Medicaid MY2025 PLD File Specifications

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Revision date: December 13, 2024

MEDICAID

MEASURE COLUMN LENGTH COLUMN START COLUMN END FIELD SPECIFICATION
GENERAL INFO 1 1 1 Record Identifier Use the tilde (~) character to start the line.
GENERAL INFO 5 2 6 Submission ID The unique identifier assigned by NCQA for summary-level data submission
GENERAL INFO 18 7 24 Product Line MEDICAID, HIVSNP, HARP
GENERAL INFO 30 25 54 Member ID Member ID should be Medicaid Client ID Number (CIN).
For Medicaid: AA#####A
For CHP: 0####### or 5#######
GENERAL INFO 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
AAB 2 97 98 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 99 100 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 2 101 102 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 2 103 104 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 2 105 106 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 2 107 108 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 1 109 109 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 1 110 110 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 1 111 111 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 1 112 112 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 1 113 113 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 1 114 114 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 1 115 115 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 1 116 116 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 1 117 117 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 1 118 118 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 1 119 119 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 1 120 120 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 1 121 121 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 1 122 122 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 1 123 123 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 1 124 124 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 1 125 125 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 1 126 126 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 1 127 127 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 1 128 128 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 1 129 129 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 1 130 130 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 1 131 131 Denominator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 19 -30 years] [2] Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
AIS-E 1 132 132 Numerator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 19 -30 years] [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
AIS-E 1 133 133 Denominator 4 for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 31- 59 years] [4] Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AIS-E 1 134 134 Numerator for Adult Immunization Status (AIS-E): Hepatitis B (Population Criteria 5) [Members 31- 59 years] [5] Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
AMR 1 135 135 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 1 136 136 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 1 137 137 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 1 138 138 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 1 139 139 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 1 140 140 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 1 141 141 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 1 142 142 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 1 143 143 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 1 144 144 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 1 145 145 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 1 146 146 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 1 147 147 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 1 148 148 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 1 149 149 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 1 150 150 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 1 151 151 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 1 152 152 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 2 153 154 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 2 155 156 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 2 157 158 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 2 159 160 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 2 161 162 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 2 163 164 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 1 165 165 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 1 166 166 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 1 167 167 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 1 168 168 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 1 169 169 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 1 170 170 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 1 171 171 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 1 172 172 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 1 173 173 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 1 174 174 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 1 175 175 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 1 176 176 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 1 177 177 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 1 178 178 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 1 179 179 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 1 180 180 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 1 181 181 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 1 182 182 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 1 183 183 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 1 184 184 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 1 185 185 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 1 186 186 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 1 187 187 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 1 188 188 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 1 189 189 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 1 190 190 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 1 191 191 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 1 192 192 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 1 193 193 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 1 194 194 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 1 195 195 Denominator for Colorectal Cancer Screening Electronic (COL-E): 46-50 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL-E 1 196 196 Numerator for Colorectal Cancer Screening Electronic (COL-E): 46-50 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
COL-E 1 197 197 Denominator for Colorectal Cancer Screening (COL-E): 51-75 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
COL-E 1 198 198 Numerator for Colorectal Cancer Screening (COL-E): 51-75 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 199 199 Denominator for Cardiac Rehabilitation Initiation 18-64 (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 200 200 Numerator Initiation (CRE): 18-64 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 201 201 Denominator for Cardiac Rehabilitation Initiation 65+ (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 202 202 Numerator Initiation (CRE): 65+ Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 203 203 Denominator for Cardiac Rehabilitation Engagement 1 18-64 (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 204 204 Numerator Engagement 1 (CRE): 18-64 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 205 205 Denominator for Cardiac Rehabilitation Engagement 1 65+ (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 206 206 Numerator Engagement 1 (CRE): 65+ Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 207 207 Denominator for Cardiac Rehabilitation Engagement 2 18-64 (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 208 208 Numerator Engagement 2 (CRE): 18-64 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 209 209 Denominator for Cardiac Rehabilitation Engagement 2 65+ (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 210 210 Numerator Engagement 2 (CRE): 65+ Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 211 211 Denominator for Cardiac Rehabilitation Achievement 18-64 (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 212 212 Numerator Achievement (CRE): 18-64 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CRE 1 213 213 Denominator for Cardiac Rehabilitation Achievement 65+ (CRE) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CRE 1 214 214 Numerator Achievement (CRE): 65+ Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CVS 1 215 215 Denominator for COVID-19 Vaccination Status (CVS): 6 months - 4 years old Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 216 216 Numerator for COVID-19 Vaccination Status (CVS): 6 months - 4 years old Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CVS 1 217 217 Denominator for COVID-19 Vaccination Status (CVS): 5-11 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 218 218 Numerator for COVID-19 Vaccination Status (CVS): 5-11 Years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CVS 1 219 219 Denominator for COVID-19 Vaccination Status (CVS): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 220 220 Numerator for COVID-19 Vaccination Status (CVS): 12-17 Years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
CVS 1 221 221 Denominator for COVID-19 Vaccination Status (CVS): 18- 64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
