Commercial MY2023 PLD File Specifications
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Revision date: February 14, 2024
NYS MY2023 Patient-Level Detail File Specifications
COMMERCIAL
| 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 | CPPO, CEPO, CHMO, EP |
| GENERAL INFO | 30 | 25 | 54 | Member ID | Member ID should be the health plan's internal, individual member identifier. Do not report a family identifier, and do not report the identifier used in HEDIS. For Essential Plans plans, please report the member's NYHX Member ID. |
| 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 sex 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 |
| GENERAL INFO | 2 | 66 | 67 | Race | Enter the member's race: 01=White 02=Black or African American 03=American Indian/Alaskan Native 04=Asian 05=Native Hawaiian/Pacific Islander 06=SomeOtherRace 07=Two or more races 08=Asked But No Answer 09=Unknown |
| GENERAL INFO | 2 | 68 | 69 | Source of Race Data | Provide the source of race data: 20 = Health Plan Direct (Direct) 21 = CMS databases (Direct) 22 = State Databases (Direct) 23 = Surname Analysis (Indirect) 24 = Geo-coding Analysis (Indirect) 28 = Unknown - Use this as the race source value when the member's race is "UNK" for Unknown Race 29 = Other (Direct) 30 = Unknown (Indirect) |
| GENERAL INFO | 1 | 70 | 70 | Ethnicity | Enter the Member's ethnicity: 1=Hispanic or Latino 2=Non-Hispanic or Latino 9=Unknown 0=Asked but not answered |
| GENERAL INFO | 2 | 71 | 72 | Source of Ethnicity Data | Provide the source of ethnicity data: 20 = Health Plan Direct (Direct) 21 = CMS databases (Direct) 22 = State Databases (Direct) 23 = Surname Analysis (Indirect) 24 = Geo-coding Analysis (Indirect) 28 = Unknown - Use this as the race source value when the member's race is "UNK" for Unknown Race 29 = Other (Direct) 30 = Unknown (Indirect) |
| GENERAL INFO | 2 | 73 | 74 | Asian American Subgroups | If member is Asian then identify the specific subgroup: 01=Chinese 02=Japanese 03=Filipino 04=Korean 05=Vietnamese 06=Asian Indian 07=Laotian 08=Cambodian 09=Bangladeshi 10=Hmong 12=Malaysian 13=Pakistani 14=Sri Lankan 15=Taiwanese 16=Nepalese 18=Thai 19=Unknown 20=Declined 00=Not Asian |
| GENERAL INFO | 1 | 75 | 75 | Native Hawaiian/Pacific Islander Subgroups | If member is Native Hawaiian or Pacific Islander then identify the subgroup: 1=Hawaiian 2=Guamanian/Chamorro 3=Samoan 4=Fijian 5=Tongan 6=Unknown 7=Declined 0=Not Asian |
| GENERAL INFO | 3 | 76 | 78 | Language Spoken | Enter the member's spoken language: 001=English *For all other languages other than English see the Language Value Set on the Managed Care Information for Health Plans > Quality Assurance Reporting Requirements (QARR) > 2023 > NYS QARR Language Value Set webpage. 197=Unknown 199=Declined |
| GENERAL INFO | 3 | 79 | 81 | County of Residence | Enter the 3-digit county FIPS code for each member's residence of county. See the attachment for codes and values to enter here. ### = FIPS Code 000 = Outside of NYS 999 = Unknown |
| PLAN CATEGORY | 1 | 82 | 82 | Essential Plan category for the member. This field only applies to members enrolled in an Essential Plan product. Enter '0' for members enrolled in Commercial HMO and PPO products. | 0 = Not Applicable 1 = Essential Plan 1: Individuals with income greater than 150 percent of the FPL and less than or equal to 200 percent of the FPL. 2 = Essential Plan 2: Individuals with income greater than 138 percent of the FPL and less than or equal to 150 percent of the FPL. 3 = Essential Plan 3: Individuals with income equal to or greater than 100 percent of the FPL and less than or equal to 138 percent of the FPL and not eligible for Medicaid due to immigration status. 4 = Essential Plan 4: Individuals with income below 100 percent of the FPL and not eligible for Medicaid due to immigration status. 9 = Unknown |
| AAB | 2 | 83 | 84 | Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months-17 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| AAB | 2 | 85 | 86 | Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months-17 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 | 87 | 88 | Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 18-64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| AAB | 2 | 89 | 90 | Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 18-64 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 | 91 | 92 | 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 | 93 | 94 | 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 |
| AAP | 1 | 95 | 95 | 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 | 96 | 96 | 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 | 97 | 97 | 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 | 98 | 98 | 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 | 99 | 99 | 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 | 100 | 100 | 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 |
| ADD | 1 | 101 | 101 | 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 | 102 | 102 | 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 | 103 | 103 | 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 | 104 | 104 | 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 |
| ADD-E | 1 | 105 | 105 | Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): Initiation Phase | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| ADD-E | 1 | 106 | 106 | Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): 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-E | 1 | 107 | 107 | Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): 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-E | 1 | 108 | 108 | Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): 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 |
| AIS-E | 1 | 109 | 109 | Denominator 1 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 1) [Members 19 -65 years] | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| AIS-E | 1 | 110 | 110 | Numerator for Adult Immunization Status (AIS-E): Influenza (Population Criteria 1) [Members 19 -65 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 |
| AIS-E | 1 | 111 | 111 | Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 2) [Members 19 -65 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 |
