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To examine time trends in receipt of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services in serial cohorts of Medicaid beneficiaries 21 years, as Medicaid managed care (MMC) was adopted by states. Using annual state-level data from the Centers for Medicare Medicaid Services, we performed national analyses of Medicaid beneficiaries 21 years from 2000 to 2017. We used generalized linear models to assess the relationship between MMC enrollment and EPSDT encounters, accounting for repeated measures, first at the national level