Commercial MY2022 PLD File Specifications

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Revision date: November 22, 2022

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.
GENERAL INFO 8 55 62 Date of birth The birth date must contain 8 digits with month, day, year Enter:
MMDDYYYY (e.g., September 20, 1983 would be 09201983)
GENERAL INFO 2 63 64 Member Months The member month contribution this member adds according to the Enrollment by Product Line measure. Valid values are between 0 ‐ 12.
GENERAL INFO 1 65 65 Sex Enter:
The gender assigned at birth
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, 3‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 69 69 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 3‐11 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 70 70 Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 71 71 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): BMI Percentile, 12‐17 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 72 72 Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 3‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 73 73 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 3‐11 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 74 74 Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 75 75 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Nutrition, 12‐17 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 76 76 Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 3‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 77 77 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 3‐11 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 78 78 Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCC 1 79 79 Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC): Counseling for Physical Activity, 12‐17 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 80 80 Denominator for Childhood Immunization Status (CIS) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CIS 1 81 81 Numerator for Childhood Immunization Status (CIS): DTaP Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 82 82 Numerator for Childhood Immunization Status (CIS): IPV Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 83 83 Numerator for Childhood Immunization Status (CIS): MMR Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 84 84 Numerator for Childhood Immunization Status (CIS): HiB Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 85 85 Numerator for Childhood Immunization Status (CIS): HepB Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 86 86 Numerator for Childhood Immunization Status (CIS): VZV Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 87 87 Numerator for Childhood Immunization Status (CIS): PCV Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 88 88 Numerator for Childhood Immunization Status (CIS): HepA Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 89 89 Numerator for Childhood Immunization Status (CIS): RV Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 90 90 Numerator for Childhood Immunization Status (CIS): Influenza Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 91 91 Numerator for Childhood Immunization Status (CIS): Combo 2 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 92 92 Numerator for Childhood Immunization Status (CIS): Combo 3 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 93 93 Numerator for Childhood Immunization Status (CIS): Combo 4 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 94 94 Numerator for Childhood Immunization Status (CIS): Combo 5 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 95 95 Numerator for Childhood Immunization Status (CIS): Combo 6 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 96 96 Numerator for Childhood Immunization Status (CIS): Combo 7 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 97 97 Numerator for Childhood Immunization Status (CIS): Combo 8 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 98 98 Numerator for Childhood Immunization Status (CIS): Combo 9 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS 1 99 99 Numerator for Childhood Immunization Status (CIS): Combo 10 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IMA 1 100 100 Denominator for Immunizations for Adolescents (IMA) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
IMA 1 101 101 Numerator for Immunizations for Adolescents (IMA): Meningococcal Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IMA 1 102 102 Numerator for Immunizations for Adolescents (IMA): Tdap Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IMA 1 103 103 Numerator for Immunizations for Adolescents (IMA): Combo 1 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IMA 1 104 104 Numerator for Immunizations for Adolescents (IMA): HPV Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IMA 1 105 105 Numerator for Immunizations for Adolescents (IMA): Combo 2 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
BCS 1 106 106 Removed from PLD‐ See BCS‐E blank
BCS 1 107 107 Removed from PLD‐ See BCS‐E blank
CCS 1 108 108 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 1 109 109 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 1 110 110 Moved to group new age stratifications blank
COL 1 111 111 Moved to group new age stratifications blank
CHL 1 112 112 Denominator for Chlamydia Screening in Women (CHL): 16‐20 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CHL 1 113 113 Numerator for Chlamydia Screening in Women (CHL): 16‐20 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CHL 1 114 114 Denominator for Chlamydia Screening in Women (CHL): 21‐24 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CHL 1 115 115 Numerator for Chlamydia Screening in Women (CHL): 21‐24 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CWP 2 116 117 Denominator for Appropriate Testing 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 2 118 119 Numerator for Appropriate Testing 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 2 120 121 Denominator for Appropriate Testing 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 2 122 123 Numerator for Appropriate Testing 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 2 124 125 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 2 126 127 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 2 128 129 Denominator Total‐ removed blank
CWP 2 130 131 Numerator Total‐ removed blank
SPR 1 132 132 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 1 133 133 Numerator for Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
PCE 2 134 135 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 2 136 137 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 2 138 139 Numerator for Pharmacotherapy Management of COPD Exacerbation (PCE): Bronchodilator Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
MMA 1 140 140 Measure Retired blank
MMA 1 141 141 Measure Retired blank
MMA 1 142 142 Measure Retired blank
MMA 1 143 143 Measure Retired blank
MMA 1 144 144 Measure Retired blank
MMA 1 145 145 Measure Retired blank
MMA 1 146 146 Measure Retired blank
MMA 1 147 147 Measure Retired blank
MMA 1 148 148 Measure Retired blank
MMA 1 149 149 Measure Retired blank
MMA 1 150 150 Measure Retired blank
MMA 1 151 151 Measure Retired blank
AMR 1 152 152 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 1 153 153 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 1 154 154 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 1 155 155 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 1 156 156 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 1 157 157 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 1 158 158 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 1 159 159 Numerator for Asthma Medication Ratio (AMR): 51‐64 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CBP 1 160 160 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 1 161 161 Numerator for Controlling High Blood Pressure (CBP) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
PBH 1 162 162 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 1 163 163 Numerator for Persistence of Beta‐Blocker Treatment After a Heart Attack (PBH) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SPC 1 164 164 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 1 165 165 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 1 166 166 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 1 167 167 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 1 168 168 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 1 169 169 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 1 170 170 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 1 171 171 Numerator for Statin Therapy for Patients With Cardiovascular Disease (SPC): Females 40‐75, Statin Adherence 80% Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CDC 1 172 172 Retired Blank
CDC 1 173 173 Retired Blank
CDC 1 174 174 Retired Blank
CDC 1 175 175 Retired Blank
CDC 1 176 176 Retired Blank
CDC 1 177 177 Retired Blank
CDC 1 178 178 Retired Blank
CDC 1 179 179 Retired Blank
CDC 1 180 180 Retired Blank
CDC 1 181 181 Retired Blank
CDC 1 182 182 Retired Blank
CDC 1 183 183 Retired Blank
CDC 1 184 184 Retired Blank
CDC 1 185 185 Retired Blank
SPD 1 186 186 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 1 187 187 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 1 188 188 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 1 189 189 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
AMM 1 190 190 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 1 191 191 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 1 192 192 Numerator for Antidepressant Medication Management (AMM): Effective Continuation Phase Treatment Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
ADD 1 193 193 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 1 194 194 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 1 195 195 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 1 196 196 Numerator for Follow‐Up Care for Children Prescribed ADHD Medication (ADD): Continuation and Maintenance (C&M) Phase Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
FUH 2 197 198 Denominator 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 denominator
'0' if the member is not in the denominator
FUH 2 199 200 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 2 201 202 Denominator 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 denominator
'0' if the member is not in the denominator
FUH 2 203 204 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 2 205 206 Denominator for Follow‐Up After Hospitalization for Mental Illness (FUH): 65+ years, 7‐day follow‐up Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
FUH 2 207 208 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
FUH 2 209 210 Denominator 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 2 211 212 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 the numerator
'0' if the member is not in the numerator OR the information is missing
FUH 2 213 214 Denominator 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 denominator
'0' if the member is not in the denominator
FUH 2 215 216 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 2 217 218 Denominator for Follow‐Up After Hospitalization for Mental Illness (FUH): 65+ 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 2 219 220 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
APM 1 221 221 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 1 222 222 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 1 223 223 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 1 224 224 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 1 225 225 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 1 226 226 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
NCS 1 227 227 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 1 228 228 Numerator for Non‐Recommended Cervical Cancer Screening in Adolescent Females (NCS) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
URI 2 229 230 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 2 231 232 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 2 233 234 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 2 235 236 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 2 237 238 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 2 239 240 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 2 241 242 Denominator Total‐ removed blank
URI 2 243 244 Numerator Total‐ removed blank
AAB 2 245 246 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 2 247 248 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 2 249 250 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 2 251 252 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 2 253 254 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 2 255 256 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 2 257 258 Denominator Total‐ removed blank
AAB 2 259 260 Numerator Total‐ removed blank
LBP 1 261 261 Moved to group new age stratifications blank
LBP 1 262 262 Moved to group new age stratifications blank
AAP 1 263 263 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 1 264 264 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 1 265 265 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 1 266 266 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 1 267 267 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 1 268 268 Numerator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 65 years and older Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CAP 1 269 269 Measure Retired blank
CAP 1 270 270 Measure Retired blank
CAP 1 271 271 Measure Retired blank
CAP 1 272 272 Measure Retired blank
CAP 1 273 273 Measure Retired blank
CAP 1 274 274 Measure Retired blank
CAP 1 275 275 Measure Retired blank
CAP 1 276 276 Measure Retired blank
IET 2 277 278 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 2 279 280 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD 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 2 281 282 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD 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 2 283 284 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 2 285 286 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD 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 2 287 288 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD 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 2 289 290 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 2 291 292 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD 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 2 293 294 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD 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 2 295 296 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 2 297 298 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation 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 2 299 300 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 2 301 302 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 2 303 304 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation 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 2 305 306 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 2 307 308 Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18‐64 other substance use disoder Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
IET 2 309 310 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation 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
IET 2 311 312 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 2 313 314 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 2 315 316 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 2 317 318 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 2 319 320 Numerator for Prenatal and Postpartum Care (PPC): Postpartum Care Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
APP 1 321 321 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 1 322 322 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 1 323 323 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 1 324 324 Numerator for Use of First‐Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP): 12‐17 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
W15 1 325 325 Measure removed blank
W15 1 326 326 Measure removed blank
W15 1 327 327 Measure removed blank
W15 1 328 328 Measure removed blank
W15 1 329 329 Measure removed blank
W15 1 330 330 Measure removed blank
W15 1 331 331 Measure removed blank
W15 1 332 332 Measure removed blank
W34 1 333 333 Measure removed blank
W34 1 334 334 Measure removed blank
AWC 1 335 335 Measure removed blank
AWC 1 336 336 Measure removed blank
FUM 2 337 338 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 339 340 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 2 341 342 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 343 344 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 2 345 346 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 347 348 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
FUM 2 349 350 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 351 352 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 2 353 354 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 355 356 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 2 357 358 Denominator 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 denominator
'0' if the member is not in the denominator
FUM 2 359 360 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
ADL 1 361 361 Removed blank
ADL 1 362 362 Removed blank
ADL 1 363 363 Removed blank
ADL 1 364 364 Removed blank
ADL 1 365 365 Removed blank
FUA 2 366 367 Denominator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13‐17 years Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
FUA 2 368 369 Numerator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13‐17 years, 30‐day follow‐ up Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
FUA 2 370 371 Numerator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 13‐17 years, 7‐day follow‐up Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
FUA 2 372 373 Denominator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
FUA 2 374 375 Numerator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years, 30‐day follow‐up Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
FUA 2 376 377 Numerator for Follow‐Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA): 18+ years, 7‐day follow‐up Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
LSC 1 378 378 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 1 379 379 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
HDO 1 380 380 Denominator for Use of Opiods at High Dosage (HDO) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
HDO 1 381 381 Numerator for Use of Opiods 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
UOP 1 382 382 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 1 383 383 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 1 384 384 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 1 385 385 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
General Info 2 386 387 Age Grouping for the member as of December 31 of the measurement year Enter the age grouping for the member's age as of December 31 of the measurement year.
00 = < 1 year
01 = 1‐4 yrs.
02 = 5‐9 yrs.
03 = 10‐14 yrs.
04 = 15‐17 yrs.
05 = 18‐19 yrs.
06 = 20‐24 yrs.
07 = 25‐29 yrs.
08 = 30‐34 yrs.
09 = 35‐39 yrs.
10 = 40‐44 yrs.
11 = 45‐49 yrs.
12 = 50‐54 yrs.
13 = 55‐59 yrs.
14 = 60‐64 yrs.
15 = 65 and up
99 = Unknown
General Info 1 388 388 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=Some Other Race
7=Two or more races
8=Asked But No Answer
9=Unknown
General Info 1 389 389 Ethnicity Enter the Member's ethnicity:
1=Hispanic or Latino
2=Non‐Hispanic or Latino
9=Unknown 0=Asked but not answered
General Info 1 390 390 Language Spoken Enter the member's spoken language:
1=English
2=Non‐English
9=Unknown
0=Declined
General Info 3 391 393 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
99 = Unknown
General Info 2 394 395 Indirect Race Estimate ‐ White Source of Race Data Enter the indirectly estimated probability of the member's race being White as a percentage of 100 Provide the source of race data:
20 = Health Plan Direct (Direct)
21 = CMS databases (Direct)
23 = Surname Analysis (Indirect)
24 = Geo‐coding Analysis (Indirect)
28 = Unknown (use this when race is unknown or asked but no answer)
29 = Other (direct)
30 = Other (indirect)
General Info 2 396 397 Indirect Race Estimate ‐Black Source of Ethnicity Data Enter the indirectly estimated probability of the member's race being Black as a percentage of 100 Provide the source of ethnicity data:
20 = Health Plan Direct (Direct)
21 = CMS databases (Direct)
23 = Surname Analysis (Indirect)
24 = Geo‐coding Analysis (Indirect)
28 = Unknown (use this when ethnicity is unknown or asked but no answer)
29 = Other (direct)
30 = Other (indirect)
General Info 3 398 400 Indirect Race Estimate ‐ Asian blank Removed ‐ can leave blank '000'
General Info 3 401 403 Indirect Race Estimate ‐American Indian/Alaskan Native blank Removed ‐ can leave blank '000'
General Info 3 404 406 Indirect Race Estimate ‐ Other blank Removed ‐ can leave blank '000'
General Info 3 407 409 Indirect Ethnicity Estimate ‐Hispanic or Latino blank Removed ‐ can leave blank '000'
SAA 1 410 410 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 1 411 411 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
FUI 2 412 413 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 414 415 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 2 416 417 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 418 419 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 2 420 421 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 422 423 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
FUI 2 424 425 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 426 427 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 2 428 429 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 430 431 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 2 432 433 Denominator 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 denominator
'0' if the member is not in the denominator
FUI 2 434 435 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
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
KED 1 444 444 Denominator for Kidney Health Evaluation for Patients With Diabetes: 18‐ 64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
KED 1 445 445 Numerator for Kidney Health Evaluation for Patients With Diabetes: 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 1 446 446 Denominator for Kidney Health Evaluation for Patients With Diabetes: 65‐ 74 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
KED 1 447 447 Numerator for Kidney Health Evaluation for Patients With Diabetes: 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 1 448 448 Denominator for Kidney Health Evaluation for Patients With Diabetes: 75‐ 85 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
KED 1 449 449 Numerator for Kidney Health Evaluation for Patients With Diabetes: 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
W30 1 450 450 Denominator for Well‐Child Visits in the First 15 Months. Children who turned 15 months old during MY: 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 1 451 451 Numerator for Well‐Child Visits in the First 15 Months. Children who turned 15 months old during MY: 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 1 452 452 Denominator for Well‐Child Visits for Age 15 Months‐30 Months. Children who turned 30 months old during the MY: 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 1 453 453 Numerator for Well‐Child Visits for Age 15 Months‐30 Months. Children who turned 30 months old during the MY: 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
WCV 1 454 454 Denominator for Child and Adolescent Well‐Care Visits: 3‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCV 1 455 455 Numerator for Child and Adolescent Well‐Care Visits: 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 1 456 456 Denominator for Child and Adolescent Well‐Care Visits: 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCV 1 457 457 Numerator for Child and Adolescent Well‐Care Visits: 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 1 458 458 Denominator for Child and Adolescent Well‐Care Visits: 18‐21 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
WCV 1 459 459 Numerator for Child and Adolescent Well‐Care Visits: 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
BCS‐E 1 460 460 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 1 461 461 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
COL‐E 1 462 462 Moved to group new age stratifications blank
COL‐E 1 463 463 Moved to group new age stratifications blank
AIS‐E 1 464 464 Denominator 1 for Adult Immunization Status Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS‐E 1 465 465 Numerator for Adult Immunization Status: Influenza (Population Criteria 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
AIS‐E 1 466 466 Numerator for Adult Immunization Status: Td/Tdap (Population Criteria 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
AIS‐E 1 467 467 Denominator 3 for Adult Immunization Status Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS‐E 1 468 468 Numerator for Adult Immunization Status: Zoster (Population Criteria 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
PRS‐E 2 469 470 Denominator for Prenatal Immunization Status Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
PRS‐E 2 471 472 Numerator for Prenatal Immunization Status: 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 2 473 474 Numerator for Prenatal Immunization Status: 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
DSF‐E 1 475 475 Denominator 1 for Depression Screening and Follow‐up: 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 476 476 Numerator Depression Screening (Population Criteria 1): 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 1 477 477 Denominator 1 for Depression Screening and Follow‐up: 18‐64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 478 478 Numerator Depression Screening (Population Criteria 1): 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 1 479 479 Denominator 1 for Depression Screening and Follow‐up: 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 480 480 Numerator Depression Screening (Population Criteria 1): 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 1 481 481 Denominator 2 for Depression Screening and Follow‐up: 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 482 482 Numerator Follow‐Up on Positive Screen (Population Criteria 2): 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 1 483 483 Denominator 2 for Depression Screening and Follow‐up: 18‐64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 484 484 Numerator Follow‐Up on Positive Screen (Population Criteria 2): 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 1 485 485 Denominator 2 for Depression Screening and Follow‐up: 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF‐E 1 486 486 Numerator Follow‐Up on Positive Screen (Population Criteria 2): 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
PLAN CATEGORY 1 487 487 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
PDS‐E 2 488 489 Denominator 1 for Postpartum Depression Screening Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
PDS‐E 2 490 491 Numerator 1 for Postpartum 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
PDS‐E 2 492 493 Denominator 2 for Postpartum Depression Follow‐up Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
PDS‐E 2 494 495 Numerator 2 for Postpartum Depression 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
CRE 1 496 496 Denominator for Cardiac Rehabilitation Initiation 18‐64 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 497 497 Numerator Initiation: 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 1 498 498 Denominator for Cardiac Rehabilitation Initiation 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 499 499 Numerator Initiation: 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 1 500 500 Denominator for Cardiac Rehabilitation Engagement 1 18‐64 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 501 501 Numerator Engagement 1: 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 1 502 502 Denominator for Cardiac Rehabilitation Engagement 1 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 503 503 Numerator Engagement 1: 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 1 504 504 Denominator for Cardiac Rehabilitation Engagement 2 18‐64 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 505 505 Numerator Engagement 2: 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 1 506 506 Denominator for Cardiac Rehabilitation Engagement 2 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 507 507 Numerator Engagement 2: 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 1 508 508 Denominator for Cardiac Rehabilitation Achievement 18‐64 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 509 509 Numerator Achievement: 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 1 510 510 Denominator for Cardiac Rehabilitation Achievement 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 511 511 Numerator Achievement: 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
DEV‐N 1 512 512 Moved to include all appropriate denominators blank
DEV‐N 1 513 513 Moved to include all appropriate denominators blank
DEV‐N 1 514 514 Moved to include all appropriate denominators blank
DEV‐N 1 515 515 Moved to include all appropriate denominators blank
DEV‐N 1 516 516 Moved to include all appropriate denominators blank
BPD 1 517 517 Denominator for Blood Pressure Control for Patients with Diabetes Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
BPD 1 518 518 Numerator for Blood Pressure Control 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
HBD 1 519 519 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 1 520 520 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 1 521 521 Numerator for HbA1c Poor Control >9% Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
EED 1 522 522 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 1 523 523 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
AXR 2 524 525 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 2 526 527 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 2 528 529 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 2 530 531 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 2 532 533 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 2 534 535 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
ADD‐E 1 536 536 Denominator for Follow‐Up Care for Children Prescribed ADHD Medication (ADD‐E): Initiation Phase Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
ADD‐E 1 537 537 Numerator for Follow‐Up Care for Children Prescribed ADHD Medication (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 1 538 538 Denominator for Follow‐Up Care for Children Prescribed ADHD Medication (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 1 539 539 Numerator for Follow‐Up Care for Children Prescribed ADHD Medication (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
IET 2 540 541 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 2 542 543 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 2 544 545 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 2 546 547 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 2 548 549 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of Opioid Use Disorder, 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 2 550 551 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of Opioid Use Disorder, 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 2 552 553 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 2 554 555 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 2 556 557 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
ADV 1 558 558 Removed. Not Required. Blank
ADV 1 559 559 Removed. Not Required. Blank
PND‐E 2 560 561 Denominator for Prenatal Depression Screening and Follow‐Up‐Electronic: Demoninator 1 Initial Popuation Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
PND‐E 2 562 563 Numerator for Prenatal Depression Screening and Follow‐Up‐Electronic: 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 2 564 565 Denominator for Prenatal Depression Screening and Follow Up Electronic: 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 2 566 567 Numerator for Prenatal Depression Screening and Follow‐Up‐Electronic: 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
General Info 3 568 570 Indirect Race Estimate blank Removed ‐ can leave blank '000'
General Info 3 571 573 Indirect Race Estimate blank Removed ‐ can leave blank '000'
General Info 3 574 576 Indirect Race Estimate blank Removed ‐ can leave blank '000'
General Info 3 577 579 Indirect Race Estimate blank Removed ‐ can leave blank '000'
General Info 3 580 582 Indirect Race Estimate blank Removed ‐ can leave blank '000'
General Info 3 583 585 Indirect Race Estimate blank Removed ‐ can leave blank '000'
COL 1 586 586 Denominator for Colorectal Cancer Screening (COL): 46‐49 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL 1 587 587 Numerator for Colorectal Cancer Screening (COL): 46‐49 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 1 588 588 Denominator for Colorectal Cancer Screening (COL): 50‐75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL 1 589 589 Numerator for Colorectal Cancer Screening (COL): 50‐75 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 1 590 590 Denominator for Colorectal Cancer Screening (COL‐E): 46‐49 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL‐E 1 591 591 Numerator for Colorectal Cancer Screening (COL‐E): 46‐49 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 1 592 592 Denominator for Colorectal Cancer Screening (COL‐E): 50‐75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL‐E 1 593 593 Numerator for Colorectal Cancer Screening (COL‐E): 50‐75 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
CVS 1 594 594 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 1 595 595 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 1 596 596 Denominator for COVID‐19 Vaccination Status: Primary Series 5‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 597 597 Numerator for COVID‐19 Vaccination Status: 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 1 598 598 Denominator for COVID‐19 Vaccination Status: Primary Series 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 599 599 Numerator for COVID‐19 Vaccination Status: 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 1 600 600 Denominator for COVID‐19 Vaccination Status: Primary Series 18‐ 64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 601 601 Numerator for COVID‐19 Vaccination Status: 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 1 602 602 Denominator for COVID‐19 Vaccination Status: Booster 5‐11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 603 603 Numerator for COVID‐19 Vaccination Status: 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 1 604 604 Denominator for COVID‐19 Vaccination Status: Booster 12‐17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 605 605 Numerator for COVID‐19 Vaccination Status: 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 1 606 606 Denominator for COVID‐19 Vaccination Status: Booster 18‐ 64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 607 607 Numerator for COVID‐19 Vaccination Status: 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
LBP 1 608 608 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 1 609 609 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 1 610 610 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 1 611 611 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
DEV‐N 1 612 612 Denominator for Development Screening 1 : 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 1 613 613 Numerator: 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 1 614 614 Denominator for Development Screening 2: 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 1 615 615 Numerator: 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 1 616 616 Denominator for Development Screening 3: 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 1 617 617 Numerator: 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
Revision date: November 22, 2022

COMMERCIAL

Version Date Data Element Change Summary
Specification Release MY2022 11/9/2021 Multiple Initial MY2022 update per HEDIS 2022 specifications.
Clarification #2 12/24/2021 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 from 110‐111 to group the new age stratifications together.
Clarification #4 6/16/2022 COL‐E Removed colorectal‐e from 298‐299 to group the new age stratifications together.
Clarification #4 6/16/2022 ADV Removed requirement to submit data for ADV from 522‐523.
Clarification #4 6/16/2022 COL Added the new age stratifications for COL in 546‐553
Clarification #4 6/16/2022 COL‐E Added the new age stratifications for COL‐E in 554‐561
Clarification #4 6/16/2022 CVS Added the new COVID‐19 Immunization Status Measure from 562‐ 589
Clarification #6 9/1/2022 Multiple Beginning in column 551, the new measures, COL, COL‐E, and CVS had two spaces for data entry. This has been corrected to 1 space. This impacts 551‐572.
Clarification #6 9/1/2022 Multiple The FUA measure started at column 343 which was the retired ADL. FUA now begins at 348 which has shifted all of the column starts by 5.
Clarification #7 10/19/2022 PND‐E Allows for the member to appear in the measure multiple times.
Clarification #7 10/19/2022 LBP Removed the LBP 18‐64 measure from 261‐262. Added both the measure stratifications to 573‐576.
Clarification #7 10/19/2022 DEV‐N Removed from 496‐500 because there were insufficient denominators. Regrouped to 577‐582 to combine all of the appropriate numerators and denominators together.
Clarification #7 10/19/2022 HBD Fixed the acronym from HBP (=typo) to HBD.
Clarification #7 10/19/2022 IET Changed the numerator and denominator language to reflect the episodic language.
Clarification #8 11/15/2022 IET Created two spaces for the numerator and denominator from columns 277 to 312 and 534 to 551. This impacts every column start after column 278.
Clarification #8 11/15/2022 General Info Removed the indirect race and ethnicity estimates from columns 394 to 409 and 565 to 582. Added source of race data to columns 394 to 395. Added source of ethnicity data to 396 to 397. Reduced the column field size (length) from 3 to 2 for columns 394 to 397.
Clarification #8 11/15/2022 PND‐E Created 2 spaces for the numerator and denominator. This impacts columns 554 to 564.
Clarification #9 11/21/2022 AXR Updated measure specifications to allow for episodic tracking in numerator and denominator. Increased column length from 1 to 2. This impacts every Column Start and Column End after 525.
Clarification #9 11/21/2022 PND‐E Corrected numbering sequence between columns 564 to 565 to account for the change in the measure's denominator size (Clarification #8). This impacts every Column Start after 565.