| AIS-E | 1 | 112 | 112 | Denominator 3 for Adult Immunization Status (AIS-E): Zoster (Population Criteria 3) [Members 50 - 65 years] | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| AIS-E | 1 | 113 | 113 | Numerator for Adult Immunization Status (AIS-E): Zoster (Population Criteria 3) [Members 50 - 65 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 |
| AIS-E | 1 | 114 | 114 | Denominator 4 for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 66 years and older] | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| AIS-E | 1 | 115 | 115 | Numerator for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 66 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 |
| AMM | 1 | 116 | 116 | 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 | 117 | 117 | 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 | 118 | 118 | 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 |
| AMR | 1 | 119 | 119 | 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 | 120 | 120 | 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 | 121 | 121 | 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 | 122 | 122 | 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 | 123 | 123 | 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 | 124 | 124 | 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 | 125 | 125 | 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 | 126 | 126 | 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 |
| APM | 1 | 127 | 127 | Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): 1-11 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| APM | 1 | 128 | 128 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received blood glucose testing (APM): 1-11 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 | 129 | 129 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received cholesterol testing (APM): 1-11 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 | 130 | 130 | 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 | 131 | 131 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received blood glucose testing (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 |
| APM | 1 | 132 | 132 | Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received cholesterol testing (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 |
| APP | 1 | 133 | 133 | Denominator for Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 1-11 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| APP | 1 | 134 | 134 | Numerator for Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 1-11 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 | 135 | 135 | 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 | 136 | 136 | 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 |
| AXR | 2 | 137 | 138 | Denominator for Antibiotic Utilization for Respiratory Conditions (AXR) 3m- 17 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| AXR | 2 | 139 | 140 | Numerator for Antibiotic Utilization for Respiratory Conditions (AXR) 3m- 17 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 |
| AXR | 2 | 141 | 142 | Denominator for Antibiotic Utilization for Respiratory Conditions (AXR) 18- 64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| AXR | 2 | 143 | 144 | Numerator for Antibiotic Utilization for Respiratory Conditions (AXR) 18-64 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 |
| AXR | 2 | 145 | 146 | Denominator for Antibiotic Utilization for Respiratory Conditions (AXR) 65+ years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| AXR | 2 | 147 | 148 | Numerator for Antibiotic Utilization for Respiratory Conditions 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 |
| BCS-E | 1 | 149 | 149 | Denominator for Breast Cancer Screening (BCS-E) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| BCS-E | 1 | 150 | 150 | Numerator for Breast Cancer Screening (BCS-E) | 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 |
| BPD | 1 | 151 | 151 | Denominator for Blood Pressure Control for Patients with Diabetes (BPD) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| BPD | 1 | 152 | 152 | Numerator for Blood Pressure Control for Patients with Diabetes (BPD) | 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 | 153 | 153 | 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 | 154 | 154 | 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 |
| CCS | 1 | 155 | 155 | 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 | 156 | 156 | 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 |
| CCS-E | 1 | 157 | 157 | Denominator for Cervical Cancer Screening Electronic (CCS-E) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CCS-E | 1 | 158 | 158 | Numerator for Cervical Cancer Screening Electronic (CCS-E) | 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 | 159 | 159 | 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 | 160 | 160 | 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 | 161 | 161 | 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 | 162 | 162 | 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 |
| CIS | 1 | 163 | 163 | 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 | 164 | 164 | 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 | 165 | 165 | 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 | 166 | 166 | 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 | 167 | 167 | 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 | 168 | 168 | 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 | 169 | 169 | 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 | 170 | 170 | 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 | 171 | 171 | 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 | 172 | 172 | 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 | 173 | 173 | 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 | 174 | 174 | 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 | 175 | 175 | 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 | 176 | 176 | 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-E | 1 | 177 | 177 | Denominator for Childhood Immunization Status Electronic (CIS-E) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CIS-E | 1 | 178 | 178 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 179 | 179 | Numerator for Childhood Immunization Status Electronic (CIS-E): 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-E | 1 | 180 | 180 | Numerator for Childhood Immunization Status Electronic (CIS-E): 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-E | 1 | 181 | 181 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 182 | 182 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 183 | 183 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 184 | 184 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 185 | 185 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 186 | 186 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 187 | 187 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 188 | 188 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 189 | 189 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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-E | 1 | 190 | 190 | Numerator for Childhood Immunization Status Electronic (CIS-E) : 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 |
