Commercial MY2024 PLD File Specifications

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Revision date: November 5, 2024

COMMERCIAL

MEASURE COLUMN LENGTH COLUMN START COLUMN END FIELD SPECIFICATION
GENERAL INFO 1 1 1 Record Identifier Use the tilde (~) character to start the line.
GENERAL INFO 5 2 6 Submission ID The unique identifier assigned by NCQA for summary-level data submission
GENERAL INFO 18 7 24 Product Line CPPO, CEPO, CHMO, EP
GENERAL INFO 30 25 54 Member ID Member ID should be the health plan's internal, individual member identifier. Do not report a family identifier, and do not report the identifier used in HEDIS.

For the Essential Plan, report the NYS-issued member ID. The NYS-issued member ID for non-Aliessa members should be an 8-digit number beginning with 7. For Aliessa members, report the assigned CIN, an 8-digit number starting with two alpha characters followed by five digits and one alpha.
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=Some Other Race
07=Two or more races
08=Asked But No Answer
09=Unknown
GENERAL INFO 2 68 69 Source of Race Data Provide the source of Race data:
20 = Health Plan Direct (Direct)
21 = CMS databases (Direct)
22 = State Databases (Direct)
23 = Surname Analysis (Indirect)
24 = Geo-coding Analysis (Indirect)
28 = Unknown – Use this as the race source value when the member's race is "UNK" for Unknown Race.
29 = Other (Direct)
30 = Other (Indirect) - Use when "other" indirect method is used to determine Race.
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 ethnicity source value when the member's ethnicity is "UNK" for Unknown Ethnicity.
29 = Other (Direct)
30 = Other (Indirect) - Use when "other" indirect method is used to determine Ethnicity
GENERAL INFO 2 73 74 Asian American Subgroups If member's race is White, Black or African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Two or More Races, Some Other Race, Asked But No Answer, or Unknown then Enter:
00=Not Applicable
If member's race is Asian, or Two or More Races, then identify the specific subgroup:
01=Chinese
02=Japanese
03=Filipino
04=Korean
05=Vietnamese
06=Asian Indian
07=Laotian
08=Cambodian
09=Bangladeshi
10=Hmong
11=Indonesian
12=Malaysian
13=Pakistani
14=Sri Lankan
15=Taiwanese
16=Nepalese
17=Burmese
18=Thai
19=Two or more subgroups
20=Unknown Asian Subgroup
21=Declined
22=Other Asian Subgroup
GENERAL INFO 1 75 75 Native Hawaiian/Pacific Islander Subgroups If member's race is White, Black or African American, American Indian/Alaskan Native, Asian, Some Other Race, Two or more races, Asked But No Answer, or Unknown then Enter:
0=Not Applicable
If member's race is Native Hawaiian/Pacific Islander then identify the specific subgroup:
1=Hawaiian
2=Guamanian/Chamorro
3=Samoan
4=Fijian
5=Tongan
6=Two or more subgroups
7=Unknown Native Hawaiian/Pacific Islander Subgroup
8=Declined
9=Other Native Hawaiian/Pacific Islander Subgroup
GENERAL INFO 3 76 78 Language Spoken Enter the member's spoken language:
001=English
*For all other languages other than English see the Language Value Set on the Managed Care > Information for Health Plans > Quality Assurance Reporting Requirements (QARR)> 2024> NYS QARR Language Value Set webpage

