HEDIS(r) 2010 (Summary) Documentation for Reporting Year 2009
General Information
This documentation presents (1) a description of each HEDIS(r) measure that CMS collected for 466 Medicare 
managed care contracts for health care provided in calendar year 2009 to Medicare beneficiaries and (2) the 
location of the rates associated with each HEDIS measure within the HEDIS workbook (HEDIS2010.XLS). 
CMS took the description and additional information for each measure from HEDIS 2010 Volume 2: Technical 
Specifications. This release contains only those rates, percentages, or averages for each measure and not the 
numerator or denominator used to create those measures. CMS has made minor modifications to the original 
data. CMS confirmed that all reported rates are commensurate with the HEDIS general guidelines. For 
example, the HEDIS guidelines advise plans to report "not applicable" for measures that rely on a small number 
of observations, and CMS appropriately suppressed these rates. CMS also added two variables to the 
database. A brief discussion of each issue identified here appears below. 
For this measurement year, CMS required that all managed care organizations undergo an audit on all HEDIS 
measures. The summary data file includes all submitted data.
The HEDIS measure descriptions reprinted here are done so with the permission of the National Committee for 
Quality Assurance ("NCQA"). HEDIS (R) is a registered trademark of NCQA, and a copyright for HEDIS (R) 
2010 is held by the National Committee for Quality Assurance, 1100 13th Street, NW, Suite 1000, Washington, 
DC 20005. All rights reserved.
The Medicare HEDIS reporting unit is the contract
In 2010, CMS collected data from 466 Medicare managed care contracts for health care delivered in 2009. 
CMS considers the reporting unit for a health plan as the equivalent to a contract. CMS signs a contract with 
health plans to provide health care for a given geographic service area. One contract still divides its geographic 
service area in two and reports at the "market area" level. This makes the total number of reported submissions 
467.
The "GENERAL" sheet in the HEDIS workbook identifies the state and counties for each submission. The 
contract that reports at the "market area" level is shown with the market area after the state (CA: Northern 
California" and "CA: Southern California.")
CMS copied the description of each measure from the HEDIS Technical Specifications
The description and related information provided for each measure in this documentation are taken from the 
HEDIS 2010 Technical Specifications, which are the specific instructions for calculating HEDIS measures that 
NCQA provides to Medicare managed care plans. For each measure, the Technical Specifications detail the 
precise method for sampling (when appropriate), identification of the numerator and denominator, measure 
calculation, and any other important considerations specific to that measure. The technical specifications also 
contain general guidelines that apply to all measures, such as the use of medical records and when a plan 
should not report a measure because its eligible membership is too small. Some measures require more 
detailed specifications than others. As opposed to the Beta Blocker measure described below, the calculation of 
the measure for the number of years a plan has had a commercial product is fairly straightforward. The 
technical specifications necessary to produce HEDIS measures are available from NCQA in HEDIS 2010, 
Volume 2: Technical Specifications."
The specifications for Beta Blocker Treatment After Heart Attack demonstrate the extent of detailed 
instructions provided for many measures. For this measure, the specifications describe the unit of 
measurement (members vs. procedures or discharges); data sources used to identify the numerator and 
denominator (membership, claims/encounter, hospital discharge, and pharmacy data); the period of time under 
consideration (the reporting year); age ranges for member inclusion in the measure (35 and older); diagnosis 
codes to identify acute myocardial infarction (AMI); diagnosis codes to identify exclusions for beta blocker; a list 
of beta blocker prescriptions; appropriate sample size if the plan chooses to use a sample; and other 
instructions, such as the appropriate interpretation of  two AMI episodes for an individual member.
 
HEDIS Guidelines identify three types of missing values: NA, NB and NR
The HEDIS guidelines distinguish between three different types of missing values in the rate field: Not 
Applicable (NA), No Benefit (NB) and Not Report (NR). Health plans report NA when they: do not have a large 
enough population to calculate a representative rate (e.g., many measures require that rates be based on at 
least 30 members) or are not eligible for a measure (e.g., a health plan cannot calculate outpatient drug 
utilization if it does not offer an outpatient drug benefit; a health plan cannot calculate a measure requiring a 
year of continuous enrollment if its first enrollment began mid-way through the reporting year.)
A value of NB is recorded when the health plan did not offer the health benefit required by the measure (e.g., 
Mental Health/Chemical Dependency). Health plans report NR when: they choose not to calculate and report a 
rate, or the health plan's HEDIS Compliance Auditor determines that a rate is materially biased (applicable only 
to audited measures).
For measures reported as a percentage, material bias is defined as a deviation of more than five percentage 
points from the true rate. For other measures (e.g., procedures per 1000 member years), material bias exists if 
the number of counted procedures deviates by more than ten percent from the true number of procedures.
CMS suppressed a small number of rates to meet privacy requirements.
Under the Privacy Act, CMS cannot publish or otherwise disclose the data in a form raising unacceptable 
possibilities that an individual could be identified (i.e., the data must not be beneficiary-specific and must be 
aggregated to a level where no data cells have 10 or fewer beneficiaries). To ensure that no beneficiary can be 
identified, CMS has chosen not to report certain measures, specifically reported enrollment by age category, 
and has suppressed an extremely small number of rates. CMS has replaced suppressed rates with a 'NA.' 
Please see the section on missing values above for an explanation of missing value designations.
CMS has added variables to the HEDIS data.
CMS includes our record of enrollment as of December of the measurement year in the "GENERAL" sheet in 
the HEDIS workbook. The HEDIS reported value is adjusted for individuals with partial-year enrollment and 
reflects the entire contract's enrollment. CMS's enrollment is now broken down by the number enrolled in the 
CMS approved contract market area.
We have included the Medicare Modernization Act plan type designations as well as indicators if the contract 
offers a Special Needs benefit packages or a Part D Drug benefit in 2009. These values can be found on the 
sheet named "GENERAL".
We have also changed the way we are reporting the area served by each contract. The states served by each 
contract used to be reported within every measure. Since this data is constant for the measurement year and 
the size of the areas covered by each contract have increased dramatically, we have moved the area served 
into its own separate reports. You will find a separate sheet called "Service Area" in the HEDIS workbook which 
contains the contract, state(s) and counties served by the contracts reporting HEDIS. There is additional field 
"EGHP" which indicates if the county is available only to beneficiaries in Employer Groups. The old "Service 
State" field in each measure now just lists the Market Area served by the contract for the contracts still reporting 
by market area.
National Enrollment Weighted Average Score
CMS has calculated and included a weighted National average for all of the Effectiveness of Care (EOC) 
measures. These rates are reported on a separate sheet called "National Rates" in the HEDIS Workbook. The 
rate for each of the EOC measures was calculated using the following formula:
((En1/TotE)*Sn1)+((En2/TotE)*Sn2)+...+((Enx/TotE)*Snx)=National Enrollment Weighted Average Score
Where:	TotE = Total enrollment for all contracts with a valid numeric rate in the measure 
En1 = Enrollment in the first contract with a valid numeric rate 
Sn1 = Reported rate for the first contract with a valid numeric rate 
Enx = Enrollment in the last contract with a valid numeric rate 
Snx = Reported rate for the last contract with a valid numeric rate
Measure	Measure Name/Measure Description/Field Name/Field Description
AOC201 - Adults' Access to Preventive/Ambulatory Health Services
	DESCRIPTION - The percentage of members 20 years and older who had an ambulatory or preventive care visit. The 
organization reports three separate percentages for each product line.
	• Medicaid and Medicare members who had an ambulatory or preventive care visit during the measurement year
	• Commercial members who had an ambulatory or preventive care visit during the measurement year or the two years prior to 
the measurement year
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 220)
	REPORTING LEVEL - Contract
	AOC201-0010	Rate 20-44
	AOC201-0020	Rate 45-64
	AOC201-0030	Rate 65+
	AOC201-0040	Lower Confidence Interval - 20-44
	AOC201-0050	Upper Confidence Interval - 20-44
	AOC201-0060	Lower Confidence Interval - 45-64
	AOC201-0070	Upper Confidence Interval - 45-64
	AOC201-0080	Lower Confidence Interval - 65+
	AOC201-0090	Upper Confidence Interval - 65+
	AOC201-0095	Rate - Total
	AOC201-0100	Lower Confidence Interval - All
	AOC201-0110	Upper Confidence Interval - All
AOC220 - Call Abandonment
	DESCRIPTION - The percentage of calls received by the organization's Member Services call centers (during operating hours) 
during the measurement year that were abandoned by the caller before being answered by a live voice. Lower rates represent 
better performance. (HEDIS 2010, Volume 2: Technical Specification, Pg. 243)
	REPORTING LEVEL - Contract
	AOC220-0010	Reported rate
	AOC220-0020	Lower Confidence Interval
	AOC220-0030	Upper Confidence Interval
AOC225 - Call Answer Timeliness
	DESCRIPTION - The percentage of calls received by the organization's Member Services call centers (during operating hours) 
during the measurement  year that were answered by a live voice within 30 seconds. (HEDIS 2010, Volume 2: Technical 
Specification, Pg. 245)
	REPORTING LEVEL - Contract
	AOC225-0010	Reported rate
	AOC225-0020	Lower Confidence Interval
	AOC225-0030	Upper Confidence Interval
AOC235 - Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
	DESCRIPTION - The percentage of adolescent and adult members with a new episode of alcohol or other drug (AOD) 
dependence who received the following.
	• Initiation of AOD Treatment. The percentage of members who initiate treatment through an inpatient AOD admission, outpatient 
visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis.
	• Engagement of AOD Treatment. The percentage of members who initiated treatment and who had two or more additional 
services with an AOD diagnosis within 30 days of the initiation visit.
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 226)
	REPORTING LEVEL - Contract
	AOC235-0010	Rate - Engagement - Overall Year Olds
	AOC235-0020	Lower Confidence Interval - Engagement - Overall Year Olds
	AOC235-0030	Upper Confidence Interval - Engagement - Overall Year Olds
	AOC235-0040	Rate - Initiation - Overall Year Olds
	AOC235-0050	Lower Confidence Interval - Initiation - Overall Year Olds
	AOC235-0060	Upper Confidence Interval - Initiation - Overall Year Olds
 
Measure	Measure Name/Measure Description/Field Name/Field Description
EOC003 - Breast Cancer Screening
	DESCRIPTION - The percentage of women 40-69 years of age who had a mammogram to screen for breast cancer.  (HEDIS 
2010, Volume 2: Technical Specification, Pg. 80)
	REPORTING LEVEL - Contract
	EOC003-0040	Reported Rate - 42-51
	EOC003-0050	Lower Confidence Interval - 42-51
	EOC003-0060	Upper Confidence Interval - 42-51
	EOC003-0070	Reported Rate - 52-69
	EOC003-0080	Lower Confidence Interval - 52-69
	EOC003-0090	Upper Confidence Interval - 52-69
	EOC003-0100	Rate - Total
	EOC003-0110	Lower Confidence Interval - tot
	EOC003-0120	Upper Confidence Interval - tot
EOC010 - Followup after Hospitalization for Mental Illness
	DESCRIPTION - The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of 
selected mental health disorders and who had an outpatient visit, an intensive outpatient encounter or partial hospitalization with 
a mental health practitioner. Two rates are reported.
	1. The percentage of members who received follow-up within 30 days of discharge
	2. The percentage of members who received follow-up within 7 days of discharge
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 180)
	REPORTING LEVEL - Contract
	EOC010-0011	Rate - 7 Days
	EOC010-0012	Rate - 30 Days
	EOC010-0021	Upper Confidence Interval - 7 Days
	EOC010-0022	Upper Confidence Interval - 30 Days
	EOC010-0031	Lower Confidence Interval - 7 Days
	EOC010-0032	Lower Confidence Interval - 30 Days
EOC020 - Comprehensive Diabetes Care
	DESCRIPTION - The percentage of members 18-75 years of age with diabetes (type 1 and type 2) who had each of the 
following.
