Commercial MY2025 PLD File Specifications

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Revision date: December 13, 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 9 55 63 Member Attributed Practice Tax ID#* Enter the 9-digit Federally assigned Tax Identification Number for the Practice of the member's provider. Populate with valid TINs only. If unavailable or invalid set to '999999999'
GENERAL INFO 10 64 73 Member Attributed Physician NPI* Populate with valid NPIs only. This is the unique 10-digit National Provider Identifier (NPI) of the provider/organization the member was serviced by during the reporting period. This should be a provider that had frequent contact with the member and, therefore, could potentially affect the need for hospitalization or not. [1]
GENERAL INFO 8 74 81 Member 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 82 83 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 84 84 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 85 86 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 1 87 87 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 88 89 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, 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 90 90 Native Hawaiian/Pacific Islander Subgroups 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:
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 91 93 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)> 2025> NYS QARR Language Value Set webpage.
197=Unknown
199=Declined
GENERAL INFO 3 94 96 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 97 97 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 98 99 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 2 100 101 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 2 102 103 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 2 104 105 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 2 106 107 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 2 108 109 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 1 110 110 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 1 111 111 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 1 112 112 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 1 113 113 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 1 114 114 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 1 115 115 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 1 116 116 Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): (6-12 years) Initiation Phase Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
ADD-E 1 117 117 Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): (6-12 years) 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 1 118 118 Denominator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): (6-12 years) 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 1 119 119 Numerator for Follow-Up Care for Children Prescribed ADHD Medication Electronic (ADD-E): (6-12 years) 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 1 120 120 Denominator 1 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 1) [Members 19 -64 years] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 121 121 Numerator for Adult Immunization Status (AIS-E): Influenza (Population Criteria 1) [Members 19 -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
AIS-E 1 122 122 Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 2) [Members 19 -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
AIS-E 1 123 123 Denominator 2 for Adult Immunization Status (AIS-E): Influenza and Td/Tdap (Population Criteria 4) [Members 65 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 1 124 124 Numerator for Adult Immunization Status (AIS-E): Influenza (Population Criteria 4) [Members 65 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 1 125 125 Numerator for Adult Immunization Status (AIS-E): Td/Tdap (Population Criteria 4) [Members 65 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 1 126 126 Denominator 3 for Adult Immunization Status (AIS-E): Zoster (Population Criteria 3) [Members 50 - 64 years] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 127 127 Numerator for Adult Immunization Status (AIS-E): Zoster (Population Criteria 3) [Members 50 - 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
AIS-E 1 128 128 Denominator 4 for Adult Immunization Status (AIS-E): Zoster (Population Criteria 4) [Members 65 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 1 129 129 Numerator for Adult Immunization Status (AIS-E): Zoster (Population Criteria 4) [Members 65 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 1 130 130 Denominator 4 for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 65 years and older] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 131 131 Numerator for Adult Immunization Status (AIS-E): Pneumococcal (Population Criteria 4) [Members 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
AIS-E 1 132 132 Denominator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 19 -30 years] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 133 133 Numerator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 19 -30 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 1 134 134 Denominator 4 for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 31- 59 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 1 135 135 Numerator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 31- 59 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 1 136 136 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 1 137 137 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 1 138 138 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 1 139 139 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 1 140 140 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 1 141 141 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 1 142 142 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 1 143 143 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 1 144 144 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 1 145 145 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 1 146 146 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 1 147 147 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 1 148 148 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 1 149 149 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 1 150 150 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 1 151 151 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 1 152 152 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 1 153 153 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 2 154 155 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 2 156 157 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 2 158 159 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 2 160 161 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 2 162 163 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 2 164 165 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 1 166 166 Denominator for Breast Cancer Screening (BCS-E): (50-74 years) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
BCS-E 1 167 167 Numerator for Breast Cancer Screening (BCS-E): (50-74 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
BPC-E 1 168 168 Denominator for Blood Pressure Control for Patients With Hypertension (BPC-E): 18–85 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
BPC-E 1 169 169 Numerator for Blood Pressure Control for Patients With Hypertension (BPC-E): 18–85 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
BPD 1 170 170 Denominator for Blood Pressure Control for Patients with Diabetes (BPD): 18-75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
BPD 1 171 171 Numerator for Blood Pressure Control for Patients with Diabetes (BPD): 18-75 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
CBP 1 172 172 Denominator for Controlling High Blood Pressure (CBP): 18-85 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CBP 1 173 173 Numerator for Controlling High Blood Pressure (CBP): 18-85 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
CCS-E 1 174 174 Denominator for Cervical Cancer Screening Electronic (CCS-E): 21-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CCS-E 1 175 175 Numerator for Cervical Cancer Screening Electronic (CCS-E): 21-64 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
CET 1 176 176 Denominator for Continued Engagement in Substance Use Disorder Treatment (CET): 18+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CET 1 177 177 Numerator for Continued Engagement in Substance Use Disorder Treatment (CET): 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
CHL 1 178 178 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 1 179 179 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 1 180 180 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 1 181 181 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-E 1 182 182 Denominator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CIS-E 1 183 183 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 184 184 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 185 185 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 186 186 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 187 187 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 188 188 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 189 189 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 190 190 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 191 191 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 192 192 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 193 193 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 194 194 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 195 195 Numerator for Childhood Immunization Status Electronic (CIS-E): completed by age 2 - 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 1 196 196 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 1 197 197 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 1 198 198 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 1 199 199 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 1 200 200 Denominator for Cardiac Rehabilitation Initiation (CRE): 18-64 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): 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 Initiation (CRE): 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 203 203 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 1 204 204 Denominator for Cardiac Rehabilitation Engagement 1 (CRE): 18-64 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): 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 1 (CRE): 65+ Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 207 207 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 1 208 208 Denominator for Cardiac Rehabilitation Engagement 2 (CRE): 18-64 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): 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 Engagement 2 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 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 1 212 212 Denominator for Cardiac Rehabilitation Achievement (CRE): 18-64 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): 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 1 214 214 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 1 215 215 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 1 216 216 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 1 217 217 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 1 218 218 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 1 219 219 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 1 220 220 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 1 221 221 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 1 222 222 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 1 223 223 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 2 224 225 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 2 226 227 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 2 228 229 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 2 230 231 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 2 232 233 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 2 234 235 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
DBM-E 2 236 237 Denominator for Documented Assessment After Mammogram (DBM-E): members aged 40–74 Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
DBM-E 2 238 239 Numerator for Documented Assessment After Mammogram (DBM-E): members aged 40–74 Enter:
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 1 240 240 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 1 241 241 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 1 242 242 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 1 243 243 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 1 244 244 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 1 245 245 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 1 246 246 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 1 247 247 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 1 248 248 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 1 249 249 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 1 250 250 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 1 251 251 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 1 252 252 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 1 253 253 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 1 254 254 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 1 255 255 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 1 256 256 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 1 257 257 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 1 258 258 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 1 259 259 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 1 260 260 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 1 261 261 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 1 262 262 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 1 263 263 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 1 264 264 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 1 265 265 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 1 266 266 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 1 267 267 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 1 268 268 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 1 269 269 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 1 270 270 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 1 271 271 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 1 272 272 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 1 273 273 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 1 274 274 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 1 275 275 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 1 276 276 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 1 277 277 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 1 278 278 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 1 279 279 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 1 280 280 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 1 281 281 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 1 282 282 Denominator for Eye Exam for Patients with Diabetes (EED): 18-75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
