NYS Patient-Level Detail File Specifications - MARKETPLACE
- File Specs also available in Portable Document Format (PDF)
December 13, 2018
| MEASURE | COLUMN LENGTH | COLUMN START | COLUMN END | FIELD | SPECIFICATION |
|---|---|---|---|---|---|
| GENERAL INFO | 1 | 1 | 1 | Record Identifier | Use the tilde (~) character to start the line. |
| GENERAL INFO | 5 | 2 | 6 | Submission ID | The unique identifier assigned by NCQA for summary–level data submission |
| GENERAL INFO | 18 | 7 | 24 | Product Line | QHP_HMO, QHP_POS, QHP_PPO, QHP_EPO |
| GENERAL INFO | 30 | 25 | 54 | Member ID | Member ID that is used in the HEDIS software to calculate the rates. |
| GENERAL INFO | 8 | 55 | 62 | Date of birth | The birth date must contain 8 digits with month, day, year Enter: MMDDYYYY (e.g., September 20, 1983 would be 09201983) |
| GENERAL INFO | 2 | 63 | 64 | Member Months | The member month contribution this member adds according to enrollment data. Valid values are between 0 12. |
| GENERAL INFO | 1 | 65 | 65 | Sex | Enter: The gender assigned at birth ´F´ if this member is female ´M´ if this member is male ´O´ if the member refused to provide gender No other characters are allowed |
| ABA | 1 | 66 | 66 | Denominator for Adult BMI Assessment (ABA) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ABA | 1 | 67 | 67 | Numerator for Adult BMI Assessment (ABA) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 68 | 68 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 3–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 69 | 69 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 3–11 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 70 | 70 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 12–17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 71 | 71 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 12–17 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 72 | 72 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 3–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 73 | 73 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 3–11 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 74 | 74 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 12–17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 75 | 75 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 12–17 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 76 | 76 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 3–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 77 | 77 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 3–11 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| WCC | 1 | 78 | 78 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 12–17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| WCC | 1 | 79 | 79 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 12–17 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 80 | 80 | Denominator for Childhood Immunization Status (CIS) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CIS | 1 | 81 | 81 | Numerator for Childhood Immunization Status (CIS): DTaP | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 82 | 82 | Numerator for Childhood Immunization Status (CIS): IPV | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 83 | 83 | Numerator for Childhood Immunization Status (CIS): MMR | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 84 | 84 | Numerator for Childhood Immunization Status (CIS): HiB | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 85 | 85 | Numerator for Childhood Immunization Status (CIS): HepB | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 86 | 86 | Numerator for Childhood Immunization Status (CIS): VZV | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 87 | 87 | Numerator for Childhood Immunization Status (CIS): PCV | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CIS | 1 | 88 | 88 | Numerator for Childhood Immunization Status (CIS): Combo 3 | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IMA | 1 | 89 | 89 | Denominator for Immunizations for Adolescents (IMA) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IMA | 1 | 90 | 90 | Numerator for Immunizations for Adolescents (IMA): Meningococcal | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IMA | 1 | 91 | 91 | Numerator for Immunizations for Adolescents (IMA): Tdap | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IMA | 1 | 92 | 92 | Numerator for Immunizations for Adolescents (IMA): HPV | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IMA | 1 | 93 | 93 | Numerator for Immunizations for Adolescents (IMA): Combo 2 | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| BCS | 1 | 94 | 94 | Denominator for Breast Cancer Screening (BCS) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| BCS | 1 | 95 | 95 | Numerator for Breast Cancer Screening (BCS) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CCS | 1 | 96 | 96 | Denominator for Cervical Cancer Screening (CCS) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CCS | 1 | 97 | 97 | Numerator for Cervical Cancer Screening (CCS) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| COL | 1 | 98 | 98 | Denominator for Colorectal Cancer Screening (COL) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| COL | 1 | 99 | 99 | Numerator for Colorectal Cancer Screening (COL) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CHL | 1 | 100 | 100 | Denominator for Chlamydia Screening in Women (CHL): 16–20 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CHL | 1 | 101 | 101 | Numerator for Chlamydia Screening in Women (CHL): 16–20 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CHL | 1 | 102 | 102 | Denominator for Chlamydia Screening in Women (CHL): 21–24 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CHL | 1 | 103 | 103 | Numerator for Chlamydia Screening in Women (CHL): 21–24 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CWP | 1 | 104 | 104 | Denominator for Appropriate Testing for Children With Pharyngitis (CWP) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CWP | 1 | 105 | 105 | Numerator for Appropriate Testing for Children With Pharyngitis (CWP) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| MMA | 1 | 106 | 106 | Denominator for Medication Management for People with Asthma (MMA): 5–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MMA | 1 | 107 | 107 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 75%, 5–11 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| MMA | 1 | 108 | 108 | Denominator for Medication Management for People with Asthma (MMA): 12–18 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MMA | 1 | 109 | 109 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 75%, 12–18 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| MMA | 1 | 110 | 110 | Denominator for Medication Management for People with Asthma (MMA): 19–50 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MMA | 1 | 111 | 111 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 75%, 19–50 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| MMA | 1 | 112 | 112 | Denominator for Medication Management for People with Asthma (MMA): 51–64 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MMA | 1 | 113 | 113 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 75%, 51–64 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CBP | 1 | 114 | 114 | Denominator for Controlling High Blood Pressure (CBP) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CBP | 1 | 115 | 115 | Numerator for Controlling High Blood Pressure (CBP) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CDC | 1 | 116 | 116 | Denominator for Comprehensive Diabetes Care (CDC): HbA1c Control <8% | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 117 | 117 | Numerator for Comprehensive Diabetes Care (CDC): HbA1c Control <8% | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CDC | 1 | 118 | 118 | Denominator for Comprehensive Diabetes Care (CDC): Eye Exam | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 119 | 119 | Numerator for Comprehensive Diabetes Care (CDC): Eye Exam | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| CDC | 1 | 120 | 120 | Denominator for Comprehensive Diabetes Care (CDC): Medical Attention for Nephropathy | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 121 | 121 | Numerator for Comprehensive Diabetes Care (CDC): Medical Attention for Nephropathy | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| AMM | 1 | 122 | 122 | Denominator for Antidepressant Medication Management (AMM) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AMM | 1 | 123 | 123 | Numerator for Antidepressant Medication Management (AMM): Effective Acute Phase Treatment | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| AMM | 1 | 124 | 124 | Numerator for Antidepressant Medication Management (AMM): Effective Continuation Phase Treatment | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADD | 1 | 125 | 125 | Denominator for Follow–Up Care for Children Prescribed ADHD Medication (ADD): Initiation Phase | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADD | 1 | 126 | 126 | Numerator for Follow–Up Care for Children Prescribed ADHD Medication (ADD): Initiation Phase | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADD | 1 | 127 | 127 | Denominator for Follow–Up Care for Children Prescribed ADHD Medication (ADD): Continuation and Maintenance (C&M) Phase | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADD | 1 | 128 | 128 | Numerator for Follow–Up Care for Children Prescribed ADHD Medication (ADD): Continuation and Maintenance (C&M) Phase | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| FUH | 2 | 129 | 130 | Denominator for Follow–Up After Hospitalization for Mental Illness (FUH) | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| FUH | 2 | 131 | 132 | Numerator for Follow–Up After Hospitalization for Mental Illness (FUH): 7–day follow–up | Enter: The number of times this member is in the numerator ´0´ if the member is not in the numerator OR the information is missing |
