Marketplace MY2022 PLD File Specifications
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NYS MY2022 PatientLevel Detail File Specifications
Revision date: November 22, 2022
MARKETPLACE
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 summarylevel 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 should be the member's NYSissued HIXNY Member ID. Do not report the identifier used in HEDIS. 
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 012. 
GENERAL INFO  1  65  65  Sex  Enter: The gender assigned at birth 'F' member is female 'M' member is male 'O' includes, but is not limited to: missing, refused, and unspecified No other characters are allowed 
ABA  1  66  66  Measure Retired  blank 
ABA  1  67  67  Measure Retired  blank 
WCC  1  68  68  Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 311 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, 311 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, 1217 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, 1217 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, 311 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, 311 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, 1217 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, 1217 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, 311 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, 311 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, 1217 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, 1217 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 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 
CIS  1  89  89  Numerator for Childhood Immunization Status (CIS): Rotavirus  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): 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  91  91  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 
IMA  1  92  92  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  93  93  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  94  94  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  95  95  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  96  96  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  97  97  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  98  98  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  99  99  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  100  100  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  101  101  removed to allow for new groupings  blank 
COL  1  102  102  removed to allow for new groupings  blank 
CHL  1  103  103  Denominator for Chlamydia Screening in Women (CHL): 1620 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
CHL  1  104  104  Numerator for Chlamydia Screening in Women (CHL): 1620 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  105  105  Denominator for Chlamydia Screening in Women (CHL): 2124 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
CHL  1  106  106  Numerator for Chlamydia Screening in Women (CHL): 2124 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  2  107  108  Denominator for Appropriate Testing Pharyngitis (CWP): 317 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
CWP  2  109  110  Numerator for Appropriate Testing Pharyngitis (CWP): 317 years  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 
CWP  2  111  112  Denominator for Appropriate Testing Pharyngitis (CWP): 1864 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
CWP  2  113  114  Numerator for Appropriate Testing Pharyngitis (CWP): 1864 years  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 
CWP  2  115  116  Denominator for Appropriate Testing Pharyngitis (CWP): 65+ years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
CWP  2  117  118  Numerator for Appropriate Testing Pharyngitis (CWP): 65+ years  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 
CWP  2  119  120  Denominator Total Removed  blank 
CWP  2  121  122  Numerator Total Removed  blank 
MMA  1  123  123  Measure Retired  blank 
MMA  1  124  124  Measure Retired  blank 
MMA  1  125  125  Measure Retired  blank 
MMA  1  126  126  Measure Retired  blank 
MMA  1  127  127  Measure Retired  blank 
MMA  1  128  128  Measure Retired  blank 
MMA  1  129  129  Measure Retired  blank 
MMA  1  130  130  Measure Retired  blank 
CBP  1  131  131  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  132  132  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  133  133  Measure Retired  blank 
CDC  1  134  134  Measure Retired  blank 
CDC  1  135  135  Measure Retired  blank 
CDC  1  136  136  Measure Retired  blank 
CDC  1  137  137  Measure Retired  blank 
CDC  1  138  138  Measure Retired  blank 
AMM  1  139  139  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  140  140  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  141  141  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 
FUH  2  142  143  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 617 years, 7day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  144  145  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 617 years, 7day followup  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  146  147  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 1864 years, 7day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  148  149  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 1864 years, 7day followup  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  150  151  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 65+ years, 7day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  152  153  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 65+ years, 7day followup  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 
URI  2  154  155  Denominator for Appropriate Treatment for Upper Respiratory Infection (URI): 3 months17 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
URI  2  156  157  Numerator for Appropriate Treatment for Upper Respiratory Infection (URI): 3 months17 years  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 
URI  2  158  159  Denominator for Appropriate Treatment for Upper Respiratory Infection (URI): 1864 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
URI  2  160  161  Numerator for Appropriate Treatment for Upper Respiratory Infection (URI): 1864 years  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 
URI  2  162  163  Denominator for Appropriate Treatment for Upper Respiratory Infection (URI): 65+ years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
URI  2  164  165  Numerator for Appropriate Treatment for Upper Respiratory Infection (URI): 65+ years  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 
URI  2  166  167  Denominator Total  Remove  blank 
URI  2  168  169  Numerator Total  Remove  blank 
AAB  2  170  171  Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months17 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
AAB  2  172  173  Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months17 years  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 
AAB  2  174  175  Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 1864 years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
AAB  2  176  177  Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 1864 years  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 
