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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

MCR-59-012-12

Data Quality Measure
Last updated

Key Information

Measure Name % of claim lines with PAYMENT-LEVEL-IND=2 (claim detail) that have Medicaid Paid Amount greater than a non-zero Allowed Amount
File Type CRX
Measure ID MCR-59-012-12
Measure Type Claims Percentage
Content area MCR

Validation

Validation Type Inferential

Measure Priority

Measure Priority N/A
Focus Area N/A
Category N/A

Claim Information

Claim Type Medicaid,Enc or CHIP,Enc
Adjustment Type Original
Crossover Type All Indicators

Thresholds

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

Data Elements

DD Data Element ALLOWED-AMT • MEDICAID-PAID-AMT • PAYMENT-LEVEL-IND
DD Data Element Number CRX122 • CRX125 • CRX058

Annotation N/A
Specification N/A