NYS Patient-Level Detail File Specifications - MEDICAID
- 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 | MEDICAID, HIVSNP, HARP, or EP |
| GENERAL INFO | 30 | 25 | 54 | Member ID | Member ID should be Medicaid Client ID Number (CIN). For Medicaid: AA#####A For CHP: 0####### or 5####### |
| 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 the Enrollment by Product Line measure. 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): HepA | 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 | 89 | 89 | Numerator for Childhood Immunization Status (CIS): RV | 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 | 90 | 90 | Numerator for Childhood Immunization Status (CIS): Influenza | 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 | 91 | 91 | Numerator for Childhood Immunization Status (CIS): 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 |
| CIS | 1 | 92 | 92 | 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 |
| CIS | 1 | 93 | 93 | Numerator for Childhood Immunization Status (CIS): Combo 4 | 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 | 94 | 94 | Numerator for Childhood Immunization Status (CIS): Combo 5 | 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 | 95 | 95 | Numerator for Childhood Immunization Status (CIS): Combo 6 | 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 | 96 | 96 | Numerator for Childhood Immunization Status (CIS): Combo 7 | 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 | 97 | 97 | Numerator for Childhood Immunization Status (CIS): Combo 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 |
| CIS | 1 | 98 | 98 | Numerator for Childhood Immunization Status (CIS): Combo 9 | 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 | 99 | 99 | Numerator for Childhood Immunization Status (CIS): Combo 10 | 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 | 100 | 100 | 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 | 101 | 101 | 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 | 102 | 102 | 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 | 103 | 103 | Numerator for Immunizations for Adolescents (IMA): Combo 1 | 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 | 104 | 104 | 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 | 105 | 105 | 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 |
| LSC | 1 | 106 | 106 | Denominator for Lead Screening in Children (LSC) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| LSC | 1 | 107 | 107 | Numerator for Lead Screening in Children (LSC) | 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 | 108 | 108 | 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 | 109 | 109 | 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 | 110 | 110 | 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 | 111 | 111 | 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 |
| CHL | 1 | 112 | 112 | 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 | 113 | 113 | 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 | 114 | 114 | 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 | 115 | 115 | 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 | 116 | 116 | 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 | 117 | 117 | 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 |
| SPR | 1 | 118 | 118 | Denominator for Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPR | 1 | 119 | 119 | Numerator for Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) | 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 |
| PCE | 2 | 120 | 121 | Denominator for Pharmacotherapy Management of COPD Exacerbation (PCE) | Enter: The number of times this member is in the denominator ´0´ if the member is not in the denominator |
| PCE | 2 | 122 | 123 | Numerator for Pharmacotherapy Management of COPD Exacerbation (PCE): Systemic Corticosteroid | 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 |
| PCE | 2 | 124 | 125 | Numerator for Pharmacotherapy Management of COPD Exacerbation (PCE): Bronchodilator | 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 |
| MMA | 1 | 126 | 126 | 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 | 127 | 127 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 50%, 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 | 128 | 128 | 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 | 129 | 129 | 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 | 130 | 130 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 50%, 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 | 131 | 131 | 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 | 132 | 132 | 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 | 133 | 133 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 50%, 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 | 134 | 134 | 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 | 135 | 135 | 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 | 136 | 136 | Numerator for Medication Management for People with Asthma (MMA): Medication Compliance 50%, 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 |
| MMA | 1 | 137 | 137 | 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 |
| AMR | 1 | 138 | 138 | Denominator for Asthma Medication Ratio (AMR): 5–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AMR | 1 | 139 | 139 | Numerator for Asthma Medication Ratio (AMR): 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 |
| AMR | 1 | 140 | 140 | Denominator for Asthma Medication Ratio (AMR): 12–18 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AMR | 1 | 141 | 141 | Numerator for Asthma Medication Ratio (AMR): 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 |
| AMR | 1 | 142 | 142 | Denominator for Asthma Medication Ratio (AMR): 19–50 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AMR | 1 | 143 | 143 | Numerator for Asthma Medication Ratio (AMR): 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 |
| AMR | 1 | 144 | 144 | Denominator for Asthma Medication Ratio (AMR): 51–64 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AMR | 1 | 145 | 145 | Numerator for Asthma Medication Ratio (AMR): 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 | 146 | 146 | 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 | 147 | 147 | 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 |
| PBH | 1 | 148 | 148 | Denominator for Persistence of Beta–Blocker Treatment After a Heart Attack (PBH) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| PBH | 1 | 149 | 149 | Numerator for Persistence of Beta–Blocker Treatment After a Heart Attack (PBH) | 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 |