	• Hemoglobin A1c (HbA1c) testing
	• HbA1c poor control (>9.0%)
	• HbA1c good control (<7.0%)
	• Eye exam (retinal) performed
	• LDL-C screening
	• LDL-C control (<100 mg/dL)
	• Medical attention for nephropathy
	• Blood pressure control (<130/80 mm Hg)
	• Blood pressure control (<140/90 mm Hg)
	(HEDIS 2010, Volume 2: Technical Specifications, Pg. 134)
	REPORTING LEVEL - Contract
	EOC020-0010	Rate - HbA1c Testing
	EOC020-0020	Lower Confidence Interval - HbA1c Testing
	EOC020-0030	Upper Confidence Interval - HbA1c Testing
	EOC020-0040	Rate - Poor HbA1c Control
	EOC020-0050	Lower Confidence Interval - Poor HbA1c Control
	EOC020-0060	Upper Confidence Interval - Poor HbA1c Control
	EOC020-0070	Rate - Eye Exams
	EOC020-0080	Lower Confidence Interval - Eye Exams
	EOC020-0090	Upper Confidence Interval - Eye Exams
	EOC020-0100	Rate - Lipid Profile
	EOC020-0110	Lower Confidence Interval - Lipid Profile
	EOC020-0120	Upper Confidence Interval - Lipid Profile
	EOC020-0160	Rate - Monitoring Diabetic Nephropathy
	EOC020-0170	Lower Confidence Interval - Monitoring Diabetic Nephropathy
	EOC020-0180	Upper Confidence Interval - Monitoring Diabetic Nephropathy
	EOC020-0220	Rate <100 LDL-C Level
	EOC020-0230	Lower Confidence Interval <100 LDL-C Level
Measure	Measure Name/Measure Description/Field Name/Field Description
	EOC020-0240	Upper Confidence Interval <100 LDL-C Level
	EOC020-0250	Rate - Good HbA1c Control
	EOC020-0260	Lower Confidence Interval - Good HbA1c Control
	EOC020-0270	Upper Confidence Interval - Good HbA1c Control
	EOC020-0280	Rate - Blood Press Cont <130/80
	EOC020-0290	Lower Confidence Interval - Blood Press Cont <130/80
	EOC020-0300	Upper Confidence Interval - Blood Press Cont <130/80
	EOC020-0310	Rate - Blood Press Cont <140/90
	EOC020-0320	Lower Confidence Interval - Blood Press Cont <140/90
	EOC020-0330	Upper Confidence Interval - Blood Press Cont <140/90
	EOC020-0340	Rate - HbA1c Control (<8.0%)
	EOC020-0350	Lower Confidence Interval - HbA1c Control (<8.0%)
	EOC020-0360	Upper Confidence Interval - HbA1c Control (<8.0%)
EOC026 - Cholesterol Management for Patients with Cardiovascular Conditions
	DESCRIPTION - The percentage of members 18-75 years of age who were discharged alive for AMI, coronary artery bypass 
graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1-November 1 of the year prior to the 
measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior 
to measurement year, who had each of the following during the measurement year.
	• LDL-C screening
	• LDL-C control (<100 mg/dL)
	(HEDIS 2010, Volume 2: Technical Specifications, Pg. 126)
	REPORTING LEVEL - Contract
	EOC026-0010	Rate - LDL-C Screening
	EOC026-0020	Lower Confidence Interval - LDL-C Screening
	EOC026-0030	Upper Confidence Interval - LDL-C Screening
	EOC026-0070	Rate <100 LDL-C Level
	EOC026-0080	Lower Confidence Interval <100 LDL-C Level
	EOC026-0090	Upper Confidence Interval <100 LDL-C Level
EOC030 - Antidepressant Medication Management
	DESCRIPTION - The percentage of members 18 years of age and older who were diagnosed with a new episode of major 
depression, treated with antidepressant medication, and who remained on an antidepressant medication treatment. Two rates 
are reported.
	• Effective Acute Phase Treatment. The percentage of newly diagnosed and treated members who remained on an 
antidepressant medication for at least 84 days (12 weeks). 
	• Effective Continuation Phase Treatment. The percentage of newly diagnosed and treated members who remained on an 
antidepressant medication for at least 180 days (6 months).
	(HEDIS 2010, Volume 2: Technical Specifications, Pg. 170)
	REPORTING LEVEL - Contract
	EOC030-0010	Rate - Effect.Continuation Phase Treat.
	EOC030-0020	Lower Confidence Interval - Effect.Continuation Phase Treat.
	EOC030-0030	Upper Confidence Interval - Effect.Continuation Phase Treat.
	EOC030-0040	Rate - Effect.Acute Phase Treatment
	EOC030-0050	Lower Confidence Interval - Effect.Acute Phase Treatment
	EOC030-0060	Upper Confidence Interval - Effect.Acute Phase Treatment
	EOC030-0070	Rate - Optimal Practioner Contacts for Medication Mngmnt.
	EOC030-0080	Lower Confidence Interval - Contacts for Medication Mngmnt.
	EOC030-0090	Upper Confidence Interval - Contacts for Medication Mngmnt.
EOC035 - Controlling High Blood Pressure
	DESCRIPTION - The percentage of members 18-85 years of age who had a diagnosis of hypertension (HTN) and whose BP 
was adequately controlled (<140/90) during the measurement year. Use the Hybrid Method for this measure. (HEDIS 2010, 
Volume 2: Technical Specification, Pg. 130)
	REPORTING LEVEL - Contract
	EOC035-0100	Rate - Total
	EOC035-0110	Lower Confidence Interval tot
	EOC035-0120	Upper Confidence Interval tot
 
Measure	Measure Name/Measure Description/Field Name/Field Description
EOC040 - Colorectal Cancer Screening
	DESCRIPTION - The percentage of members 50-75 years of age who had appropriate screening for colorectal cancer. (HEDIS 
2010, Volume 2: Technical Specification, Pg. 85)
	REPORTING LEVEL - Contract
	EOC040-0010	Rate
	EOC040-0020	Lower Confidence Interval
	EOC040-0030	Upper Confidence Interval
EOC045 - Osteoporosis Management in Women Who Had a Fracture
	DESCRIPTION - The percentage of women 67 years of age and older who suffered a fracture and who had either a bone mineral 
density (BMD) test or prescription for a drug to treat or prevent osteoporosis in the six months after the fracture. (HEDIS 2010, 
Volume 2: Technical Specification, Pg. 130)
	REPORTING LEVEL - Contract
	EOC045-0010	Reported rate
	EOC045-0020	Lower Confidence Interval
	EOC045-0030	Upper Confidence Interval
EOC050 - Glaucoma Screening in Older Adults
	DESCRIPTION - The percentage of Medicare members 65 years and older, without a prior diagnosis of glaucoma or glaucoma 
suspect, who received a glaucoma eye exam by an eye care professional for early identification of glaucomatous conditions.  
(HEDIS 2010, Volume 2: Technical Specification, Pg. 93)
	REPORTING LEVEL - Contract
	EOC050-0010	Reported Rate
	EOC050-0020	Lower Confidence Interval
	EOC050-0030	Upper Confidence Interval
EOC055 - Persistence of Beta-Blocker Treatment After a Heart Attack
	DESCRIPTION - The percentage of members 18 years of age and older during the measurement year who were hospitalized 
and discharged alive from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis 
of AMI and who received persistent beta-blocker treatment for six months after discharge. (HEDIS 2010, Volume 2: Technical 
Specification, Pg. 135)
	REPORTING LEVEL - Contract
	EOC055-0010	Reported rate
	EOC055-0020	Lower Confidence Interval
	EOC055-0030	Upper Confidence Interval
EOC060 - Management of Urinary Incontinence in Older Adults
	DESCRIPTION - The following components of this measure assess the management of urinary incontinence in older adults.
	Discussing Urinary Incontinence - The percentage of Medicare members 65 years of age and older who reported having a 
problem with urine leakage in the past six months and who discussed their urine leakage problem with their current practitioner.
	Receiving Urinary Incontinence Treatment - The percentage of Medicare members 65 years of age and older who reported 
having a urine leakage problem in the past six months and who received treatment for their current urine leakage problem.
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 208)
	REPORTING LEVEL - Contract
	EOC060-0010	Discussing Urinary Incontinence Rate
	EOC060-0020	Receiving Urinary Incontinence Treatment Rate
EOC065 - Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis
	DESCRIPTION - The percentage of members who were diagnosed with rheumatoid arthritis and who were dispensed at least 
one ambulatory prescription for a disease modifying anti-rheumatic drug (DMARD). (HEDIS 2010, Volume 2: Technical 
Specification, Pg. 160)
	REPORTING LEVEL - Contract
	EOC065-0010	Reported rate
	EOC065-0020	Lower Confidence Interval
	EOC065-0030	Upper Confidence Interval
 
Measure	Measure Name/Measure Description/Field Name/Field Description
EOC070 - Use of High-Risk Medications in the Elderly
	DESCRIPTION - • The percentage of Medicare members 65 years of age and older who received at least one high risk 
medication
	• The percentage of Medicare members 65 years of age and older who received at least two different high risk medications
	For both rates, a lower rate represents better performance. 	(HEDIS 2010, Volume 2: Technical Specification, Pg. 201)
	REPORTING LEVEL - Contract
	EOC070-0010	Rate - one prescription
	EOC070-0020	Lower Confidence Interval - one prescription
	EOC070-0030	Upper Confidence Interval - one prescription
	EOC070-0040	Rate - at least 2 prescriptions
	EOC070-0050	Lower Confidence Interval - at least 2 prescriptions
	EOC070-0060	Upper Confidence Interval - at least 2 prescriptions
EOC075 - Annual Monitoring for Patients on Persistent Medications
	DESCRIPTION - The percentage of members 18 years of age and older who received at least 180 treatment days of ambulatory 
medication therapy for a select therapeutic agent during the measurement year and at least one therapeutic monitoring event for 
the therapeutic agent in the measurement year. For each product line, report each of the four rates separately and as a total rate.
	• Annual monitoring for members on angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB)
	• Annual monitoring for members on digoxin
	• Annual monitoring for members on diuretics
	• Annual monitoring for members on anticonvulsants
	• Total rate (the sum of the four numerators divided by the sum of the four denominators)
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 186)
	REPORTING LEVEL - Contract
	EOC075-0010	Reported rate - ACE inhibitors or ARBs
	EOC075-0020	Lower Confidence Interval - ACE inhibitors or ARBs
	EOC075-0030	Upper Confidence Interval - ACE inhibitors or ARBs
	EOC075-0040	Reported rate - Digoxin
	EOC075-0050	Lower Confidence Interval - Digoxin
	EOC075-0060	Upper Confidence Interval - Digoxin
	EOC075-0070	Reported rate - Diuretics
	EOC075-0080	Lower Confidence Interval - Diuretics
	EOC075-0090	Upper Confidence Interval - Diuretics
	EOC075-0100	Reported rate - Anticonvulsants
	EOC075-0110	Lower Confidence Interval - Anticonvulsants
	EOC075-0120	Upper Confidence Interval - Anticonvulsants
	EOC075-0160	Reported rate - Total
	EOC075-0170	Lower Confidence Interval - Total
	EOC075-0180	Upper Confidence Interval - Total
EOC080 - Use of Spirometry Testing in the Assessment and Diagnosis of COPD
	DESCRIPTION - The percentage of members 40 years of age and older with a new diagnosis or newly active COPD who 
received appropriate spirometry testing to confirm the diagnosis. (HEDIS 2010, Volume 2: Technical Specification, Pg. 115)
	REPORTING LEVEL - Contract
	EOC080-0010	Reported rate
	EOC080-0020	Lower Confidence Interval
	EOC080-0030	Upper Confidence Interval
EOC085 - Physical Activity in Older Adults (HOS)
	DESCRIPTION - The following components of this measure assess different facets of promoting physical activity in older adults.
	Discussing Physical Activity - The percentage of Medicare members 65 years of age and older who had a doctor's visit in the past 
12 months and who spoke with a doctor or other health provider about their level of exercise or physical activity.
	Advising Physical Activity - The percentage of Medicare members 65 years of age and older who had a doctor's visit in the past 
12 months and who received advice to start, increase or maintain their level exercise or physical activity. (HEDIS 2010, Volume 2: 
Technical Specification, Pg. 210)
	REPORTING LEVEL - Contract
	EOC085-0010	Discussing Physical Activity Rate
	EOC085-0020	Advising Physical Activity Rate
 
Measure	Measure Name/Measure Description/Field Name/Field Description
EOC090 - Potentially Harmful Drug-Disease Interactions in the Elderly
	DESCRIPTION - The percentage of Medicare members 65 years of age and older who have evidence of an underlying disease, 
condition or health concern and who were dispensed an ambulatory prescription for a contraindicated medication, concurrent 
with or after the diagnosis.Report each of the three rates separately and as a total rate.
	• A history of falls and a prescription for tricyclic antidepressants, antipsychotics or sleep agents
	• Dementia and a prescription for tricyclic antidepressants or anticholinergic agents
	• CRF and prescription for nonaspirin NSAIDs or Cox-2 Selective NSAIDs
	• Total rate (the sum of the three numerators divided by the sum of the three denominators)
	Members with more than one disease or condition can appear in the measure multiple times (i.e., in each indicator for which they 
qualify). For all three rates, a lower rate represents better performance.(HEDIS 2010, Volume 2: Technical Specification, Pg. 195)
	REPORTING LEVEL - Contract
	EOC090-0010	Rate - DDI Falls + Tricyclic Antidepress or Antipsych
	EOC090-0020	Lower Confidence Interval - DDI Falls + Tricyclic Antidepress or Antipsych
	EOC090-0030	Upper Confidence Interval - DDI Falls + Tricyclic Antidepress or Antipsych
	EOC090-0040	Rate - DDI Dementia + Tricyclic Antidepress or Anticholl
	EOC090-0050	Lower Confidence Interval - DDI Dementia + Tricyclic Antidepress or Anticholl
	EOC090-0060	Upper Confidence Interval - DDI Dementia + Tricyclic Antidepress or Anticholl
	EOC090-0070	Rate - DDI Chronic Renal Failure + Non Asp NSAIDs or Cox-2
	EOC090-0080	Lower Confidence Interval - DDI Chronic Renal Failure + Non Asp NSAIDs or Cox-2
	EOC090-0090	Upper Confidence Interval - DDI Chronic Renal Failure + Non Asp NSAIDs or Cox-2
	EOC090-0100	Rate - Total
	EOC090-0110	Lower Confidence Interval - Total
	EOC090-0120	Upper Confidence Interval - Total
EOC095 - Fall Risk Management
	DESCRIPTION - The following components of this measure assess different facets of fall risk management.
	Discussing Fall Risk - The percentage of Medicare members 75 years of age and older or 65-74 years of age with balance or 
walking problems or a fall in the past 12 months, who were seen by a practitioner in the past 12 months and who discussed falls 
or problems with balance or walking with their current practitioner.
	Managing Fall Risk - The percentage of Medicare members 65 years of age and older who had a fall or had problems with 
balance or walking in the past 12 months, who were seen by a practitioner in the past 12 months and who received fall risk 
intervention from their current practitioner.
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 207)
	REPORTING LEVEL - Contract
	EOC095-0010	Discussing Falls Risk Rate
	EOC095-0020	Discussing Falls Risk Rate
EOC100 - Osteoporosis Testing in Older Women
	DESCRIPTION - The percentage of Medicare women 65 years of age and older who report ever having received a bone density 
test to check for osteoporosis. (HEDIS 2010, Volume 2: Technical Specification, Pg. 209)
	REPORTING LEVEL - Contract
	EOC100-0010	Osteoporosis Testing Percent
EOC105 - Pharmacotherapy Management of COPD Exacerbation
	DESCRIPTION - The percentage of COPD exacerbations for members 40 years of age and older who had an acute inpatient 
discharge or ED encounter between January 1-November 30 of the measurement year and who were dispensed appropriate 
medications. Two rates are reported. 
	1. Dispensed a systemic corticosteroid within 14 days of the event
	2. Dispensed a bronchodilator within 30 days of the event
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 117)
	REPORTING LEVEL - Contract
	EOC105-0010	Reported rate - Systemic corticosteroid
	EOC105-0020	Lower 95% confidence interval - Systemic corticosteroid
	EOC105-0030	Upper 95% confidence interval - Systemic corticosteroid
	EOC105-0040	Reported rate - Bronchodilator
	EOC105-0050	Lower 95% confidence interval - Bronchodilator
	EOC105-0060	Upper 95% confidence interval - Bronchodilator
 
Measure	Measure Name/Measure Description/Field Name/Field Description
EOC110 - Adult BMI Assessment
	DESCRIPTION - The percentage of members 18-74 years of age who had an outpatient visit and who had their body mass index 
(BMI) documented during the measurement year or the year prior the measurement year.
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 60)
	REPORTING LEVEL - Contract
	EOC110-0010	Reported rate
	EOC110-0020	Lower Confidence Interval
	EOC110-0030	Upper Confidence Interval
General - General Information
	DESCRIPTION - General organization Information. These fields are not explicitly identified in the HEDIS Technical Specifications.
	REPORTING LEVEL - N/A
	General-0010	Type of Organization (Local CCP, 1876 Cost, etc.)
	General-0011	Type of Plan (Post Balanced Budget Amendment Naming)
	General-0014	Offers Special Needs Plans to beneficiaries (Yes or No)
	General-0015	Offers Part D benefits (Yes or No)
	General-0020	Line of Business (HMO, POS, etc.)
	General-0050	12/2007 Enrollment as reported by the Medicare Advantage Prescription Drug (MARx) system
	General-0060	CMS Region Number
	General-0070	CMS Region Name
	General-0080	Patient Population
	General-0085	Submitted summary level HEDIS 2008 data to NCQA
	General-0087	Included in HOS data from NCQA
HPS403 - Years In Business/Total Membership
	DESCRIPTION - The number of members enrolled as of December 31 of the measurement year.  (HEDIS 2010, Volume 2: 
Technical Specification, Pg. 413)
	REPORTING LEVEL - Contract
	HPS403-0010	Years in Bus. HMO-Tot
	HPS403-0020	Years in Bus. HMO-Medicaid
	HPS403-0030	Years in Bus. HMO-Commercial
	HPS403-0040	Years in Bus. HMO-Medicare Risk/Cost
	HPS403-0060	Years in Bus. HMO-Self-insured
	HPS403-0070	Years in Bus. HMO-Oth
	HPS403-0080	Years in Bus. PPO-Tot
	HPS403-0090	Years in Bus. PPO-Commercial
	HPS403-0100	Years in Bus. PPO-Medicare Risk/Cost
	HPS403-0120	Years in Bus. PPO-Self-insured
	HPS403-0130	Years in Bus. PPO-Oth
	HPS403-0140	Years in Bus. POS-Tot
	HPS403-0150	Years in Bus. POS-Commercial
	HPS403-0160	Years in Bus. POS-Medicare Risk/Cost
	HPS403-0180	Years in Bus. POS-Self-insured
	HPS403-0190	Years in Bus. POS-Oth
	HPS403-0210	Membership HMO-Tot
	HPS403-0220	Membership HMO-Medicaid
	HPS403-0230	Membership HMO-Commercial
	HPS403-0240	Membership HMO-Medicare Risk/Cost
	HPS403-0260	Membership HMO-Self-insured
	HPS403-0270	Membership HMO-Oth
	HPS403-0280	Membership PPO-Tot
	HPS403-0290	Membership PPO-Commercial
	HPS403-0300	Membership PPO-Medicare Risk/Cost
	HPS403-0320	Membership PPO-Self-insured
	HPS403-0330	Membership PPO-Oth
	HPS403-0340	Membership POS-Tot
	HPS403-0350	Membership POS-Commercial
	HPS403-0360	Membership POS-Medicare Risk/Cost
	HPS403-0380	Membership POS-Self-insured
	HPS403-0390	Membership POS-Oth
	HPS403-0400	Tot Membership Tot
	HPS403-0410	Years in Bus. PPO-Medicaid
Measure	Measure Name/Measure Description/Field Name/Field Description
	HPS403-0420	Membership PPO-Medicaid
	HPS403-0430	Years in Bus. POS-Medicaid
	HPS403-0440	Membership POS-Medicaid
	HPS403-0450	Membership FFS-Commercial
	HPS403-0460	Membership FFS-Medicare Risk/Cost
	HPS403-0470	Membership FFS-Medicaid
	HPS403-0480	Membership FFS-Oth
	HPS403-0490	Membership FFS-Tot
National_Rates - National Rates
	CMS has calculated and included a weighted National average for all of the Effectivenes of Care (EOC) measures. These rates 
are reported on a separate sheet called "National Rates" in the HEDIS Workbook. The rate for each of the EOC measures was 
calculated using the following formula:
	((En1/TotE)*Sn1)+((En2/TotE)*Sn2)+...+((Enx/TotE)*Snx)=National Weighted Average Score
	Where:
	TotE = Total enrollment for all contracts with a valid numeric rate in the measure
	En1 = Enrollment in the first contract with a valid numeric rate
	Sn1 = Reported rate for the first contract with a valid numeric rate
	Enx = Enrollment in the last contract with a valid numeric rate
	Snx = Reported rate for the last contract with a valid numeric rate
	REPORTING LEVEL - National
	NR-010	Measure from the HEDIS Public Use File for which the national rate has been calculated
	NR-020	Field from the HEDIS Public Use File for which the national rate has been calculated
	NR-030	The National Rate for this measure and field
	NR-040	The number of contracts that submitted a numeric HEDIS rate for this measure and field
	NR-050	The total number of enrollees in the contracts that submitted a numeric HEDIS rate for this measure and 
field
PDI801 - Board Certification/Residency Completion
	DESCRIPTION - The percentage of the following physicians whose board certification is active as of December 31 of the 
measurement year. 