| COL | 1 | 191 | 191 | Denominator for Colorectal Cancer Screening (COL): 46-50 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| COL | 1 | 192 | 192 | Numerator for Colorectal Cancer Screening (COL): 46-50 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 |
| COL | 1 | 193 | 193 | Denominator for Colorectal Cancer Screening (COL): 51-75 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| COL | 1 | 194 | 194 | Numerator for Colorectal Cancer Screening (COL): 51-75 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-E | 1 | 195 | 195 | Denominator for Colorectal Cancer Screening Electronic (COL-E): 46-50 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| COL-E | 1 | 196 | 196 | Numerator for Colorectal Cancer Screening Electronic (COL-E): 46-50 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 |
| COL-E | 1 | 197 | 197 | Denominator for Colorectal Cancer Screening (COL-E): 51-75 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| COL-E | 1 | 198 | 198 | Numerator for Colorectal Cancer Screening (COL-E): 51-75 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 |
| CRE | 1 | 199 | 199 | Denominator for Cardiac Rehabilitation Initiation 18-64 (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 200 | 200 | Numerator Initiation (CRE): 18-64 | 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 |
| CRE | 1 | 201 | 201 | Denominator for Cardiac Rehabilitation Initiation 65+ (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 202 | 202 | Numerator Initiation (CRE): 65+ | 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 |
| CRE | 1 | 203 | 203 | Denominator for Cardiac Rehabilitation Engagement 1 18-64 (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 204 | 204 | Numerator Engagement 1 (CRE): 18-64 | 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 |
| CRE | 1 | 205 | 205 | Denominator for Cardiac Rehabilitation Engagement 1 65+ (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 206 | 206 | Numerator Engagement 1 (CRE): 65+ | 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 |
| CRE | 1 | 207 | 207 | Denominator for Cardiac Rehabilitation Engagement 2 18-64 (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 208 | 208 | Numerator Engagement 2 (CRE): 18-64 | 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 |
| CRE | 1 | 209 | 209 | Denominator for Cardiac Rehabilitation Engagement 2 65+ (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 210 | 210 | Numerator Engagement 2 (CRE): 65+ | 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 |
| CRE | 1 | 211 | 211 | Denominator for Cardiac Rehabilitation Achievement 18-64 (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 212 | 212 | Numerator Achievement (CRE): 18-64 | 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 |
| CRE | 1 | 213 | 213 | Denominator for Cardiac Rehabilitation Achievement 65+ (CRE) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CRE | 1 | 214 | 214 | Numerator Achievement (CRE): 65+ | 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 |
| CVS | 1 | 215 | 215 | Denominator for COVID-19 Vaccination Status (CVS): Primary Series 6 months - 4 years old | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 216 | 216 | Numerator for COVID-19 Vaccination Status (CVS): Primary Series 6 months - 4 years old | 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 |
| CVS | 1 | 217 | 217 | Denominator for COVID-19 Vaccination Status (CVS): Primary Series 5-11 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 218 | 218 | Numerator for COVID-19 Vaccination Status (CVS): Primary Series 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 |
| CVS | 1 | 219 | 219 | Denominator for COVID-19 Vaccination Status (CVS): Primary Series 12-17 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 220 | 220 | Numerator for COVID-19 Vaccination Status (CVS): Primary Series 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 |
| CVS | 1 | 221 | 221 | Denominator for COVID-19 Vaccination Status (CVS): Primary Series 18- 64 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 222 | 222 | Numerator for COVID-19 Vaccination Status (CVS): Primary Series 18-64 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 |
| CVS | 1 | 223 | 223 | Denominator for COVID-19 Vaccination Status (CVS): Booster 5-11 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 224 | 224 | Numerator for COVID-19 Vaccination Status (CVS): Booster 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 |
| CVS | 1 | 225 | 225 | Denominator for COVID-19 Vaccination Status (CVS): Booster 12-17 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 226 | 226 | Numerator for COVID-19 Vaccination Status (CVS): Booster 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 |
| CVS | 1 | 227 | 227 | Denominator for COVID-19 Vaccination Status (CVS): Booster 18- 64 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| CVS | 1 | 228 | 228 | Numerator for COVID-19 Vaccination Status (CVS): Booster 18-64 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 |
| CWP | 2 | 229 | 230 | Denominator for Appropriate Testing for Pharyngitis (CWP): 3-17 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| CWP | 2 | 231 | 232 | Numerator for Appropriate Testing for Pharyngitis (CWP): 3-17 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 | 233 | 234 | Denominator for Appropriate Testing for Pharyngitis (CWP): 18-64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| CWP | 2 | 235 | 236 | Numerator for Appropriate Testing for Pharyngitis (CWP): 18-64 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 | 237 | 238 | Denominator for Appropriate Testing for 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 | 239 | 240 | Numerator for Appropriate Testing for 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 |
