Medicaid MY2023 PLD File Specifications

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Revision date: February 14, 2024

MEDICAID

MEASURE COLUMN LENGTH COLUMN START COLUMN END FIELD SPECIFICATION
GENERAL INFO 1 1 1 Record Identifier Use the tilde (~) character to start the line.
GENERAL INFO 5 2 6 Submission ID The unique identifier assigned by NCQA for summary-level data submission
GENERAL INFO 18 7 24 Product Line MEDICAID, HIVSNP, HARP
GENERAL INFO 30 25 54 Member ID Member ID should be Medicaid Client ID Number (CIN). For Medicaid: AA#####A For CHP:
0####### or 5#######
GENERAL INFO 8 55 62 Date of birth The birth date must contain 8 digits with month, day, year Enter:
MMDDYYYY (e.g., September 20, 1983 would be 09201983)
GENERAL INFO 2 63 64 Member Months The member month contribution this member adds according to the Enrollment by Product Line measure. Valid values are between 0 - 12.
GENERAL INFO 1 65 65 Sex Enter:
The 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=AskedButNoAnswer
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 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
AAB 2 82 83 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 84 85 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 86 87 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 88 89 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 90 91 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 92 93 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 97 97 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 98 98 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 99 99 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 1 100 100 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 1 101 101 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 1 102 102 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 1 103 103 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 1 104 104 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 1 105 105 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 1 106 106 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 1 107 107 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
AIS-E 1 108 108 Denominator 1 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 1) [Members 19 years - 65 years] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 109 109 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 1 110 110 Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 2) [Members 19 years - 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 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 1 112 112 Numerator for Adult Immunization Status (AIS-E): Zoster (Population Criteria 3) [Members 50 years - 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
AMM 1 113 113 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 1 114 114 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
AMR 1 118 118 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 1 119 119 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 1 120 120 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 1 121 121 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 1 122 122 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 1 123 123 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 1 124 124 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 1 125 125 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 1 126 126 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 1 127 127 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 1 128 128 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 1 129 129 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 1 130 130 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 1 131 131 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 1 132 132 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 1 133 133 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 2 134 135 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 2 136 137 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 2 144 145 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 1 146 146 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 1 147 147 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 1 148 148 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 1 149 149 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 1 150 150 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 1 151 151 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 1 152 152 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 1 153 153 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 1 154 154 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 1 155 155 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 1 156 156 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 1 157 157 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 1 158 158 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 1 159 159 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 1 160 160 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 1 161 161 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 1 162 162 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): 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 1 167 167 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 1 168 168 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 1 169 169 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 1 170 170 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 1 171 171 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 1 172 172 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 1 173 173 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 1 174 174 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 1 175 175 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 1 176 176 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 1 177 177 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 1 178 178 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 1 179 179 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 1 180 180 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 1 181 181 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 1 182 182 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 1 183 183 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) : 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 1 188 188 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 1 189 189 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 1 190 190 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 1 191 191 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 1 192 192 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 1 193 193 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 1 194 194 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 1 195 195 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 1 196 196 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 1 197 197 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 1 198 198 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 1 199 199 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 1 200 200 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 1 201 201 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 1 202 202 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 1 203 203 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 1 204 204 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 1 205 205 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 1 206 206 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 1 207 207 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 1 208 208 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 1 209 209 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 1 210 210 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 1 211 211 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 1 212 212 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 1 213 213 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 1 214 214 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 1 215 215 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 1 216 216 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 1 217 217 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 1 218 218 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 1 219 219 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 1 220 220 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 1 221 221 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 1 222 222 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 1 223 223 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 1 224 224 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 1 225 225 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 2 226 227 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 2 228 229 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 2 230 231 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 2 232 233 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 2 234 235 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 2 236 237 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 1 238 238 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 1 239 239 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 1 240 240 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 1 241 241 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 1 242 242 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 1 243 243 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 1 244 244 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (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 1 245 245 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 1 246 246 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (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 1 247 247 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 1 248 248 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 249 249 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 1 250 250 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (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 1 251 251 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 1 252 252 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (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 1 253 253 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 1 254 254 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 255 255 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 1 256 256 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 1 257 257 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 2 258 259 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 2 260 261 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 2 262 263 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 2 264 265 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 2 266 267 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 2 268 269 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 2 270 271 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 2 272 273 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 2 274 275 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 2 276 277 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 2 278 279 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 2 280 281 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 2 282 283 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 2 284 285 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 2 286 287 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 2 288 289 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 2 290 291 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 2 292 293 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 2 294 295 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 2 296 297 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 2 298 299 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 2 300 301 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 2 302 303 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 2 304 305 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 2 306 307 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 2 308 309 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 2 310 311 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 2 312 313 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 2 314 315 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 2 316 317 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 2 318 319 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 2 320 321 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 2 322 323 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 1 324 324 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 1 325 325 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 1 326 326 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 1 327 327 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 1 328 328 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
IET 2 329 330 Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET) 13-17 years old Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
IET 2 331 332 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment 13-17 year olds 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 2 333 334 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 2 335 336 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 2 337 338 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 2 339 340 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 2 341 342 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 2 343 344 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 2 345 346 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 2 347 348 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 2 349 350 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 2 351 352 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 2 353 354 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 2 355 356 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 2 357 358 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 2 359 360 Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 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 2 361 362 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 18-64 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 2 363 364 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 18-64 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 2 365 366 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 2 367 368 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 2 369 370 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 2 371 372 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 2 373 374 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of AOD Treatment, 65+ years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 375 376 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of AOD Treatment, 65+ years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 377 378 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 2 379 380 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of Other substance use disorder, 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 2 381 382 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of other substance use disorder 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 1 383 383 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 1 384 384 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 1 385 385 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 1 386 386 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 1 387 387 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 1 388 388 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 1 389 389 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 1 390 390 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 1 391 391 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 1 392 392 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 1 393 393 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 1 394 394 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 1 395 395 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 1 396 396 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 1 397 397 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 1 398 398 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 1 399 399 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 1 400 400 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 1 401 401 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 1 402 402 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 1 403 403 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 1 404 404 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 1 405 405 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 1 406 406 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 1 407 407 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 1 408 408 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
OED 1 409 409 Denominator: Oral Evaluation, Dental Services (OED) - 0-2 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 410 410 Numerator: Oral Evaluation, Dental Services (OED) - 0-2 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
OED 1 411 411 Denominator: Oral Evaluation, Dental Services (OED) -3-5 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 412 412 Numerator: Oral Evaluation, Dental Services (OED) -3-5 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
OED 1 413 413 Denominator: Oral Evaluation, Dental Services (OED) - 6-14 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 414 414 Numerator: Oral Evaluation, Dental Services (OED) - 6-14 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
OED 1 415 415 Denominator: Oral Evaluation, Dental Services (OED) - 15-20 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 416 416 Numerator: Oral Evaluation, Dental Services (OED) - 15-20 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
PBH 1 417 417 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 1 418 418 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 2 419 420 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 2 421 422 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 2 423 424 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 2 425 426 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 2 427 428 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 2 429 430 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 2 431 432 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 2 433 434 Denominator for Prenatal Depression Screening and Follow-Up- Electronic (PND-E): 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 2 435 436 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 2 437 438 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 2 439 440 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
POA 1 441 441 Denominator for Use of Pharmacotherapy for Alcohol Use or Dependence (POA) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
POA 1 442 442 Numerator for Use of Pharmacotherapy for Alcohol Use or Dependence (POA) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
POD 2 443 444 Denominator for Pharmacotherapy for Opioid Use 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 2 445 446 Numerator for Pharmacotherapy for Opioid Use 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 2 447 448 Denominator for Pharmacotherapy for Opioid Use 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 2 449 450 Numerator for Pharmacotherapy for Opioid Use 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
POD-N 1 451 451 Denominator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD-N) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
POD-N 1 452 452 Numerator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD-N) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
PPC 2 453 454 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 2 455 456 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 2 457 458 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 2 459 460 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 2 461 462 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 2 463 464 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 2 465 466 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 1 467 467 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 1 468 468 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
SMC 1 469 469 Denominator for Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SMC 1 470 470 Numerator for Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SMD 1 471 471 Denominator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SMD 1 472 472 Numerator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SNS-E 1 473 473 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 1 474 474 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 1 475 475 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 1 476 476 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 1 477 477 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 1 478 478 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 1 479 479 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 1 480 480 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 1 481 481 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 1 482 482 Social Need Screening and Intervention (SNS-E) Numerator 5: 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).