AAB  2  178  179  Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 65+ years  Enter: The number of times this member is in the denominator '0' if the member is not in the denominator 
AAB  2  180  181  Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 65+ years  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 
AAB  2  182  183  Denominator Total  Remove  blank 
AAB  2  184  185  Numerator Total  Remove  blank 
LBP  1  186  186  removed to allow for new groupings  blank 
LBP  1  187  187  removed to allow for new groupings  blank 
ADV  1  188  188  Denominator for Annual Dental Visit (ADV): 23 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  189  189  Numerator for Annual Dental Visit (ADV): 23 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  190  190  Denominator for Annual Dental Visit (ADV): 46 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  191  191  Numerator for Annual Dental Visit (ADV): 46 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  192  192  Denominator for Annual Dental Visit (ADV): 710 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  193  193  Numerator for Annual Dental Visit (ADV): 710 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  194  194  Denominator for Annual Dental Visit (ADV): 1114 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  195  195  Numerator for Annual Dental Visit (ADV): 1114 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  196  196  Denominator for Annual Dental Visit (ADV): 1518 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  197  197  Numerator for Annual Dental Visit (ADV): 1518 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  198  198  Denominator for Annual Dental Visit (ADV): 1920 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
ADV  1  199  199  Numerator for Annual Dental Visit (ADV): 1920 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  200  201  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1317 years Alcohol Use Disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  202  203  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1317 years Alcohol Use DIsorder  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 
IET  1  204  205  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 1317 years Alcohol Use Disorder  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 
IET  1  206  207  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1317 years Opioid Use Disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  208  209  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1317 years Opioid Use Disorder  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 
IET  1  210  211  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 1317 years Opioid Use Disorder  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 
IET  1  212  213  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1317 years Other substance use disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  214  215  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1317 years Other substance use disorder  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 
IET  1  216  217  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 1317 years Other substance use disorder  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 
IET  1  218  219  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1864 years Alcohol use disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  220  221  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1864 years Alcohol use disorder  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 
IET  1  222  223  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 18 64 years Alcohol use disorder  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 
IET  1  224  225  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1864 years Opioid use disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  226  227  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1864 years Opioid use disorder  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 
IET  1  228  229  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 18 64 years Opioid use disorder  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 
IET  1  230  231  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 1864 other substance use disoder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  232  233  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 1864 other substance use disoder  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 
IET  1  234  235  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 18 64 other substance use disoder  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  236  237  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  238  239  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  240  241  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  242  243  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  244  244  Measure removed  blank 
W15  1  245  245  Measure removed  blank 
W34  1  246  246  Measure removed  blank 
W34  1  247  247  Measure removed  blank 
PDC  1  248  248  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  249  249  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  250  250  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  251  251  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  252  252  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  253  253  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  254  255  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 = 14 yrs. 02 = 59 yrs. 03 = 1014 yrs. 04 = 1517 yrs. 05 = 1819 yrs. 06 = 2024 yrs. 07 = 2529 yrs. 08 = 3034 yrs. 09 = 3539 yrs. 10 = 4044 yrs. 11 = 4549 yrs. 12 = 5054 yrs. 13 = 5559 yrs. 14 = 6064 yrs. 15 = 65 and up 99 = Unknown 
General Info  1  256  256  Race  Enter the member's race: 1=White 2=Black or African American 3=American Indian/Alaskan Native 4=Asian 5=Native Hawaiian/Pacific Islander 6=SomeOtherRace 7=Two or more races 8=AskedButNoAnswer 9=Unknown 
General Info  1  257  257  Ethnicity  Enter the Member's ethnicity: 1=Hispanic or Latino 2=NonHispanic or Latino 9=Unknown 0=Asked but not answered 
General Info  1  258  258  Language Spoken  Enter the member's spoken language: 1=English 2=NonEnglish 9=Unknown 0=Declined 
General Info  3  259  261  County of Residence  Enter the 3digit 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  262  263  20 = Health Plan Direct (Direct) 21 = CMS databases (Direct) 23 = Surname Analysis (Indirect) 24 = Geocoding Analysis (Indirect) 28 = Unknown (use this when race is unknown or asked but no answer) 29= Other (direct) 30 = Other (indirect) 

General Info  3  264  265  20 = Health Plan Direct (Direct) 21 = CMS databases (Direct) 23 = Surname Analysis (Indirect) 24 = Geocoding Analysis (Indirect) 28 = Unknown (use this when race is unknown or asked but no answer) 29= Other (direct) 30 = Other (indirect) 

General Info  3  266  268  Removed  can leave blank '000'  
General Info  3  269  271  Removed  can leave blank '000'  
General Info  3  272  274  Removed  can leave blank '000'  
General Info  3  275  277  Removed  can leave blank '000'  
General Info  1  278  278  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  279  279  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. 