EED 1 283 283 Numerator for Eye Exam for Patients with Diabetes (EED): 18-75 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
FMA-E 2 284 285 Denominator for Follow-Up After Abnormal Mammogram Assessment (FMA-E): members aged 40–74 Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
FMA-E 2 286 287 Numerator for Follow-Up After Abnormal Mammogram Assessment (FMA-E): members aged 40–74 Enter:
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 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 2 290 291 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 2 292 293 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 2 294 295 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 2 296 297 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 2 298 299 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 2 300 301 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 2 302 303 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 2 304 305 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 2 306 307 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 2 308 309 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 2 310 311 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 2 312 313 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 2 314 315 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 2 316 317 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 2 318 319 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 2 320 321 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 2 322 323 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 2 324 325 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 2 326 327 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 2 328 329 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 2 330 331 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 2 332 333 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 2 334 335 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 2 336 337 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 2 338 339 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 2 340 341 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 2 342 343 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 2 344 345 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 2 346 347 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 2 348 349 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 2 350 351 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 2 352 353 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 1 354 354 Denominator for Glycemic Status Assessment for Patients With Diabetes (GSD): 18-75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
GSD 1 355 355 Numerator for Glycemic Status <8.0% (GSD): 18-75 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
GSD 1 356 356 Numerator for Glycemic Status >9.0% (GSD): 18-75 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
HDO 1 357 357 Denominator for Use of Opioids at High Dosage (HDO): 18+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
HDO 1 358 358 Numerator for Use of Opioids at High Dosage (HDO): 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
IET 2 359 360 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 2 361 362 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 2 363 364 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 2 365 366 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 2 367 368 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 2 369 370 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 2 371 372 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 2 373 374 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 2 375 376 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 2 377 378 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 2 379 380 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 2 381 382 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 2 383 384 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 2 385 386 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 2 387 388 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 2 389 390 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 2 391 392 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 2 393 394 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 2 395 396 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 2 397 398 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 2 399 400 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 2 401 402 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 2 403 404 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 2 405 406 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 2 407 408 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 2 409 410 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 2 411 412 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-E 1 413 413 Denominator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
IMA-E 1 414 414 Numerator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 - 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 1 415 415 Numerator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 - 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 1 416 416 Numerator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 - 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 1 417 417 Numerator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 - 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 1 418 418 Numerator for Immunizations for Adolescents Electronic (IMA-E): completed by age 13 - 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 1 419 419 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 1 420 420 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 1 421 421 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 1 422 422 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 1 423 423 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 1 424 424 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 1 425 425 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 1 426 426 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 1 427 427 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 1 428 428 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 1 429 429 Denominator for Lead Screening in Children (LSC): completed by age 2 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
LSC 1 430 430 Numerator for Lead Screening in Children (LSC): completed by age 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
PBH 1 431 431 Denominator for Persistence of Beta-Blocker Treatment After a Heart Attack (PBH): 18+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
PBH 1 432 432 Numerator for Persistence of Beta-Blocker Treatment After a Heart Attack (PBH): 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
PCE 2 433 434 Denominator for Pharmacotherapy Management of COPD Exacerbation (PCE): 40+ years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
PCE 2 435 436 Numerator for Pharmacotherapy Management of COPD Exacerbation (PCE): 40+ years - 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 2 437 438 Numerator for Pharmacotherapy Management of COPD Exacerbation (PCE): 40+ years - 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 2 439 440 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 2 441 442 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 2 443 444 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 2 445 446 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 2 447 448 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 2 449 450 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 2 451 452 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 2 453 454 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 2 455 456 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 2 457 458 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 2 459 460 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 2 461 462 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 2 463 464 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 2 465 466 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 2 467 468 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 2 469 470 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 2 471 472 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 2 473 474 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 2 475 476 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 1 477 477 Denominator for Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA): 18+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SAA 1 478 478 Numerator for Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA): 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
SNS-E 1 479 479 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 1 480 480 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 1 481 481 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 1 482 482 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 1 483 483 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 1 484 484 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 1 485 485 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 1 486 486 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 1 487 487 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 1 488 488 Social Need Screening and Intervention (SNS-E) Numerator 5:
Total Number of Members in denominator 5 with a documented result for transportation insecurity screening performed between January 1 and December 1 of the measurement period.		 Enter:
'1' 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 1 489 489 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 1 490 490 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 1 491 491 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 1 492 492 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 1 493 493 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 1 494 494 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 1 495 495 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 1 496 496 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 1 497 497 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 1 498 498 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 1 499 499 Denominator for Statin Therapy for Patients With Diabetes (SPD): 40-75 years - Received Statin Therapy Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SPD 1 500 500 Numerator for Statin Therapy for Patients With Diabetes (SPD): 40-75 years - 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 1 501 501 Denominator for Statin Therapy for Patients With Diabetes (SPD): 40-75 years - Statin Adherence 80% Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SPD 1 502 502 Numerator for Statin Therapy for Patients With Diabetes (SPD): 40-75 years - 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 1 503 503 Denominator for Use of Opioids from Multiple Providers (UOP): 18+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
UOP 1 504 504 Numerator for Use of Opioids from Multiple Providers (UOP): 18+ years - 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 1 505 505 Numerator for Use of Opioids from Multiple Providers (UOP): 18+ years - 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 1 506 506 Numerator for Use of Opioids from Multiple Providers (UOP): 18+ years - 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 2 507 508 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 2 509 510 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 2 511 512 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 2 513 514 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 2 515 516 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 2 517 518 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 1 519 519 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 1 520 520 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 1 521 521 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 1 522 522 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 1 523 523 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 1 524 524 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 1 525 525 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 1 526 526 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 1 527 527 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 1 528 528 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 1 529 529 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 1 530 530 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 1 531 531 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 1 532 532 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 1 533 533 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 1 534 534 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 1 535 535 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 1 536 536 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 1 537 537 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 1 538 538 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 1 539 539 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 1 540 540 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
MY2025 12/16/2024 Multiple Member Attributed Practice Tax ID#
Field added for MY2025 as OPTIONAL reporting requirement, will become REQUIRED for MY2026.