| SPC | 1 | 150 | 150 | Denominator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Males 21–75, Received Statin Therapy | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPC | 1 | 151 | 151 | Numerator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Males 21–75, Received Statin Therapy | 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 |
| SPC | 1 | 152 | 152 | Denominator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Males 21–75, Statin Adherence 80% | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPC | 1 | 153 | 153 | Numerator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Males 21–75, Statin Adherence 80% | 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 |
| SPC | 1 | 154 | 154 | Denominator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Females 40–75, Received Statin Therapy | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPC | 1 | 155 | 155 | Numerator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Females 40–75, Received Statin Therapy | 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 |
| SPC | 1 | 156 | 156 | Denominator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Females 40–75, Statin Adherence 80% | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPC | 1 | 157 | 157 | Numerator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Females 40–75, Statin Adherence 80% | 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 | 158 | 158 | Denominator for Comprehensive Diabetes Care (CDC): HbA1c Testing | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 159 | 159 | Numerator for Comprehensive Diabetes Care (CDC): HbA1c Testing | 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 | 160 | 160 | Denominator for Comprehensive Diabetes Care (CDC): HbA1c Poor Control >9% | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 161 | 161 | Numerator for Comprehensive Diabetes Care (CDC): HbA1c Poor Control >9% | 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 | 162 | 162 | 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 | 163 | 163 | 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 | 164 | 164 | Denominator for Comprehensive Diabetes Care (CDC): HbA1c Control <7% for a selected population | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 165 | 165 | Numerator for Comprehensive Diabetes Care (CDC): HbA1c Control <7% for a selected population | 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 | 166 | 166 | 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 | 167 | 167 | 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 | 168 | 168 | 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 | 169 | 169 | 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 |
| CDC | 1 | 170 | 170 | Denominator for Comprehensive Diabetes Care (CDC): BP Control <140/90 | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CDC | 1 | 171 | 171 | Numerator for Comprehensive Diabetes Care (CDC): BP Control <140/90 | 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 |
| SPD | 1 | 172 | 172 | Denominator for Statin Therapy for Patients With Diabetes (SPD): Received Statin Therapy | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPD | 1 | 173 | 173 | Numerator for Statin Therapy for Patients With Diabetes (SPD): Received Statin Therapy | 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 |
| SPD | 1 | 174 | 174 | Denominator for Statin Therapy for Patients With Diabetes (SPD): Statin Adherence 80% | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SPD | 1 | 175 | 175 | Numerator for Statin Therapy for Patients With Diabetes (SPD): Statin Adherence 80% | 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 |
| ART | 1 | 176 | 176 | Denominator for Disease–Modifying Anti–Rheumatic Drug Therapy for Rheumatoid Arthritis (ART) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ART | 1 | 177 | 177 | Numerator for Disease–Modifying Anti–Rheumatic Drug Therapy for Rheumatoid Arthritis (ART) | 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 | 178 | 178 | 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 | 179 | 179 | 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 | 180 | 180 | 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 | 181 | 181 | 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 | 182 | 182 | 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 | 183 | 183 | 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 | 184 | 184 | 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 | 185 | 186 | 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 | 187 | 188 | 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 |
| FUH | 2 | 189 | 190 | Numerator for Follow–Up After Hospitalization for Mental Illness (FUH): 30–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 |
| SSD | 1 | 191 | 191 | Denominator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SSD | 1 | 192 | 192 | Numerator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) | 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 |
| SMD | 1 | 193 | 193 | Denominator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SMD | 1 | 194 | 194 | Numerator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) | 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 |
| SMC | 1 | 195 | 195 | Denominator for Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SMC | 1 | 196 | 196 | Numerator for Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC) | 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 |
| SAA | 1 | 197 | 197 | Denominator for Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| SAA | 1 | 198 | 198 | Numerator for Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA) | 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 |
| APM | 1 | 199 | 199 | Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 1–5 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APM | 1 | 200 | 200 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 1–5 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 |
| APM | 1 | 201 | 201 | Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 6–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APM | 1 | 202 | 202 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 6–11 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 |
| APM | 1 | 203 | 203 | Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 12–17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APM | 1 | 204 | 204 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 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 |