| MPM | 1 | 133 | 133 | Denominator for Annual Monitoring for Patients on Persistent Medications (MPM): Annual Monitoring for Members on ACE Inhibitors or ARBs | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MPM | 1 | 134 | 134 | Numerator for Annual Monitoring for Patients on Persistent Medications (MPM): Annual Monitoring for Members on ACE Inhibitors or ARBs | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| MPM | 1 | 135 | 135 | Denominator for Annual Monitoring for Patients on Persistent Medications (MPM): Annual Monitoring for Members on Diuretics | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| MPM | 1 | 136 | 136 | Numerator for Annual Monitoring for Patients on Persistent Medications (MPM): Annual Monitoring for Members on Diuretics | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| URI | 1 | 137 | 137 | Denominator for Appropriate Treatment for Children With Upper Respiratory Infection (URI) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| URI | 1 | 138 | 138 | Numerator for Appropriate Treatment for Children With Upper Respiratory Infection (URI) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| AAB | 1 | 139 | 139 | Denominator for Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis (AAB) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AAB | 1 | 140 | 140 | Numerator for Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis (AAB) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| LBP | 1 | 141 | 141 | Denominator for Use of Imaging Studies for Low Back Pain (LBP) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| LBP | 1 | 142 | 142 | Numerator for Use of Imaging Studies for Low Back Pain (LBP) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 143 | 143 | Denominator for Annual Dental Visit (ADV): 2–3 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 144 | 144 | Numerator for Annual Dental Visit (ADV): 2–3 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 145 | 145 | Denominator for Annual Dental Visit (ADV): 4–6 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 146 | 146 | Numerator for Annual Dental Visit (ADV): 4–6 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 147 | 147 | Denominator for Annual Dental Visit (ADV): 7–10 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 148 | 148 | Numerator for Annual Dental Visit (ADV): 7–10 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 149 | 149 | Denominator for Annual Dental Visit (ADV): 11–14 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 150 | 150 | Numerator for Annual Dental Visit (ADV): 11–14 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 151 | 151 | Denominator for Annual Dental Visit (ADV): 15–18 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 152 | 152 | Numerator for Annual Dental Visit (ADV): 15–18 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| ADV | 1 | 153 | 153 | Denominator for Annual Dental Visit (ADV): 19–20 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADV | 1 | 154 | 154 | Numerator for Annual Dental Visit (ADV): 19–20 years | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 155 | 155 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 13–17 years Alcohol abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 156 | 156 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 13–17 years Alcohol abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 157 | 157 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 13–17 years Alcohol abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 158 | 158 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 13–17 years Opioid abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 159 | 159 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 13–17 years Opioid abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 160 | 160 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 13–17 years Opioid abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 161 | 161 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 13–17 years Other drug abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 162 | 162 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 13–17 years Other drug abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 163 | 163 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 13–17 years Other drug abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 164 | 164 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 18+ years Alcohol abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 165 | 165 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 18+ years Alcohol abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 166 | 166 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 18+ years Alcohol abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 167 | 167 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 18+ years Opioid abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 168 | 168 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 18+ years Opioid abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 169 | 169 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 18+ years Opioid abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 170 | 170 | Denominator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): 18+ years Other drug abuse or dependence | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| IET | 1 | 171 | 171 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Initiation of AOD Treatment, 18+ years Other drug abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| IET | 1 | 172 | 172 | Numerator for Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET): Engagement of AOD Treatment, 18+ years Other drug abuse or dependence | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| PPC | 2 | 173 | 174 | Denominator for Prenatal and Postpartum Care (PPC): Timeliness of Prenatal Care | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| PPC | 2 | 175 | 176 | Numerator for Prenatal and Postpartum Care (PPC): Timeliness of Prenatal Care | Enter: The number of times this member is in the numerator ´0´ if the member is not in the numerator OR the information is missing |