CVS 1 222 222 Numerator for COVID-19 Vaccination Status (CVS): 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 2 223 224 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 2 225 226 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 2 227 228 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 2 229 230 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 2 231 232 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 2 233 234 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 1 235 235 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
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 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 1 241 241 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 1 242 242 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 1 243 243 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 1 244 244 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 1 245 245 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 1 246 246 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 1 247 247 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 1 248 248 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 1 249 249 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 1 250 250 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 1 251 251 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 1 252 252 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 1 253 253 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 1 254 254 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 1 255 255 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 1 256 256 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 1 257 257 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 1 258 258 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 1 259 259 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 1 260 260 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 1 261 261 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 1 262 262 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 1 263 263 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 1 264 264 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 1 265 265 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 1 266 266 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 1 267 267 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 1 268 268 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 1 269 269 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 270 270 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 1 271 271 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 18-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 272 272 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 1 273 273 Denominator 1 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 274 274 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 1 275 275 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 12-17 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 276 276 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 1 277 277 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 18-64 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 278 278 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 1 279 279 Denominator 2 for Depression Screening and Follow-up for Adolescents and Adults (DSF-E): 65+ years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
DSF-E 1 280 280 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 1 281 281 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 1 282 282 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 2 283 284 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 2 285 286 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 2 287 288 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 2 289 290 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 2 291 292 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 2 293 294 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 2 295 296 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 2 297 298 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 2 299 300 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 2 301 302 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 2 303 304 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 2 305 306 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 2 307 308 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 2 309 310 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 2 311 312 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 2 313 314 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 2 315 316 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 2 317 318 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 2 319 320 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 2 321 322 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 2 323 324 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 2 325 326 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 2 327 328 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 2 329 330 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 2 331 332 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 2 333 334 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 2 335 336 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 2 337 338 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 2 339 340 Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 6-17 years, 7-day follow-up Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
FUM 2 341 342 Denominator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 18-64 years Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
FUM 2 343 344 Numerator for Follow-Up After Emergency Department Visit for Mental Illness (FUM): 18-64 years, 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 2 345 346 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 2 347 348 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 2 349 350 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 2 351 352 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 1 353 353 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 1 354 354 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 1 355 355 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 1 356 356 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 1 357 357 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 2 358 359 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment 13-17 year olds Alcohol Use Disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 360 361 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 2 362 363 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 2 364 365 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 2 366 367 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 2 368 369 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 2 370 371 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 2 372 373 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 2 374 375 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 2 376 377 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 2 378 379 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 2 380 381 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 2 382 383 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 2 384 385 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 2 386 387 Denominator for Initiation and Engagement of Substance Use Disorder Treatment (IET): 18-64 years Other substance use disorder Enter:
The number of times this member is in denominator
'0' if the member is not in the denominator
IET 2 388 389 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of SUD Treatment, 18-64 years Other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 390 391 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of SUD Treatment, 18-64 years Other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 392 393 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 2 394 395 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 2 396 397 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 2 398 399 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 2 400 401 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 2 402 403 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 2 404 405 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 2 406 407 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Initiation of Other substance use disorder, 65+ other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IET 2 408 409 Numerator for Initiation and Engagement of Substance Use Disorder Treatment (IET): Engagement of other substance use disorder 65+ other substance use disorder Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
IMA-E 1 410 410 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 1 411 411 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 1 412 412 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 1 413 413 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 1 414 414 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 1 415 415 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 1 416 416 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 1 417 417 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 1 418 418 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 1 419 419 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 1 420 420 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 1 421 421 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 1 422 422 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 1 423 423 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 1 424 424 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 1 425 425 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 1 426 426 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 1 427 427 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