| DEV-N | 1 | 241 | 241 | Denominator for Development Screening 1 (DEV-N): The children in the eligible population who turned 1 during the measurement year. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DEV-N | 1 | 242 | 242 | Numerator (DEV-N): First Year | 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 |
| DEV-N | 1 | 243 | 243 | Denominator for Development Screening 2 (DEV-N): The children in the eligible population who turned 2 during the measurement year. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DEV-N | 1 | 244 | 244 | Numerator (DEV-N): Second Year | 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 |
| DEV-N | 1 | 245 | 245 | Denominator for Development Screening 3 (DEV-N): The children in the eligible population who turned 3 during the measurement year. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DEV-N | 1 | 246 | 246 | Numerator (DEV-N): Third Year | 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 |
| DSF-E | 1 | 247 | 247 | Denominator 1 for Depression Screening and Follow-up (DSF-E): 12-17 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 248 | 248 | Numerator Depression Screening (Population Criteria 1) (DSF-E): 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 |
| DSF-E | 1 | 249 | 249 | Denominator 1 for Depression Screening and Follow-up (DSF-E): 18-64 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 250 | 250 | Numerator Depression Screening (Population Criteria 1) (DSF-E): 18-64 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 |
| DSF-E | 1 | 251 | 251 | Denominator 1 for Depression Screening and Follow-up (DSF-E): 65+ years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 252 | 252 | Numerator Depression Screening (Population Criteria 1) (DSF-E): 65+ 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 |
| DSF-E | 1 | 253 | 253 | Denominator 2 for Depression Screening and Follow-up (DSF-E): 12-17 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 254 | 254 | Numerator Follow-Up on Positive Screen (Population Criteria 2) (DSF-E): 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 |
| DSF-E | 1 | 255 | 255 | Denominator 2 for Depression Screening and Follow-up (DSF-E): 18-64 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 256 | 256 | Numerator Follow-Up on Positive Screen (Population Criteria 2) (DSF-E): 18- 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 |
| DSF-E | 1 | 257 | 257 | Denominator 2 for Depression Screening and Follow-up (DSF-E): 65+ years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| DSF-E | 1 | 258 | 258 | Numerator Follow-Up on Positive Screen (Population Criteria 2) (DSF-E): 65+ 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 |
| EED | 1 | 259 | 259 | Denominator for Eye Exam for Patients with Diabetes (EED) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| EED | 1 | 260 | 260 | Numerator for Eye Exam for Patients with Diabetes (EED) | 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 |
| FUA | 2 | 261 | 262 | Denominator for Follow-Up After Emergency Department Visit for Substance Use (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 | 263 | 264 | Numerator for Follow-Up After Emergency Department Visit for Substance Use (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 | 265 | 266 | Numerator for Follow-Up After Emergency Department Visit for Substance Use (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 | 267 | 268 | Denominator for Follow-Up After Emergency Department Visit for Substance Use (FUA): 18+ years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUA | 2 | 269 | 270 | Numerator for Follow-Up After Emergency Department Visit for Substance Use (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 | 271 | 272 | Numerator for Follow-Up After Emergency Department Visit for Substance Use (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 |
| FUH | 2 | 273 | 274 | Denominator for Follow-Up After Hospitalization for Mental Illness (FUH): 6-17 years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUH | 2 | 275 | 276 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 6- 17 years, 30-day follow-up | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUH | 2 | 277 | 278 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 6- 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 |
| FUH | 2 | 279 | 280 | Denominator for Follow-Up After Hospitalization for Mental Illness (FUH): 18-64 years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUH | 2 | 281 | 282 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 18- 64 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 |
| FUH | 2 | 283 | 284 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 18- 64 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 |
| FUH | 2 | 285 | 286 | Denominator for Follow-Up After Hospitalization for Mental Illness (FUH): 65+ years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUH | 2 | 287 | 288 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 65+ 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 |
| FUH | 2 | 289 | 290 | Numerator for Follow-Up After Hospitalization for Mental Illness (FUH): 65+ 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 |
| FUI | 2 | 291 | 292 | Denominator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 13-17 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| FUI | 2 | 293 | 294 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 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 |
| FUI | 2 | 295 | 296 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 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 |
| FUI | 2 | 297 | 298 | Denominator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 18-64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| FUI | 2 | 299 | 300 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 18-64 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 |
| FUI | 2 | 301 | 302 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 18-64 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 |
| FUI | 2 | 303 | 304 | Denominator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 65+ years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| FUI | 2 | 305 | 306 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 65+ 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 |
| FUI | 2 | 307 | 308 | Numerator for Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): 65+ 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 |
