Advanced Primary Care (APC)
HEDIS 2018 Member–Level File Layout
- Detail File Layout is also available in EXCEL (XLSX) and Portable Document Format (PDF) formats
Member_Level
Element # | Name | Direction | Allowed Values | Required/ Optional |
Length | Start | End |
---|---|---|---|---|---|---|---|
1 | Plan ID# | Organization ID used to submit the IDSS to NCQA. | ###### = IDSS Organization ID |
R | 6 | 1 | 6 |
2 | Product Line | A member´s product line at the end of the measurement period. | 1 = Ma 2 = HIVSNP 3 = Medicare 4 = CPPO 5 = CHMO 6 = QHMO 7 = QPOS 8 = QPPO 9 = QEPO 10 = CEPO 11 = HARP 12 = EP |
R | 2 | 7 | 8 |
3 | Unique Member ID# | For Medicaid, populate with the member´s CIN, for other products, provide a unique identification number assigned by the plan. The field is alphanumeric and should be treated as a text field. This field is mandatory – do not leave it blank! |
R | 15 | 9 | 23 | |
4 | 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 |
R | 3 | 24 | 26 |
5 | Zip Code of Residence | R | 5 | 27 | 31 | ||
6 | Practice Tax ID# | Populate with valid TINs only. If unavailable or invalid set to ´999999999´ | ######### | R | 9 | 32 | 40 |
7 | PCMH Site ID# | If available plan must include a PCMH Site ID# or a Internal plan practice site ID# (see element #8) | O | 10 | 41 | 50 | |
8 | Practice Site ID# | Internal plan practice site ID# | O | 15 | 51 | 65 | |
9 | Practice Name | R | 50 | 66 | 115 | ||
10 | Practice Address Line 1 | R | 35 | 116 | 150 | ||
11 | Practice Address Line 2 | O | 35 | 151 | 185 | ||
12 | Practice Address Line 3 | O | 35 | 186 | 220 | ||
13 | Practice Address City | R | 25 | 221 | 245 | ||
14 | Practice Address State | R | 2 | 246 | 247 | ||
15 | Practice Address Zip Code | ##### | R | 5 | 248 | 252 | |
16 | Practice Telephone Number | ########## | O | 10 | 253 | 262 | |
17 | Physician NPI | R | 10 | 263 | 272 | ||
18 | Physician First Name | R | 15 | 273 | 287 | ||
19 | Physician Middle Name | O | 1 | 288 | 288 | ||
20 | Physician Last Name | R | 35 | 289 | 323 | ||
21 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (WCC): BMI Percentile, 3–11 years | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator. | 1= Yes 0 = No |
R | 1 | 324 | 324 |
22 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (WCC): BMI Percentile, 3–11 years | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 325 | 325 |
23 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (WCC): BMI Percentile, 12–17 years | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator. | 1= Yes 0 = No |
R | 1 | 326 | 326 |
24 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (WCC): BMI Percentile, 12–17 years | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 327 | 327 |
25 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 328 | 328 |
26 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 329 | 329 |
27 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 330 | 330 |
28 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 331 | 331 |
29 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 332 | 332 |
30 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 333 | 333 |
31 | Denominator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 334 | 334 |
32 | Numerator for Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adoldescents (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. | 1= Yes 0 = No |
R | 1 | 335 | 335 |
33 | Denominator for Childhood Immunization (CIS) | Enter: ´1´ if this member is in the denominator of the CIS measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 336 | 336 |
34 | Numerator for CIS – Combination 3 | Enter: ´1´ if this member received Combination 3 vaccinations meeting HEDIS specifications. Enter ´0´ if this member did not receive Combination 3 vaccinations meeting HEDIS specifications. This differs from the QARR Member Level file request, only the Combination 3 indicator requested. | 1= Yes 0 = No |
R | 1 | 337 | 337 |
35 | Denominator for Breast Cancer Screening (BCS) | Enter: ´1´ if this member is in the denominator for the Breast Cancer Screening measures, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 338 | 338 |
