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TMSIS Dataguide Medicaid.gov

Version:

MCR-53-001-1

Data Quality Measure
Last updated

Key Information

Measure Name Total # of managed care enrollments
File Type ELG
Measure ID MCR-53-001-1
Measure Type Count
Content area MCR

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area Managed care
Category Program participation

Claim Information

Claim Type N/A
Adjustment Type N/A
Crossover Type N/A

Thresholds

Minimum 1
Maximum N/A
TA Minimun 1
TA Maximum
Longitudinal Threshold N/A
For TA
(for including in compliance training)
TA- Inferential
For TA
(Longitudinal)
No

Data Elements

DD Data Element STATE-PLAN-ID-NUM • MANAGED-CARE-PLAN-TYPE • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-SERVICE • ADJUSTMENT-IND • TYPE-OF-CLAIM • TYPE-OF-CLAIM • PLAN-ID-NUMBER • MANAGED-CARE-PLAN-TYPE • MANAGED-CARE-PLAN-ID • ADJUSTMENT-IND • PLAN-ID-NUMBER • PLAN-ID-NUMBER • ADJUSTMENT-IND • PLAN-ID-NUMBER
DD Data Element Number MCR019ELG193CRX025COT037COT186CIP026CIP100CLT052CLT080MCR024ELG192COT025CIP130CRX056CLT025COT066

Annotation Sum total enrollment for all plan ids in the EL-8-002-2 table
Specification STEP 1: Total enrollment

For each non-missing Plan_Id identified in EL-8-002-2, sum Enrollment