| FUM | 2 | 309 | 310 | Denominator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 6-17 years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUM | 2 | 311 | 312 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 6-17 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 |
| FUM | 2 | 313 | 314 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 6-17 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 |
| FUM | 2 | 315 | 316 | Denominator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 18-64 years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUM | 2 | 317 | 318 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 18-64 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 |
| FUM | 2 | 319 | 320 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 18-64 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 |
| FUM | 2 | 321 | 322 | Denominator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 65+ years | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| FUM | 2 | 323 | 324 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 65+ 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 |
| FUM | 2 | 325 | 326 | Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 65+ 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 |
| HBD | 1 | 327 | 327 | Denominator for Hemoglobin A1c Control for Patients with Diabetes (HBD) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| HBD | 1 | 328 | 328 | Numerator for HbA1c Control <8% (HBD) | 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 | 329 | 329 | Numerator for HbA1c Poor Control >9% (HBD) | 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 |
| HDO | 1 | 330 | 330 | Denominator for Use of Opioids at High Dosage (HDO) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| HDO | 1 | 331 | 331 | Numerator for Use of Opioids at High Dosage (HDO) | 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 | 2 | 332 | 333 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 13-17 years Alcohol Use Disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 334 | 335 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 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 | 2 | 336 | 337 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 13-17 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 | 2 | 338 | 339 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 13-17 years Opioid Use Disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 340 | 341 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 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 | 2 | 342 | 343 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 13-17 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 | 2 | 344 | 345 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 13-17 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 | 2 | 346 | 347 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 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 | 2 | 348 | 349 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 13-17 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 | 2 | 350 | 351 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 years Alcohol use disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 352 | 353 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD 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 | 2 | 354 | 355 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD 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 | 2 | 356 | 357 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 years Opioid use disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 358 | 359 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD 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 | 2 | 360 | 361 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD 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 | 2 | 362 | 363 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 other substance use disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 364 | 365 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 18-64 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 | 2 | 366 | 367 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 18-64 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 | 2 | 368 | 369 | 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 | 2 | 370 | 371 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD 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 | 2 | 372 | 373 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD 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 | 2 | 374 | 375 | 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 | 2 | 376 | 377 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD 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 | 2 | 378 | 379 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD 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 | 2 | 380 | 381 | Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 65+ other substance use disorder | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| IET | 2 | 382 | 383 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 65+ 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 | 2 | 384 | 385 | Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 65+ 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 |
| IMA | 1 | 386 | 386 | 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 | 387 | 387 | 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 | 388 | 388 | 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 | 389 | 389 | 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 | 390 | 390 | 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 | 391 | 391 | 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 |
| IMA-E | 1 | 392 | 392 | Denominator for Immunizations for Adolescents Electronic (IMA-E) | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| IMA-E | 1 | 393 | 393 | Numerator for Immunizations for Adolescents Electronic (IMA-E): 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-E | 1 | 394 | 394 | Numerator for Immunizations for Adolescents Electronic (IMA-E): 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-E | 1 | 395 | 395 | Numerator for Immunizations for Adolescents Electronic (IMA-E): 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-E | 1 | 396 | 396 | Numerator for Immunizations for Adolescents Electronic (IMA-E): 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-E | 1 | 397 | 397 | Numerator for Immunizations for Adolescents Electronic (IMA-E): 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 |
| KED | 1 | 398 | 398 | Denominator for Kidney Health Evaluation for Patients With Diabetes (KED): 18-64 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| KED | 1 | 399 | 399 | Numerator for Kidney Health Evaluation for Patients With Diabetes (KED): 18-64 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 |
| KED | 1 | 400 | 400 | Denominator for Kidney Health Evaluation for Patients With Diabetes (KED): 65-74 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| KED | 1 | 401 | 401 | Numerator for Kidney Health Evaluation for Patients With Diabetes (KED): 65-74 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 |
| KED | 1 | 402 | 402 | Denominator for Kidney Health Evaluation for Patients With Diabetes (KED): 75-85 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| KED | 1 | 403 | 403 | Numerator for Kidney Health Evaluation for Patients With Diabetes (KED): 75-85 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 | 404 | 404 | Denominator for Use of Imaging Studies for Low Back Pain (LBP), Ages 18- 64 Years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| LBP | 1 | 405 | 405 | Numerator for Use of Imaging Studies for Low Back Pain (LBP), Ages 18-64 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 |
| LBP | 1 | 406 | 406 | Denominator for Use of Imaging Studies for Low Back Pain (LBP), Ages 65- 75 Years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| LBP | 1 | 407 | 407 | Numerator for Use of Imaging Studies for Low Back Pain (LBP), Ages 65-75 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 |
| LSC | 1 | 408 | 408 | 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 | 409 | 409 | 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 |
| NCS | 1 | 410 | 410 | 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 | 411 | 411 | 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 |
| PBH | 1 | 412 | 412 | 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 | 413 | 413 | 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 |
| PCE | 2 | 414 | 415 | 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 | 416 | 417 | 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 | 418 | 419 | 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 |
| PDS-E | 2 | 420 | 421 | Denominator 1 for Postpartum Depression Screening (PDS-E) | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| PDS-E | 2 | 422 | 423 | Numerator 1 for Postpartum Depression Screening (PDS-E) | 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 |
| PDS-E | 2 | 424 | 425 | Denominator 2 for Postpartum Depression Follow-up (PDS-E) | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| PDS-E | 2 | 426 | 427 | Numerator 2 for Postpartum Depression Follow-up (PDS-E) | 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 |
| PND-E | 2 | 428 | 429 | Denominator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Denominator 1 Initial Population | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| PND-E | 2 | 430 | 431 | Numerator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Numerator 1 Depression Screening | 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 |
| PND-E | 2 | 432 | 433 | Denominator for Prenatal Depression Screening and Follow Up Electronic (PND-E): Denominator 2 All deliveries from Numerator 1 with a positive finding for depression during pregnancy | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| PND-E | 2 | 434 | 435 | Numerator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Numerator 2—Follow-Up on Positive Screen | 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 | 2 | 436 | 437 | Denominator for Pharmacotherapy for Opioid Disorder (POD): 16-64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| POD | 2 | 438 | 439 | Numerator for Pharmacotherapy for Opioid Disorder (POD): 16-64 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 |
| POD | 2 | 440 | 441 | Denominator for Pharmacotherapy for Opioid Disorder (POD): 65+ years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| POD | 2 | 442 | 443 | Numerator for Pharmacotherapy for Opioid Disorder (POD): 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 |
| PPC | 2 | 444 | 445 | 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 | 446 | 447 | 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 | 448 | 449 | 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 | 450 | 451 | 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 |
| PRS-E | 2 | 452 | 453 | Denominator for Prenatal Immunization Status (PRS-E) | Enter: The number of times this member is in denominator '0' if the member is not in the denominator |
| PRS-E | 2 | 454 | 455 | Numerator for Prenatal Immunization Status (PRS-E): Influenza (Population Criteria 1) | 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 |
| PRS-E | 2 | 456 | 457 | Numerator for Prenatal Immunization Status (PRS-E): Td/Tdap (Population Criteria 2) | 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 |
| SAA | 1 | 458 | 458 | 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 | 459 | 459 | 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 |
| SNS-E | 1 | 460 | 460 | Social Need Screening and Intervention (SNS-E) Denominator 1: The initial population, minus exclusions. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 461 | 461 | Social Need Screening and Intervention (SNS-E) Numerator 1— Total Number of Members in denominator 1 with a documented result for food insecurity screening performed between January 1 and December 1 of the measurement period. | 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 |
| SNS-E | 1 | 462 | 462 | Social Need Screening and Intervention (SNS-E) Denominator 2: All members in numerator 1 with a positive food insecurity screen finding between January 1 and December 1 of the measurement period. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 463 | 463 | Social Need Screening and Intervention (SNS-E) Numerator 2: Total Number of Members in denominator 2 receiving a food insecurity intervention on or up to 30 days after the date of the first positive food insecurity screen (31 days total). | 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 |