OED 1 428 428 Denominator: Oral Evaluation, Dental Services (OED) - 0-2 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 429 429 Numerator: Oral Evaluation, Dental Services (OED) - 0-2 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
OED 1 430 430 Denominator: Oral Evaluation, Dental Services (OED) -3-5 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 431 431 Numerator: Oral Evaluation, Dental Services (OED) -3-5 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
OED 1 432 432 Denominator: Oral Evaluation, Dental Services (OED) - 6-14 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 433 433 Numerator: Oral Evaluation, Dental Services (OED) - 6-14 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
OED 1 434 434 Denominator: Oral Evaluation, Dental Services (OED) - 15-20 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
OED 1 435 435 Numerator: Oral Evaluation, Dental Services (OED) - 15-20 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
PBH 1 436 436 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 1 437 437 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 2 438 439 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 2 440 441 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 2 442 443 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 2 444 445 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 2 446 447 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 2 448 449 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 2 450 451 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 2 452 453 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 2 454 455 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 2 456 457 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 2 458 459 Numerator for Prenatal Depression Screening and Follow-Up-Electronic (PND-E): Numerator 2—Follow-Up on Positive Screen Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
POA 1 460 460 Denominator for Use of Pharmacotherapy for Alcohol Use or Dependence (POA) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
POA 1 461 461 Numerator for Use of Pharmacotherapy for Alcohol Use or Dependence (POA) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
POD 2 462 463 Denominator for Pharmacotherapy for Opioid Use Disorder (POD): 16-64 years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
POD 2 464 465 Numerator for Pharmacotherapy for Opioid Use Disorder (POD): 16-64 years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
POD 2 466 467 Denominator for Pharmacotherapy for Opioid Use Disorder (POD): 65+ years Enter:
The number of times this member is in the denominator
'0' if the member is not in the denominator
POD 2 468 469 Numerator for Pharmacotherapy for Opioid Use Disorder (POD): 65+ years Enter:
The number of times this member is in the numerator
'0' if the member is not in the numerator OR the information is missing
POD-N 1 470 470 Denominator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD-N) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
POD-N 1 471 471 Numerator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence (POD-N) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
PPC 2 472 473 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 2 474 475 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 2 476 477 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 2 478 479 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 2 480 481 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 2 482 483 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 2 484 485 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 1 486 486 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 1 487 487 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
SMC 1 488 488 Denominator for Cardiovascular Monitoring for People With
Cardiovascular Disease and Schizophrenia (SMC)		 Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SMC 1 489 489 Numerator for Cardiovascular Monitoring for People With
Cardiovascular Disease and Schizophrenia (SMC)		 Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SMD 1 490 490 Denominator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SMD 1 491 491 Numerator for Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
SNS-E 1 492 492 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 1 493 493 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 1 494 494 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 1 495 495 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 1 496 496 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 1 497 497 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 1 498 498 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 1 499 499 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 1 500 500 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 1 501 501 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 1 502 502 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 1 503 503 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 1 504 504 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 1 505 505 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 1 506 506 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 1 507 507 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 1 508 508 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 1 509 509 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 1 510 510 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 1 511 511 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 1 512 512 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 1 513 513 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 1 514 514 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 1 515 515 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
SSD 1 516 516 Denominator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
SSD 1 517 517 Numerator for Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD) Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
TFC 1 518 518 Denominator: Topical Fluoride for Children (TFC) - 1-2 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
TFC 1 519 519 Numerator: Topical Fluoride for Children (TFC) - 1-2 years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
TFC 1 520 520 Denominator: Topical Fluoride for Children (TFC) - 3-4 years Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
TFC 1 521 521 Numerator: Topical Fluoride for Children (TFC) - 3- 4 Years Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
UOP 1 522 522 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 1 523 523 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 1 524 524 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 1 525 525 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 2 526 527 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 2 528 529 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 2 530 531 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 2 532 533 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 2 534 535 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 2 536 537 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 1 538 538 Denominator for Well-Child Visits in the First 15 Months (W30). Children who turned 15 months old during MY: Six or more well-child visits Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
W30 1 539 539 Numerator for Well-Child Visits in the First 15 Months (W30). Children who turned 15 months old during MY: Six or more well-child visits Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
W30 1 540 540 Denominator for Well-Child Visits for Age 15 Months-30 Months (W30). Children who turned 30 months old during the MY: Two or more well-child visits. Enter:
'1' if this member is in the denominator
'0' if this member is not in the denominator
W30 1 541 541 Numerator for Well-Child Visits for Age 15 Months-30 Months (W30). Children who turned 30 months old during the MY: Two or more well-child visits. Enter:
'1' if this member is in the numerator
'0' if this member is not in the numerator OR the information for this member is missing
WCC 1 542 542 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 1 543 543 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 1 544 544 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 1 545 545 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 1 546 546 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 1 547 547 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 1 548 548 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 1 549 549 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 1 550 550 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 1 551 551 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 1 552 552 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 1 553 553 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 1 554 554 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 1 555 555 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 1 556 556 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 1 557 557 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 1 558 558 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 1 559 559 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

*Optional reporting requirement for MY2025

MEDICAID

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

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