| PPC | 2 | 177 | 178 | Denominator for Prenatal and Postpartum Care (PPC): Postpartum Care | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| PPC | 2 | 179 | 180 | Numerator for Prenatal and Postpartum Care (PPC): Postpartum Care | Enter: The number of times this member is in the numerator ´0´ if the member is not in the numerator OR the information is missing |
| W15 | 1 | 181 | 181 | Denominator for Well–Child Visits in the First 15 Months of Life (W15) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| W15 | 1 | 182 | 182 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): Six or more Well–Child Visits | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| W34 | 1 | 183 | 183 | Denominator for Well–Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| W34 | 1 | 184 | 184 | Numerator for Well–Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34) | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| PDC | 1 | 185 | 185 | Denominator for Rate 1: Renin Angiotensin System (RAS) Antagonists | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| PDC | 1 | 186 | 186 | Numerator for Rate 1: Renin Angiotensin System (RAS) Antagonists | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| PDC | 1 | 187 | 187 | Denominator for Rate 2: Diabetes Medications | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| PDC | 1 | 188 | 188 | Numerator for Rate 2: Diabetes Medications | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| PDC | 1 | 189 | 189 | Denominator for Rate 3: Statins | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| PDC | 1 | 190 | 190 | Numerator for Rate 3: Statins | Enter: ´1´ if this member is in the numerator ´0´ if this member is not in the numerator OR the information for this member is missing |
| General Info | 2 | 191 | 192 | Age Grouping for the member as of December 31 of the measurement year | Enter the age grouping for the member´s age as of December 31 of the measurement year. 00 = < 1 year 01 = 1–4 yrs. 02 = 5–9 yrs. 03 = 10–14 yrs. 04 = 15–17 yrs. 05 = 18–19 yrs. 06 = 20–24 yrs. 07 = 25–29 yrs. 08 = 30–34 yrs. 09 = 35–39 yrs. 10 = 40–44 yrs. 11 = 45–49 yrs. 12 = 50–54 yrs. 13 = 55–59 yrs. 14 = 60–64 yrs. 15 = 65 and up 99 = Unknown |
| General Info | 1 | 193 | 193 | Race | Enter the member´s race: 1=White 2=Black 3=Asian/Pacific Islander 4=American Indian/Alaskan Native 5=Other 9=Unknown 0=Declined |
| General Info | 1 | 194 | 194 | Ethnicity | Enter the Member´s ethnicity: 1=Hispanic 2=Non–Hispanic 9=Unknown 0=Declined |
| General Info | 1 | 195 | 195 | Language Spoken | Enter the member´s spoken language: 1=English 2=Non–English 9=Unknown 0=Declined |
| General Info | 3 | 196 | 198 | County of Residence | Enter the 3–digit county FIPS code for each member´s residence of county. See the attachment for codes and values to enter here. ### = FIPS Code 000= Outside of NYS 999 = Unknown |
| General Info | 3 | 199 | 201 | Indirect Race Estimate – White | Enter the indirectly estimated probability of the member´s race being White as a percentage of 100 |
| General Info | 3 | 202 | 204 | Indirect Race Estimate –Black | Enter the indirectly estimated probability of the member´s race being Black as a percentage of 100 |
| General Info | 3 | 205 | 207 | Indirect Race Estimate – Asian/Pacific Islander | Enter the indirectly estimated probability of the member´s race being Asian/Pacific Islander as a percentage of 100 |
| General Info | 3 | 208 | 210 | Indirect Race Estimate –American Indian/Alaskan Native | Enter the indirectly estimated probability of the member´s race being American Indian/Alaskan Native as a percentage of 100 |
| General Info | 3 | 211 | 213 | Indirect Race Estimate –Other | Enter the indirectly estimated probability of the member´s race being Other as a percentage of 100 |
| General Info | 3 | 214 | 216 | Indirect Race Estimate –Hispanic | Enter the indirectly estimated probability of the member´s ethnicity being Hispanic as a percentage of 100 |
| General Info | 1 | 217 | 217 | Metal Level | Enter the Metal level of coverage the enrollee is covered under. 1=Platinum 2 = Gold 3 = Silver 4 = Bronze 5 = Catastrophic 9 = Unknown |
| General Info | 1 | 218 | 218 | Marketplace Product | Enter the ´1´ if the member enrolled through the Marketplace in an individual benefit, ´2´ if the member enrolled outside of the Marketplace in an individual benefit, ´3´ if the member enrolled in the Small Business Health Options Program (SHOP) through the Marketplace, ´4´ if the member enrolled in the Small Business outside the Marketplace, and ´9´ if unknown. |