| SNS-E | 1 | 464 | 464 | Social Need Screening and Intervention (SNS-E) Denominator 3 : The initial population, minus exclusions | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 465 | 465 | Social Need Screening and Intervention (SNS-E) Numerator 3: Total Number of Members in denominator 1 with a documented result for housing instability, homelessness or housing inadequacy screening performed between January 1 and December 1 of the measurement period. | 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 |
| SNS-E | 1 | 466 | 466 | Social Need Screening and Intervention (SNS-E) Denominator 4: All members in numerator 3 with a positive housing instability, homelessness or housing inadequacy screen finding between January 1 and December 1 of the measurement period. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 467 | 467 | Social Need Screening and Intervention (SNS-E) Numerator 4: Total Number of Members in denominator 4 receiving an intervention corresponding to the type of housing need identified on or up to 30 days after the date of the first positive housing screen (31 days total). | 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 |
| SNS-E | 1 | 468 | 468 | Social Need Screening and Intervention (SNS-E) Denominator 5: The initial population, minus exclusions. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 469 | 469 | Social Need Screening and Intervention (SNS-E) Numerator 5: Total Number of Members in denominator 5 with a documented result for transportation insecurity screening performed between January 1 and December 1 of the measurement period. Total Number of Members in denominator 5 with a documented result for transportation insecurity screening performed between January 1 and December 1 of the measurement period. |
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 |
| SNS-E | 1 | 470 | 470 | Social Need Screening and Intervention (SNS-E) Denominator 6: All members in numerator 5 with a positive transportation insecurity screen finding between January 1 and December 1 of the measurement period | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| SNS-E | 1 | 471 | 471 | Social Need Screening and Intervention (SNS-E) Numerator 6: Total Number of Members in denominator 6 receiving a transportation insecurity intervention on or up to 30 days after the date of the first positive transportation screen (31 days total). | 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 | 472 | 472 | 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 | 473 | 473 | 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 | 474 | 474 | 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 | 475 | 475 | 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 | 476 | 476 | 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 | 477 | 477 | 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 | 478 | 478 | 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 | 479 | 479 | 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 |
| SPD | 1 | 480 | 480 | 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 | 481 | 481 | 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 | 482 | 482 | 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 | 483 | 483 | 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 |
| SPR | 1 | 484 | 484 | 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 | 485 | 485 | 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 |
| UOP | 1 | 486 | 486 | 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 | 487 | 487 | 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 | 488 | 488 | 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 | 489 | 489 | 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 |
| URI | 2 | 490 | 491 | Denominator for Appropriate Treatment for Upper Respiratory Infection (URI): 3 months-17 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| URI | 2 | 492 | 493 | Numerator for Appropriate Treatment for Upper Respiratory Infection (URI): 3 months-17 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 | 494 | 495 | Denominator for Appropriate Treatment for Upper Respiratory Infection (URI): 18-64 years | Enter: The number of times this member is in the denominator '0' if the member is not in the denominator |
| URI | 2 | 496 | 497 | Numerator for Appropriate Treatment for Upper Respiratory Infection (URI): 18-64 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 | 498 | 499 | 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 | 500 | 501 | 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 |
| W30 | 1 | 502 | 502 | Denominator for Well-Child Visits in the First 15 Months. Children who turned 15 months old during MY (W30): Six or more well-child visits | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| W30 | 1 | 503 | 503 | Numerator for Well-Child Visits in the First 15 Months. Children who turned 15 months old during MY (W30): 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 |
| W30 | 1 | 504 | 504 | Denominator for Well-Child Visits for Age 15 Months-30 Months. Children who turned 30 months old during the MY (W30): Two or more well-child visits. | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| W30 | 1 | 505 | 505 | Numerator for Well-Child Visits for Age 15 Months-30 Months. Children who turned 30 months old during the MY (W30): Two 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 |
| WCC | 1 | 506 | 506 | 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 | 507 | 507 | 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 | 508 | 508 | 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 | 509 | 509 | 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 | 510 | 510 | 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 | 511 | 511 | 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 | 512 | 512 | 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 | 513 | 513 | 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 | 514 | 514 | 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 | 515 | 515 | 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 | 516 | 516 | 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 | 517 | 517 | 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 |
| WCV | 1 | 518 | 518 | Denominator for Child and Adolescent Well-Care Visits (WCV): 3-11 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| WCV | 1 | 519 | 519 | Numerator for Child and Adolescent Well-Care Visits (WCV): 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 |