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 1 483 483 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 1 484 484 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 1 485 485 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 1 486 486 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 1 487 487 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 1 488 488 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 1 489 489 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 1 490 490 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 1 491 491 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 1 492 492 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 1 493 493 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 1 494 494 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 1 495 495 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 1 496 496 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 1 497 497 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 1 498 498 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
SSD 1 499 499 Denominator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SSD 1 500 500 Numerator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
TFC 1 501 501 Denominator: Topical Flouride for Children (TFC) - 1-2 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
TFC 1 502 502 Numerator: Topical Flouride for Children (TFC) - 1-2 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
TFC 1 503 503 Denominator: Topical Flouride for Children (TFC) - 3-4 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
TFC 1 504 504 Numerator: Topical Flouride for Children (TFC) - 3- 4 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
UOP 1 505 505 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 1 506 506 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 1 507 507 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 1 508 508 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 2 509 510 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 2 511 512 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 2 513 514 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 2 515 516 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 2 517 518 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 2 519 520 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 1 521 521 Denominator for Well-Child Visits in the First 15 Months (W30). 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 1 522 522 Numerator for Well-Child Visits in the First 15 Months (W30). 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 1 523 523 Denominator for Well-Child Visits for Age 15 Months-30 Months (W30). 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 1 524 524 Numerator for Well-Child Visits for Age 15 Months-30 Months (W30). 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
WCC 1 525 525 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 1 526 526 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 1 527 527 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 1 528 528 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 1 529 529 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 1 530 530 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 1 531 531 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 1 532 532 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 1 533 533 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 1 534 534 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 1 535 535 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 1 536 536 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 1 537 537 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 1 538 538 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 1 539 539 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 1 540 540 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 1 541 541 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 1 542 542 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 1 543 543 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 1 544 544 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 1 545 545 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 1 546 546 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 1 547 547 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

MEDICAID

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 shortname. 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 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.
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 General Info General Info
Native Hawaiian/Pacific Islander Subgroups: Updated
0=Not Native Hawaiian/Pacific Islander

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 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 544].

Numerators for Influenza and Td/Tdap have been added for the age band of 66 years and older [column starts 545-546].

Denominator 4 for Zoster has been added for the 66 years and older age band [column start 547].

Numerator for Zoster has been added for the 66 years and older age band [column start 548].
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