197=Unknown
199=Declined
GENERAL INFO 3 79 81 County of Residence Enter the 3-digit county FIPS code for each member's residence of county. See the attachment for codes and values to enter here.
### = FIPS Code
000= Outside of NYS
999 = Unknown
PLAN CATEGORY 1 82 82 Essential Plan category for the member. This field only applies to members enrolled in an Essential Plan product. Enter '0' for members enrolled in Commercial HMO and PPO products. 0 = Not Applicable (for Commercial LOB ONLY)
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.
5 = Essential Plan 200-250: Individuals with income greater than 200 percent of the FPL and less than or equal to 250 percent of the FPL
9 = Unknown
AAB 2 83 84 Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months-17 years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
AAB 2 85 86 Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 3 months-17 years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
AAB 2 87 88 Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 18-64 years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
AAB 2 89 90 Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 18-64 years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
AAB 2 91 92 Denominator for Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB): 65+ years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
AAB 2 93 94 Numerator for Avoidance of Antibiotic treatment for Acute Bronchitis/Bronchiolitis (AAB): 65+ years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
AAP 1 95 95 Denominator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 20-44 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AAP 1 96 96 Numerator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 20-44 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AAP 1 97 97 Denominator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 45-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AAP 1 98 98 Numerator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 45-64 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AAP 1 99 99 Denominator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 65 years and older Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AAP 1 100 100 Numerator for Adults' Access to Preventive/Ambulatory Health Services (AAP): 65 years and older Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
ADD-E 1 101 101 Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): Initiation Phase Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
ADD-E 1 102 102 Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): Initiation Phase Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
ADD-E 1 103 103 Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): Continuation and Maintenance (C&M) Phase Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
ADD-E 1 104 104 Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): Continuation and Maintenance (C&M) Phase Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AIS-E 1 105 105 Denominator 1 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 1) [Members 19 -65 years] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 106 106 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 1 107 107 Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 2) [Members 19 -65 years] Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AIS-E 1 108 108 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 1 109 109 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 1 110 110 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 1 111 111 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 - 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 1 113 113 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 1 114 114 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
AIS-E 1 115 115 Denominator 4 for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 66 years and older] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 116 116 Numerator for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 66 years and older] Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AMM 1 117 117 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 1 118 118 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 1 119 119 Numerator for Antidepressant Medication Management (AMM): Effective Continuation Phase Treatment Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AMR 1 120 120 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 1 121 121 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 1 122 122 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 1 123 123 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 1 124 124 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 1 125 125 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 1 126 126 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 1 127 127 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-E 1 128 128 Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E): 1-11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
APM-E 1 129 129 Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received blood glucose testing (APM-E): 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-E 1 130 130 Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received cholesterol testing (APM-E): 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-E 1 131 131 Denominator for Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
APM-E 1 132 132 Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received blood glucose testing (APM-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
APM-E 1 133 133 Numerator for Metabolic Monitoring for Children and Adolescents on Antipsychotics who received cholesterol testing (APM-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
APP 1 134 134 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 1 135 135 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 1 136 136 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 1 137 137 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 2 138 139 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 2 140 141 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 2 142 143 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 2 144 145 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 2 146 147 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 2 148 149 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 1 150 150 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 1 151 151 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 1 152 152 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 1 153 153 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 1 154 154 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 1 155 155 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 1 156 156 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 1 157 157 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 1 158 158 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 1 159 159 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
CET 1 160 160 Denominator for Continued Engagement in Substance Use Disorder Treatment (CET) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CET 1 161 161 Numerator for Continued Engagement in Substance Use Disorder Treatment (CET) Enter:
'1' 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 1 162 162 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 1 163 163 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 1 164 164 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 1 165 165 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 1 166 166 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 1 167 167 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 1 168 168 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 1 169 169 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 1 170 170 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 1 171 171 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 1 172 172 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 1 173 173 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 1 174 174 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 1 175 175 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 1 176 176 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 1 177 177 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 1 178 178 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 1 179 179 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 1 180 180 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 1 181 181 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 1 182 182 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 1 183 183 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 1 184 184 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 1 185 185 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 1 186 186 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 1 187 187 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 1 188 188 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 1 189 189 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 1 190 190 Numerator for Childhood Immunization Status Electronic (CIS-E) : Influenza Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS-E 1 191 191 Numerator for Childhood Immunization Status Electronic (CIS-E) : Combo 3 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS-E 1 192 192 Numerator for Childhood Immunization Status Electronic (CIS-E) : Combo 7 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CIS-E 1 193 193 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-E 1 194 194 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 1 195 195 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 1 196 196 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 1 197 197 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 1 198 198 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 1 199 199 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 1 