| MPM | 1 | 205 | 205 | 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 | 206 | 206 | 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 | 207 | 207 | 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 | 208 | 208 | 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 |
| NCS | 1 | 209 | 209 | Denominator for Non–Recommended Cervical Cancer Screening in Adolescent Females (NCS) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| NCS | 1 | 210 | 210 | Numerator for Non–Recommended Cervical Cancer Screening in Adolescent Females (NCS) | 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 | 211 | 211 | 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 | 212 | 212 | 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 | 213 | 213 | 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 | 214 | 214 | 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 | 215 | 215 | 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 | 216 | 216 | 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 |
| APC | 1 | 217 | 217 | Denominator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 1–5 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APC | 1 | 218 | 218 | Numerator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 1–5 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 |
| APC | 1 | 219 | 219 | Denominator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 6–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APC | 1 | 220 | 220 | Numerator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 6–11 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 |
| APC | 1 | 221 | 221 | Denominator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 12–17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APC | 1 | 222 | 222 | Numerator for Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC): 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 |
| AAP | 1 | 223 | 223 | Denominator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 20–44 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AAP | 1 | 224 | 224 | Numerator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 20–44 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 |
| AAP | 1 | 225 | 225 | Denominator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 45–64 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AAP | 1 | 226 | 226 | Numerator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 45–64 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 |
| AAP | 1 | 227 | 227 | Denominator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 65 years and older | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AAP | 1 | 228 | 228 | Numerator for Adults´ Access to Preventive/Ambulatory Health Services (AAP): 65 years and older | 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 |
| CAP | 1 | 229 | 229 | Denominator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 12–24 months | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CAP | 1 | 230 | 230 | Numerator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 12–24 months | 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 |
| CAP | 1 | 231 | 231 | Denominator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 25 months – 6 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CAP | 1 | 232 | 232 | Numerator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 25 months – 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 |
| CAP | 1 | 233 | 233 | Denominator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 7–11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CAP | 1 | 234 | 234 | Numerator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 7–11 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 |
| CAP | 1 | 235 | 235 | Denominator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 12–19 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| CAP | 1 | 236 | 236 | Numerator for Children and Adolescents´ Access to Primary Care Practitioners (CAP): 12–19 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 | 237 | 237 | 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 | 238 | 238 | 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 | 239 | 239 | 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 | 240 | 240 | 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 | 241 | 241 | 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 | 242 | 242 | 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 | 243 | 243 | 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 | 244 | 244 | 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 | 245 | 245 | 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 | 246 | 246 | 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 | 247 | 247 | 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 | 248 | 248 | 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 | 249 | 249 | 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 | 250 | 250 | 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 | 251 | 251 | 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 | 252 | 252 | 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 | 253 | 253 | 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 | 254 | 254 | 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 | 255 | 255 | 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 | 256 | 256 | 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 | 257 | 257 | 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 | 258 | 258 | 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 | 259 | 259 | 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 | 260 | 260 | 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 | 261 | 261 | 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 | 262 | 262 | 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 | 263 | 263 | 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 | 264 | 264 | 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 | 265 | 265 | 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 | 266 | 266 | 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 | 267 | 268 | 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 | 269 | 270 | 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 | 271 | 272 | 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 | 273 | 274 | 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 |
| APP | 1 | 275 | 275 | Denominator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 1– 5 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APP | 1 | 276 | 276 | Numerator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 1–5 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 |
| APP | 1 | 277 | 277 | Denominator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 6– 11 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APP | 1 | 278 | 278 | Numerator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 6–11 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 |
| APP | 1 | 279 | 279 | Denominator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 12– 17 years | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| APP | 1 | 280 | 280 | Numerator for Use of First–Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 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 |
| W15 | 1 | 281 | 281 | 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 | 282 | 282 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): No 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 |
| W15 | 1 | 283 | 283 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): One Well–Child Visit | 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 |
| W15 | 1 | 284 | 284 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): Two 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 |
| W15 | 1 | 285 | 285 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): Three 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 |
| W15 | 1 | 286 | 286 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): Four 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 |
| W15 | 1 | 287 | 287 | Numerator for Well–Child Visits in the First 15 Months of Life (W15): Five 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 |
| W15 | 1 | 288 | 288 | 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 | 289 | 289 | 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 | 290 | 290 | 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 |
| AWC | 1 | 291 | 291 | Denominator for Adolescent Well–Care Visits (AWC) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| AWC | 1 | 292 | 292 | Numerator for Adolescent Well–Care Visits (AWC) | 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 |
| FUM | 2 | 293 | 294 | Denominator for Follow–Up After Emergency Department Visit for Mental Illness (FUM) | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| FUM | 2 | 295 | 296 | Numerator for Follow–Up After Emergency Department Visit for Mental Illness (FUM): 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 |
| FUM | 2 | 297 | 298 | Numerator for Follow–Up After Emergency Department Visit for Mental Illness (FUM): 30–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 |
| FUA | 2 | 299 | 300 | Denominator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13–17 years | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| FUA | 2 | 301 | 302 | Numerator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13–17 years, 30–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 |
| FUA | 2 | 303 | 304 | Numerator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13–17 years, 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 |
| FUA | 2 | 305 | 306 | Denominator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| FUA | 2 | 307 | 308 | Numerator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years, 30–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 |
| FUA | 2 | 309 | 310 | Numerator for Follow–Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years, 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 |
| ADL | 1 | 311 | 311 | Denominator for Adolescent Preventive Care (ADL) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| ADL | 1 | 312 | 312 | Numerator 1 for Adolescent Preventive Care (ADL) – Sexual Activity | 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 |
| ADL | 1 | 313 | 313 | Numerator 2 for Adolescent Preventive Care (ADL) – Depression | 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 |
| ADL | 1 | 314 | 314 | Numerator 3 for Adolescent Preventive Care (ADL) – Tobacco Use | 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 |
| ADL | 1 | 315 | 315 | Numerator 4 for Adolescent Preventive Care (ADL) – Substance Use | 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 | 316 | 316 | 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 | 317 | 317 | 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 |
| COD | 2 | 318 | 319 | Denominator for Continuity of Care from Inpatient Detox to Lower Level of Care (COD) | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| COD | 2 | 320 | 321 | Numerator for Continuity of Care from Inpatient Detox to Lower Level of Care (COD) | 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 |
| COR | 2 | 322 | 323 | Denominator for Continuity of Care from Inpatient Rehabilitation for Alcohol and Other Drug Abuse or Dependence Treatment to Lower Level of Care (COR) | Enter: The number of times this member is in denominator ´0´ if the member is not in the denominator |
| COR | 2 | 324 | 325 | Numerator for Continuity of Care from Inpatient Rehabilitation for Alcohol and Other Drug Abuse or Dependence Treatment to Lower Level of Care (COR) | 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 |
| POD | 1 | 326 | 326 | Denominator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| POD | 1 | 327 | 327 | Numerator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD) | 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 |
| POA | 1 | 328 | 328 | Denominator for Use of Pharmacotherapy for Alcohol Abuse or Dependence (POA) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| POA | 1 | 329 | 329 | Numerator for Use of Pharmacotherapy for Alcohol Abuse or Dependence (POA) | 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 |
| UOD | 1 | 330 | 330 | Numerator for Use of Opiods at High Dosage (UOD) | 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 |
| UOD | 1 | 331 | 331 | Denominator for Use of Opiods at High Dosage (UOD) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| UOP | 1 | 332 | 332 | Denominator for Use of Opioids from Multiple Providers (UOP) | Enter: ´1´ if this member is in the denominator ´0´ if this member is not in the denominator |
| UOP | 1 | 333 | 333 | Numerator for Use of Opioids from Multiple Providers (UOP): Multiple prescribers | 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 |
| UOP | 1 | 334 | 334 | Numerator for Use of Opioids from Multiple Providers (UOP): Multiple pharmacies | 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 |
| UOP | 1 | 335 | 335 | Numerator for Use of Opioids from Multiple Providers (UOP): Multiple prescribers and pharmacies | 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 |
| Note: Highlighted are new measures added to PLD | |||||