	• Family medicine physicians
	• Internal medicine physicians
	• Pediatricians
	• OB/GYN physicians
	• Geriatricians
	• Other physician specialists
	Board certification refers to the various specialty certification programs of the American Board of Medical Specialties and the 
American Osteopathic Association. The organization should report separately for each product as of December 31 of the 
measurement year. (HEDIS 2010, Volume 2: Technical Specification, Pg. 393)
	REPORTING LEVEL - Contract
	PDI801-0010	Family Medicine Board Cert Pct
	PDI801-0030	Oth Specialists Board Cert Pct
	PDI801-0050	Geriatricians Board Cert Pct
	PDI801-0060	Internal Medicine Board Cert Pct
PDI806 - Enrollment by Product Line
	DESCRIPTION - The total number of members enrolled in the product line, stratified by age and sex. (HEDIS 2006, Volume 2: 
Technical Specification, Pg. 3973)
	REPORTING LEVEL - Contract
	PDI806-0010	Enr by Product Line Tot M
	PDI806-0020	Enr by Product Line Tot F
	PDI806-0030	Enr by Product Line Tot Tot
 
Measure	Measure Name/Measure Description/Field Name/Field Description
PDI807 - Language Diversity of Membership
	DESCRIPTION - An unduplicated count and percentage of Medicaid and Medicare members enrolled at any time during the 
measurement year by demand for language interpreter services and spoken language. (HEDIS 2006, Volume 2: Technical 
Specification, Pg. 402)
	REPORTING LEVEL - Contract
	PDI807-0010	Demand for Interpretation Services Yes M Pct
	PDI807-0020	Demand for Interpretation Services Yes F Pct
	PDI807-0030	Demand for Interpretation Services Yes MF Tot Pct
	PDI807-0040	Demand for Interpretation Services No M Pct
	PDI807-0050	Demand for Interpretation Services No F Pct
	PDI807-0060	Demand for Interpretation Services No MF Tot Pct
	PDI807-0070	Demand for Interpretation Services Unknown M Pct
	PDI807-0080	Demand for Interpretation Services Unknown F Pct
	PDI807-0090	Demand for Interpretation Services Unknown MF Tot Pct
	PDI807-0100	Demand for Interpretation Services M Total Pct
	PDI807-0110	Demand for Interpretation Services F Total Pct
	PDI807-0120	Demand for Interpretation Services MF Total Tot Pct
	PDI807-0130	Percentage Members With Interpretation Needs
	PDI807-0140	Spoken Language at Home English M Pct
	PDI807-0150	Spoken Language at Home English F Pct
	PDI807-0160	Spoken Language at Home English MF Tot Pct
	PDI807-0170	Spoken Language at Home Spanish/Creole M Pct
	PDI807-0180	Spoken Language at Home Spanish/Creole F Pct
	PDI807-0190	Spoken Language at Home Spanish/Creole MF Tot Pct
	PDI807-0200	Spoken Language at Home Oth Indo-European M Pct
	PDI807-0210	Spoken Language at Home Oth Indo-European F Pct
	PDI807-0220	Spoken Language at Home Oth Indo-European MF Tot Pct
	PDI807-0230	Spoken Language at Home Asian & Pacific Island M Pct
	PDI807-0240	Spoken Language at Home Asian & Pacific Island F Pct
	PDI807-0250	Spoken Language at Home Asian & Pacific Island MF Tot Pct
	PDI807-0260	Spoken Language at Home Other M Pct
	PDI807-0270	Spoken Language at Home Other F Pct
	PDI807-0280	Spoken Language at Home Other MF Tot Pct
	PDI807-0290	Spoken Language at Home Unknown M Pct
	PDI807-0300	Spoken Language at Home Unknown F Pct
	PDI807-0310	Spoken Language at Home Unknown MF Tot Pct
	PDI807-0320	Spoken Language at Home Total M Pct
	PDI807-0330	Spoken Language at Home Total F Pct
	PDI807-0340	Spoken Language at Home Total MF Tot Pct
	PDI807-0350	Percentage Members with Known Spoken Language
PDI808 - Race/Ethnicity Diversity of Membership
	DESCRIPTION - An unduplicated count and percentage of members enrolled any time during the measurement year, by race 
and ethnicity. (HEDIS 2010, Volume 2: Technical Specification, Pg. 405)
	REPORTING LEVEL - Contract
	PDI808-0010	White M Hispanic (any) Pct
	PDI808-0020	White F Hispanic (any) Pct
	PDI808-0030	White MF Hispanic (any) Tot Pct
	PDI808-0040	Black or African American M Hispanic (any) Pct
	PDI808-0050	Black or African American F Hispanic (any) Pct
	PDI808-0060	Black or African American MF Hispanic (any) Tot Pct
	PDI808-0070	American-Indian & Alaska Native M Hispanic (any) Pct
	PDI808-0080	American-Indian & Alaska Native F Hispanic (any) Pct
	PDI808-0090	American-Indian & Alaska Native MF Hispanic (any) Tot Pct
	PDI808-0100	Asian M Hispanic (any) Pct
	PDI808-0110	Asian F Hispanic (any) Pct
	PDI808-0120	Asian MF Hispanic (any) Tot Pct
	PDI808-0130	Native Hawaiian & Oth Pac Islanders M Hispanic (any) Pct
	PDI808-0140	Native Hawaiian & Oth Pac Islanders F Hispanic (any) Pct
	PDI808-0150	Native Hawaiian & Oth Pac Islanders MF Hispanic (any) Tot Pct
	PDI808-0160	Some Other Race M Hispanic (any) Pct
	PDI808-0170	Some Other Race F Hispanic (any) Pct
	PDI808-0180	Some Other Race MF Hispanic (any) Tot Pct
Measure	Measure Name/Measure Description/Field Name/Field Description
	PDI808-0190	Two or More Races M Hispanic (any) Pct
	PDI808-0200	Two or More Races F Hispanic (any) Pct
	PDI808-0210	Two or More Races MF Hispanic (any) Tot Pct
	PDI808-0220	Unknown M Hispanic (any) Pct
	PDI808-0230	Unknown F Hispanic (any) Pct
	PDI808-0240	Unknown MF Hispanic (any) Tot Pct
	PDI808-0250	Total M Hispanic (any) Pct
	PDI808-0260	Total F Hispanic (any) Pct
	PDI808-0270	Total MF Hispanic (any) Tot Pct
	PDI808-0280	White M Not Hispanic or Latino Pct
	PDI808-0290	White F Not Hispanic or Latino Pct
	PDI808-0300	White MF Not Hispanic or Latino Tot Pct
	PDI808-0310	Black or African American M Not Hispanic or Latino Pct
	PDI808-0320	Black or African American F Not Hispanic or Latino Pct
	PDI808-0330	Black or African American MF Not Hispanic or Latino Tot Pct
	PDI808-0340	American-Indian & Alaska Native M Not Hispanic or Latino Pct
	PDI808-0350	American-Indian & Alaska Native F Not Hispanic or Latino Pct
	PDI808-0360	American-Indian & Alaska Native MF Not Hispanic or Latino Tot Pct
	PDI808-0370	Asian M Not Hispanic or Latino Pct
	PDI808-0380	Asian F Not Hispanic or Latino Pct
	PDI808-0390	Asian MF Not Hispanic or Latino Tot Pct
	PDI808-0400	Native Hawaiian & Oth Pac Islanders M Not Hispanic or Latino Pct
	PDI808-0410	Native Hawaiian & Oth Pac Islanders F Not Hispanic or Latino Pct
	PDI808-0420	Native Hawaiian & Oth Pac Islanders MF Not Hispanic or Latino Tot Pct
	PDI808-0430	Some Other Race M Not Hispanic or Latino Pct
	PDI808-0440	Some Other Race F Not Hispanic or Latino Pct
	PDI808-0450	Some Other Race MF Not Hispanic or Latino Tot Pct
	PDI808-0460	Two or More Races M Not Hispanic or Latino Pct
	PDI808-0470	Two or More Races F Not Hispanic or Latino Pct
	PDI808-0480	Two or More Races MF Not Hispanic or Latino Tot Pct
	PDI808-0490	Unknown M Not Hispanic or Latino Pct
	PDI808-0500	Unknown F Not Hispanic or Latino Pct
	PDI808-0510	Unknown MF Not Hispanic or Latino Tot Pct
	PDI808-0520	Total M Not Hispanic or Latino Pct
	PDI808-0530	Total F Not Hispanic or Latino Pct
	PDI808-0540	Total MF Not Hispanic or Latino Tot Pct
	PDI808-0550	White M Unknown Ethnicity Pct
	PDI808-0560	White F Unknown Ethnicity Pct
	PDI808-0570	White MF Unknown Ethnicity Tot Pct
	PDI808-0580	Black or African American M Unknown Ethnicity Pct
	PDI808-0590	Black or African American F Unknown Ethnicity Pct
	PDI808-0600	Black or African American MF Unknown Ethnicity Tot Pct
	PDI808-0610	American-Indian & Alaska Native M Unknown Ethnicity Pct
	PDI808-0620	American-Indian & Alaska Native F Unknown Ethnicity Pct
	PDI808-0630	American-Indian & Alaska Native MF Unknown Ethnicity Tot Pct
	PDI808-0640	Asian M Unknown Ethnicity Pct
	PDI808-0650	Asian F Unknown Ethnicity Pct
	PDI808-0660	Asian MF Unknown Ethnicity Tot Pct
	PDI808-0670	Native Hawaiian & Oth Pac Islanders M Unknown Ethnicity Pct
	PDI808-0680	Native Hawaiian & Oth Pac Islanders F Unknown Ethnicity Pct
	PDI808-0690	Native Hawaiian & Oth Pac Islanders MF Unknown Ethnicity Tot Pct
	PDI808-0700	Some Other Race M Unknown Ethnicity Pct
	PDI808-0710	Some Other Race F Unknown Ethnicity Pct
	PDI808-0720	Some Other Race MF Unknown Ethnicity Tot Pct
	PDI808-0730	Two or More Races M Unknown Ethnicity Pct
	PDI808-0740	Two or More Races F Unknown Ethnicity Pct
	PDI808-0750	Two or More Races MF Unknown Ethnicity Tot Pct
	PDI808-0760	Unknown M Unknown Ethnicity Pct
	PDI808-0770	Unknown F Unknown Ethnicity Pct
	PDI808-0780	Unknown MF Unknown Ethnicity Tot Pct
	PDI808-0790	Total M Unknown Ethnicity Pct
	PDI808-0800	Total F Unknown Ethnicity Pct
	PDI808-0810	Total MF Unknown Ethnicity Tot Pct
	PDI808-0820	White M Total Pct
	PDI808-0830	White F Total Pct
Measure	Measure Name/Measure Description/Field Name/Field Description
	PDI808-0840	White MF Total Tot Pct
	PDI808-0850	Black or African American M Total Pct
	PDI808-0860	Black or African American F Total Pct
	PDI808-0870	Black or African American MF Total Tot Pct
	PDI808-0880	American-Indian & Alaska Native M Total Pct
	PDI808-0890	American-Indian & Alaska Native F Total Pct
	PDI808-0900	American-Indian & Alaska Native MF Total Tot Pct
	PDI808-0910	Asian M Total Pct
	PDI808-0920	Asian F Total Pct
	PDI808-0930	Asian MF Total Tot Pct
	PDI808-0940	Native Hawaiian & Oth Pac Islanders M Total Pct
	PDI808-0950	Native Hawaiian & Oth Pac Islanders F Total Pct
	PDI808-0960	Native Hawaiian & Oth Pac Islanders MF Total Tot Pct
	PDI808-0970	Some Other Race M Total Pct
	PDI808-0980	Some Other Race F Total Pct
	PDI808-0990	Some Other Race MF Total Tot Pct
	PDI808-1000	Two or More Races M Total Pct
	PDI808-1010	Two or More Races F Total Pct
	PDI808-1020	Two or More Races MF Total Tot Pct
	PDI808-1030	Unknown M Total Pct
	PDI808-1040	Unknown F Total Pct
	PDI808-1050	Unknown MF Total Tot Pct
	PDI808-1060	Race EthnicityM Total Pct
	PDI808-1070	Race Ethnicity F Total Pct
	PDI808-1080	Race Ethnicity MF Total Tot Pct
	PDI808-1090	Percentage Known Ethnicity
PDI809 - Enrollment by State
	DESCRIPTION - The number of members enrolled as of December 31 of the measurement year, by state (HEDIS 2010, Volume 
2: Technical Specification, Pg. 401)
	REPORTING LEVEL - Contract
	PDI809-0010	Alabama
	PDI809-0020	Alaska
	PDI809-0030	Arizona
	PDI809-0040	Arkansas
	PDI809-0050	California
	PDI809-0060	Colorado
	PDI809-0070	Connecticut
	PDI809-0080	Delaware
	PDI809-0090	District of Columbia
	PDI809-0100	Florida
	PDI809-0110	Georgia
	PDI809-0120	Hawaii
	PDI809-0130	Idaho
	PDI809-0140	Illinois
	PDI809-0150	Indiana
	PDI809-0160	Iowa
	PDI809-0170	Kansas
	PDI809-0180	Kentucky
	PDI809-0190	Louisiana
	PDI809-0200	Maine
	PDI809-0210	Maryland
	PDI809-0220	Massachusetts
	PDI809-0230	Michigan
	PDI809-0240	Minnesota
	PDI809-0250	Mississippi
	PDI809-0260	Missouri
	PDI809-0270	Montana
	PDI809-0280	Nebraska
	PDI809-0290	Nevada
	PDI809-0300	New Hampshire
	PDI809-0310	New Jersey
	PDI809-0320	New Mexico
	PDI809-0330	New York
Measure	Measure Name/Measure Description/Field Name/Field Description
	PDI809-0340	North Carolina
	PDI809-0350	North Dakota
	PDI809-0360	Ohio
	PDI809-0370	Oklahoma
	PDI809-0380	Oregon
	PDI809-0390	Pennsylvania
	PDI809-0400	Rhode Island
	PDI809-0410	South Carolina
	PDI809-0420	South Dakota
	PDI809-0430	Tennessee
	PDI809-0440	Texas
	PDI809-0450	Utah
	PDI809-0460	Vermont
	PDI809-0470	Virginia
	PDI809-0480	Washington
	PDI809-0490	West Virginia
	PDI809-0500	Wisconsin
	PDI809-0510	Wyoming
	PDI809-0520	American Samoa
	PDI809-0530	Federated States of Micronesia
	PDI809-0540	Guam
	PDI809-0550	Commonwealth of Northern Marianas
	PDI809-0560	Puerto Rico
	PDI809-0570	Virgin Islands
	PDI809-0580	Other
	PDI809-0590	Total
Service_Area - Contract Service Area
	DESCRIPTION - The area where the contract provides services to Medicare care beneficiaries. This data comes from the Health 
Plan Management System (HPMS) as reported by the contract.
	REPORTING LEVEL - N/A
	SA-0010	Market Area Name
	SA-0020	Market Area Code
	SA-0030	Social Security Administration (SSA) State/County Code
	SA-0040	American National Standards Institute (ANSI) State/County Code INCITS 31-2009 (formerly Federal 
Information Processing Standard [FIPS] State/County codes)
	SA-0050	State Abbreviation (United States Postal Service (USPS) State Code)
	SA-0060	County Name
	SA-0070	County serves only beneficiaries in an Employer Group Health Plan (Y = Yes, N = No)
UOS505 - Frequency of Selected Procedures
	DESCRIPTION - This measure summarizes the utilization of frequently performed procedures that often show wide regional 
variation and have generated concern regarding potentially inappropriate utilization.(HEDIS 2010, Volume 2: Technical 
Specification, Pg. 275)
	REPORTING LEVEL - Contract
	UOS505-0010	CABG M <65 Procs/1000
	UOS505-0020	CABG M 65-74 Procs/1000
	UOS505-0030	CABG M 75-84 Procs/1000
	UOS505-0040	CABG M 85+ Procs/1000
	UOS505-0050	Angioplasty (PTCA) M <65 Procs/1000
	UOS505-0060	Angioplasty (PTCA)M 65-74 Procs/1000
	UOS505-0070	Angioplasty (PTCA) M 75-84 Procs/1000
	UOS505-0080	Angioplasty (PTCA) M 85+ Procs/1000
	UOS505-0090	Carotid Endarterectomy M <65 Procs/1000
	UOS505-0100	Carotid Endarterectomy M 65-74 Procs/1000
	UOS505-0110	Carotid Endarterectomy M 75-84 Procs/1000
	UOS505-0120	Carotid Endarterectomy M 85+ Procs/1000
	UOS505-0130	Reduction of Fracture Femur M <65 Procs/1000
	UOS505-0140	Reduction of Fracture Femur M 65-74 Procs/1000
	UOS505-0150	Reduction of Fracture Femur M 75-84 Procs/1000
	UOS505-0160	Reduction of Fracture Femur M 85+ Procs/1000
	UOS505-0170	Total Hip Replacement M <65 Procs/1000
	UOS505-0180	Total Hip Replacement M 65-74 Procs/1000
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS505-0190	Total Hip Replacement M 75-84 Procs/1000
	UOS505-0200	Total Hip Replacement M 85+ Procs/1000
	UOS505-0210	Total Knee Replacement M <65 Procs/1000
	UOS505-0220	Total Knee Replacement M 65-74 Procs/1000
	UOS505-0230	Total Knee Replacement M 75-84 Procs/1000
	UOS505-0240	Total Knee Replacement M 85+ Procs/1000
	UOS505-0250	Partial Excision of Large Intestine M <65 Procs/1000
	UOS505-0260	Partial Excision of Large Intestine M 65-74 Procs/1000
	UOS505-0270	Partial Excision of Large Intestine M 75-84 Procs/1000
	UOS505-0280	Partial Excision of Large Intestine M 85+ Procs/1000
	UOS505-0290	Cholecystectomy opn M <65 Procs/1000
	UOS505-0300	Cholecystectomy opn M 65-74 Procs/1000
	UOS505-0310	Cholecystectomy opn M 75-84 Procs/1000
	UOS505-0320	Cholecystectomy opn M 85+ Procs/1000
	UOS505-0330	Cholecystectomy cld (laparoscopic) M <65 Procs/1000
	UOS505-0340	Cholecystectomy cld (laparoscopic) M 65-74 Procs/1000
	UOS505-0350	Cholecystectomy cld (laparoscopic) M 75-84 Procs/1000
	UOS505-0360	Cholecystectomy cld (laparoscopic) M 85+ Procs/1000
	UOS505-0370	Prostatectomy <65 Procs/1000
	UOS505-0380	Prostatectomy 65-74 Procs/1000
	UOS505-0390	Prostatectomy 75-84 Procs/1000
	UOS505-0400	Prostatectomy 85+ Procs/1000
	UOS505-0410	CABG F <65 Procs/1000
	UOS505-0420	CABG F 65-74 Procs/1000
	UOS505-0430	CABG F 75-84 Procs/1000
	UOS505-0440	CABG F 85+ Procs/1000
	UOS505-0450	Angioplasty (PTCA)F <65 Procs/1000
	UOS505-0460	Angioplasty (PTCA)F 65-74 Procs/1000
	UOS505-0470	Angioplasty (PTCA) F 75-84 Procs/1000
	UOS505-0480	Angioplasty (PTCA) F 85+ Procs/1000
	UOS505-0490	Carotid Endarterectomy F <65 Procs/1000
	UOS505-0500	Carotid Endarterectomy F 65-74 Procs/1000
	UOS505-0510	Carotid Endarterectomy F 75-84 Procs/1000
	UOS505-0520	Carotid Endarterectomy F 85+ Procs/1000
	UOS505-0530	Reduction of Fracture Femur F <65 Procs/1000
	UOS505-0540	Reduction of Fracture Femur F 65-74 Procs/1000
	UOS505-0550	Reduction of Fracture Femur F 75-84 Procs/1000
	UOS505-0560	Reduction of Fracture Femur F 85+ Procs/1000
	UOS505-0570	Total Hip Replacement F <65 Procs/1000
	UOS505-0580	Total Hip Replacement F 65-74 Procs/1000
	UOS505-0590	Total Hip Replacement F 75-84 Procs/1000
	UOS505-0600	Total Hip Replacement F 85+ Procs/1000
	UOS505-0610	Total Knee Replacement F <65 Procs/1000
	UOS505-0620	Total Knee Replacement F 65-74 Procs/1000
	UOS505-0630	Total Knee Replacement F 75-84 Procs/1000
	UOS505-0640	Total Knee Replacement F 85+ Procs/1000
	UOS505-0650	Partial Excision of Large Intestine F <65 Procs/1000
	UOS505-0660	Partial Excision of Large Intestine F 65-74 Procs/1000
	UOS505-0670	Partial Excision of Large Intestine F 75-84 Procs/1000
	UOS505-0680	Partial Excision of Large Intestine F 85+ Procs/1000
	UOS505-0690	Cholecystectomy opn F <65 Procs/1000
	UOS505-0700	Cholecystectomy opn F 65-74 Procs/1000
	UOS505-0710	Cholecystectomy opn F 75-84 Procs/1000
	UOS505-0720	Cholecystectomy opn F 85+ Procs/1000
	UOS505-0730	Cholecystectomy cld (laparoscopic) F <65 Procs/1000
	UOS505-0740	Cholecystectomy cld (laparoscopic) F 65-74 Procs/1000
	UOS505-0750	Cholecystectomy cld (laparoscopic) F 75-84 Procs/1000
	UOS505-0760	Cholecystectomy cld (laparoscopic) F 85+ Procs/1000
	UOS505-0771	Hysterectomy - Abdominal <65 Procs/1000
	UOS505-0772	Hysterectomy - Vaginal <65 Procs/1000
	UOS505-0781	Hysterectomy - Abdominal 65-74 Procs/1000
	UOS505-0782	Hysterectomy - Vaginal 65-74 Procs/1000
	UOS505-0791	Hysterectomy - Abdominal 75-84 Procs/1000
	UOS505-0792	Hysterectomy - Vaginal 75-84 Procs/1000
	UOS505-0801	Hysterectomy - Abdominal 85+ Procs/1000
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS505-0802	Hysterectomy - Vaginal 85+ Procs/1000
	UOS505-0810	Cardiac Catheterization M <65 Procs/1000
	UOS505-0820	Cardiac Catheterization F <65 Procs/1000
	UOS505-0830	Cardiac Catheterization M 65-74 Procs/1000
	UOS505-0840	Cardiac Catheterization F 65-74 Procs/1000
	UOS505-0850	Cardiac Catheterization M 75-84 Procs/1000
	UOS505-0860	Cardiac Catheterization F 75-84 Procs/1000
	UOS505-0870	Cardiac Catheterization M 85+ Procs/1000
	UOS505-0880	Cardiac Catheterization F 85+ Procs/1000
	UOS505-0890	Mastectomy F <65 Procs/1000
	UOS505-0900	Mastectomy F 65-74 Procs/1000
	UOS505-0910	Mastectomy F 75-84 Procs/1000
	UOS505-0920	Mastectomy F 85+ Procs/1000
	UOS505-0930	Lumpectomy F <65 Procs/1000
	UOS505-0940	Lumpectomy F 65-74 Procs/1000
	UOS505-0950	Lumpectomy F 75-84 Procs/1000
	UOS505-0960	Lumpectomy F 85+ Procs/1000
	UOS505-0970	Back Surgery M <65 Procs/1000
	UOS505-0980	Back Surgery F <65 Procs/1000
	UOS505-0990	Back Surgery M 65-74 Procs/1000
	UOS505-1000	Back Surgery F 65-74 Procs/1000
	UOS505-1010	Back Surgery M 75-84 Procs/1000
	UOS505-1020	Back Surgery F 75-84 Procs/1000
	UOS505-1030	Back Surgery M 85+ Procs/1000
	UOS505-1040	Back Surgery F 85+ Procs/1000
UOS506 - Inpatient Utilization-General Hospital/Acute Care
	DESCRIPTION - This measure summarizes utilization of acute inpatient care and services in the following categories.