36 | Numerator for Breast Cancer Screening (BCS) | Enter: ´1´ if this member is in the numerator of the Breast Cancer Screening measure, ´0´ if the member is not in the numerator for this measure. | 1= Yes 0 = No |
R | 1 | 339 | 339 |
37 | Denominator for Cervical Cancer Screening (CCS) | Enter: ´1´ if this member is in the denominator for the Cervical Cancer Screening measures, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 340 | 340 |
38 | Numerator for Cervical Cancer Screening (CCS) | Enter: ´1´ if this member is in the numerator of the Cervical Cancer Screening measure, ´0´ if the member is not in the numerator for this measure | 1= Yes 0 = No |
R | 1 | 341 | 341 |
39 | Denominator for Chlamydia Screening in Women (CHL): 16 – 20 Years | Enter: ´1´ if this member is in the denominator of the Chlamydia Screening in Women (16 – 20 Years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 342 | 342 |
40 | Numerator for Chlamydia Screening in Women (CHL): 16 – 20 Years | Enter: ´1´ if this member is in the numerator of the Chlamydia Screening in Women (16 – 20 Years) measure, ´0´ if the member is not in the numerator or the information is missing. | 1= Yes 0 = No |
R | 1 | 343 | 343 |
41 | Denominator for Chlamydia Screening in Women (CHL): 21 – 24 Years | Enter: ´1´ if this member is in the denominator of the Chlamydia Screening in Women (21–24 Years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 344 | 344 |
42 | Numerator for Chlamydia Screening in Women (CHL): 21 – 24 Years | Enter: ´1´ if this member is in the numerator of the Chlamydia Screening in Women (21–24 Years) measure, ´0´ if the member is not in the numerator or the information is missing. | 1= Yes 0 = No |
R | 1 | 345 | 345 |
43 | Denominator for Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator. | 1= Yes 0 = No |
R | 1 | 346 | 346 |
44 | Numerator for Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 347 | 347 |
45 | Denominator 1 for Medication Management for People with Asthma (MMA): 5–11 years | Enter: ´1´ if this member is in the denominator of the Medication Management for People with Asthma (5–11 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 348 | 348 |
46 | Numerator 1A for Medication Management for People with Asthma (MMA): 5–11 years, 50% | Enter: ´1´ if this member is in the numerator of ≥ 50% medication compliance of the Medication Management for People with Asthma (5–11 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 349 | 349 |
47 | Numerator 1B for Medication Management for People with Asthma (MMA): 5–11 years, 75% | Enter: ´1´ if this member is in the numerator of ≥ 75% medication compliance of the Medication Management for People with Asthma (5–11 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 350 | 350 |
48 | Denominator 2 for Medication Management for People with Asthma (MMA): 12–18 years | Enter: ´1´ if this member is in the denominator of the Medication Management for People with Asthma (12–18 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 351 | 351 |
49 | Numerator 2A for Medication Management for People with Asthma (MMA): 12–18 years, 50% | Enter: ´1´ if this member is in the numerator of ≥ 50% medication compliance of the Medication Management for People with Asthma (12–18 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 352 | 352 |
50 | Numerator 2B for Medication Management for People with Asthma (MMA): 12–18 years, 75% | Enter: ´1´ if this member is in the numerator of ≥ 75% medication compliance of the Medication Management for People with Asthma (12–18 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 353 | 353 |
51 | Denominator 3 for Medication Management for People with Asthma (MMA): 19–50 years | Enter: ´1´ if this member is in the denominator of the Medication Management for People with Asthma (19–50 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 354 | 354 |
52 | Numerator 3A for Medication Management for People with Asthma (MMA): 19–50 years, 50% | Enter: ´1´ if this member is in the numerator of ≥ 50% medication compliance of the Medication Management for People with Asthma (19–50 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 355 | 355 |
53 | Numerator 3B for Medication Management for People with Asthma (MMA): 19–50 years, 75% | Enter: ´1´ if this member is in the numerator of ≥ 75% medication compliance of the Medication Management for People with Asthma (19–50 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 356 | 356 |
54 | Denominator 4 for Medication Management for People with Asthma (MMA): 51–64 years | Enter: ´1´ if this member is in the denominator of the Medication Management for People with Asthma (51–64 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 357 | 357 |
55 | Numerator 4A for Medication Management for People with Asthma (MMA): 51–64 years, 50% | Enter: ´1´ if this member is in the numerator of ≥ 50% medication compliance of the Medication Management for People with Asthma (51–64 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 358 | 358 |
56 | Numerator 4B for Medication Management for People with Asthma (MMA): 51–64 years, 75% | Enter: ´1´ if this member is in the numerator of ≥ 75% medication compliance of the Medication Management for People with Asthma (51–64 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 359 | 359 |
57 | Denominator 5 for Medication Management for People with Asthma (MMA): 65–85 years | Enter: ´1´ if this member is in the denominator of the Medication Management for People with Asthma (65–85 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 360 | 360 |
58 | Numerator 5A for Medication Management for People with Asthma (MMA): 65–85 years, 50% | Enter: ´1´ if this member is in the numerator of ≥ 50% medication compliance of the Medication Management for People with Asthma (65–85 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 361 | 361 |
59 | Numerator 5B for Medication Management for People with Asthma (MMA): 65–85 years, 75% | Enter: ´1´ if this member is in the numerator of ≥ 75% medication compliance of the Medication Management for People with Asthma (65–85 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 362 | 362 |
60 | Denominator for Persistent Beta Blocker Treatment After Heart Attack (PBH) | Enter: ´1´ if this member is in the denominator of the Persistent Beta Blocker Treatment After Heart Attack measure, ´0´ if the member is not in the e denominator of this measure. | 1= Yes 0 = No |
R | 1 | 363 | 363 |
61 | Numerator for Persistent Beta Blocker Treatment After Heart Attack (PBH) | Enter: ´1´ if this member is in the numerator of the Persistent Beta Blocker Treatment After Heart Attack measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 364 | 364 |
62 | 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 | 1= Yes 0 = No |
R | 1 | 365 | 365 |
63 | 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. | 1= Yes 0 = No |
R | 1 | 366 | 366 |
64 | 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 | 1= Yes 0 = No |
R | 1 | 367 | 367 |
65 | 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. | 1= Yes 0 = No |
R | 1 | 368 | 368 |
66 | 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 | 1= Yes 0 = No |
R | 1 | 369 | 369 |
67 | 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. | 1= Yes 0 = No |
R | 1 | 370 | 370 |
68 | 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 | 1= Yes 0 = No |
R | 1 | 371 | 371 |
69 | 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. | 1= Yes 0 = No |
R | 1 | 372 | 372 |
70 | Denominator for Comprehensive Diabetes Care (CDC) | Enter: ´1´ if this member is in the denominator of the CDC measures, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 373 | 373 |
71 | Numerator for CDC – HbA1c Test | Enter: ´1´ if this member is in the numerator of the CDC HbA1c Test measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 374 | 374 |
72 | Numerator for CDC – HbA1c Control (<8.0%) | Enter: ´1´ if this member is in the numerator of the CDC HbA1c Control (<8.0%) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 375 | 375 |
73 | Numerator for CDC – HbA1c Poor Control (>9.0%) | Enter: ´1´ if this member is in the numerator of the CDC HbA1c Poor Control (>9.0%) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 376 | 376 |
74 | Numerator for CDC – Eye Exam | Enter: ´1´ if this member is in the numerator of the CDC Eye Exam measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 377 | 377 |
75 | Numerator for CDC – Nephropathy Monitor | Enter: ´1´ if this member is in the numerator of the CDC Nephropathy Monitor measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 378 | 378 |
76 | Denominator for Statin Therapy for Patients With Diabetes (SPD): Received Statin Therapy | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator | 1= Yes 0 = No |
R | 1 | 379 | 379 |
77 | Numerator for Statin Therapy for Patients With Diabetes (SPD): Received Statin Therapy | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 380 | 380 |
78 | Denominator for Statin Therapy for Patients With Diabetes (SPD): Statin Adherence 80% | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator | 1= Yes 0 = No |
R | 1 | 381 | 381 |
79 | Numerator for Statin Therapy for Patients With Diabetes (SPD): Statin Adherence 80% | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 382 | 382 |
80 | Denominator for Antidepressant Medication Management (AMM) | Enter: ´1´ if this member is in the denominator for the Antidepressant Medication Management measures, ´0´ if the member is not in the denominator of this measure | 1= Yes 0 = No |
R | 1 | 383 | 383 |
81 | Numerator for Antidepressant Medication Management (AMM): Effective Acute Phase Treatment | Enter: ´1´ if this member is in the numerator of the Antidepressant Medication Management – Effective Acute Phase Treatment measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 384 | 384 |
82 | Numerator for Antidepressant Medication Management (AMM): Effective Continuation Phase Treatment | Enter: ´1´ if this member is in the numerator of the Antidepressant Medication Management – Effective Continuation Phase Treatment measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 385 | 385 |
83 | 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 | 1= Yes 0 = No |
R | 1 | 386 | 386 |
84 | 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. | 1= Yes 0 = No |
R | 1 | 387 | 387 |
85 | Denominator for Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB) | Enter: ´1´ if this member is in the denominator of the Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 388 | 388 |
86 | Numerator for Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis (AAB) | Enter: ´1´ if this member is in the numerator of the Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 389 | 389 |
87 | Denominator for Use of Imaging Studies for Low Back Pain (LBP) | Enter: ´1´ if this member is in the denominator of the Use of Imaging Studies for Low Back Pain measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 390 | 390 |
88 | Numerator for Use of Imaging Studies for Low Back Pain (LBP) | Enter: ´1´ if this member is in the numerator of the Use of Imaging Studies for Low Back Pain measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 391 | 391 |
89 | Denominator for Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET): 13– 17 years | Enter: ´1´ if this member is in the denominator of the Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (13–17 years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 392 | 392 |
90 | Numerator for Initiation of Alcohol and Other Drug Dependence Treatment (IET): 13–17 years | Enter: ´1´ if this member is in the numerator of the Initiation of Alcohol and Other Drug Dependence Treatment (13–17 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 393 | 393 |
91 | Numerator for Engagement of Alcohol and Other Drug Dependence Treatment (IET): 13–17 years | Enter: ´1´ if this member is in the numerator of the Engagement of Alcohol and Other Drug Dependence Treatment (13–17 years) measure, ´0´ if the member is not in the numerator | 1= Yes 0 = No |
R | 1 | 394 | 394 |
92 | Denominator for Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: 18+ years | Enter: ´1´ if this member is in the denominator of the Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (18+ years) measure, ´0´ if the member is not in the denominator of this measure. | 1= Yes 0 = No |