200 200 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 1 201 201 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 1 202 202 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 1 203 203 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 1 204 204 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 1 205 205 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 1 206 206 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 1 207 207 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 1 208 208 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 1 209 209 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 1 210 210 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 1 211 211 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 1 212 212 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 1 213 213 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 1 214 214 Denominator for COVID-19 Vaccination Status (CVS): 6 months - 4 years old Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 215 215 Numerator for COVID-19 Vaccination Status (CVS): 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 1 216 216 Denominator for COVID-19 Vaccination Status (CVS): 5-11 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): 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 1 218 218 Denominator for COVID-19 Vaccination Status (CVS): 12-17 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): 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 1 220 220 Denominator for COVID-19 Vaccination Status (CVS): 18- 64 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): 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 2 222 223 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 2 224 225 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 2 226 227 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 2 228 229 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 2 230 231 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 2 232 233 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 1 234 234 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 1 235 235 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 1 236 236 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 1 237 237 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 1 238 238 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 1 239 239 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
DRR-E 1 240 240 Denominator 1 for Depression Remission or Response (DRR-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 241 241 Numerator Depression Follow-Up (Population Criteria 1) (DRR-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
DRR-E 1 242 242 Denominator 1 for Depression Remission or Response (DRR-E): 18-44 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 243 243 Numerator Depression Follow-Up (Population Criteria 1) (DRR-E): 18-44 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
DRR-E 1 244 244 Denominator 1 for Depression Remission or Response (DRR-E): 45-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 245 245 Numerator Depression Follow-Up (Population Criteria 1) (DRR-E): 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
DRR-E 1 246 246 Denominator 1 for Depression Remission or Response (DRR-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 247 247 Numerator Depression Follow-Up (Population Criteria 1) (DRR-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
DRR-E 1 248 248 Denominator 2 for Depression Remission or Response (DRR-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 249 249 Numerator Depression Remission (Population Criteria 2) (DRR-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
DRR-E 1 250 250 Denominator 2 for Depression Remission or Response (DRR-E): 18-44 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 251 251 Numerator Depression Remission (Population Criteria 2) (DRR-E): 18-44 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
DRR-E 1 252 252 Denominator 2 for Depression Remission or Response (DRR-E): 45-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 253 253 Numerator Depression Remission (Population Criteria 2) (DRR-E): 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
DRR-E 1 254 254 Denominator 2 for Depression Remission or Response (DRR-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 255 255 Numerator Depression Remission (Population Criteria 2) (DRR-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
DRR-E 1 256 256 Denominator 3 for Depression Remission or Response (DRR-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 257 257 Numerator Depression Response (Population Criteria 3) (DRR-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
DRR-E 1 258 258 Denominator 3 for Depression Remission or Response (DRR-E): 18-44 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 259 259 Numerator Depression Response (Population Criteria 3) (DRR-E): 18-44 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
DRR-E 1 260 260 Denominator 3 for Depression Remission or Response (DRR-E): 45-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 261 261 Numerator Depression Response (Population Criteria 3) (DRR-E): 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
DRR-E 1 262 262 Denominator 3 for Depression Remission or Response (DRR-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DRR-E 1 263 263 Numerator Depression Response (Population Criteria 3) (DRR-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 1 264 264 Denominator 1 for Depression Screening and Follow-up (DSF-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 265 265 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 1 266 266 Denominator 1 for Depression Screening and Follow-up (DSF-E): 18-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 267 267 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 1 268 268 Denominator 1 for Depression Screening and Follow-up (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 269 269 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 1 270 270 Denominator 2 for Depression Screening and Follow-up (DSF-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 271 271 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 1 272 272 Denominator 2 for Depression Screening and Follow-up (DSF-E): 18-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 273 273 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 1 274 274 Denominator 2 for Depression Screening and Follow-up (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 275 275 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 1 276 276 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 1 277 277 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 2 278 279 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 2 280 281 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 2 282 283 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 2 284 285 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 2 286 287 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 2 288 289 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 2 290 291 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 2 292 293 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 2 294 295 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 2 296 297 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 2 298 299 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 2 300 301 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 2 302 303 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 2 304 305 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 2 306 307 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 2 308 309 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 2 310 311 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 2 312 313 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 2 314 315 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 2 316 317 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 2 318 319 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 2 320 321 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 2 322 323 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 2 324 325 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 2 326 327 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 2 328 329 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 2 330 331 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 2 332 333 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 2 334 335 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 2 336 337 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 2 338 339 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 2 340 341 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 2 342 343 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
GSD 1 344 344 Denominator for Glycemic Status Assessment for Patients With Diabetes (GSD) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
GSD 1 345 345 Numerator for Glycemic Status <8.0% (GSD) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
GSD 1 346 346 Numerator for Glycemic Status >9.0% (GSD) Enter:
'1' 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 1 347 347 Denominator for Use of Opioids at High Dosage (HDO) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
HDO 1 348 348 Numerator for Use of Opioids at High Dosage (HDO) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