| WCV | 1 | 520 | 520 | Denominator for Child and Adolescent Well-Care Visits (WCV): 12-17 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| WCV | 1 | 521 | 521 | Numerator for Child and Adolescent Well-Care Visits (WCV): 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 |
| WCV | 1 | 522 | 522 | Denominator for Child and Adolescent Well-Care Visits (WCV): 18-21 years | Enter: '1' if this member is in the denominator '0' if this member is not in the denominator |
| WCV | 1 | 523 | 523 | Numerator for Child and Adolescent Well-Care Visits (WCV): 18-21 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 |
| AIS-E | 1 | 524 | 524 | Denominator 2 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 4) [Members 66 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 |
| AIS-E | 1 | 525 | 525 | Numerator for Adult Immunization Status (AIS-E): Influenza (Population Criteria 4) [Members 66 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 |
| AIS-E | 1 | 526 | 526 | Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 4) [Members 66 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 |
| AIS-E | 1 | 527 | 527 | Denominator 4 for Adult Immunization Status (AIS-E): Zoster (Population Criteria 4) [Members 66 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 |
| AIS-E | 1 | 528 | 528 | Numerator for Adult Immunization Status (AIS-E): Zoster (Population Criteria 4) [Members 66 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 |
NYS MY2023 Patient-Level Detail File Change Log
COMMERCIAL
| Version | Date | Data Element | Change Summary |
|---|---|---|---|
| Specification Release MY2023 | 1/9/2023 | Multiple | Initial MY2023 update per HEDIS 2022 specifications: This included removal of all unused columns either due to retirement or unnecessary totaling. These include the measure ABA, BCS, CWP, MMA, CDC, AAB total, CAP, WC, AWL ADL, and ADV. There was a combining of measure columns when they were separated which impacted COL, COL-E, DEV-N, and IET. Pneumococcal was added as a numerator for AIS-E. General information was grouped together at the top of the file. We have added requests for Asian American subgroup, Pacific Island group, and more detailed information for language other than English. The word gender was removed and has been replaced by sex. The full name of FUA has been updated to remove the word abuse. We have removed the proportion indirect estimate and added a place for information on the direct or indirect estimate of race and ethnicity. There were excess denominators and repetitive denominators for follow up measures that have now been condensed. Measures are alphabetically arranged by short name. Changes or additions will be added to the bottom of the file for 2023. The file will be re-sorted alphabetically for 2024. |
| Clarification #1 | 6/5/2023 | Multiple | Field Member ID: The following note was added as a note for Essential Plans reporting member ID in the PLD, "For Essential Plans plans, please report the member's NYHX Member ID." Field Source of Race Data: 22 = State Databases (Direct) was added as a response option. Field Source of Ethnicity Data: 22 = State Databases (Direct) was added as a response option. Measure COL (non-electronic version): Age bands were incorrect in the original release and have been corrected. Column Start and Column End numbering was corrected. |
| Clarification #2 | 8/28/2023 | Multiple | Column Length Changed = 2 for Race Column Length Changed = 2 for Source of Race Data Source of Race Data field, valid values have been updated to align with NCQA/HEDIS specifications. Column Length Changed = 2 for Source of Ethnicity Data Source of Ethnicity Data field, valid values have been updated to align with NCQA/HEDIS specifications. The Language Spoken field has been updated to include a link to Language Value Set on the NYS QARR Language Value Set webpage. Column Start and Column End numbering was corrected. |
| Clarification #3 | 10/17/2023 | Multiple | General Info Native Hawaiian/Pacific Islander Subgroups: Updated 0=Not Native Hawaiian/Pacific Islander Measure CIS-E (electronic version): Combo 2 – is Not required to be reported and has been removedColumn Start and Column End numbering has been corrected. Measure COL: Denominator and Numerator specifications have been updated for 46-50 and 51-75 age-bands for this measure. Measure COL-E (electronic version): Denominator and Numerator specifications have been updated for 46-50 and 51-75 age-bands for this measure. |
| Clarification #4 | 11/7/2023 | Multiple | Measure AIS-E (electronic version): Labels and descriptions updated to match HEDIS numerator and denominator population criteria. Measure SNS-E (electronic version) Updated numerator labels to include "Total Number of Members", per HEDIS Reporting specifications: The total is the sum of the age stratifications. |
| Clarification #5 | 11/21/2023 | AIS-E | Measure AIS-E (electronic version):
Label and description for Influenza and Td/Tdap denominator 1 has been updated to represent the 19-65 year old age band [column start 109]. Labels and descriptions for Influenza and Td/Tdap numerators have been updated to represent the 19-65 year old age band [column starts 110-111]. Label and description for Zoster denominator 3 has been updated to represent the 50-65 year old age band [column start 112]. Label and description for Zoster numerator has been updated to represent the 50-65 year old age band [column start 113]. Denominator 2 for Influenza and Td/Tdap has been added for the 66 years and older age band [column start 524]. Numerators for Influenza and Td/Tdap have been added for the age band of 66 years and older [column starts 525-526]. Denominator 4 for for Zoster has been added for the 66 years and older age band [column start 527]. Numerator for Zoster has been added for the 66 years and older age band [column start 528]. |
| Clarification #6 | 12/14/2023 | SNS-E | Measure Social Need Screening and Intervention (SNS-E): Label and description for numerator 5 has been updated to represent transportation insecurity screening. |
| Clarification #7 | 12/14/2024 | Source of Race Data | Updated: 28 = Unknown – Use this as the race source value when the member's race is "UNK" for Unknown Race
Updated: 30 = Other (Indirect) – Use when "other" indirect method is used to determine Race |
| Source of Ethnicity Data | Updated: 28 = Unknown – Use this as the race source value when the member's race is "UNK" for Unknown Ethnicity
Updated: 30 = Other (Indirect) – Use when "other" indirect method is used to determine Ethnicity |