R | 1 | 395 | 395 |
93 | Numerator for Initiation of Alcohol and Other Drug Dependence Treatment (IET): 18+ years | Enter: ´1´ if this member is in the numerator of the Initiation of Alcohol and Other Drug Dependence Treatment (18+ years) measure, ´0´ if the member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 396 | 396 |
94 | Numerator for Engagement of Alcohol and Other Drug Dependence Treatment (IET): 18+ years | Enter: ´1´ if this member is in the numerator of the Engagement of Alcohol and Other Drug Dependence Treatment (18+ years) measure, ´0´ if the member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 397 | 397 |
95 | Ambulatory Care (AMB): Outpatient Visits | Enter the total number of Outpatient visits for this member, ´0´ if the member does not have Oupatient visits. | ### | R | 3 | 398 | 400 |
96 | Ambulatory Care (AMB): ED Visits | Enter the total number of ED visits for this member, ´0´ if the member does not have ED visits. | ### | R | 3 | 401 | 403 |
97 | Inpatient Utilization–General Hospital/Acute Care (IPU): Total Inpatient | Enter the total Inpatient discharges for this member, ´0´ if the member does not have Inpatient discharges. | ### | R | 3 | 404 | 406 |
98 | Inpatient Utilization–General Hospital/Acute Care (IPU): Medicine Discharges | Enter the total Medicine discharges for this member, ´0´ if the member does not have Medicine discharges. | ### | R | 3 | 407 | 409 |
99 | Inpatient Utilization–General Hospital/Acute Care (IPU): Surgery Discharges | Enter the total Surgery discharges for this member, ´0´ if the member does not have Surgery discharges. | ### | R | 3 | 410 | 412 |
100 | Inpatient Utilization–General Hospital/Acute Care (IPU): Maternity Discharges | Enter the total Maternity discharges for this member, ´0´ if the member does not have Maternity discharges. | ### | R | 3 | 413 | 415 |
101 | Denominator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence | Enter: ´1´ if this member is in the denominator, ´0´ if this member is not in the denominator. | 1= Yes 0 = No |
R | 1 | 416 | 416 |
102 | Numerator for Initiation of Pharmacotherapy upon New Episode of Opioid Dependence | Enter: ´1´ if this member is in the numerator, ´0´ if this member is not in the numerator. | 1= Yes 0 = No |
R | 1 | 417 | 417 |
103 | Contractor Tax ID# | Populate with valid TINs only. If unavailable or invalid set to ´999999999´ | ######### | O | 9 | 418 | 426 |
104 | Practice Address Zip Code + 4 | Populate with last four digits only | #### | O | 4 | 427 | 430 |
Changes from APC 2017 file layout:
- Product line ´12´ for EP added
- Practice Tax ID field length decreased from 10 to 9.
- Practice Site ID field length increased from 10 to 15.
- Fields highlighted in yellow are measures added and new fields for APC 2018
- Contractor Tax ID field added
- Practice Zip Code + field added
FIPS Code
NYS Counties | FIPS Code | NYS Counties | FIPS Code | NYS Counties | FIPS Code |
---|---|---|---|---|---|
ALBANY | 001 | JEFFERSON | 045 | ST LAWRENCE | 089 |
ALLEGANY | 003 | KINGS | 047 | SARATOGA | 091 |
BRONX | 005 | LEWIS | 049 | SCHENECTADY | 093 |
BROOME | 007 | LIVINGSTON | 051 | SCHOHARIE | 095 |
CATTARAUGUS | 009 | MADISON | 053 | SCHUYLER | 097 |
CAYUGA | 011 | MONROE | 055 | SENECA | 099 |
CHAUTAUQUA | 013 | MONTGOMERY | 057 | STEUBEN | 101 |
CHEMUNG | 015 | NASSAU | 059 | SUFFOLK | 103 |
CHENANGO | 017 | NEWYORK | 061 | SULLIVAN | 105 |
CLINTON | 019 | NIAGARA | 063 | TIOGA | 107 |
COLUMBIA | 021 | ONEIDA | 065 | TOMPKINS | 109 |
CORTLAND | 023 | ONONDAGA | 067 | ULSTER | 111 |
DELAWARE | 025 | ONTARIO | 069 | WARREN | 113 |
DUTCHESS | 027 | ORANGE | 071 | WASHINGTON | 115 |
ERIE | 029 | ORLEANS | 073 | WAYNE | 117 |
ESSEX | 031 | OSWEGO | 075 | WESTCHESTER | 119 |
FRANKLIN | 033 | OTSEGO | 077 | WYOMING | 121 |
FULTON | 035 | PUTNAM | 079 | YATES | 123 |
GENESEE | 037 | QUEENS | 081 | OUTOFSTATE | 000 |
GREENE | 039 | RENSSELAER | 083 | UKNOWN/MISSING | 999 |
HAMILTON | 041 | RICHMOND | 085 | ||
HERKIMER | 043 | ROCKLAND | 087 |
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