	• Total inpatient
	• Medicine
	• Surgery
	• Maternity
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 291)
	REPORTING LEVEL - Contract
	UOS506-0010	Tot IP Ds/1000 <1
	UOS506-0020	Tot IP Days/1000 <1
	UOS506-0030	Tot IP ALOS <1
	UOS506-0040	Tot IP Ds/1000 1-9
	UOS506-0050	Tot IP Days/1000 MM 1-9
	UOS506-0060	Tot IP ALOS 1-9
	UOS506-0070	Tot IP Ds/1000 MM 10-19
	UOS506-0080	Tot IP Days/1000 MM 10-19
	UOS506-0090	Tot IP ALOS 10-19
	UOS506-0100	Tot IP 20-44 Ds/1000
	UOS506-0110	Tot IP Days/1000 MM 20-44
	UOS506-0120	Tot IP ALOS 20-44
	UOS506-0130	Tot IP Ds/1000 MM 45-64
	UOS506-0140	Tot IP Days/1000 MM 45-64
	UOS506-0150	Tot IP ALOS 45-64
	UOS506-0160	Tot IP Ds/1000 MM 65-74
	UOS506-0170	Tot IP Days/1000 MM 65-74
	UOS506-0180	Tot IP ALOS 65-74
	UOS506-0190	Tot IP Ds/1000 MM 75-84
	UOS506-0200	Tot IP Days/1000 MM 75-84
	UOS506-0210	Tot IP ALOS 75-84
	UOS506-0220	Tot IP Ds/1000 MM 85+
	UOS506-0230	Tot IP Days/1000 MM 85+
	UOS506-0240	Tot IP ALOS 85+
	UOS506-0270	Tot IP Unk ALOS
	UOS506-0280	Tot IP Tot Ds/1000 MM
	UOS506-0290	Tot IP Tot Days/1000 MM
	UOS506-0300	Tot IP Tot ALOS
	UOS506-0310	Medicine <1 Ds/1000
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS506-0320	Medicine <1 Days/1000 MM
	UOS506-0330	Medicine <1 ALOS
	UOS506-0340	Medicine 1-9 Ds/1000 MM
	UOS506-0350	Medicine 1-9 Days/1000 MM
	UOS506-0360	Medicine 1-9 ALOS
	UOS506-0370	Medicine 10-19 Ds/1000 MM
	UOS506-0380	Medicine 10-19 Days/1000 MM
	UOS506-0390	Medicine 10-19 ALOS
	UOS506-0400	Medicine 20-44 Ds/1000
	UOS506-0410	Medicine 20-44 Days/1000 MM
	UOS506-0420	Medicine 20-44 ALOS
	UOS506-0430	Medicine 45-64 Days/1000 MM
	UOS506-0440	Medicine 45-64 Ds/1000
	UOS506-0450	Medicine 45-64 Days
	UOS506-0460	Medicine 65-74 Ds/1000
	UOS506-0470	Medicine 65-74 Days/1000 MM
	UOS506-0480	Medicine 65-74 ALOS
	UOS506-0490	Medicine 75-84 Ds/1000
	UOS506-0500	Medicine 75-84 Days/1000 MM
	UOS506-0510	Medicine 75-84 ALOS
	UOS506-0520	Medicine 85+ Ds/1000
	UOS506-0530	Medicine 85+ Days/1000 MM
	UOS506-0540	Medicine 85+ ALOS
	UOS506-0570	Medicine Unk ALOS
	UOS506-0580	Medicine Tot Ds/1000
	UOS506-0590	Medicine Tot Days/1000 MM
	UOS506-0600	Medicine Tot ALOS
	UOS506-0610	Surgery <1 Ds/1000
	UOS506-0620	Surgery <1 Days/1000 MM
	UOS506-0630	Surgery <1 ALOS
	UOS506-0640	Surgery 1-9 Ds/1000 MM
	UOS506-0650	Surgery 1-9 Days/1000 MM
	UOS506-0660	Surgery 1-9 ALOS
	UOS506-0670	Surgery 10-19 Ds/1000 MM
	UOS506-0680	Surgery 10-19 Days/1000 MM
	UOS506-0690	Surgery 10-19 ALOS
	UOS506-0700	Surgery 20-44 Ds/1000
	UOS506-0710	Surgery 20-44 Days/1000 MM
	UOS506-0720	Surgery 20-44 ALOS
	UOS506-0730	Surgery 45-64 Ds/1000
	UOS506-0740	Surgery 45-64 Days/1000 MM
	UOS506-0750	Surgery 45-64 ALOS
	UOS506-0760	Surgery 65-74 Ds/1000
	UOS506-0770	Surgery 65-74 Days/1000 MM
	UOS506-0780	Surgery 65-74 ALOS
	UOS506-0790	Surgery 75-84 Ds/1000
	UOS506-0800	Surgery 75-84 Days/1000 MM
	UOS506-0810	Surgery 75-84 ALOS
	UOS506-0820	Surgery 85+ Ds/1000
	UOS506-0830	Surgery 85+ Days/1000 MM
	UOS506-0840	Surgery 85+ ALOS
	UOS506-0870	Surgery Unk ALOS
	UOS506-0880	Surgery Tot Ds/1000
	UOS506-0890	Surgery Tot Days/1000 MM
	UOS506-0900	Surgery Tot ALOS
	UOS506-0910	Maternity 10-19 Ds/1000 MM
	UOS506-0920	Maternity 10-19 Days/1000 MM
	UOS506-0930	Maternity 10-19 ALOS
	UOS506-0940	Maternity 20-44 Ds/1000
	UOS506-0950	Maternity 20-44 Days/1000 MM
	UOS506-0960	Maternity 20-44 ALOS
	UOS506-0970	Maternity 45-64 Ds/1000
	UOS506-0980	Maternity 45-64 Days/1000 MM
	UOS506-0990	Maternity 45-64 ALOS
	UOS506-1020	Maternity Unk ALOS
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS506-1030	Maternity Tot Ds/1000
	UOS506-1040	Maternity Tot Days/1000 MM
	UOS506-1050	Maternity Tot ALOS
UOS507 - Ambulatory Care
	DESCRIPTION - This measure summarizes utilization of ambulatory care in the following categories.
	• Outpatient Visits
	• ED Visits
	• Ambulatory Surgery/Procedures
	• Observation Room Stays
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 286)
	REPORTING LEVEL - Contract
	UOS507-0010	AMB Tot OP <1 Visit/1000
	UOS507-0020	AMB Tot ER <1 Visit/1000
	UOS507-0030	AMB Tot Amb <1 Surg/Procs Procs/1000
	UOS507-0040	AMB Tot Observ Rm <1 Ds Stays/1000
	UOS507-0050	AMB Tot OP 1-9 Visit/1000
	UOS507-0060	AMB Tot ER 1-9 Visit/1000
	UOS507-0070	AMB Tot Amb 1-9 Surg/Procs Procs/1000
	UOS507-0080	AMB Tot Observ Rm 1-9 Ds Stays/1000
	UOS507-0090	AMB Tot OP 10-19 Visit/1000
	UOS507-0100	AMB Tot ER 10-19 Visit/1000
	UOS507-0110	AMB Tot Amb 10-19 Surg/Procs Procs/1000
	UOS507-0120	AMB Tot Observ Rm 10-19 Ds Stays/1000
	UOS507-0130	AMB Tot OP 20-44 Visit/1000
	UOS507-0140	AMB Tot ER 20-44 Visit/1000
	UOS507-0150	AMB Tot Amb 20-44 Surg/Procs Procs/1000
	UOS507-0160	AMB Tot Observ Rm 20-44 Ds Stays/1000
	UOS507-0170	AMB Tot OP 45-64 Visit/1000
	UOS507-0180	AMB Tot ER 45-64 Visit/1000
	UOS507-0190	AMB Tot Amb 45-64 Surg/Procs Procs/1000
	UOS507-0200	AMB Tot Observ Rm 45-64 Ds Stays/1000
	UOS507-0210	AMB Tot OP 65-74 Visit/1000
	UOS507-0220	AMB Tot ER 65-74 Visit/1000
	UOS507-0230	AMB Tot Amb 65-74 Surg/Procs Procs/1000
	UOS507-0240	AMB Tot Observ Rm 65-74 Ds Stays/1000
	UOS507-0250	AMB Tot OP 75-84 Visit/1000
	UOS507-0260	AMB Tot ER 75-84 Visit/1000
	UOS507-0270	AMB Tot Amb 75-84 Surg/Procs Procs/1000
	UOS507-0280	AMB Tot Observ Rm 75-84 Ds Stays/1000
	UOS507-0290	AMB Tot OP 85+ Visit/1000
	UOS507-0300	AMB Tot ER 85+ Visit/1000
	UOS507-0310	AMB Tot Amb 85+ Surg/Procs Procs/1000
	UOS507-0320	AMB Tot Observ Rm 85+ Ds Stays/1000
	UOS507-0370	AMB Tot OP Tot Visit/1000
	UOS507-0380	AMB Tot ER Tot Visit/1000
	UOS507-0390	AMB Tot Amb Tot Surg/Procs Procs/1000
	UOS507-0400	AMB Tot Observ Rm Tot Ds Stays/1000
UOS508 - Inpatient Utilization-NonAcute Care
	DESCRIPTION - This measure summarizes utilization of nonacute inpatient care in hospice, nursing home, rehabilitation, SNF, 
transitional care and respite. (HEDIS 2010, Volume 2: Technical Specification, Pg. 297)
	REPORTING LEVEL - Contract
	UOS508-0010	Inpat Nonacute <1 Ds/1000
	UOS508-0020	Inpat Nonacute <1 Days/1000
	UOS508-0030	Inpat Nonacute <1 ALOS
	UOS508-0040	Inpat Nonacute 1-9 Ds/1000
	UOS508-0050	Inpat Nonacute 1-9 Days/1000
	UOS508-0060	Inpat Nonacute 1-9 ALOS
	UOS508-0070	Inpat Nonacute 10-19 Ds/1000
	UOS508-0080	Inpat Nonacute 10-19 Days/1000
	UOS508-0090	Inpat Nonacute 10-19 ALOS
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS508-0100	Inpat Nonacute 20-44 Ds/1000
	UOS508-0110	Inpat Nonacute 20-44 Days/1000
	UOS508-0120	Inpat Nonacute 20-44 ALOS
	UOS508-0130	Inpat Nonacute 45-64 Ds/1000
	UOS508-0140	Inpat Nonacute 45-64 Days/1000
	UOS508-0150	Inpat Nonacute 45-64 ALOS
	UOS508-0160	Inpat Nonacute 65-74 Ds/1000
	UOS508-0170	Inpat Nonacute 65-74 Days/1000
	UOS508-0180	Inpat Nonacute 65-74 ALOS
	UOS508-0190	Inpat Nonacute 75-84 Ds/1000
	UOS508-0200	Inpat Nonacute 75-84 Days/1000
	UOS508-0210	Inpat Nonacute 75-84 ALOS
	UOS508-0220	Inpat Nonacute 85+ Ds/1000
	UOS508-0230	Inpat Nonacute 85+ Days/1000
	UOS508-0240	Inpat Nonacute 85+ ALOS
	UOS508-0270	Inpat Nonacute Unk ALOS
	UOS508-0280	Inpat Nonacute Tot Ds/1000
	UOS508-0290	Inpat Nonacute Tot Days/1000
	UOS508-0300	Inpat Nonacute Tot ALOS
UOS513 - Mental Health Utilization
	DESCRIPTION - The number and percentage of members receiving the following mental health services during the 
measurement year. 