Member Attributed Physician NPI*
Field added for MY2025 as OPTIONAL reporting requirement, will become REQUIRED for MY2026.

Source of Race Data
Removed the data source reporting requirement from the race stratification.

Source of Ethnicity Data
Removed the data source reporting requirement from the ethnicity stratification.

Language Spoken
Updated NYS QARR Language Value Set webpage link

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: Individuals with income greater than 200 percent of the FPL and less than or equal to 250 percent of the FPL.

The following measures have been removed due to retirement by the steward:
  • Antidepressant Medication Management (AMM).
  • Cervical Cancer Screening (CCS)*.
  • Childhood Immunization Status (CIS)*.
  • Immunizations for Adolescents (IMA)*.
    *Only the CIS-E, IMA-E and CCS-E measures will be reported.
    *Column Start and Column End numbering has been updated
Adult Immunization Status (AIS-E)
  • Updated age stratifications for the Influenza, Td/Tdap, Zoster, and Pneumococcal immunization indicators. (per HEDIS MY2025 Specifications)
  • Added a hepatitis B immunization indicator
Blood Pressure Control for Patients With Hypertension (BPC-E)
Is a new HEDIS measure for MY 2025 and has been added as a required ECDS measure.

Documented Assessment After Mammogram (DBM-E)
Is a new HEDIS measure for MY 2025 and has been added as a required ECDS measure.

Follow-Up After Abnormal Mammogram Assessment (FMA-E)
Is a new HEDIS measure for MY 2025 and has been added as a required ECDS measure.

Age specifications added to the following measures:
ADD-E
BCS-E
BPD
CBP
CCS-E
CET
CIS-E
EED
GSD
HDO
IMA-E
LSC
PBH
PCE
SAA
SPD
UOP