) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Utilization N/A
RULE-7740 % missing: TYPE-OF-SERVICE (CRX00003) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Utilization Managed care
RULE-7254 % missing: TYPE-OF-CLAIM (CIP00002) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7255 % missing: TYPE-OF-CLAIM (CLT00002) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7256 % missing: TYPE-OF-CLAIM (COT00002) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7257 % missing: TYPE-OF-CLAIM (CRX00002) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7262 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CIP00003) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7263 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CLT00003) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7892 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (COT00003) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7736 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (COT00003) N/A COT Medicaid,Cap or CHIP,Cap Original and Replacement All Indicators N/A N/A
RULE-7265 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (CRX00003) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7349 % of claim lines with non-missing Place of Service that have missing Procedure Code High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7351 % of claim lines missing Type of Bill and Place of Service High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7352 % of claim lines with non-missing Type of Bill that have missing Revenue Code High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7353 % of claim lines with non-missing Revenue Code that have missing Type of Bill High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7354 % of claim lines missing Procedure Code and Revenue Code High COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7816 % of claim lines with missing Days Supply High CRX Medicaid,FFS or CHIP,FFS Original Non-Crossover Utilization N/A
RULE-7750 % of claim lines with missing Days Supply High CRX Medicaid,Enc or CHIP,Enc Original Non-Crossover Utilization Managed care
RULE-7817 % of claim lines with missing Prescription Quantity Actual High CRX Medicaid,FFS or CHIP,FFS Original Non-Crossover Utilization N/A
RULE-7751 % of claim lines with missing Prescription Quantity Actual High CRX Medicaid,Enc or CHIP,Enc Original Non-Crossover Utilization Managed care
RULE-7313 % of claim header record segments missing ADJUDICATION-DATE (CIP00002) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7317 % of claim line record segments missing ADJUDICATION-DATE (CIP00003) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7314 % of claim header record segments missing ADJUDICATION-DATE (CLT00002) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7318 % of claim line record segments missing ADJUDICATION-DATE (CLT00003) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7315 % of claim header record segments missing ADJUDICATION-DATE (COT00002) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7319 % of claim line record segments missing ADJUDICATION-DATE (COT00003) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7316 % of claim header record segments missing ADJUDICATION-DATE (CRX00002) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7320 % of claim line record segments missing ADJUDICATION-DATE (CRX00003) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7901 % missing: MEDICAID-PAID-DATE (CIP00002) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7904 % missing: MEDICAID-PAID-DATE (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7903 % missing: MEDICAID-PAID-DATE (COT00002) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7902 % missing: MEDICAID-PAID-DATE (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Expenditures N/A
RULE-7752 % missing: MEDICAID-PAID-DATE (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
RULE-7755 % missing: MEDICAID-PAID-DATE (CLT00002) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
RULE-7754 % missing: MEDICAID-PAID-DATE (COT00002) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
RULE-7753 % missing: MEDICAID-PAID-DATE (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Expenditures Managed care
MIS-6-024_42 % missing: ORDERING-PROV-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-6-024_43 % missing: ORDERING-PROV-NPI-NUM (COT00002) N/A COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators N/A N/A
ALL-16-016-16 % of claims with IHS-SERVICE-IND = “1” not linked to any MSIS ID where AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = “1” Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Utilization N/A
ALL-16-017-17 % of claims with IHS-SERVICE-IND = “1” not linked to any MSIS ID where AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = “1” Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Utilization N/A
ALL-16-018-18 % of claims with IHS-SERVICE-IND = “1” not linked to any MSIS ID where AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = “1” Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Utilization N/A
ALL-16-019-19 % of claims with IHS-SERVICE-IND = “1” not linked to any MSIS ID where AMERICAN-INDIAN-ALASKAN-NATIVE-INDICATOR = “1” Medium Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators Utilization N/A
ALL-16-020-20 % of claims with IHS-SERVICE-IND = “1” (IP) not linked to any MSIS ID where RACE = “003” (American Indian or Alaskan Native) N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-021-21 % of claims with IHS-SERVICE-IND = “1” (LT) not linked to any MSIS ID where RACE = “003” (American Indian or Alaskan Native) N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-022-22 % of claims with IHS-SERVICE-IND = “1” (OT) not linked to any MSIS ID where RACE = “003” (American Indian or Alaskan Native) N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
ALL-16-023-23 % of claims with IHS-SERVICE-IND = “1” (RX) not linked to any MSIS ID where RACE = “003” (American Indian or Alaskan Native) N/A Multiple Files Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators N/A N/A
EL-6-038-38 % of MSIS IDs with an IMMIGRATION-STATUS = 3 (Eligible only for payment for emergency services) N/A ELG N/A N/A N/A N/A N/A
EL-6-039-39 % of MSIS IDs with a RESTRICTED-BENEFITS-CODE = 2 (Noncitizen restricted benefits code status) N/A ELG N/A N/A N/A N/A N/A
EL-6-040-40 % of MSIS IDs enrolled in the past year with at least one gap in enrollment over that time High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
EL-6-042-42 % of MSIS IDs Age < 19 with restricted benefits (RESTRICTED-BENEFITS-CODE = "02", "03", or "06") Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-043-43 % of MSIS IDs Age 19 - 64 with restricted benefits (RESTRICTED-BENEFITS-CODE = "02", "03", or "06") Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-044-44 % of MSIS IDs Age 65+ with restricted benefits (RESTRICTED-BENEFITS-CODE = "02", "03", or "06")  Medium ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-045-45 % of MSIS IDs Age < 19 without a valid Restricted Benefits Code N/A ELG N/A N/A N/A N/A N/A
EL-6-046-46 % of MSIS IDs Age 19 - 64 without a valid Restricted Benefits Code N/A ELG N/A N/A N/A N/A N/A
EL-6-047-47 % of MSIS IDs Age 65+ without a valid Restricted Benefits Code  N/A ELG N/A N/A N/A N/A N/A
EL-3-030-39 % of MSIS IDs Age < 19 without a valid Eligibility Group N/A ELG N/A N/A N/A N/A N/A
EL-3-031-40 % of MSIS IDs Age 19 - 64 without a valid Eligibility Group N/A ELG N/A N/A N/A N/A N/A
EL-3-032-41 % of MSIS IDs Age 65+ without a valid Eligibility Group  N/A ELG N/A N/A N/A N/A N/A
RULE-7358 % of segments missing FACILITY-GROUP-INDIVIDUAL-CODE (PRV00002) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7359 % of segments missing PROV-IDENTIFIER (PRV00005) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7360 % of segments missing PROV-IDENTIFIER-EFF-DATE (PRV00005) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7361 % of segments missing PROV-IDENTIFIER-ISSUING-ENTITY-ID (PRV00005) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7362 % of segments missing PROV-IDENTIFIER-TYPE (PRV00005) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7363 % of segments missing PROV-CLASSIFICATION-CODE (PRV00006) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7364 % of segments missing PROV-CLASSIFICATION-TYPE (PRV00006) High PRV N/A N/A N/A Provider characteristics N/A
RULE-7532 % of record segments where county code does not align with address state and is not missing High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7980 % of record segments where zip code does not align with address state and is not missing High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-2051 % of record segments with CITIZENSHIP-IND = 1 or 2 (U.S. Citizen or U.S. National) but IMMIGRATION-STATUS does not equal 8 (Not applicable) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-2157 % of record segments with an alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) but CITIZENSHIP-IND = 1 or 2 (U.S. Citizen or U.S. National) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7529 % of record segments with an alien restricted benefits code status (RESTRICTED-BENEFITS-CODE = 2) but a non-qualified alien immigration status (IMMIGRATION-STATUS not 1, 2, or 3) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7528 % of record segments with an IMMIGRATION-STATUS = 8 (Not applicable) but CITIZENSHIP-IND does not equal 1 or 2 (U.S. Citizen or U.S. National) High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7380 % of record segments with missing Citizenship Indicator High ELG N/A N/A N/A Beneficiary demographics N/A
RULE-7381 % of record segments with missing Immigration Status High ELG N/A N/A N/A Beneficiary demographics N/A
EL-3-033-42 % of MSIS IDs with ELIGIBILITY-GROUP = 11 (Individuals Receiving SSI) without full benefits High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-3-034-43 % of MSIS IDs with ELIGIBILITY-GROUP = 05 (Pregnant Women) where SEX is not equal to “M” with Age 40-44 High ELG N/A N/A N/A Beneficiary eligibility N/A
EL-6-041-41 % of MSIS IDs enrolled in the past year with at least three gaps in enrollment over that time High ELG N/A N/A N/A Beneficiary eligibility Enrollment monitoring
RULE-7760 % missing: BILLING-PROV-NPI-NUM (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7818 % missing: BILLING-PROV-NPI-NUM (CIP00002) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7756 % missing: BILLING-PROV-NUM (CIP00002) High CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7821 % missing: BILLING-PROV-NUM (CIP00002) High CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7916 % of claim headers that have an invalid Billing Provider Taxonomy High CIP Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7917 % of claim headers that have an invalid Billing Provider Taxonomy High CIP Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7905 % of claim headers with Billing Provider NPI Number in an invalid format High CIP Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7909 % of claim headers with Billing Provider NPI Number in an invalid format High CIP Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7762 % missing: BILLING-PROV-NPI-NUM (CLT00002) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7820 % missing: BILLING-PROV-NPI-NUM (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7757 % missing: BILLING-PROV-NUM (CLT00002) High CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7822 % missing: BILLING-PROV-NUM (CLT00002) High CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7913 % of claim headers that have an invalid Billing Provider Taxonomy High CLT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7918 % of claim headers that have an invalid Billing Provider Taxonomy High CLT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7906 % of claim headers with Billing Provider NPI Number in an invalid format High CLT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7910 % of claim headers with Billing Provider NPI Number in an invalid format High CLT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7758 % missing: BILLING-PROV-NUM (COT00002) High COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7823 % missing: BILLING-PROV-NUM (COT00002) High COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7914 % of claim headers that have an invalid Billing Provider Taxonomy High COT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7919 % of claim headers that have an invalid Billing Provider Taxonomy High COT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7907 % of claim headers with Billing Provider NPI Number in an invalid format High COT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7911 % of claim headers with Billing Provider NPI Number in an invalid format High COT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7763 % missing: BILLING-PROV-NPI-NUM (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7827 % missing: BILLING-PROV-NPI-NUM (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7759 % missing: BILLING-PROV-NUM (CRX00002) High CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider information Managed care
RULE-7824 % missing: BILLING-PROV-NUM (CRX00002) High CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider information N/A
RULE-7908 % of claim headers with Billing Provider NPI Number in an invalid format High CRX Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Provider information Managed care
RULE-7912 % of claim headers with Billing Provider NPI Number in an invalid format High CRX Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Provider information N/A
RULE-7419 % of segments with ELIGIBILITY-GROUP = 23 through 26 (QMB, QDWI, SLMB or QI) without valid DUAL-ELIGIBLE-CODE 01 through 10 High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7420 % of segments (RESTRICTED-BENEFITS-CODE = 3) without a partial dual code (DUAL-ELIGIBLE-CODE not 01, 03, 05, 06) High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7421 % of segments (DUAL-ELIGIBLE-CODE = 01, 03, 05, 06) without an RBC of dual (RESTRICTED-BENEFITS-CODE not 3) High ELG N/A N/A N/A Beneficiary eligibility N/A
RULE-7897 % of claim headers with an MSIS ID not enrolled on Admission Date N/A Multiple Files Medicaid,Supp or CHIP,Supp Non-void All Indicators N/A N/A
RULE-7898 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service N/A Multiple Files Medicaid,Supp or CHIP,Supp Non-void All Indicators N/A N/A
RULE-7899 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service N/A Multiple Files Medicaid,Supp or CHIP,Supp Non-void All Indicators N/A N/A
RULE-7900 % of claim headers with an MSIS ID not enrolled on Prescription Fill Date N/A Multiple Files Medicaid,Supp or CHIP,Supp Non-void All Indicators N/A N/A
RULE-7633 % of claim headers that have no corresponding non-denied claim lines Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7634 % of claim headers that have no corresponding non-denied claim lines Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7635 % of claim headers that have no corresponding non-denied claim lines Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7636 % of claim headers that have no corresponding non-denied claim lines Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-7976 % of claim lines where all lines with the same claim key are denied that have no corresponding denied claim header High CIP N/A All Adjustment Types All Indicators File integrity N/A
RULE-7977 % of claim lines where all lines with the same claim key are denied that have no corresponding denied claim header High CLT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7978 % of claim lines where all lines with the same claim key are denied that have no corresponding denied claim header High COT N/A All Adjustment Types All Indicators File integrity N/A
RULE-7979 % of claim lines where all lines with the same claim key are denied that have no corresponding denied claim header High CRX N/A All Adjustment Types All Indicators File integrity N/A
RULE-7974 % of claim headers with HCBS-SERVICE-CODE = 4 that are missing Waiver ID High COT Medicaid,Enc or CHIP,Enc All Adjustment Types All Indicators Utilization N/A
RULE-7975 % of claim headers with HCBS-SERVICE-CODE = 4 that are missing Waiver ID High COT Medicaid,FFS or CHIP,FFS All Adjustment Types All Indicators Utilization N/A
RULE-7921 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Admission Date High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7922 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Beginning Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7923 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Beginning Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7924 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7929 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Admission Date High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7930 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Beginning Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7931 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Beginning Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7932 % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7925 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7926 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7927 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7928 % of claim headers with a Dispensing Prescription Drug Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date High Multiple Files Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators Provider enrollment Managed care
RULE-7933 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7934 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7935 % of claim lines with a Servicing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Ending Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7936 % of claim headers with a Dispensing Prescription Drug Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date High Multiple Files Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators Provider enrollment N/A
RULE-7782 % of claim headers with an MSIS ID not enrolled on Admission Date High Multiple Files Medicaid,FFS or CHIP,FFS Non-void All Indicators File integrity N/A
RULE-7783 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Non-void All Indicators File integrity N/A
RULE-7784 % of claim headers with an MSIS ID not enrolled on Beginning Date of Service High Multiple Files Medicaid,FFS or CHIP,FFS Non-void All Indicators File integrity N/A
RULE-7785 % of claim headers with an MSIS ID not enrolled on Prescription Fill Date High Multiple Files Medicaid,FFS or CHIP,FFS Non-void All Indicators File integrity N/A
MIS-91-001-1 % missing: DIAGNOSIS-CODE (CIP00004) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-91-001-2 % missing: DIAGNOSIS-CODE-FLAG (CIP00004) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-91-001-3 % missing: DIAGNOSIS-POA-FLAG (CIP00004) N/A CIP Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-92-001-1 % missing: DIAGNOSIS-CODE (CLT00004) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-92-001-2 % missing: DIAGNOSIS-CODE-FLAG (CLT00004) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-92-001-3 % missing: DIAGNOSIS-POA-FLAG (CLT00004) N/A CLT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-93-001-1 % missing: DIAGNOSIS-CODE (COT00004) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-93-001-2 % missing: DIAGNOSIS-CODE-FLAG (COT00004) N/A COT Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-94-001-1 % missing: DIAGNOSIS-CODE (CRX00004) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-94-001-2 % missing: DIAGNOSIS-CODE-FLAG (CRX00004) N/A CRX Medicaid,FFS or CHIP,FFS Original and Replacement All Indicators N/A N/A
MIS-95-001-1 % missing: DIAGNOSIS-CODE (CIP00004) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-95-001-2 % missing: DIAGNOSIS-CODE-FLAG (CIP00004) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-95-001-3 % missing: DIAGNOSIS-POA-FLAG (CIP00004) N/A CIP Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-96-001-1 % missing: DIAGNOSIS-CODE (CLT00004) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-96-001-2 % missing: DIAGNOSIS-CODE-FLAG (CLT00004) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-96-001-3 % missing: DIAGNOSIS-POA-FLAG (CLT00004) N/A CLT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-97-001-1 % missing: DIAGNOSIS-CODE (COT00004) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-97-001-2 % missing: DIAGNOSIS-CODE-FLAG (COT00004) N/A COT Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-98-001-1 % missing: DIAGNOSIS-CODE (CRX00004) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MIS-98-001-2 % missing: DIAGNOSIS-CODE-FLAG (CRX00004) N/A CRX Medicaid,Enc or CHIP,Enc Original and Replacement All Indicators N/A N/A
MCR-31-003_3-11 % of MSIS IDs enrolled on Capitation Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-31-003_3-12 % of MSIS IDs enrolled on Premium Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-31-003_3-13 % of MSIS IDs enrolled on Coverage Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-31-008_8-14 % of MSIS IDs enrolled on Capitation Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-31-008_8-15 % of MSIS IDs enrolled on Premium Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
MCR-31-008_8-16 % of MSIS IDs enrolled on Coverage Period Start Date N/A Multiple Files N/A All Adjustment Types All Indicators N/A N/A
RULE-8405 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8425 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8441 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8458 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8475 01/30/2026 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8494 01/30/2026 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8513 01/30/2026 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8530 01/30/2026 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8547 01/30/2026 % of records with an invalid Adjustment Indicator (ADJUSTMENT-IND is 2, 3, 9, other invalid value) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8746 01/30/2026 % of records with an MSIS ID not enrolled on CAPITATION-PERIOD-START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-8747 01/30/2026 % of records with an MSIS ID not enrolled on PREMIUM-PERIOD-START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-8748 01/30/2026 % of records with an MSIS ID not enrolled on PREMIUM-PERIOD-START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-8749 01/30/2026 % of records with an MSIS ID not enrolled on COVERAGE-PERIOD -START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-8750 01/30/2026 % of records with an MSIS ID not enrolled on PERFORMANCE-PERIOD-START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-8751 01/30/2026 % of records with an MSIS ID not enrolled on PAYMENT-PERIOD-START-DATE Critical Multiple Files N/A All Adjustment Types N/A File integrity N/A
RULE-9126 % of claim headers with invalid Diagnosis Code Medium COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp Non-void All Indicators Utilization N/A
RULE-8719 % of records with a PAYEE ID that is not found on the provider file during the capitation period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8720 % of records with a PAYEE ID that is not found on the provider file during the premium period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8721 % of records with a PAYEE ID that is not found on the provider file during the premium period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8722 % of records with a PAYEE ID that is not found on the provider file during the coverage period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8723 % of records with a PAYEE ID that is not found on the provider file during the performance period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8724 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8725 % of records with a PAYEE ID that is not found on the provider file during the cost settlement period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8726 % of records with a PAYEE ID that is not found on the provider file during the wrap period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8727 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8728 % of records with a PAYEE ID that is not found on the provider file during the capitation period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8729 % of records with a PAYEE ID that is not found on the provider file during the premium period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8730 % of records with a PAYEE ID that is not found on the provider file during the premium period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8731 % of records with a PAYEE ID that is not found on the provider file during the coverage period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8732 % of records with a PAYEE ID that is not found on the provider file during the performance period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8733 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8734 % of records with a PAYEE ID that is not found on the provider file during the cost settlement period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8735 % of records with a PAYEE ID that is not found on the provider file during the wrap period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8736 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8737 % of records with a PAYEE ID that is not found on the provider file during the capitation period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8741 % of records with a PAYEE ID that is not found on the provider file during the performance period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8742 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8743 % of records with a PAYEE ID that is not found on the provider file during the cost settlement period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8744 % of records with a PAYEE ID that is not found on the provider file during the wrap period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8745 % of records with a PAYEE ID that is not found on the provider file during the payment period start date Medium Multiple Files N/A All Adjustment Types N/A Provider information N/A
RULE-8710 % of duplicate individual capitation or sub-capitation payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8711 % of duplicate individual health insurance premium payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8712 % of duplicate group insurance premium payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8713 % of duplicate cost sharing offsets Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8714 01/30/2026 % of duplicate value-based payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8715 01/30/2026 % of duplicate state directed payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8716 01/30/2026 % of duplicate cost settlement payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8717 01/30/2026 % of duplicate FQHC wrap payments Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8718 01/30/2026 % of duplicate miscellaneous payment transactions Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-9170 % of DX record segments missing ADJUDICATION-DATE (CIP00004) Critical CIP Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-9188 % of DX record segments missing ADJUDICATION-DATE (CLT00004) Critical CLT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-8638 02/28/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8639 02/28/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8640 02/28/2026 % of records missing PAYMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8641 02/28/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8642 01/30/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8643 01/30/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8644 01/30/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8645 01/30/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8646 02/28/2026 % of records missing PAYMENT-OR-RECOUPMENT-DATE Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-9207 % of DX record segments missing ADJUDICATION-DATE (COT00004) Critical COT Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-9221 % of DX record segments missing ADJUDICATION-DATE (CRX00004) Critical CRX Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp All Adjustment Types All Indicators File integrity N/A
RULE-8665 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00002) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8666 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00003) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8667 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00004) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8668 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00005) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8669 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00006) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8670 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00007) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8671 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00008) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8672 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00009) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8673 01/30/2026 % missing: MBESCBES-CATEGORY-OF-SERVICE (FTX00095) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8649 % missing: PREMIUM-PERIOD-START-DATE (FTX00004) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8658 % missing: PREMIUM-PERIOD-END-DATE (FTX00004) High FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8629 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8630 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8631 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8632 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8633 01/30/2026 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8634 01/30/2026 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8635 01/30/2026 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8636 01/30/2026 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8637 01/30/2026 % of records with a missing Adjustment Indicator Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-9226 % of claim headers with a Procedure Code indicating a dental claim and non-missing Diagnosis Code Flag that have a missing Diagnosis Code Medium COT Medicaid,FFS or Medicaid,Enc or CHIP,FFS or CHIP,Enc Original and Replacement All Indicators Utilization N/A
RULE-8752 01/30/2026 % of records with a valid value for Payee ID (FTX00002) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8753 01/30/2026 % of records with a valid value for Payee ID (FTX00003) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8754 01/30/2026 % of records with a valid value for Payee ID (FTX00004) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8755 01/30/2026 % of records with a valid value for Payee ID (FTX00005) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8756 01/30/2026 % of records with a valid value for Payee ID (FTX00006) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8757 01/30/2026 % of records with a valid value for Payee ID (FTX00007) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8758 01/30/2026 % of records with a valid value for Payee ID (FTX00008) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8759 01/30/2026 % of records with a valid value for Payee ID (FTX00009) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8760 01/30/2026 % of records with a valid value for Payee ID (FTX00095 ) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8761 01/30/2026 % of records with a valid value for Payer ID (FTX00002) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8762 01/30/2026 % of records with a valid value for Payer ID (FTX00006) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8763 01/30/2026 % of records with a valid value for Payer ID (FTX00007) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8764 01/30/2026 % of records with a valid value for Payer ID (FTX00008) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8765 01/30/2026 % of records with a valid value for Payer ID (FTX00009) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8766 01/30/2026 % of records with a valid value for Payer ID (FTX00095 ) that do not have a corresponding MCR Managed Care Main segment for the same time period High Multiple Files N/A All Adjustment Types N/A Program participation Managed care