	• Any services
	• Inpatient
	• Intensive outpatient or partial hospitalization
	• Outpatient or ED
	(HEDIS 2006, Volume 2: Technical Specification, Pg. 305)
	REPORTING LEVEL - Contract
	UOS513-0010	MH Svs Any 0-12 M Pct
	UOS513-0020	MH Svs Inpat 0-12 M Pct
	UOS513-0030	MH Svs Day/Night 0-12 M Pct
	UOS513-0040	MH Svs Amb 0-12 M Pct
	UOS513-0050	MH Svs Any 13-17 M Pct
	UOS513-0060	MH Svs Inpat13-17 M Pct
	UOS513-0070	MH Svs Day/Night 13-17 M Pct
	UOS513-0080	MH Svs Amb 13-17 M Pct
	UOS513-0090	MH Svs Any 18-64 M Pct
	UOS513-0100	MH Svs Inpat 18-64 M Pct
	UOS513-0110	MH Svs Day/Night 18-64 M Pct
	UOS513-0120	MH Svs Amb 18-64 M Pct
	UOS513-0130	MH Svs Any 65+ M Pct
	UOS513-0140	MH Svs Inpat 65+ M Pct
	UOS513-0150	MH Svs Day/Night 65+ M Pct
	UOS513-0160	MH Svs Amb 65+ M Pct
	UOS513-0170	MH Svs Any Unk M Pct
	UOS513-0180	MH Svs Inpat Unk M Pct
	UOS513-0190	MH Svs Day/Night Unk M Pct
	UOS513-0200	MH Svs Amb Unk M Pct
	UOS513-0210	MH Svs Any Tot M Pct
	UOS513-0220	MH Svs Inpat Tot M Pct
	UOS513-0230	MH Svs Day/Night Tot M Pct
	UOS513-0240	MH Svs Amb Tot M Pct
	UOS513-0250	MH Svs Any 0-12 F Pct
	UOS513-0260	MH Svs Inpat 0-12 F Pct
	UOS513-0270	MH Svs Day/Night 0-12 F Pct
	UOS513-0280	MH Svs Amb 0-12 F Pct
	UOS513-0290	MH Svs Any 13-17 F Pct
	UOS513-0300	MH Svs Inpat 13-17 F Pct
	UOS513-0310	MH Svs Day/Night 13-17 F Pct
	UOS513-0320	MH Svs Amb 13-17 F Pct
	UOS513-0330	MH Svs Any 18-64 F Pct
	UOS513-0340	MH Svs Inpat 18-64 F Pct


Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS513-0350	MH Svs Day/Night 18-64 F Pct
	UOS513-0360	MH Svs Amb 18-64 F Pct
	UOS513-0370	MH Svs Any 65+ F Pct
	UOS513-0380	MH Svs Inpat 65+ F Pct
	UOS513-0390	MH Svs Day/Night 65+ F Pct
	UOS513-0400	MH Svs Amb 65+ F Pct
	UOS513-0410	MH Svs Any Unk F Pct
	UOS513-0420	MH Svs Inpat Unk F Pct
	UOS513-0430	MH Svs Day/Night Unk F Pct
	UOS513-0440	MH Svs Amb Unk F Pct
	UOS513-0450	MH Svs Any Tot F Pct
	UOS513-0460	MH Svs Inpat Tot Num
	UOS513-0470	MH Svs Day/Night Tot F Pct
	UOS513-0480	MH Svs Amb Tot F Pct
	UOS513-0490	MH Svs Any 0-12 Tot Pct
	UOS513-0500	MH Svs Inpat 0-12 Tot Pct
	UOS513-0510	MH Svs Day/Night 0-12 Tot Pct
	UOS513-0520	MH Svs Amb 0-12 Tot Pct
	UOS513-0530	MH Svs Any 13-17 Tot Pct
	UOS513-0540	MH Svs Inpat 13-17 Tot Pct
	UOS513-0550	MH Svs Day/Night 13-17 Tot Pct
	UOS513-0560	MH Svs Amb 13-17 Tot Pct
	UOS513-0570	MH Svs Any 18-64 Tot Pct
	UOS513-0580	MH Svs Inpat 18-64 Tot Pct
	UOS513-0590	MH Svs Day/Night 18-64 Tot Pct
	UOS513-0600	MH Svs Amb 18-64 Tot Pct
	UOS513-0610	MH Svs Any 65+ Tot Pct
	UOS513-0620	MH Svs Inpat 65+ Tot Pct
	UOS513-0630	MH Svs Day/Night 65+ Tot Pct
	UOS513-0640	MH Svs Amb 65+ Tot Pct
	UOS513-0650	MH Svs Any Unk Tot Pct
	UOS513-0660	MH Svs Inpat Unk Tot Pct
	UOS513-0670	MH Svs Day/Night Unk Tot Pct
	UOS513-0680	MH Svs Amb Unk Tot Pct
	UOS513-0690	MH Svs Any Tot Pct
	UOS513-0700	MH Svs Inpat Tot Pct
	UOS513-0710	MH Svs Day/Night Tot Pct
	UOS513-0720	MH Svs Amb Tot Pct
UOS518 - Outpatient Drug Utilization
	DESCRIPTION - This measure summarizes data on outpatient utilization of drug prescriptions, stratified by age, during 
measurement year. The following data are reported.
	• Total cost of prescriptions
	• Average cost of prescriptions PMPM
	• Total number of prescriptions
	• Average number of prescriptions PMPY
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 319)
	REPORTING LEVEL - Contract
	UOS518-0010	OP Rx 0-9 Avg Cst of Rx/Mem/Mnth
	UOS518-0020	OP Rx 0-9 Avg Num of Rx/
	UOS518-0030	OP Rx 10-19 Avg Cst of Rx/Mem/Mnth
	UOS518-0032	OP Rx 10-17 Avg Cst of Rx/Mem/Mnth
	UOS518-0040	OP Rx 10-19 Avg Num of Rx/
	UOS518-0042	OP Rx 10-17 Avg Num of Rx/
	UOS518-0050	OP Rx 20-44 Avg Cst of Rx/Mem/Mnth
	UOS518-0052	OP Rx 18-34 Avg Cst of Rx/Mem/Mnth
	UOS518-0060	OP Rx 20-44 Avg Num of Rx/
	UOS518-0062	OP Rx 18-34 Avg Num of Rx/
	UOS518-0070	OP Rx 45-64 Avg Cst of Rx/Mem/Mnth
	UOS518-0072	OP Rx 35-49 Avg Cst of Rx/Mem/Mnth
	UOS518-0080	OP Rx 45-64 Avg Num of Rx/
	UOS518-0082	OP Rx 35-49 Avg Num of Rx/
	UOS518-0084	OP Rx 50-64 Avg Cst of Rx/Mem/Mnth
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS518-0086	OP Rx 50-64 Avg Num of Rx/
	UOS518-0090	OP Rx 65-74 Avg Cst of Rx/Mem/Mnth
	UOS518-0100	OP Rx 65-74 Avg Num of Rx/
	UOS518-0110	OP Rx 75-84 Avg Cst of Rx/Mem/Mnth
	UOS518-0120	OP Rx 75-84 Avg Num of Rx/
	UOS518-0130	OP Rx 85+ Avg Cst of Rx/Mem/Mnth
	UOS518-0140	OP Rx 85+ Avg Num of Rx/
	UOS518-0170	OP Rx Tot Avg Cst of Rx/Mem/Mnth
	UOS518-0180	OP Rx Tot Avg Num of Rx/
UOS520 - Identification of Alcohol and Other Drug Services
	DESCRIPTION - This measure summarizes the number and percentage of members with an alcohol and other drug (AOD) claim 
who received the following chemical dependency services during the measurement year.
	• Any services
	• Inpatient
	• Intensive outpatient or partial hospitalization
	• Outpatient or ED
	An AOD claim contains a diagnosis of AOD abuse or dependence and a specific AOD-related service. (HEDIS 2010, Volume 2: 
Technical Specification, Pg. 300)
	REPORTING LEVEL - Contract
	UOS520-0010	ID Svs Any 0-12 M Pct
	UOS520-0020	ID Svs Any 0-12 F Pct
	UOS520-0030	ID Svs Any 0-12 Tot Pct
	UOS520-0040	ID Svs Any 13-17 M Pct
	UOS520-0050	ID Svs Any 13-17 F Pct
	UOS520-0060	ID Svs Any 13-17 Tot Pct
	UOS520-0072	ID Svs Any 18-24 M Pct
	UOS520-0074	ID Svs Any 18-24 F Pct
	UOS520-0076	ID Svs Any 18-24 Tot Pct
	UOS520-0078	ID Svs Any 25-34 M Pct
	UOS520-0082	ID Svs Any 25-34 F Pct
	UOS520-0084	ID Svs Any 25-34 Tot Pct
	UOS520-0086	ID Svs Any 35-64 M Pct
	UOS520-0088	ID Svs Any 35-64 F Pct
	UOS520-0092	ID Svs Any 35-64 Tot Pct
	UOS520-0100	ID Svs Any 65+ M Pct
	UOS520-0110	ID Svs Any 65+ F Pct
	UOS520-0120	ID Svs Any 65+ Tot Pct
	UOS520-0130	ID Svs Any Unk M Pct
	UOS520-0140	ID Svs Any Unk F Pct
	UOS520-0150	ID Svs Any Unk Tot Pct
	UOS520-0160	ID Svs Any Tot M Pct
	UOS520-0170	ID Svs Any Tot F Pct
	UOS520-0180	ID Svs Any Tot Pct
	UOS520-0190	ID Svs Inpat 0-12 M Pct
	UOS520-0200	ID Svs Inpat 0-12 F Pct
	UOS520-0210	ID Svs Inpat 0-12 Tot Pct
	UOS520-0220	ID Svs Inpat 13-17 M Pct
	UOS520-0230	ID Svs Inpat 13-17 F Pct
	UOS520-0240	ID Svs Inpat 13-17 Tot Pct
	UOS520-0252	ID Svs Inpat 18-24 M Pct
	UOS520-0254	ID Svs Inpat 18-24 F Pct
	UOS520-0256	ID Svs Inpat 18-24 Tot Pct
	UOS520-0258	ID Svs Inpat 25-34 M Pct
	UOS520-0262	ID Svs Inpat 25-34 F Pct
	UOS520-0264	ID Svs Inpat 25-34 Tot Pct
	UOS520-0266	ID Svs Inpat 35-64 M Pct
	UOS520-0268	ID Svs Inpat 35-64 F Pct
	UOS520-0270	ID Svs Inpat 35-64 Tot Pct
	UOS520-0280	ID Svs Inpat 65+ M Pct
	UOS520-0290	ID Svs Inpat 65+ F Pct
	UOS520-0300	ID Svs Inpat 65+ Tot Pct
	UOS520-0310	ID Svs Inpat Unk M Pct
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS520-0320	ID Svs Inpat Unk F Pct
	UOS520-0330	ID Svs Inpat Unk Tot Pct
	UOS520-0340	ID Svs Inpat Tot M Pct
	UOS520-0350	ID Svs Inpat Tot F Pct
	UOS520-0360	ID Svs Inpat Tot Pct
	UOS520-0370	ID Svs Day/Night 0-12 M Pct
	UOS520-0380	ID Svs Day/Night 0-12 F Pct
	UOS520-0390	ID Svs Day/Night 0-12 Tot Pct
	UOS520-0400	ID Svs Day/Night 13-17 M Pct
	UOS520-0410	ID Svs Day/Night 13-17 F Pct
	UOS520-0420	ID Svs Day/Night 13-17 Tot Pct
	UOS520-0432	ID Svs Intermediate 18-24 M Pct
	UOS520-0434	ID Svs Intermediate 18-24 F Pct
	UOS520-0436	ID Svs Intermediate 18-24 Tot Pct
	UOS520-0438	ID Svs Intermediate 25-34 M Pct
	UOS520-0442	ID Svs Intermediate 25-34 F Pct
	UOS520-0444	ID Svs Intermediate 25-34 Tot Pct
	UOS520-0446	ID Svs Intermediate 35-64 M Pct
	UOS520-0448	ID Svs Intermediate 35-64 F Pct
	UOS520-0452	ID Svs Intermediate 35-64 Tot Pct
	UOS520-0460	ID Svs Day/Night 65+ M Pct
	UOS520-0470	ID Svs Day/Night 65+ F Pct
	UOS520-0480	ID Svs Day/Night 65+ Tot Pct
	UOS520-0490	ID Svs Day/Night Unk M Pct
	UOS520-0500	ID Svs Day/Night Unk F Pct
	UOS520-0510	ID Svs Day/Night Unk Tot Pct
	UOS520-0520	ID Svs Day/Night Tot M Pct
	UOS520-0530	ID Svs Day/Night Tot F Pct
	UOS520-0540	ID Svs Day/Night Tot Pct
	UOS520-0550	ID Svs Amb 0-12 M Pct
	UOS520-0560	ID Svs Amb 0-12 F Pct
	UOS520-0570	ID Svs Amb 0-12 Tot Pct
	UOS520-0580	ID Svs Amb 13-17 M Pct
	UOS520-0590	ID Svs Amb 13-17 F Pct
	UOS520-0600	ID Svs Amb 13-17 Tot Pct
	UOS520-0612	ID Svs Amb 18-24 M Pct
	UOS520-0614	ID Svs Amb 18-24 F Pct
	UOS520-0616	ID Svs Amb 18-24 Tot Pct
	UOS520-0618	ID Svs Amb 25-34 M Pct
	UOS520-0622	ID Svs Amb 25-34 F Pct
	UOS520-0624	ID Svs Amb 25-34 Tot Pct
	UOS520-0626	ID Svs Amb 35-64 M Pct
	UOS520-0628	ID Svs Amb 35-64 F Pct
	UOS520-0632	ID Svs Amb 35-64 Tot Pct
	UOS520-0640	ID Svs Amb 65+ M Pct
	UOS520-0650	ID Svs Amb 65+ F Pct
	UOS520-0660	ID Svs Amb 65+ Tot Pct
	UOS520-0670	ID Svs Amb Unk M Pct
	UOS520-0680	ID Svs Amb Unk F Pct
	UOS520-0690	ID Svs Amb Unk Tot Pct
	UOS520-0700	ID Svs Amb Tot M Pct
	UOS520-0710	ID Svs Amb Tot F Pct
	UOS520-0720	ID Svs Amb Tot Pct
 
Measure	Measure Name/Measure Description/Field Name/Field Description
UOS522 - Antibiotic Utilization
	DESCRIPTION - This measure summarizes the following data on outpatient utilization of antibiotic prescriptions during the 
measurement year, stratified by age and gender. 
