We were trying to run create-icfrequency.pl and found a bug in the source code. In line 282 (https://metacpan.org/source/BTMCINNES/UMLS-Similarity-1.41/utils/create-icfrequency.pl#L282 https://metacpan.org/source/BTMCINNES/UMLS-Similarity-1.41/utils/create-icfrequency.pl#L282) it has $opt_metamay instead of $opt_metamap, which causes it to print an error message whenever one wants to use the metamap option.
It seems to work fine when the typo is removed. -Albert