RULE-8656 % missing: CAPITATION-PERIOD-END-DATE (FTX00002) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8657 % missing: PREMIUM-PERIOD-END-DATE (FTX00003) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8659 % missing: COVERAGE-PERIOD-END-DATE (FTX00005) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8660 01/30/2026 % missing: PERFORMANCE-PERIOD-END-DATE (FTX00006) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8661 01/30/2026 % missing: PAYMENT-PERIOD-END-DATE (FTX00007) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8662 01/30/2026 % missing: COST-SETTLEMENT-PERIOD-END-DATE (FTX00008) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8663 01/30/2026 % missing: WRAP-PERIOD-END-DATE (FTX00009) High FTX N/A All Adjustment Types N/A Utilization N/A
RULE-8664 01/30/2026 % missing: PAYMENT-PERIOD-END-DATE (FTX00095) High FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8647 01/30/2026 % missing: CAPITATION-PERIOD-START-DATE (FTX00002) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8648 % missing: PREMIUM-PERIOD-START-DATE (FTX00003) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8650 % missing: COVERAGE-PERIOD-START-DATE (FTX00005) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8651 01/30/2026 % missing: PERFORMANCE-PERIOD-START-DATE (FTX00006) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8652 01/30/2026 % missing: PAYMENT-PERIOD-BEGIN-DATE (FTX00007) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8653 01/30/2026 % missing: COST-SETTLEMENT-PERIOD-START-DATE (FTX00008) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8654 01/30/2026 % missing: WRAP-PERIOD-START-DATE (FTX00009) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8655 01/30/2026 % missing: PAYMENT-PERIOD-BEGIN-DATE (FTX00095) Critical FTX N/A All Adjustment Types N/A File integrity N/A
RULE-8674 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00002) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8675 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00003) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8676 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00004) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8677 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00005) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8678 01/30/2026 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00006) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8679 01/30/2026 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00007) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8680 01/30/2026 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00008) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8681 01/30/2026 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00009) High FTX N/A All Adjustment Types N/A Expenditures N/A
RULE-8682 01/30/2026 % missing: CATEGORY-FOR-FEDERAL-REIMBURSEMENT (FTX00095) High FTX N/A All Adjustment Types N/A Expenditures N/A
EXP-46-001-1 05/07/2026 % difference between T-MSIS inpatient hospital expenditures and CMS-64 inpatient hospital expenditures (Medicaid FFS) High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-002-2 05/07/2026 % difference between T-MSIS inpatient long-term care facility expenditures and CMS-64 inpatient long-term care facility expenditures (Medicaid FFS) High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-003-3 05/07/2026 % difference between T-MSIS all other FFS medical services expenditures and CMS-64 all other medical services expenditures (Medicaid FFS) High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-004-4 05/07/2026 % difference between T-MSIS prescription drugs expenditures and CMS-64 prescription drug expenditures (Medicaid FFS) High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-005-5 05/07/2026 % difference between T-MSIS payments to comprehensive managed care plans and CMS-64 payments to managed care organizations High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-006-6 05/07/2026 % difference between T-MSIS payments to prepaid health plans and CMS-64 payments to prepaid health plans High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-007-7 05/07/2026 % difference between T-MSIS payments for premium assistance and CMS-64 Medicaid premium assistance payments High Multiple Files N/A All Adjustment Types N/A Expenditures N/A
EXP-46-008-8 05/07/2026 % difference between T-MSIS primary care case management fees and CMS-64 payments for primary care case management High Multiple Files N/A All Adjustment Types N/A Expenditures N/A