	• Total number of antibiotic prescriptions
	• Average number of antibiotic prescriptions per member per year (PMPY)
	• Total days supplied for all antibiotic prescriptions
	• Average days supplied per antibiotic prescription
	• Total number of prescriptions for antibiotics of concern
	• Average number of prescriptions PMPY for antibiotics of concern 
	• Percentage of antibiotics of concern for all antibiotic prescriptions
	• Average number of antibiotics PMPY reported by drug class: 
			- For selected "antibiotics of concern"
			- For all other antibiotics
	(HEDIS 2010, Volume 2: Technical Specification, Pg. 309)
	REPORTING LEVEL - Contract
	UOS522-0010	AU Antibiotic Scrips PMPY M Tot Avg
	UOS522-0020	AU Antibiotic Scrips PMPY F Tot Avg
	UOS522-0030	AU Antibiotic Scrips PMPY MF Tot Avg
	UOS522-0040	AU Days Supplied per Antibiotic Scrip M Tot Avg
	UOS522-0050	AU Days Supplied per Antibiotic Scrip F Tot Avg
	UOS522-0060	AU Days Supplied per Antibiotic Scrip MF Tot Avg
	UOS522-0070	AU Scrips PMPY for Anitbiotics of Concern M Tot Avg
	UOS522-0080	AU Scrips PMPY for Anitbiotics of Concern F Tot Avg
	UOS522-0090	AU Scrips PMPY for Anitbiotics of Concern MF Tot Avg
	UOS522-0100	AU Pct Antibiotics of All Antibiotic Scrips M Tot
	UOS522-0110	AU Pct Antibiotics of All Antibiotic Scrips F Tot
	UOS522-0120	AU Pct Antibiotics of All Antibiotic Scrips MF Tot
	UOS522-0130	AC Quinolones PMPY M Tot
	UOS522-0140	AC Quinolones PMPY F Tot
	UOS522-0150	AC Quinolones PMPY MF Tot
	UOS522-0160	AC Cephalosporins 2nd-4th Generation PMPY M Tot
	UOS522-0170	AC Cephalosporins 2nd-4th Generation PMPY F Tot
	UOS522-0180	AC Cephalosporins 2nd-4th Generation PMPY MF Tot
	UOS522-0190	AC Azithromycin and Clarithromycin PMPY M Tot
	UOS522-0200	AC Azithromycin and Clarithromycin PMPY F Tot
	UOS522-0210	AC Azithromycin and Clarithromycin PMPY MF Tot
	UOS522-0220	AC Amoxicillin/Clavulanate PMPY M Tot
	UOS522-0230	AC Amoxicillin/Clavulanate PMPY F Tot
	UOS522-0240	AC Amoxicillin/Clavulanate PMPY MF Tot
	UOS522-0250	AC Ketolides PMPY M Tot
	UOS522-0260	AC Ketolides PMPY F Tot
	UOS522-0270	AC Ketolides PMPY MF Tot
	UOS522-0280	AC Clindamycin PMPY M Tot
	UOS522-0290	AC Clindamycin PMPY F Tot
	UOS522-0300	AC Clindamycin PMPY MF Tot
	UOS522-0310	AC Misc Antibiotics of Concern PMPY M Tot
	UOS522-0320	AC Misc Antibiotics of Concern PMPY F Tot
	UOS522-0330	AC Misc Antibiotics of Concern PMPY MF Tot
	UOS522-0340	AO Absorbable Sulfonamides PMPY M Tot
	UOS522-0350	AO Absorbable Sulfonamides PMPY F Tot
	UOS522-0360	AO Absorbable Sulfonamides PMPY MF Tot
	UOS522-0370	AO Aminoglycosides PMPY M Tot
	UOS522-0380	AO Aminoglycosides PMPY F Tot
	UOS522-0390	AO Aminoglycosides PMPY MF Tot
	UOS522-0400	AO 1st Generation Cephalosporins PMPY M Tot
	UOS522-0410	AO 1st Generation Cephalosporins PMPY F Tot
	UOS522-0420	AO 1st Generation Cephalosporins PMPY MF Tot
	UOS522-0430	AO Lincosamides PMPY M Tot
	UOS522-0440	AO Lincosamides PMPY F Tot
	UOS522-0450	AO Lincosamides PMPY MF Tot
Measure	Measure Name/Measure Description/Field Name/Field Description
	UOS522-0460	AO Macrolides (not azith or clarith) PMPY M Tot
	UOS522-0470	AO Macrolides (not azith or clarith) PMPY F Tot
	UOS522-0480	AO Macrolides (not azith or clarith) PMPY MF Tot
	UOS522-0490	AO Penicillins PMPY M Tot
	UOS522-0500	AO Penicillins PMPY F Tot
	UOS522-0510	AO Penicillins PMPY MF Tot
	UOS522-0520	AO Tetracyclines PMPY M Tot
	UOS522-0530	AO Tetracyclines PMPY F Tot
	UOS522-0540	AO Tetracyclines PMPY MF Tot
	UOS522-0550	AO Misc Antibiotics PMPY M Tot
	UOS522-0560	AO Misc Antibiotics PMPY F Tot
	UOS522-0570	AO Misc Antibiotics PMPY MF Tot
	UOS522-0580	AC Quinolone Scrips M Tot Num
	UOS522-0590	AC Quinolone Scrips F Tot Num
	UOS522-0600	AC Quinolone Scrips MF Tot Num
	UOS522-0610	AC Cephalosporin Scrips 2nd-4th Generation M Tot Num
	UOS522-0620	AC Cephalosporin Scrips 2nd-4th Generation F Tot Num
	UOS522-0630	AC Cephalosporin Scrips 2nd-4th Generation MF Tot Num
	UOS522-0640	AC Azithromycin and Clarithromycin Scrips M Tot Num
	UOS522-0645	AC Azithromycin and Clarithromycin Scrips F Tot Num
	UOS522-0650	AC Azithromycin and Clarithromycin Scrips MF Tot Num
	UOS522-0660	AC Amoxicillin/Clavulanate Scrips M Tot Num
	UOS522-0670	AC Amoxicillin/Clavulanate Scrips F Tot Num
	UOS522-0680	AC Amoxicillin/Clavulanate Scrips MF Tot Num
	UOS522-0690	AC Ketolide Scrips M Tot Num
	UOS522-0700	AC Ketolide Scrips F Tot Num
	UOS522-0710	AC Ketolide Scrips MF Tot Num
	UOS522-0720	AC Clindamycin Scrips M Tot Num
	UOS522-0730	AC Clindamycin Scrips F Tot Num
	UOS522-0740	AC Clindamycin Scrips MF Tot Num
	UOS522-0750	AC Misc Antibiotics of Concern Scrips M Tot Num
	UOS522-0760	AC Misc Antibiotics of Concern Scrips F Tot Num
	UOS522-0770	AC Misc Antibiotics of Concern Scrips MF Tot Num
	UOS522-0780	AO Absorbable Sulfonamide Scrips M Tot Num
	UOS522-0790	AO Absorbable Sulfonamide Scrips F Tot Num
	UOS522-0800	AO Absorbable Sulfonamide Scrips MF Tot Num
	UOS522-0810	AO Aminoglycoside Scrips M Tot Num
	UOS522-0820	AO Aminoglycoside Scrips F Tot Num
	UOS522-0830	AO Aminoglycoside Scrips MF Tot Num
	UOS522-0840	AO 1st Generation Cephalosporin Scrips M Tot Num
	UOS522-0850	AO 1st Generation Cephalosporin Scrips F Tot Num
	UOS522-0860	AO 1st Generation Cephalosporin Scrips MF Tot Num
	UOS522-0870	AO Lincosamide Scrips M Tot Num
	UOS522-0880	AO Lincosamide Scrips F Tot Num
	UOS522-0890	AO Lincosamide Scrips MF Tot Num
	UOS522-0900	AO Macrolide (not azith or clarith) Scrips M Tot Num
	UOS522-0910	AO Macrolide (not azith or clarith) Scrips F Tot Num
	UOS522-0920	AO Macrolide (not azith or clarith) Scrips MF Tot Num
	UOS522-0930	AO Penicillin Scrips M Tot Num
	UOS522-0940	AO Penicillin Scrips F Tot Num
	UOS522-0950	AO Penicillin Scrips MF Tot Num
	UOS522-0960	AO Tetracycline Scrips M Tot Num
	UOS522-0970	AO Tetracycline Scrips F Tot Num
	UOS522-0980	AO Tetracycline Scrips MF Tot Num
	UOS522-0990	AO Misc Antibiotic Scrips M Tot Num
	UOS522-1000	AO Misc Antibiotic Scrips F Tot Num
	UOS522-1010	AO Misc Antibiotic Scrips MF Tot Num

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