IET 2 349 350 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 2 351 352 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 years Alcohol Use Disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 353 354 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 2 355 356 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 2 357 358 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 years Opioid Use Disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 359 360 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 13-17 years Opioid Use Disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 361 362 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 2 363 364 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 13-17 years Other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 365 366 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 13-17 years Other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 367 368 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 2 369 370 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 18-64 years Alcohol use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 371 372 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 18-64 years Alcohol use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 373 374 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 2 375 376 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 18-64 years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 377 378 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 18-64 years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 379 380 Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 other substance use disorder Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
IET 2 381 382 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 18-64 other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 383 384 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 18-64 other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 385 386 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 2 387 388 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 65+ years Alcohol use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 389 390 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 65+ years Alcohol use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 391 392 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 2 393 394 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 65+ years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 395 396 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 65+ years Opioid use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 397 398 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 2 399 400 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 65+ other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 401 402 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 65+ other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IMA 1 403 403 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 1 404 404 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 1 405 405 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 1 406 406 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 1 407 407 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 1 408 408 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 1 409 409 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 1 410 410 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 1 411 411 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 1 412 412 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 1 413 413 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 1 414 414 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 1 415 415 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 1 416 416 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 1 417 417 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 1 418 418 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 1 419 419 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 1 420 420 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 1 421 421 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 1 422 422 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 1 423 423 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 1 424 424 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 1 425 425 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 1 426 426 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
PBH 1 427 427 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 1 428 428 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 2 429 430 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 2 431 432 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 2 433 434 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 2 435 436 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 2 437 438 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 2 439 440 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 2 441 442 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 2 443 444 Denominator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Denominator 1 Initial Population Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
PND-E 2 445 446 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 2 447 448 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 2 449 450 Numerator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Numerator 2—Follow-Up on Positive Screen Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
POD 2 451 452 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 2 453 454 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 2 455 456 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 2 457 458 Numerator for Pharmacotherapy for Opioid Disorder (POD): 65+ years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
PPC 2 459 460 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 2 461 462 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 2 463 464 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 2 465 466 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 2 467 468 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 2 469 470 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 2 471 472 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 1 473 473 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 1 474 474 Numerator for Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SNS-E 1 475 475 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 1 476 476 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 1 477 477 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 1 478 478 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 1 479 479 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 1 480 480 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 1 481 481 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 1 482 482 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 1 483 483 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 1 484 484 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 1 485 485 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 1 486 486 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 1 487 487 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 1 488 488 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 1 489 489 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 1 490 490 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 1 491 491 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 1 492 492 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 1 493 493 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 1 494 494 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 1 495 495 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 1 496 496 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 1 497 497 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 1 498 498 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
UOP 1 499 499 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 1 500 500 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 1 501 501 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 1 502 502 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 2 503 504 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 2 505 506 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 2 507 508 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 2 509 510 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 2 511 512 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 2 513 514 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 1 515 515 Denominator for Well-Child Visits in the First 15 Months. Children who turned 15 months old during MY (W30): Six or more well-child visits Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
W30 1 516 516 Numerator for Well-Child Visits in the First 15 Months. Children who turned 15 months old during MY (W30): Six or more well-child visits Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
W30 1 517 517 Denominator for Well-Child Visits for Age 15 Months-30 Months. Children who turned 30 months old during the MY (W30): Two or more well-child visits. Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
W30 1 518 518 Numerator for Well-Child Visits for Age 15 Months-30 Months. Children who turned 30 months old during the MY (W30): Two or more well-child visits. Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 519 519 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 1 520 520 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 1 521 521 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 1 522 522 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 1 523 523 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 1 524 524 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 1 525 525 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 1 526 526 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 1 527 527 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 1 528 528 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 1 529 529 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 1 530 530 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 1 531 531 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 1 532 532 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 1 533 533 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 1 534 534 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 1 535 535 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 1 536 536 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