INR  1  280  280  Denominator for International Normalized ratio Monitoring for Individuals on Warfarin  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
INR  1  281  281  Numerator for International Normalized ratio Monitoring for Individuals on Warfarin  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 
W30  1  282  282  Denominator for WellChild Visits in the First 15 Months. Children who turned 15 months old during MY: Six or more wellchild visits  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
W30  1  283  283  Numerator for WellChild Visits in the First 15 Months. Children who turned 15 months old during MY: Six or more wellchild 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 
W30  1  284  284  Denominator for WellChild Visits for Age 15 Months30 Months. Children who turned 30 months old during the MY: Two or more wellchild visits.  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
W30  1  285  285  Numerator for WellChild Visits for Age 15 Months30 Months. Children who turned 30 months old during the MY: Two or more wellchild 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 
WCV  1  286  286  Denominator for Child and Adolescent WellCare Visits: 311 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
WCV  1  287  287  Numerator for Child and Adolescent WellCare Visits: 311 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 
WCV  1  288  288  Denominator for Child and Adolescent WellCare Visits: 1217 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
WCV  1  289  289  Numerator for Child and Adolescent WellCare Visits: 1217 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 
WCV  1  290  290  Denominator for Child and Adolescent WellCare Visits: 1821 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
WCV  1  291  291  Numerator for Child and Adolescent WellCare Visits: 1821 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 
AMO  1  292  292  Denominator for Annual Monitoring for Persons on Longterm Opioid Therapy: 18+ years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
AMO  1  293  293  Numerator for Annual Monitoring for Persons on Longterm Opioid Therapy: 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  294  294  Denominator for Asthma Medication Ratio (AMR): 511 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
AMR  1  295  295  Numerator for Asthma Medication Ratio (AMR): 511 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  296  296  Denominator for Asthma Medication Ratio (AMR): 1218 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
AMR  1  297  297  Numerator for Asthma Medication Ratio (AMR): 1218 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  298  298  Denominator for Asthma Medication Ratio (AMR): 1950 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
AMR  1  299  299  Numerator for Asthma Medication Ratio (AMR): 1950 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  300  300  Denominator for Asthma Medication Ratio (AMR): 5164 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
AMR  1  301  301  Numerator for Asthma Medication Ratio (AMR): 5164 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 
FUH  2  302  303  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 617 years, 30day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  304  305  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 617 years, 30day followup  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  306  307  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 1864 years, 30day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  308  309  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 1864 years, 30day followup  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  310  311  Denominator for FollowUp After Hospitalization for Mental Illness (FUH): 65+ years, 30day followup  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
FUH  2  312  313  Numerator for FollowUp After Hospitalization for Mental Illness (FUH): 65+ years, 30day followup  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 
BPD  1  314  314  Measure removed  Blank 
BPD  1  315  315  Measure removed  Blank 
HBD  1  316  316  Denominator for Hemoglobin A1c Control for Patients with Diabetes  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
HBD  1  317  317  Numerator for 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 
HBD  1  318  318  Removed  Removed 
EED  1  319  319  Denominator for Eye Exam for Patients with Diabetes  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
EED  1  320  320  Numerator for Eye Exam for Patients with Diabetes  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  321  322  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 65+ years Alcohol Use Disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  323  324  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 65+ years Alcohol use disorder  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 
IET  1  325  326  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 65+ years Alcohol use disorder  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 
IET  1  327  328  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 65+ years Opioid use disorder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  329  330  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 65+ years Opioid use disorder  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 
IET  1  331  332  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 65+ years Opioid use disorder  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 
IET  1  333  334  Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 65+ other substance use disoder  Enter: The number of times this member is in denominator '0' if the member is not in the denominator 
IET  1  335  336  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of Other substance use disorder, 65+ other substance use disoder  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 
IET  1  337  338  Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagment of other substance use disorder 65+ other substance use disoder  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 
General Info  3  339  341  Blank  Removed  can leave blank '000' 
General Info  3  342  344  Blank  Removed  can leave blank '000' 
General Info  3  345  347  Blank  Enter the indirectly estimated probability of the member's race being Two or other other races as a percentage of 100 
General Info  3  348  350  Blank  Removed  can leave blank '000' 
General Info  3  351  353  Blank  Removed  can leave blank '000' 
General Info  3  354  356  Blank  Removed  can leave blank '000' 
COL  1  357  357  Denominator for Colorectal Cancer Screening (COL): 4649 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
COL  1  358  358  Numerator for Colorectal Cancer Screening (COL): 4649 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 
COL  1  359  359  Denominator for Colorectal Cancer Screening (COL): 5075 years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
COL  1  360  360  Numerator for Colorectal Cancer Screening (COL): 5075 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 
LBP  1  361  361  Denominator for Use of Imaging Studies for Low Back Pain (LBP), Ages 1864 Years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
LBP  1  362  362  Numerator for Use of Imaging Studies for Low Back Pain (LBP), Ages 1864 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 
LBP  1  363  363  Denominator for Use of Imaging Studies for Low Back Pain (LBP), Ages 6575 Years  Enter: '1' if this member is in the denominator '0' if this member is not in the denominator 
LBP  1  364  364  Numerator for Use of Imaging Studies for Low Back Pain (LBP), Ages 6575 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 
NYS MY2022 PatientLevel Detail File Change Log
MARKETPLACE
MARKETPLACE  Revision date: November 22, 2022  

Version  Date  Data Element  Change Summary 
Specification Release MY2022  11/9/2021  Multiple  Initial MY2022 update per HEDIS 2022 specifications. 
Clarification #2  12/21/2021  Multiple  There were multiple places where the column start did not begin in the correct location, creating duplicate column figures. This has been corrected. 
Clarification #4  6/16/2022  COL  Removed colorectal to allow for age stratification grouping 101102. 
Clarification #4  6/16/2022  COL  Added the new colorectal stratifications 333339. 
Clarification #6  9/1/2022  Multiple  Beginning in column 332, the new measure, COL, had two spaces for data entry. This has been corrected to 1 space. This impacts 332335. 
Clarification #7  10/19/2022  HBD  There were duplicate numerators for HBD. One has been removed on 302. 
Clarification #7  10/19/2022  IET  Changed the numerator and denominator language to reflect the episodic language. 
Clarification #7  10/19/2022  LBP  Removed the measure from 186187 Combined both age stratifications and located them in 336339. 
Clarification #8  11/15/2022  IET  Removed the measure from 186?187 Combined both age stratifications and located them in 336339. 
Clarification #8  11/15/2022  General Info  Removed the indirect race and ethnicity estimates from columns 262 to 277 and 340 to 356. Add source of race data to columns 262 to 263. Added source of ethnicity data to 264 to 265. Reduced the column field size (length) from 3 to 2 for columns 262 to 265. 
Clarification #9  11/21/2022  BPD  Removed from required reporting for PPO/EPO and HMO/POS product lines. This impacts columns 314 to 315 of the Exchange PLD. 