COMMERCIAL

Version Date Data Element Change Summary
Specification Release MY2024 12/11/2024 Multiple Asian American Subgroups
Adding a "two or more subgroups" option

Native Hawaiian/Pacific Islander Subgroups
Adding a "two or more subgroups" option
  • Continued Engagement in Substance Use Disorder (SUD) Treatment (CET)
    has been added as a new NYS measure.
  • Depression Remission or Response for Adolescents and Adults (DRR-E)
    has been added as a required ECDS measure.
The following Measures have been removed due to retirement by the steward:
  • Follow-Up Care for Children Prescribed ADHD Medication (ADD)*
  • Ambulatory Care (AMB)
  • Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)*
  • Colorectal Cancer Screening (COL)*
  • Inpatient Utilization—General Hospital/Acute Care (IPU)
  • Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
  • Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR).
    *Only the COL-E, ADD-E and APM-E measures will be reported.
  • COVID-19 Immunization Status (CVS )
    Specifications and reporting requirements have been updated.
  • Hemoglobin A1c (HbA1c) Control for Patients With Diabetes (HBD) has been replaced by Glycemic Status Assessment for Patients With Diabetes (GSD)
Clarification #1 5/9/2024 Multiple Source of Race Data
  • Valid values have been updated to align with NCQA/HEDIS specifications
    28 = Unknown
    30 = Other (indirect)
Source of Ethnicity Data
  • Valid values have been updated to align with NCQA/HEDIS specifications
    28=Unknown
    30=Other (indirect)
Asian American Subgroups
  • Updated values
    19=Two or more subgroups
    20=Unknown
    21=Declined
    00=Not Asian
PLAN CATEGORY
  • New tier added for expanded Essential Plan 200-250
Social Needs Screening & Intervention (SNS-E)
  • Updated label/definition for Numerator 5
Clarification #2 8/6/2024 Multiple Asian American Subgroups
  • Updated description and values:
    If member's race is White, Black or African American, American Indian/Alaskan
    Native, Native Hawaiian/Pacific Islander, Two Or More Races, Some Other Race,
    Asked But No Answer, or Unknown then Enter:
    00= Not applicable
    If member's race is Asian, then identify the specific
    subgroup:
    20=Unknown Asian subgroup
    22=Other Asian subgroup
Native Hawaiian/Pacific Islander Subgroups
  • Updated description and values:
    If member's race is White, Black or African American, American Indian/Alaskan
    Native, Asian, Two Or More Races, Some Other Race, Asked But No Answer, or Unknown then Enter:
    0=Not Applicable
    If member's race is Native Hawaiian/Pacific Islander then identify the specific
    subgroup:
    7=Unknown Native Hawaiian/Pacific Islander Subgroup
    9=Other Native Hawaiian/Pacific Islander Subgroup
Clarification #4 9/23/2024 Member ID Updated Member ID submission specifications for Commercial and Essential plans.
Clarification #5 10/23/2024 Plan Category Updated specification guidelines, noting that 0=Not Applicable is a valid response for Commercial LOB ONLY. Essential Plan LOBs should select 1-5 as a plan category.

Clarification: 5= Essential Plan 200-250*
EP 200-250 is for individuals with income greater than 200 percent of the FPL and less than or equal to 250 percent of the FPL.
Clarification #6 11/5/2024 Commercial PLD - PDF version Commercial PLD:

Asian American Subgroups
  • Updated description on PDF version:
    • Added or Two or more races to 00=Not Applicable description:

      If member's race is White, Black or African American, American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, Two or More Races, Some Other Race, Asked But No Answer, or Unknown then Enter:

    • Removed or Two or more races subgroup description:

      If member's race is Asian or or Two or more races then identify the specific subgroup: