# HEDIS® 2004 (Summary) Documentation for Reporting Year 2003

## General Information

This documentation presents (1) a description of each HEDIS® measure that CMS collected for 167 Medicare managed care contract markets on health care provided in calendar year 2003 to Medicare beneficiaries and (2) the location of the rates associated with each HEDIS measure within the HEDIS workbook (HEDIS2004.XLS). CMS took the description and additional information for each measure from HEDIS 2004 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) 2004 is held by the National Committee for Quality Assurance, 2000 L Street, NW, Suite 500, Washington, DC 20036. All rights reserved.

## The Medicare HEDIS reporting unit is the contract

In 2004, CMS collected data from 166 Medicare managed care contracts for health care delivered in 2003. 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 167.

The "Service_Area" sheet in the HEDIS workbook identifies the state and counties for each submission. If 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 2004 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 2004, 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 two types of missing values: NA and NR

The HEDIS guidelines distinguish between two different types of missing values in the rate field: Not Applicable (NA) 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.)

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 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 enrollees age 20 through 44, 45 through 64 and 65 years and older who had an ambulatory or preventive-care visit. Nine separate rates are calculated, one for each of the three product lines for each of the three age groups. MCOs report the percentage of:

- Medicaid and Medicare enrollees who were continuously enrolled during the measurement year and who had an ambulatory or preventive-care visit during the measurement year

- Commercial enrollees who were continuously enrolled during the measurement year and the two years prior to the measurement year and who had an ambulatory or preventive-care visit during the measurement year or the two years prior to the measurement year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 150)

##### REPORTING LEVEL - Contract Market

AOC201-0010 Rate (Ages 20-44)

AOC201-0020 Rate (Ages 45-64)

AOC201-0030 Rate (Ages 65 and older)

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 Combined Total

AOC201-0100 Lower Confidence Interval - All

AOC201-0110 Upper Confidence Interval - All

#### AOC220 – Call Abandonment

DESCRIPTION - The percentage of calls received by the MCO member services call centers (during member services operating hours) during the measurement year that were abandoned by the caller before being answered by a live voice. (HEDIS 2004, Volume 2: Technical Specification, Pg. 178)

##### REPORTING LEVEL - Contract Market

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 MCO member services call centers (during member services operating hours) during the measurement year that were answered by a live voice within 30 seconds. (HEDIS 2004, Volume 2: Technical Specification, Pg. 175)

##### REPORTING LEVEL - Contract Market

AOC225-0010 Reported rate

AOC225-0020 Lower Confidence Interval

AOC225-0030 Upper Confidence Interval

#### AOC230 – Claims Timeliness

DESCRIPTION - The percentage of all claims received by the MCO or its claims processing centers, from January 1–December 1 of the measurement year, that were paid or denied within 30 calendar days of receipt. (HEDIS 2004, Volume 2: Technical Specification, Pg. 172)

##### REPORTING LEVEL - Contract Market

AOC230-0010 Reported rate

AOC230-0020 Lower Confidence Interval

AOC230-0030 Upper Confidence Interval

### Measure Measure Name/Measure Description/Field Name/Field Description

#### AOC235 – Initiation and Engagement of Alcohol and Other Drug Dependence Treatmen

DESCRIPTION - The components of this measure assess the degree to which plans initiate and engage members identified with a need for alcohol and other drug (AOD) dependence services.

Initiation of Alcohol and Other Drug Dependence Treatment: The percentage of adults diagnosed with AOD dependence who initiate treatment through one of the following:

-an inpatient AOD admission, or

-an outpatient service for AOD abuse or dependence and any additional AOD services within 14 days.

Treatment engagement is an intermediate step between initially accessing care (in the first visit) and completing a full course of treatment. This measure is designed to assess the degree to which members engage in treatment with two additional AOD treatments within 30 days after initiating treatment. (HEDIS 2004, Volume 2: Technical Specification, Pg. 167)

##### REPORTING LEVEL - Contract Market

AOC235-0010 Rate - Engagement

AOC235-0020 Lower Confidence Interval - Engagement

AOC235-0030 Upper Confidence Interval - Engagement

#### EOC003 – Breast Cancer Screening

DESCRIPTION - The percentage of women age 50 through 69 years, who were continuously enrolled during the measurement year and the year prior to the measurement year, and who had a mammogram during the measurement year or year prior to the measurement year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 91)

##### REPORTING LEVEL - Contract Market

EOC003-0010 Rate

EOC003-0020 Lower 95% confidence interval

EOC003-0030 Upper 95% confidence interval

#### EOC008 – Beta Blocker Treatment

DESCRIPTION - The percentage of enrolled members age 35 years and older during the measurement year, who were hospitalized and discharged alive from January 1 through December 24 of the measurement year with a diagnosis of acute myocardial infarction (AMI) and who received an ambulatory prescription for beta blockers upon discharge. The intent of this measure is to assess whether appropriate follow-up care has been rendered to members who suffer a heart attack. (HEDIS 2004, Volume 2: Technical Specification, Pg. 108)

##### REPORTING LEVEL - Contract Market

EOC008-0010 Rate

EOC008-0020 Lower 95% confidence interval

EOC008-0030 Upper 95% confidence interval

#### EOC010 – Followup after Hospitalization for Mental Illness

DESCRIPTION - The percentage of members age six years and older who were hospitalized for treatment of selected mental health disorders who were continuously enrolled for 30 days after discharge (without gaps) and who were seen on an ambulatory basis or were in day/night treatment with a mental health provider. This specification uses either hospital inpatient discharge summaries or the UB-92 to identify those members who have been discharged with a selected mental health diagnosis and uses encounter data (CMS 1500, UB-92, or equivalent) to identify those who have received appropriate follow-up care. Six separate calculations are required—one for each of the three product lines for both of the following:

- the percentage of discharges for members who had an ambulatory or day/night mental health visit within 30 days of hospital discharge

- the percentage of discharges for members who had an ambulatory or day/night mental health visit within 7 days of hospital discharge. (HEDIS 2004, Volume 2: Technical Specification, Pg. 130)

##### REPORTING LEVEL - Contract Market

EOC010-0011 Rate within 7days

EOC010-0012 Rate within 30days

EOC010-0021 Lower 95% confidence interval within 7days

EOC010-0022 Lower 95% confidence interval within 30days

EOC010-0031 Upper 95% confidence interval within 7days

EOC010-0032 Upper 95% confidence interval within 30days

### Measure Measure Name/Measure Description/Field Name/Field Description

#### EOC020 – Comprehensive Diabetes Care

DESCRIPTION - The percentage of members 18-75 years with diabetes (Type 1 and Type 2) who were continuously enrolled during the measurement year and who had each of the following:

- Hemoglobin A1c (HbA1c) tested

- HbA1c poorly controlled (greater than 9.5%)

- LDL-C screening performed

- LDL-C controlled (LDL less than 130 mg/dL)

- eye exam (retinal) performed

- kidney disease (nephropathy) monitored.

MCOs will report six separate rates (one for each aspect of diabetes care identified) for each product line. These measures are consistent with the Diabetes Quality Improvement Project (DQIP) set of measures (excluding hypertension and foot care). (HEDIS 2004, Volume 2: Technical Specifications, Pg. 116)

##### REPORTING LEVEL - Contract Market

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 - Nephropathy Monitor

EOC020-0170 Lower Confidence Interval - Nephropathy Monitor

EOC020-0180 Upper Confidence Interval - Nephropathy Monitor

EOC020-0190 Rate <130 LDL-C Level

EOC020-0200 Lower Confidence Interval <130 LDL-C Level

EOC020-0210 Upper Confidence Interval <130 LDL-C Level

EOC020-0220 Rate <100 LDL-C Level

EOC020-0230 Lower Confidence Interval <100 LDL-C Level

EOC020-0240 Upper Confidence Interval <100 LDL-C Level

#### EOC025 – Cholesterol Management After Acute Cardiovascular Events

DESCRIPTION - The percentage of members age 18 - 75 years old as of December 31 of the measurement year, who were discharged alive in the year prior to the measurement year for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) and had evidence of LDL-C screening and an LDL-C less than 130mg/dL. (HEDIS 2004, Volume 2: Techincal Specifications, Pg. 112)

##### REPORTING LEVEL - Contract Market

EOC025-0010 Rate - LDL-C Screening

EOC025-0020 Lower Confidence Interval - LDL-C Screening

EOC025-0030 Upper Confidence Interval - LDL-C Screening

EOC025-0070 Rate <130 LDL-C Level

EOC025-0080 Lower Confidence Interval <130 LDL-C Level

EOC025-0090 Upper Confidence Interval <130 LDL-C Level

EOC025-0100 Rate <100 LDL-C Level

EOC025-0110 Lower Confidence Interval <100 LDL-C Level

EOC025-0120 Upper Confidence Interval <100 LDL-C Level

### Measure Measure Name/Measure Description/Field Name/Field Description

#### EOC030 – Antidepressant Medication Management

DESCRIPTION - The following components of this measure assess different facets of the successful pharmacological management of depression:

1. Optimal Practitioner Contacts for Medication Management. The percentage of members 18 years and older as of the 120th day of the measurement year who were diagnosed with a new episode of depression and treated with antidepressant medication and had at least three follow-up contacts with a primary care practitioner or mental health practitioner coded with a mental health diagnosis during the 84-day (12-week) Acute Treatment Phase. At least one of the three follow-up contacts must be with a prescribing practitioner (e.g., licensed physician, physician assistant of other practitioner with prescribing privileges). This process measure assesses the adequacy of clinical management of new treatment episodes for adult members with a major depressive disorder.

2. Effective Acute Phase Treatment. The percentage of members 18 years and older as of the 120th day of the measurement year who were diagnosed with a new episode of depression and treated with antidepressant medication and remained on an antidepressant drug during the entire 84-day (12-week) Acute Treatment Phase. This intermediate outcome measure assesses the percentage of adult members initiated on an antidepressant drug who received a continuous trial of medication treatment during the Acute Treatment Phase.

3. Effective Continuation Phase Treatment. The percentage of members 18 years and older as of the 120th day of the measurement year who were diagnosed with a new episode of depression and treated with antidepressant medication and remained on an antidepressant drug for at least 180 days (6 months). This intermediate-outcome measure assesses the effectiveness of clinical management in achieving medication compliance and the likely effectiveness of the established dosage regimen by determining if adult members completed a period of Continuation Phase Treatment adequate for defining a recovery according to Agency for Healthcare Research and Quality (AHRQ, formerly known as AHCPR) Depression in Primary Care.

(HEDIS 2004, Volume 2: Technical Specifications, Pg. 133)

##### REPORTING LEVEL - Contract Market

EOC030-0010 Rate - Effective Continuation Phase Treatment

EOC030-0020 Lower Confidence Interval - Effective Continuation Phase Treatment

EOC030-0030 Upper Confidence Interval - Effective Continuation Phase Treatment

EOC030-0040 Rate - Effective Acute Phase Treatment

EOC030-0050 Lower Confidence Interval - Effective Acute Phase Treatment

EOC030-0060 Upper Confidence Interval - Effective Acute Phase Treatment

EOC030-0070 Rate-Practitioner Contacts for Medication Management

EOC030-0080 Lower Confidence Interval - Practitioner Contacts for Medication Management

EOC030-0090 Upper Confidence Interval - Practitioner Contacts for Medication Management

#### EOC035 – Controlling High Blood Pressure

DESCRIPTION -This intermediate outcome measure assesses whether blood pressure (BP) was controlled among adult persons with diagnosed hypertension (HTN). This measure can be calculated only by using the hybrid method. This specification uses membership data and ambulatory claims/encounter data to identify members with a diagnosis of hypertension age 46 to 85 years old and medical record review to confirm the HTN diagnosis and assess BP control during the measurement year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 103)

##### REPORTING LEVEL - Contract Market

EOC035-0010 Rate - Effective Control of Hypertension

EOC035-0020 Lower Confidence Interval - Effective Control of Hypertension

EOC035-0030 Upper Confidence Interval - Effective Control of Hypertension

#### EOC040 – Colorectal Cancer Screening

DESCRIPTION -The percentage of adults 50–80 years of age who had appropriate screening for colorectal cancer (CRC). The hybrid method is recommended to calculate this measure. (HEDIS 2004, Volume 2: Technical Specification, Pg. 88)

##### REPORTING LEVEL - Contract Market

EOC040-0010 Rate

EOC040-0020 Lower Confidence Interval

EOC040-0030 Upper Confidence Interval

### Measure Measure Name/Measure Description/Field Name/Field Description

#### 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 6 months after date of the fracture. Because women who suffer a fracture are at an increased risk of additional fractures and are more likely to have osteoporosis, this measure assesses how well plans manage women at high risk for a second fracture. (HEDIS 2004, Volume 2: Technical Specification, Pg. 100)

##### REPORTING LEVEL - Contract Market

EOC045-0010 Reported rate

EOC045-0020 Lower Confidence Interval

EOC045-0030 Upper Confidence Interval

#### General – General Information

DESCRIPTION - General MCO Information. These fields are not explicitly identified in the HEDIS Technical Specifications.

##### REPORTING LEVEL - N/A

General-0010 Type of Plan (Risk, Cost)

General-0011 Type of Plan (Post Balanced Buget Amendment Naming)

General-0012 M+C Plan Type (Yes or No)

General-0013 Coordinated Care Plan Type (Yes or No)

General-0020 Line of Business (HMO, POS)

General-0030 Model Type (Group, IPA, Mixed, Network, Other, Staff)

General-0050 2000 Enrollment as Reported by HCFA's Plan Information Control System (PICS)

General-0060 HCFA Region Number

General-0070 HCFA Region Name

General-0080 Patient Population

#### HPS402 – Practitioner Turnover

DESCRIPTION - MCOs use their provider databases to report the following two percentages for each product line:

- The percentage of primary care physicians affiliated with the MCO as of December 31 of the year preceding the measurement year who were not affiliated with the MCO as of December 31 of the measurement year.

- The percentage of non-physician primary care practitioners affiliated with the MCO as of December 31 of the year preceding the measurement year who were not affiliated with the MCO as of December 31 of the measurement year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 189)

##### REPORTING LEVEL - Contract Market

HPS402-0010 Provider Turnover- Primary Care Physicians

HPS402-0020 Provider Turnover- Non-Physicians Primary Care Providers

#### HPS403 – Years In Business/Total Membership

DESCRIPTION - This table reports the number of years since licensure (i.e., the number of years each product line has existed) and the number of members enrolled as of December 31 of the measurement year. The number of years of operation should be considered when evaluating an MCO’s financial profile. For example, a new MCO may have a greater level of debt than a more mature MCO and financial profiles may vary according to MCO type (e.g., staff model HMO, POS, IPA). (e.g., staff model HMO, POS, IPA). (HEDIS 2004, Volume 2: Technical Specification, Pg. 194)

##### REPORTING LEVEL - Contract Market

HPS403-0010 HMO Total (Years In Business)

HPS403-0020 HMO Medicaid (Years In Business)

HPS403-0030 HMO Commercial (Years In Business)

HPS403-0040 HMO Medicare Risk (Years In Business)

HPS403-0060 HMO Self-insured (Years In Business)

HPS403-0070 HMO Other (Years In Business)

HPS403-0080 PPO Total (Years In Business)

HPS403-0090 PPO Commercial (Years In Business)

HPS403-0100 PPO Medicare Risk (Years In Business)

HPS403-0120 PPO Self-insured (Years In Business)

HPS403-0130 PPO Other (Years In Business)

HPS403-0140 POS Total (Years In Business)

HPS403-0150 POS Commercial (Years In Business)

HPS403-0160 POS Medicare Risk (Years In Business)

### Measure Measure Name/Measure Description/Field Name/Field Description

HPS403-0180 POS Self-insured (Years In Business)

HPS403-0190 POS Other (Years In Business)

HPS403-0210 HMO Total (Members)

HPS403-0220 HMO Medicaid (Members)

HPS403-0230 HMO Commercial (Members)

HPS403-0240 HMO Medicare Risk (Members)

HPS403-0260 HMO Self-insured (Members)

HPS403-0270 HMO Other (Members)

HPS403-0280 PPO Total (Members)

HPS403-0290 PPO Commercial (Members)

HPS403-0300 PPO Medicare Risk (Members)

HPS403-0320 PPO Self-insured (Members)

HPS403-0330 PPO Other (Members)

HPS403-0340 POS Total (Members)

HPS403-0350 POS Commercial (Members)

HPS403-0360 POS Medicare Risk (Members)

HPS403-0380 POS Self-insured (Members)

HPS403-0390 POS Other (Members)

HPS403-0400 Total Product Lines/Payers (Members)

#### PDI801 – Board Certification/Residency Completion

DESCRIPTION - This measure reports the percentage of the following physicians who are board certified:

-primary care physicians

-OB/GYN physicians

-pediatric physicians specialists

-geriatricians

-all other physicians specialists.

Board certification refers to the various specialty certification programs of the American Board of Medical Specialties and the American Osteopathic Association. The MCO should report separately for each product as of December 31 of the measurement year. This measure does not capture chiropractors, podiatrists or other practitioners who are certified by other programs. (HEDIS 2004, Volume 2: Technical Specification, Pg. 289)

##### REPORTING LEVEL - Contract Market

PDI801-0010 Board Certification - Primary Care Physicians (Percentage)

PDI801-0030 Board Certification - Physician Specialists (Percentage)

PDI801-0050 Board Certification - Geriatricians (Percentage)

#### PDI805 – Total Enrollment by Percentage

DESCRIPTION - This measure is intended to provide an overview of the mix of MCO membership. MCOs report the percentage of total member months contributed by each product by age and sex during the measurement year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 294)

##### REPORTING LEVEL - Contract

PDI805-0010 Percent of Plan's Total Member Months (Male - Commercial - Age < 1)

PDI805-0020 Percent of Plan's Total Member Months (Male - Medicaid - Age < 1)

PDI805-0030 Percent of Plan's Total Member Months (Male - Medicare - Age < 1)

PDI805-0040 Percent of Plan's Total Member Months (Male - Other - Age < 1)

PDI805-0050 Percent of Plan's Total Member Months (Male - Commercial - Age 1-4)

PDI805-0060 Percent of Plan's Total Member Months (Male - Medicaid - Age 1-4)

PDI805-0070 Percent of Plan's Total Member Months (Male - Medicare - Age 1-4)

PDI805-0080 Percent of Plan's Total Member Months (Male - Other - Age 1-4)

PDI805-0090 Percent of Plan's Total Member Months (Male - Commercial - Age 5-9)

PDI805-0100 Percent of Plan's Total Member Months (Male - Medicaid - Age 5-9)

PDI805-0110 Percent of Plan's Total Member Months (Male - Medicare - Age 5-9)

PDI805-0120 Percent of Plan's Total Member Months (Male - Other - Age 5-9)

PDI805-0130 Percent of Plan's Total Member Months (Male - Commercial - Age 10-14)

PDI805-0140 Percent of Plan's Total Member Months (Male - Medicaid - Age 10-14)

PDI805-0150 Percent of Plan's Total Member Months (Male - Medicare - Age 10-14)

### Measure Measure Name/Measure Description/Field Name/Field Description

PDI805-0160 Percent of Plan's Total Member Months (Male - Other - Age 10-14)

PDI805-0170 Percent of Plan's Total Member Months (Male - Commercial - Age 15-17)

PDI805-0180 Percent of Plan's Total Member Months (Male - Medicaid - Age 15-17)

PDI805-0190 Percent of Plan's Total Member Months (Male - Medicare - Age 15-17)

PDI805-0200 Percent of Plan's Total Member Months (Male - Other - Age 15-17)

PDI805-0210 Percent of Plan's Total Member Months (Male - Commercial - Age 18-19)

PDI805-0220 Percent of Plan's Total Member Months (Male - Medicaid - Age 18-19)

PDI805-0230 Percent of Plan's Total Member Months (Male - Medicare - Age 18-19)

PDI805-0240 Percent of Plan's Total Member Months (Male - Other - Age 18-19)

PDI805-0250 Percent of Plan's Total Member Months (Male - Commercial - Subtotal: Age 0-19)

PDI805-0260 Percent of Plan's Total Member Months (Male - Medicaid - Subtotal: Age 0-19)

PDI805-0270 Percent of Plan's Total Member Months (Male - Medicare - Age 0-19)

PDI805-0280 Percent of Plan's Total Member Months (Male - Other - Age 0-19)

PDI805-0290 Percent of Plan's Total Member Months (Male - Commercial - Age 20-24)

PDI805-0300 Percent of Plan's Total Member Months (Male - Medicaid - Age 20-24)

PDI805-0310 Percent of Plan's Total Member Months (Male - Medicare - Age 20-24)

PDI805-0320 Percent of Plan's Total Member Months (Male - Other - Age 20-24)

PDI805-0330 Percent of Plan's Total Member Months (Male - Commercial - Age 25-29)

PDI805-0340 Percent of Plan's Total Member Months (Male - Medicaid - Age 25-29)

PDI805-0350 Percent of Plan's Total Member Months (Male - Medicare - Age 25-29)

PDI805-0360 Percent of Plan's Total Member Months (Male - Other - Age 25-29)

PDI805-0370 Percent of Plan's Total Member Months (Male - Commercial - Age 30-34)

PDI805-0380 Percent of Plan's Total Member Months (Male - Medicaid - Age 30-34)

PDI805-0390 Percent of Plan's Total Member Months (Male - Medicare - Age 30-34)

PDI805-0400 Percent of Plan's Total Member Months (Male - Other - Age 30-34)

PDI805-0410 Percent of Plan's Total Member Months (Male - Commercial - Age 35-39)

PDI805-0420 Percent of Plan's Total Member Months (Male - Medicaid - Age 35-39)

PDI805-0430 Percent of Plan's Total Member Months (Male - Medicare - Age 35-39)

PDI805-0440 Percent of Plan's Total Member Months (Male - Other - Age 35-39)

PDI805-0450 Percent of Plan's Total Member Months (Male - Commercial - Age 40-44)

PDI805-0460 Percent of Plan's Total Member Months (Male - Medicaid - Age 40-44)

PDI805-0470 Percent of Plan's Total Member Months (Male - Medicare - Age 40-44)

PDI805-0480 Percent of Plan's Total Member Months (Male - Other - Age 40-44)

PDI805-0490 Percent of Plan's Total Member Months (Male - Commercial - Subtotal: Age 20-44)

PDI805-0500 Percent of Plan's Total Member Months (Male - Medicaid - Subtotal: Age 20-44)

PDI805-0510 Percent of Plan's Total Member Months (Male - Medicare - Age 20-44)

PDI805-0520 Percent of Plan's Total Member Months (Male - Other - Age 20-44)

PDI805-0530 Percent of Plan's Total Member Months (Male - Commercial - Age 45-49)

PDI805-0540 Percent of Plan's Total Member Months (Male - Medicaid - Age 45-49)

PDI805-0550 Percent of Plan's Total Member Months (Male - Medicare - Age 45-49)

PDI805-0560 Percent of Plan's Total Member Months (Male - Other - Age 45-49)

PDI805-0570 Percent of Plan's Total Member Months (Male - Commercial - Age 50-54)

PDI805-0580 Percent of Plan's Total Member Months (Male - Medicaid - Age 50-54)

PDI805-0590 Percent of Plan's Total Member Months (Male - Medicare - Age 50-54)

PDI805-0600 Percent of Plan's Total Member Months (Male - Other - Age 50-54)

PDI805-0610 Percent of Plan's Total Member Months (Male - Commercial - Age 55-59)

PDI805-0620 Percent of Plan's Total Member Months (Male - Medicaid - Age 55-59)

PDI805-0630 Percent of Plan's Total Member Months (Male - Medicare - Age 55-59)

PDI805-0640 Percent of Plan's Total Member Months (Male - Other - Age 55-59)

PDI805-0650 Percent of Plan's Total Member Months (Male - Commercial - Age 60-64)

PDI805-0660 Percent of Plan's Total Member Months (Male - Medicaid - Age 60-64)

PDI805-0670 Percent of Plan's Total Member Months (Male - Medicare - Age 60-64)

PDI805-0680 Percent of Plan's Total Member Months (Male - Other - Age 60-64)

PDI805-0690 Percent of Plan's Total Member Months (Male - Commercial - Subtotal: Age 45-64)

PDI805-0700 Percent of Plan's Total Member Months (Male - Medicaid - Subtotal: Age 45-64)

PDI805-0710 Percent of Plan's Total Member Months (Male - Medicare - Age 45-64)

### Measure Measure Name/Measure Description/Field Name/Field Description

PDI805-0720 Percent of Plan's Total Member Months (Male - Other - Age 45-64)

PDI805-0730 Percent of Plan's Total Member Months (Male - Commercial - Age 65-69)

PDI805-0740 Percent of Plan's Total Member Months (Male - Medicaid - Age 65-69)

PDI805-0750 Percent of Plan's Total Member Months (Male - Medicare - Age 65-69)

PDI805-0760 Percent of Plan's Total Member Months (Male - Other - Age 65-69)

PDI805-0770 Percent of Plan's Total Member Months (Male - Commercial - Age 70-74)

PDI805-0780 Percent of Plan's Total Member Months (Male - Medicaid - Age 70-74)

PDI805-0790 Percent of Plan's Total Member Months (Male - Medicare - Age 70-74)

PDI805-0800 Percent of Plan's Total Member Months (Male - Other - Age 70-74)

PDI805-0810 Percent of Plan's Total Member Months (Male - Commercial - Age 75-79)

PDI805-0820 Percent of Plan's Total Member Months (Male - Medicaid - Age 75-79)

PDI805-0830 Percent of Plan's Total Member Months (Male - Medicare - Age 75-79)

PDI805-0840 Percent of Plan's Total Member Months (Male - Other - Age 75-79)

PDI805-0850 Percent of Plan's Total Member Months (Male - Commercial - Age 80-84)

PDI805-0860 Percent of Plan's Total Member Months (Male - Medicaid - Age 80-84)

PDI805-0870 Percent of Plan's Total Member Months (Male - Medicare - Age 80-84)

PDI805-0880 Percent of Plan's Total Member Months (Male - Other - Age 80-84)

PDI805-0890 Percent of Plan's Total Member Months (Male - Commercial - Age 85-89)

PDI805-0900 Percent of Plan's Total Member Months (Male - Medicaid - Age 85-89)

PDI805-0910 Percent of Plan's Total Member Months (Male - Medicare - Age 85-89)

PDI805-0920 Percent of Plan's Total Member Months (Male - Other - Age 85-89)

PDI805-0930 Percent of Plan's Total Member Months (Male - Commercial - Age >=90)

PDI805-0940 Percent of Plan's Total Member Months (Male - Medicaid - Age >=90)

PDI805-0950 Percent of Plan's Total Member Months (Male - Medicare - Age >=90)

PDI805-0960 Percent of Plan's Total Member Months (Male - Other - Age >=90)

PDI805-0970 Percent of Plan's Total Member Months (Male - Commercial - Subtotal: Age >=65)

PDI805-0980 Percent of Plan's Total Member Months (Male - Medicaid - Subtotal: Age >=65)

PDI805-0990 Percent of Plan's Total Member Months (Male - Medicare - Age >=65)

PDI805-1000 Percent of Plan's Total Member Months (Male - Other - Age >=65)

PDI805-1010 Percent of Plan's Total Member Months (Female - Commercial - Age < 1)

PDI805-1020 Percent of Plan's Total Member Months (Female - Medicaid - Age < 1)

PDI805-1030 Percent of Plan's Total Member Months (Female - Medicare - Age < 1)

PDI805-1040 Percent of Plan's Total Member Months (Female - Other - Age < 1)

PDI805-1050 Percent of Plan's Total Member Months (Female - Commercial - Age 1-4)

PDI805-1060 Percent of Plan's Total Member Months (Female - Medicaid - Age 1-4)

PDI805-1070 Percent of Plan's Total Member Months (Female - Medicare - Age 1-4)

PDI805-1080 Percent of Plan's Total Member Months (Female - Other - Age 1-4)

PDI805-1090 Percent of Plan's Total Member Months (Female - Commercial - Age 5-9)

PDI805-1100 Percent of Plan's Total Member Months (Female - Medicaid - Age 5-9)

PDI805-1110 Percent of Plan's Total Member Months (Female - Medicare - Age 5-9)

PDI805-1120 Percent of Plan's Total Member Months (Female - Other - Age 5-9)

PDI805-1130 Percent of Plan's Total Member Months (Female - Commercial - Age 10-14)

PDI805-1140 Percent of Plan's Total Member Months (Female - Medicaid - Age 10-14)

PDI805-1150 Percent of Plan's Total Member Months (Female - Medicare - Age 10-14)

PDI805-1160 Percent of Plan's Total Member Months (Female - Other - Age 10-14)

PDI805-1170 Percent of Plan's Total Member Months (Female - Commercial - Age 15-17)

PDI805-1180 Percent of Plan's Total Member Months (Female - Medicaid - Age 15-17)

PDI805-1190 Percent of Plan's Total Member Months (Female - Medicare - Age 15-17)

PDI805-1200 Percent of Plan's Total Member Months (Female - Other - Age 15-17)

PDI805-1210 Percent of Plan's Total Member Months (Female - Commercial - Age 18-19)

PDI805-1220 Percent of Plan's Total Member Months (Female - Medicaid - Age 18-19)

PDI805-1230 Percent of Plan's Total Member Months (Female - Medicare - Age 18-19)

PDI805-1240 Percent of Plan's Total Member Months (Female - Other - Age 18-19)

PDI805-1250 Percent of Plan's Total Member Months (Female - Commercial - Subtotal: Age 0-19)

PDI805-1260 Percent of Plan's Total Member Months (Female - Medicaid - Subtotal: Age 0-19)

PDI805-1270 Percent of Plan's Total Member Months (Female - Medicare - Age 0-19)

### Measure Measure Name/Measure Description/Field Name/Field Description

PDI805-1280 Percent of Plan's Total Member Months (Female - Other - Age 0-19)

PDI805-1290 Percent of Plan's Total Member Months (Female - Commercial - Age 20-24)

PDI805-1300 Percent of Plan's Total Member Months (Female - Medicaid - Age 20-24)

PDI805-1310 Percent of Plan's Total Member Months (Female - Medicare - Age 20-24)

PDI805-1320 Percent of Plan's Total Member Months (Female - Other - Age 20-24)

PDI805-1330 Percent of Plan's Total Member Months (Female - Commercial - Age 25-29)

PDI805-1340 Percent of Plan's Total Member Months (Female - Medicaid - Age 25-29)

PDI805-1350 Percent of Plan's Total Member Months (Female - Medicare - Age 25-29)

PDI805-1360 Percent of Plan's Total Member Months (Female - Other - Age 25-29)

PDI805-1370 Percent of Plan's Total Member Months (Female - Commercial - Age 30-34)

PDI805-1380 Percent of Plan's Total Member Months (Female - Medicaid - Age 30-34)

PDI805-1390 Percent of Plan's Total Member Months (Female - Medicare - Age 30-34)

PDI805-1400 Percent of Plan's Total Member Months (Female - Other - Age 30-34)

PDI805-1410 Percent of Plan's Total Member Months (Female - Commercial - Age 35-39)

PDI805-1420 Percent of Plan's Total Member Months (Female - Medicaid - Age 35-39)

PDI805-1430 Percent of Plan's Total Member Months (Female - Medicare - Age 35-39)

PDI805-1440 Percent of Plan's Total Member Months (Female - Other - Age 35-39)

PDI805-1450 Percent of Plan's Total Member Months (Female - Commercial - Age 40-44)

PDI805-1460 Percent of Plan's Total Member Months (Female - Medicaid - Age 40-44)

PDI805-1470 Percent of Plan's Total Member Months (Female - Medicare - Age 40-44)

PDI805-1480 Percent of Plan's Total Member Months (Female - Other - Age 40-44)

PDI805-1490 Percent of Plan's Total Member Months (Female - Commercial - Subtotal: Age 20-44)

PDI805-1500 Percent of Plan's Total Member Months (Female - Medicaid - Subtotal: Age 20-44)

PDI805-1510 Percent of Plan's Total Member Months (Female - Medicare - Age 20-44)

PDI805-1520 Percent of Plan's Total Member Months (Female - Other - Age 20-44)

PDI805-1530 Percent of Plan's Total Member Months (Female - Commercial - Age 45-49)

PDI805-1540 Percent of Plan's Total Member Months (Female - Medicaid - Age 45-49)

PDI805-1550 Percent of Plan's Total Member Months (Female - Medicare - Age 45-49)

PDI805-1560 Percent of Plan's Total Member Months (Female - Other - Age 45-49)

PDI805-1570 Percent of Plan's Total Member Months (Female - Commercial - Age 50-54)

PDI805-1580 Percent of Plan's Total Member Months (Female - Medicaid - Age 50-54)

PDI805-1590 Percent of Plan's Total Member Months (Female - Medicare - Age 50-54)

PDI805-1600 Percent of Plan's Total Member Months (Female - Other - Age 50-54)

PDI805-1610 Percent of Plan's Total Member Months (Female - Commercial - Age 55-59)

PDI805-1620 Percent of Plan's Total Member Months (Female - Medicaid - Age 55-59)

PDI805-1630 Percent of Plan's Total Member Months (Female - Medicare - Age 55-59)

PDI805-1640 Percent of Plan's Total Member Months (Female - Other - Age 55-59)

PDI805-1650 Percent of Plan's Total Member Months (Female - Commercial - Age 60-64)

PDI805-1660 Percent of Plan's Total Member Months (Female - Medicaid - Age 60-64)

PDI805-1670 Percent of Plan's Total Member Months (Female - Medicare - Age 60-64)

PDI805-1680 Percent of Plan's Total Member Months (Female - Other - Age 60-64)

PDI805-1690 Percent of Plan's Total Member Months (Female - Commercial - Subtotal: Age 45-64)

PDI805-1700 Percent of Plan's Total Member Months (Female - Medicaid - Subtotal: Age 45-64)

PDI805-1710 Percent of Plan's Total Member Months (Female - Medicare - Age 45-64)

PDI805-1720 Percent of Plan's Total Member Months (Female - Other - Age 45-64)

PDI805-1730 Percent of Plan's Total Member Months (Female - Commercial - Age 65-69)

PDI805-1740 Percent of Plan's Total Member Months (Female - Medicaid - Age 65-69)

PDI805-1750 Percent of Plan's Total Member Months (Female - Medicare - Age 65-69)

PDI805-1760 Percent of Plan's Total Member Months (Female - Other - Age 65-69)

PDI805-1770 Percent of Plan's Total Member Months (Female - Commercial - Age 70-74)

PDI805-1780 Percent of Plan's Total Member Months (Female - Medicaid - Age 70-74)

PDI805-1790 Percent of Plan's Total Member Months (Female - Medicare - Age 70-74)

PDI805-1800 Percent of Plan's Total Member Months (Female - Other - Age 70-74)

PDI805-1810 Percent of Plan's Total Member Months (Female - Commercial - Age 75-79)

PDI805-1820 Percent of Plan's Total Member Months (Female - Medicaid - Age 75-79)

PDI805-1830 Percent of Plan's Total Member Months (Female - Medicare - Age 75-79)

### Measure Measure Name/Measure Description/Field Name/Field Description

PDI805-1840 Percent of Plan's Total Member Months (Female - Other - Age 75-79)

PDI805-1850 Percent of Plan's Total Member Months (Female - Commercial - Age 80-84)

PDI805-1860 Percent of Plan's Total Member Months (Female - Medicaid - Age 80-84)

PDI805-1870 Percent of Plan's Total Member Months (Female - Medicare - Age 80-84)

PDI805-1880 Percent of Plan's Total Member Months (Female - Other - Age 80-84)

PDI805-1890 Percent of Plan's Total Member Months (Female - Commercial - Age 85-89)

PDI805-1900 Percent of Plan's Total Member Months (Female - Medicaid - Age 85-89)

PDI805-1910 Percent of Plan's Total Member Months (Female - Medicare - Age 85-89)

PDI805-1920 Percent of Plan's Total Member Months (Female - Other - Age 85-89)

PDI805-1930 Percent of Plan's Total Member Months (Female - Commercial - Age >=90)

PDI805-1940 Percent of Plan's Total Member Months (Female - Medicaid - Age >=90)

PDI805-1950 Percent of Plan's Total Member Months (Female - Medicare - Age >=90)

PDI805-1960 Percent of Plan's Total Member Months (Female - Other - Age >=90)

PDI805-1970 Percent of Plan's Total Member Months (Female - Commercial - Subtotal: Age >=65)

PDI805-1980 Percent of Plan's Total Member Months (Female - Medicaid - Subtotal: Age >=65)

PDI805-1990 Percent of Plan's Total Member Months (Female - Medicare - Age >=65)

PDI805-2000 Percent of Plan's Total Member Months (Female - Other - Age >=65)

PDI805-2010 Percent of Plan's Total Member Months (Total - Commercial - Subtotal: Age 0-19)

PDI805-2020 Percent of Plan's Total Member Months (Total - Medicaid - Subtotal: Age 0-19)

PDI805-2030 Percent of Plan's Total Member Months (Total - Medicare - Subtotal: Age 0-19)

PDI805-2040 Percent of Plan's Total Member Months (Total - Other - Subtotal: Age 0-19)

PDI805-2050 Percent of Plan's Total Member Months (Total - Commercial - Subtotal: Age 20-44)

PDI805-2060 Percent of Plan's Total Member Months (Total - Medicaid - Subtotal: Age 20-44)

PDI805-2070 Percent of Plan's Total Member Months (Total - Medicare - Subtotal: Age 20-44)

PDI805-2080 Percent of Plan's Total Member Months (Total - Other - Subtotal: Age 20-44)

PDI805-2090 Percent of Plan's Total Member Months (Total - Commercial - Subtotal: Age 45-64)

PDI805-2100 Percent of Plan's Total Member Months (Total - Medicaid - Subtotal: Age 45-64)

PDI805-2110 Percent of Plan's Total Member Months (Total - Medicare - Subtotal: Age 45-64)

PDI805-2120 Percent of Plan's Total Member Months (Total - Other - Subtotal: Age 45-64)

PDI805-2130 Percent of Plan's Total Member Months (Total - Commercial - Subtotal: Age >=65)

PDI805-2140 Percent of Plan's Total Member Months (Total - Medicaid - Subtotal: Age >=65)

PDI805-2150 Percent of Plan's Total Member Months (Total - Medicare - Subtotal: Age >=65)

PDI805-2160 Percent of Plan's Total Member Months (Total - Other - Subtotal: Age >=65)

PDI805-2170 Percent of Plan's Total Member Months (Total - Commercial - Subtotal: Age Unknown)

PDI805-2180 Percent of Plan's Total Member Months (Total - Medicaid - Subtotal: Age Unknown)

PDI805-2190 Percent of Plan's Total Member Months (Total - Medicare - Subtotal: Age Unknown)

PDI805-2200 Percent of Plan's Total Member Months (Total - Other - Subtotal: Age Unknown)

PDI805-2210 Percent of Plan's Total Member Months (Total - Commercial)

PDI805-2220 Percent of Plan's Total Member Months (Total - Medicaid)

PDI805-2230 Percent of Plan's Total Member Months (Total - Medicare)

PDI805-2240 Percent of Plan's Total Member Months (Total - Other)

#### PDI806 – Enrollment by Product Line

DESCRIPTION - This measure reports the total number of members enrolled for each product line stratified by age and sex.

- Medicaid is reported in the member months contributed by enrollees during the measurement year, it is stratified by Medicaid eligibility category, age and sex. MCOs can report this information only if it is provided by their state Medicaid agencies.

- Commercial and Medicare are reported in the number of member years contributed by enrollees during the measurement year, stratified by product line, age and sex. (HEDIS 2004, Volume 2: Technical Specification, Pg. 298)

##### REPORTING LEVEL - Contract

PDI806-0010 Member Years of Enrollment: Medicare Risk (Male)

PDI806-0020 Member Years of Enrollment: Medicare Risk (Female)

PDI806-0030 Member Years of Enrollment: Medicare Risk (Total)

### Measure Measure Name/Measure Description/Field Name/Field Description

#### 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 provides a summary of the number and rate of several frequently performed procedures. These procedures often show wide regional variation and have generated concern regarding potentially inappropriate utilization. For Medicaid members, MCOs report the absolute number of procedures and the number of procedures per 1,000 member months. For commercial and Medicare members, MCOs report the absolute number of procedures and the number of procedures per 1,000 members per year. (HEDIS 2004, Volume 2: Technical Specification, Pg. 220)

##### REPORTING LEVEL - Contract Market

UOS505-0010 CABG <65 (Male)

UOS505-0020 CABG 65-74 (Male)

UOS505-0030 CABG 75-84 (Male)

UOS505-0040 CABG 85+ (Male)

UOS505-0050 Angioplasty(PTCA) <65 (Male)

UOS505-0060 Angioplasty(PTCA) 65-74 (Male)

UOS505-0070 Angioplasty(PTCA) 75-84 (Male)

UOS505-0080 Angioplasty(PTCA) 85+ (Male)

UOS505-0090 Carotid Endarterectomy <65 (Male)

UOS505-0100 Carotid Endarterectomy 65-74 (Male)

UOS505-0110 Carotid Endarterectomy 75-84 (Male)

UOS505-0120 Carotid Endarterectomy 85+ (Male)

UOS505-0130 Reduction of Fracture of Femur <65 (Male)

UOS505-0140 Reduction of Fracture of Femur 65-74 (Male)

UOS505-0150 Reduction of Fracture of Femur 75-84 (Male)

UOS505-0160 Reduction of Fracture of Femur 85+ (Male)

UOS505-0170 Total Hip Replacement <65 (Male)

UOS505-0180 Total Hip Replacement 65-74 (Male)

UOS505-0190 Total Hip Replacement 75-84 (Male)

UOS505-0200 Total Hip Replacement 85+ (Male)

UOS505-0210 Total Knee Replacement <65 (Male)

UOS505-0220 Total Knee Replacement 65-74 (Male)

UOS505-0230 Total Knee Replacement 75-84 (Male)

UOS505-0240 Total Knee Replacement 85+ (Male)

UOS505-0250 Partial Excision of Large Intestine <65 (Male)

UOS505-0260 Partial Excision of Large Intestine 65-74 (Male)

UOS505-0270 Partial Excision of Large Intestine 75-84 (Male)

UOS505-0280 Partial Excision of Large Intestine 85+ (Male)

UOS505-0290 Cholecystectomy -open <65 (Male)

UOS505-0300 Cholecystectomy -open 65-74 (Male)

UOS505-0310 Cholecystectomy -open 75-84 (Male)

UOS505-0320 Cholecystectomy -open 85+ (Male)

UOS505-0330 Cholecystectomy -closed(laparoscopic) <65 (Male)

UOS505-0340 Cholecystectomy -closed(laparoscopic) 65-74 (Male)

UOS505-0350 Cholecystectomy -closed(laparoscopic) 75-84 (Male)

UOS505-0360 Cholecystectomy -closed(laparoscopic) 85+ (Male)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS505-0370 Prostatectomy <65 (Male)

UOS505-0380 Prostatectomy 65-74 (Male)

UOS505-0390 Prostatectomy 75-84 (Male)

UOS505-0400 Prostatectomy 85+ (Male)

UOS505-0410 CABG <65 (Female)

UOS505-0420 CABG 65-74 (Female)

UOS505-0430 CABG 75-84 (Female)

UOS505-0440 CABG 85+ (Female)

UOS505-0450 Angioplasty(PTCA) <65 (Female)

UOS505-0460 Angioplasty(PTCA) 65-74 (Female)

UOS505-0470 Angioplasty(PTCA) 75-84 (Female)

UOS505-0480 Angioplasty(PTCA) 85+ (Female)

UOS505-0490 Carotid Endarterectomy <65 (Female)

UOS505-0500 Carotid Endarterectomy 65-74 (Female)

UOS505-0510 Carotid Endarterectomy 75-84 (Female)

UOS505-0520 Carotid Endarterectomy 85+ (Female)

UOS505-0530 Reduction of Fracture of Femur <65 (Female)

UOS505-0540 Reduction of Fracture of Femur 65-74 (Female)

UOS505-0550 Reduction of Fracture of Femur 75-84 (Female)

UOS505-0560 Reduction of Fracture of Femur 85+ (Female)

UOS505-0570 Total Hip Replacement <65 (Female)

UOS505-0580 Total Hip Replacement 65-74 (Female)

UOS505-0590 Total Hip Replacement 75-84 (Female)

UOS505-0600 Total Hip Replacement 85+ (Female)

UOS505-0610 Total Knee Replacement <65 (Female)

UOS505-0620 Total Knee Replacement 65-74 (Female)

UOS505-0630 Total Knee Replacement 75-84 (Female)

UOS505-0640 Total Knee Replacement 85+ (Female)

UOS505-0650 Partial Excision of Large Intestine <65 (Female)

UOS505-0660 Partial Excision of Large Intestine 65-74 (Female)

UOS505-0670 Partial Excision of Large Intestine 75-84 (Female)

UOS505-0680 Partial Excision of Large Intestine 85+ (Female)

UOS505-0690 Cholecystectomy -open <65 (Female)

UOS505-0700 Cholecystectomy -open 65-74 (Female)

UOS505-0710 Cholecystectomy -open 75-84 (Female)

UOS505-0720 Cholecystectomy -open 85+ (Female)

UOS505-0730 Cholecystectomy -closed(laparoscopic) <65 (Female)

UOS505-0740 Cholecystectomy -closed(laparoscopic) 65-74 (Female)

UOS505-0750 Cholecystectomy -closed(laparoscopic) 75-84 (Female)

UOS505-0760 Cholecystectomy -closed(laparoscopic) 85+ (Female)

UOS505-0771 Hysterectomy - Abdominal <65 (Female)

UOS505-0772 Hysterectomy - Vaginal <65 (Female)

UOS505-0781 Hysterectomy - Abdominal 65-74 (Female)

UOS505-0782 Hysterectomy - Vaginal 65-74 (Female)

UOS505-0791 Hysterectomy - Abdominal 75-84 (Female)

UOS505-0792 Hysterectomy - Vaginal 75-84 (Female)

UOS505-0801 Hysterectomy - Abdominal 85+ (Female)

UOS505-0802 Hysterectomy - Vaginal 85+ (Female)

UOS505-0810 Cardiac Catherterization - <65 (Male)

UOS505-0820 Cardiac Catherterization - 65-74 (Male)

UOS505-0830 Cardiac Catherterization - 75-84 (Male)

UOS505-0840 Cardiac Catherterization - 85+ (Male)

UOS505-0850 Cardiac Catherterization - <65 (Female)

UOS505-0860 Cardiac Catherterization - 65-74 (Female)

UOS505-0870 Cardiac Catherterization - 75-84 (Female)

UOS505-0880 Cardiac Catherterization - 85+ (Female)

### Measure Measure Name/Measure Description/Field Name/Field Description

#### UOS506 – Inpatient Utilization-General Hospital/Acute Care

DESCRIPTION - This measure summarizes utilization of acute inpatient services in the following categories: total services, medicine, surgery and maternity. Nonacute care, mental health and chemical dependency services, as well as newborn care, are excluded. Medical and surgical services are reported separately because the factors influencing utilization in these two categories vary. This also facilitates comparisons between ambulatory surgery utilization (refer to the Ambulatory Care measure) and inpatient surgery utilization. (HEDIS 2004, Volume 2: Technical Specification, Pg. 230)

##### REPORTING LEVEL - Contract Market

UOS506-0010 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age < 1)

UOS506-0020 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age < 1)

UOS506-0030 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age < 1)

UOS506-0040 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 1-9)

UOS506-0050 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 1-9)

UOS506-0060 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 1-9)

UOS506-0070 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 10-19)

UOS506-0080 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 10-19)

UOS506-0090 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 10-19)

UOS506-0100 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 20-44)

UOS506-0110 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 20-44)

UOS506-0120 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 20-44)

UOS506-0130 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 45-64)

UOS506-0140 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 45-64)

UOS506-0150 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 45-64)

UOS506-0160 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 65-74)

UOS506-0170 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 65-74)

UOS506-0180 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 65-74)

UOS506-0190 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 75-84)

UOS506-0200 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 75-84)

UOS506-0210 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 75-84)

UOS506-0220 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Age 85+)

UOS506-0230 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Age 85+)

UOS506-0240 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age 85+)

UOS506-0270 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Age Unknown)

UOS506-0280 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Total Inpatient - Total)

UOS506-0290 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Total Inpatient - Total)

UOS506-0300 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Total Inpatient - Total)

UOS506-0310 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age < 1)

UOS506-0320 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age < 1)

UOS506-0330 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age < 1)

UOS506-0340 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 1-9)

UOS506-0350 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 1-9)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS506-0360 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 1-9)

UOS506-0370 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 10-19)

UOS506-0380 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 10-19)

UOS506-0390 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 10-19)

UOS506-0400 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 20-44)

UOS506-0410 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 20-44)

UOS506-0420 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 20-44)

UOS506-0430 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 45-64)

UOS506-0440 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 45-64)

UOS506-0450 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 45-64)

UOS506-0460 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 65-74)

UOS506-0470 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 65-74)

UOS506-0480 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 65-74)

UOS506-0490 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 75-84)

UOS506-0500 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 75-84)

UOS506-0510 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 75-84)

UOS506-0520 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Age 85+)

UOS506-0530 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Age 85+)

UOS506-0540 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age 85+)

UOS506-0570 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Age Unknown)

UOS506-0580 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Medicine - Total)

UOS506-0590 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Medicine - Total)

UOS506-0600 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Medicine - Total)

UOS506-0610 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age < 1)

UOS506-0620 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age < 1)

UOS506-0630 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age < 1)

UOS506-0640 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 1-9)

UOS506-0650 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 1-9)

UOS506-0660 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 1-9)

UOS506-0670 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 10-19)

UOS506-0680 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 10-19)

UOS506-0690 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 10-19)

UOS506-0700 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 20-44)

UOS506-0710 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 20-44)

UOS506-0720 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 20-44)

UOS506-0730 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 45-64)

UOS506-0740 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 45-64)

UOS506-0750 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 45-64)

UOS506-0760 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 65-74)

UOS506-0770 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 65-74)

UOS506-0780 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 65-74)

UOS506-0790 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 75-84)

UOS506-0800 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 75-84)

UOS506-0810 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 75-84)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS506-0820 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Age 85+)

UOS506-0830 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Age 85+)

UOS506-0840 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age 85+)

UOS506-0870 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Age Unknown)

UOS506-0880 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Surgery - Total)

UOS506-0890 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Surgery - Total)

UOS506-0900 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Surgery - Total)

UOS506-0910 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Maternity - Age 10-19)

UOS506-0920 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Maternity - Age 10-19)

UOS506-0930 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Age 10-19)

UOS506-0940 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Maternity - Age 20-44)

UOS506-0950 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Maternity - Age 20-44)

UOS506-0960 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Age 20-44)

UOS506-0970 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Maternity - Age 45-64)

UOS506-0980 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Maternity - Age 45-64)

UOS506-0990 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Age 45-64)

UOS506-1020 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Age Unknown)

UOS506-1030 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Maternity - Total)

UOS506-1040 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Maternity - Total)

UOS506-1050 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Total)

UOS506-1090 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Discharges/1000 (Maternity - Ages 65+)

UOS506-1100 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Days/1000 (Maternity - Ages 65+)

UOS506-1110 Inpatient Utilization - General Hospital/Acute Care- Total Inpatient Average Length of Stay (Maternity - Ages 65+)

#### UOS507 – Ambulatory Care

DESCRIPTION - This measure summarizes utilization of ambulatory services in the following categories: Outpatient Visits, Emergency Department Visits, Ambulatory Surgery/Procedures performed in hospital outpatient facilities or freestanding surgical centers and Observation Room Stays that result in discharge. (Observation Room Stays resulting in an inpatient admission are counted in the Inpatient Utilization—General Hospital/Acute Care measure.) (HEDIS 2004, Volume 2: Technical Specification, Pg. 237)

##### REPORTING LEVEL - Contract Market

UOS507-0010 Ambulatory Care- Total Outpatient Visits/1000 (Age < 1)

UOS507-0020 Ambulatory Care- Total Emergency Room Visits/1000 (Age < 1)

UOS507-0030 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age < 1)

UOS507-0040 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age < 1)

UOS507-0050 Ambulatory Care- Total Outpatient Visits/1000 (Age 1-9)

UOS507-0060 Ambulatory Care- Total Emergency Room Visits/1000 (Age 1-9)

UOS507-0070 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 1-9)

UOS507-0080 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 1-9)

UOS507-0090 Ambulatory Care- Total Outpatient Visits/1000 (Age 10-19)

UOS507-0100 Ambulatory Care- Total Emergency Room Visits/1000 (Age 10-19)

UOS507-0110 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 10-19)

UOS507-0120 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 10-19)

UOS507-0130 Ambulatory Care- Total Outpatient Visits/1000 (Age 20-44)

UOS507-0140 Ambulatory Care- Total Emergency Room Visits/1000 (Age 20-44)

UOS507-0150 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 20-44)

UOS507-0160 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 20-44)

UOS507-0170 Ambulatory Care- Total Outpatient Visits/1000 (Age 45-64)

UOS507-0180 Ambulatory Care- Total Emergency Room Visits/1000 (Age 45-64)

UOS507-0190 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 45-64)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS507-0200 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 45-64)

UOS507-0210 Ambulatory Care- Total Outpatient Visits/1000 (Age 65-74)

UOS507-0220 Ambulatory Care- Total Emergency Room Visits/1000 (Age 65-74)

UOS507-0230 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 65-74)

UOS507-0240 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 65-74)

UOS507-0250 Ambulatory Care- Total Outpatient Visits/1000 (Age 75-84)

UOS507-0260 Ambulatory Care- Total Emergency Room Visits/1000 (Age 75-84)

UOS507-0270 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 75-84)

UOS507-0280 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 75-84)

UOS507-0290 Ambulatory Care- Total Outpatient Visits/1000 (Age 85+)

UOS507-0300 Ambulatory Care- Total Emergency Room Visits/1000 (Age 85+)

UOS507-0310 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Age 85+)

UOS507-0320 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Age 85+)

UOS507-0370 Ambulatory Care- Total Outpatient Visits/1000 (Total)

UOS507-0380 Ambulatory Care- Total Emergency Room Visits/1000 (Total)

UOS507-0390 Ambulatory Care- Total Ambulatory Surgery Procedures/1000 (Total)

UOS507-0400 Ambulatory Care- Observation Room Stays Resulting in Discharge/1000 (Total)

#### UOS508 – Inpatient Utilization-NonAcute Care

DESCRIPTION - This measure summarizes utilization of nonacute inpatient care in the following facilities: hospice, nursing home, rehabilitation, SNF, transitional care and respite. These data exclude services with a principal diagnosis of mental health and chemical dependency. (HEDIS 2004, Volume 2: Technical Specification, Pg. 244)

##### REPORTING LEVEL - Contract Market

UOS508-0010 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age < 1)

UOS508-0020 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age < 1)

UOS508-0030 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age < 1)

UOS508-0040 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 1-9)

UOS508-0050 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 1-9)

UOS508-0060 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 1-9)

UOS508-0070 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 10-19)

UOS508-0080 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 10-19)

UOS508-0090 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 10-19)

UOS508-0100 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 20-44)

UOS508-0110 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 20-44)

UOS508-0120 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 20-44)

UOS508-0130 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 45-64)

UOS508-0140 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 45-64)

UOS508-0150 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 45-64)

UOS508-0160 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 65-74)

UOS508-0170 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 65-74)

UOS508-0180 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 65-74)

UOS508-0190 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 75-84)

UOS508-0200 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 75-84)

UOS508-0210 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 75-84)

UOS508-0220 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Age 85+)

UOS508-0230 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Age 85+)

UOS508-0240 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age 85+)

UOS508-0270 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Age Unknown)

UOS508-0280 Inpatient Utilization - Non-Acute Care- Total Inpatient Discharges/1000 (Total)

UOS508-0290 Inpatient Utilization - Non-Acute Care- Total Inpatient Days/1000 (Total)

UOS508-0300 Inpatient Utilization - Non-Acute Care- Total Inpatient Average Length of Stay (Total)

### Measure Measure Name/Measure Description/Field Name/Field Description

#### UOS512 – Mental Health Utilization-Inpatient Discharges/Average Length of Stay

DESCRIPTION - This measure summarizes utilization of inpatient mental health services, stratified by age and sex. (HEDIS 2004, Volume 2: Technical Specification, Pg. 257)

##### REPORTING LEVEL - Contract Market

UOS512-0010 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Male - Age 0-12)

UOS512-0020 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Age 0-12)

UOS512-0030 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Male - Age 13-17)

UOS512-0040 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Age 13-17)

UOS512-0050 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Male - Age 18-64)

UOS512-0060 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Age 18-64)

UOS512-0070 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Male - Age 65+)

UOS512-0080 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Age 65+)

UOS512-0100 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Age Uknown)

UOS512-0110 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Male - Total)

UOS512-0120 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Male - Total)

UOS512-0130 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Female - Age 0-12)

UOS512-0140 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Age 0-12)

UOS512-0150 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Female - Age 13-17)

UOS512-0160 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Age 13-17)

UOS512-0170 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Female - Age 18-64)

UOS512-0180 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Age 18-64)

UOS512-0190 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Female - Age 65+)

UOS512-0200 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Age 65+)

UOS512-0220 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Age Uknown)

UOS512-0230 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Female - Total)

UOS512-0240 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Female - Total)

UOS512-0250 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Total - Age 0-12)

UOS512-0260 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Age 0-12)

UOS512-0270 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Total - Age 13-17)

UOS512-0280 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Age 13-17)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS512-0290 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Total - Age 18-64)

UOS512-0300 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Age 18-64)

UOS512-0310 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Total - Age 65+)

UOS512-0320 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Age 65+)

UOS512-0340 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Age Uknown)

UOS512-0350 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Discharges/1000 (Total - Total)

UOS512-0360 Mental Health Utilization -- Inpatient Discharges And Average Length of Stay- Total Average Length of Stay (Total - Total)

#### UOS513 – Mental Health Utilization-% of Members Receiving Inpatient, Day/Night, and Ambulatory Services

DESCRIPTION - This measure reports the number and percentage of members receiving mental health services during the measurement year in the following categories: Any Mental Health Services (inpatient, day/night, ambulatory), Inpatient Mental Health Services, Day/Night Mental Health Services and Ambulatory Mental Health Services.

Report in each category the number of members who received the respective service and, of all enrollees with a mental health benefit, the percentage who received the respective service. This information is reported by age and sex. This measure is intended to give an overview of the extent to which the MCO uses the different levels of mental health care. (HEDIS 2004, Volume 2: Technical Specification, Pg. 260)

##### REPORTING LEVEL - Contract Market

UOS513-0010 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 0-12)

UOS513-0020 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 0-12)

UOS513-0030 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 0-12)

UOS513-0040 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 0-12)

UOS513-0050 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 13-17)

UOS513-0060 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 13-17)

UOS513-0070 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 13-17)

UOS513-0080 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 13-17)

UOS513-0090 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 18-64)

UOS513-0100 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 18-64)

UOS513-0110 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 18-64)

UOS513-0120 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 18-64)

UOS513-0130 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 65+)

UOS513-0140 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 65+)

UOS513-0150 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 65+)

UOS513-0160 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 65+)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS513-0170 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age Unknown)

UOS513-0180 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age Unknown)

UOS513-0190 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age Unknown)

UOS513-0200 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age Unknown)

UOS513-0210 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Total)

UOS513-0220 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Total)

UOS513-0230 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Total)

UOS513-0240 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male -Total)

UOS513-0250 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 0-12)

UOS513-0260 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 0-12)

UOS513-0270 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 0-12)

UOS513-0280 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 0-12)

UOS513-0290 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 13-17)

UOS513-0300 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 13-17)

UOS513-0310 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 13-17)

UOS513-0320 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 13-17)

UOS513-0330 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 18-64)

UOS513-0340 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 18-64)

UOS513-0350 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 18-64)

UOS513-0360 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 18-64)

UOS513-0370 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 65+)

UOS513-0380 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 65+)

UOS513-0390 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 65+)

UOS513-0400 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 65+)

UOS513-0410 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age Unknown)

UOS513-0420 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age Unknown)

UOS513-0430 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age Unknown)

UOS513-0440 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age Unknown)

UOS513-0450 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Total)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS513-0460 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Total)

UOS513-0470 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Total)

UOS513-0480 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female -Total)

UOS513-0490 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 0-12)

UOS513-0500 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 0-12)

UOS513-0510 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 0-12)

UOS513-0520 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 0-12)

UOS513-0530 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 13-17)

UOS513-0540 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 13-17)

UOS513-0550 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 13-17)

UOS513-0560 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 13-17)

UOS513-0570 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 18-64)

UOS513-0580 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 18-64)

UOS513-0590 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 18-64)

UOS513-0600 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 18-64)

UOS513-0610 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 65+)

UOS513-0620 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 65+)

UOS513-0630 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 65+)

UOS513-0640 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 65+)

UOS513-0650 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age Unknown)

UOS513-0660 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age Unknown)

UOS513-0670 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age Unknown)

UOS513-0680 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age Unknown)

UOS513-0690 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Total)

UOS513-0700 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Total)

UOS513-0710 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Total)

UOS513-0720 Mental Health Utilization -- Percentage Of Members Receiving Inpatient And Day/Night And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total -Total)

### Measure Measure Name/Measure Description/Field Name/Field Description

#### UOS515 – Chemical Dependency utilization-Inpatient Discharges/Average Length of Stay

DESCRIPTION - This measure summarizes utilization of inpatient chemical dependency services, stratified by age and sex.. (HEDIS 2004, Volume 2: Technical Specification, Pg. 2264)

##### REPORTING LEVEL - Contract Market

UOS515-0010 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Male - Age 0-12)

UOS515-0020 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Age 0-12)

UOS515-0030 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Male - Age 13-17)

UOS515-0040 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Age 13-17)

UOS515-0050 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Male - Age 18-64)

UOS515-0060 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Age 18-64)

UOS515-0070 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Male - Age 65+)

UOS515-0080 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Age 65+)

UOS515-0100 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Age Unknown)

UOS515-0110 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Male - Total)

UOS515-0120 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Male - Total)

UOS515-0130 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Female - Age 0-12)

UOS515-0140 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Age 0-12)

UOS515-0150 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Female - Age 13-17)

UOS515-0160 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Age 13-17)

UOS515-0170 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Female - Age 18-64)

UOS515-0180 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Age 18-64)

UOS515-0190 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Female - Age 65+)

UOS515-0200 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Age 65+)

UOS515-0220 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Age Unknown)

UOS515-0230 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Female - Total)

UOS515-0240 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Female - Total)

UOS515-0250 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Total - Age 0-12)

UOS515-0260 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Age 0-12)

UOS515-0270 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Total - Age 13-17)

UOS515-0280 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Age 13-17)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS515-0290 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Total - Age 18-64)

UOS515-0300 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Age 18-64)

UOS515-0310 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Total - Age 65+)

UOS515-0320 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Age 65+)

UOS515-0340 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Age Unknown)

UOS515-0350 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Discharges/1000 (Total - Total)

UOS515-0360 Chemical Dependency Utilization -- Inpatient Discharges And Average Length Of Stay- Total Average Length of Stay (Total - Total)

#### UOS516 – Chemical Dependency utilization-% of members Receiving Inpatient, Day/Night, and Ambulatory Services

DESCRIPTION - This measure reports the number and percentage of members receiving chemical dependency services during the measurement year in the following categories: Any Chemical Dependency Services (inpatient, day/night, ambulatory), Inpatient Chemical Dependency Services, Day/Night Chemical Dependency Services and Ambulatory Chemical Dependency Services. Report in each category the number of members who received the respective service and, of all enrollees with a chemical dependency benefit, the percentage that received the respective service. This information is reported by age and sex.

This measure is intended to give an overview of the extent to which the MCO uses the different levels of chemical dependency care. (HEDIS 2004, Volume 2: Technical Specification, Pg. 267)

##### REPORTING LEVEL - Contract Market

UOS516-0010 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 0-12)

UOS516-0020 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 0-12)

UOS516-0030 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 0-12)

UOS516-0040 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 0-12)

UOS516-0050 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 13-17)

UOS516-0060 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 13-17)

UOS516-0070 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 13-17)

UOS516-0080 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 13-17)

UOS516-0090 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 18-64)

UOS516-0100 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 18-64)

UOS516-0110 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 18-64)

UOS516-0120 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 18-64)

UOS516-0130 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age 65+)

UOS516-0140 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age 65+)

UOS516-0150 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age 65+)

UOS516-0160 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age 65+)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS516-0170 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Age Uknown)

UOS516-0180 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Age Unknown)

UOS516-0190 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Age Unknown)

UOS516-0200 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Age Unknown)

UOS516-0210 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Male - Total)

UOS516-0220 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Male - Total)

UOS516-0230 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Male - Total)

UOS516-0240 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Male - Total)

UOS516-0250 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 0-12)

UOS516-0260 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 0-12)

UOS516-0270 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 0-12)

UOS516-0280 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 0-12)

UOS516-0290 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 13-17)

UOS516-0300 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 13-17)

UOS516-0310 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 13-17)

UOS516-0320 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 13-17)

UOS516-0330 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 18-64)

UOS516-0340 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 18-64)

UOS516-0350 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 18-64)

UOS516-0360 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 18-64)

UOS516-0370 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age 65+)

UOS516-0380 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age 65+)

UOS516-0390 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age 65+)

UOS516-0400 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age 65+)

UOS516-0410 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Age Uknown)

UOS516-0420 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Age Unknown)

UOS516-0430 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Age Unknown)

UOS516-0440 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Age Unknown)

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS516-0450 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Female - Total)

UOS516-0460 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Female - Total)

UOS516-0470 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Female - Total)

UOS516-0480 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Female - Total)

UOS516-0490 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 0-12)

UOS516-0500 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 0-12)

UOS516-0510 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 0-12)

UOS516-0520 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 0-12)

UOS516-0530 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 13-17)

UOS516-0540 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 13-17)

UOS516-0550 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 13-17)

UOS516-0560 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 13-17)

UOS516-0570 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 18-64)

UOS516-0580 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 18-64)

UOS516-0590 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 18-64)

UOS516-0600 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 18-64)

UOS516-0610 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age 65+)

UOS516-0620 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age 65+)

UOS516-0630 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age 65+)

UOS516-0640 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age 65+)

UOS516-0650 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Age Uknown)

UOS516-0660 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Age Unknown)

UOS516-0670 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Age Unknown)

UOS516-0680 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Age Unknown)

UOS516-0690 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Any Mental Health Services (Total - Total)

UOS516-0700 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Inpatient Mental Health Services (Total - Total)

UOS516-0710 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Day/Night Mental Health Services (Total - Total)

UOS516-0720 Chemical Dependency Utilization -- Percentage Of Members Receiving Inpatient And Day/Night Care And Ambulatory Services- Total Percentage Receiving Ambulatory Mental Health Services (Total - Total)

### Measure Measure Name/Measure Description/Field Name/Field Description

#### UOS518 – Outpatient Drug Utilization

DESCRIPTION - This measure summarizes data on outpatient utilization of drug prescriptions (Total Cost of Prescriptions, Average Cost of Prescriptions per Member per Month, Total Number of Prescriptions and Average Number of Prescriptions per Member per Year) during the measurement year, stratified by age. (HEDIS 2004, Volume 2: Technical Specification, Pg. 276)

##### REPORTING LEVEL - Contract Market

UOS518-0010 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 0-9)

UOS518-0020 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 0-9)

UOS518-0030 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 10-19)

UOS518-0040 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 10-19)

UOS518-0050 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 20-44)

UOS518-0060 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 20-44)

UOS518-0070 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 45-64)

UOS518-0080 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 45-64)

UOS518-0090 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 65-74)

UOS518-0100 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 65-74)

UOS518-0110 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 75-84)

UOS518-0120 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 75-84)

UOS518-0130 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Age 85+)

UOS518-0140 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Age 85+)

UOS518-0170 Outpatient Drug Utilization- Total Average Cost of Prescriptions Per Member Per Month (Total)

UOS518-0180 Outpatient Drug Utilization- Total Average Number of Prescriptions Per Member Per Year (Total)

#### UOS520 – Identification of Alcohol and Other Drug Services

This measure reports the number and percentage of members with an alcohol and other drug (AOD) claim. AOD claims contain a diagnosis of AOD abuse or dependence and a specific AOD-related service during the measurement year, in the following categories:

-any chemical dependency services (inpatient, day/night, ambulatory)

-inpatient chemical dependency services

-day/night chemical dependency services

-ambulatory chemical dependency services.

Report by age and sex:

-the number of members in each category who received the service

-from all enrollees with a chemical dependency benefit, the percentage of members who received the service.

This measure provides an overview of members with an AOD dependence diagnosis and the extent to which the different levels of chemical dependency services are utilized. (HEDIS 2004, Volume 2: Technical Specification, Pg. 271)

##### REPORTING LEVEL - Contract Market

UOS520-0010 Identification of Alcohol and Other Drug Services: Any, Age:0-12, Percent of Males

UOS520-0020 Identification of Alcohol and Other Drug Services: Any, Age:0-12, Percent of Females

UOS520-0030 Identification of Alcohol and Other Drug Services: Any, Age:0-12, Total Percent

UOS520-0040 Identification of Alcohol and Other Drug Services: Any, Age:13-17, Percent of Males

UOS520-0050 Identification of Alcohol and Other Drug Services: Any, Age:13-17, Percent of Females

UOS520-0060 Identification of Alcohol and Other Drug Services: Any, Age:13-17, Total Percent

UOS520-0070 Identification of Alcohol and Other Drug Services: Any, Age:18-64, Percent of Males

UOS520-0080 Identification of Alcohol and Other Drug Services: Any, Age:18-64, Percent of Females

UOS520-0090 Identification of Alcohol and Other Drug Services: Any, Age:18-64, Total Percent

UOS520-0100 Identification of Alcohol and Other Drug Services: Any, Age:65+, Percent of Males

UOS520-0110 Identification of Alcohol and Other Drug Services: Any, Age:65+, Percent of Females

UOS520-0120 Identification of Alcohol and Other Drug Services: Any, Age:65+, Total Percent

UOS520-0130 Identification of Alcohol and Other Drug Services: Any, Age:Unk, Percent of Males

UOS520-0140 Identification of Alcohol and Other Drug Services: Any, Age:Unk, Percent of Females

UOS520-0150 Identification of Alcohol and Other Drug Services: Any, Age:Unk, Total Percent

UOS520-0160 Identification of Alcohol and Other Drug Services: Any, Total Percent of Males

UOS520-0170 Identification of Alcohol and Other Drug Services: Any, Total Percent of Females

UOS520-0180 Identification of Alcohol and Other Drug Services: Any, Total Percent

UOS520-0190 Identification of Alcohol and Other Drug Services: Inpatient, 0-12, Percent of Males

UOS520-0200 Identification of Alcohol and Other Drug Services: Inpatient, 0-12, Percent of Females

### Measure Measure Name/Measure Description/Field Name/Field Description

UOS520-0210 Identification of Alcohol and Other Drug Services: Inpatient, 0-12, Total Percent

UOS520-0220 Identification of Alcohol and Other Drug Services: Inpatient, 13-17, Percent of Males

UOS520-0230 Identification of Alcohol and Other Drug Services: Inpatient, 13-17, Percent of Females

UOS520-0240 Identification of Alcohol and Other Drug Services: Inpatient, 13-17, Total Percent

UOS520-0250 Identification of Alcohol and Other Drug Services: Inpatient, 18-64,, Percent of Males

UOS520-0260 Identification of Alcohol and Other Drug Services: Inpatient, 18-64, Percent of Females

UOS520-0270 Identification of Alcohol and Other Drug Services: Inpatient, 18-64, Total Percent

UOS520-0280 Identification of Alcohol and Other Drug Services: Inpatient, 65+, Percent of Males

UOS520-0290 Identification of Alcohol and Other Drug Services: Inpatient, 65+, Percent of Females

UOS520-0300 Identification of Alcohol and Other Drug Services: Inpatient, 65+, Total Percent

UOS520-0310 Identification of Alcohol and Other Drug Services: Inpatient, Unk, Percent of Males

UOS520-0320 Identification of Alcohol and Other Drug Services: Inpatient, Unk, Percent of Females

UOS520-0330 Identification of Alcohol and Other Drug Services: Inpatient, Unk, Total Percent

UOS520-0340 Identification of Alcohol and Other Drug Services: Inpatient, Total Percentber of Males

UOS520-0350 Identification of Alcohol and Other Drug Services: Inpatient, Total Percentber of Females

UOS520-0360 Identification of Alcohol and Other Drug Services: Inpatient, Total Percent

UOS520-0370 Identification of Alcohol and Other Drug Services: Day/Night, 0-12, Percent of Males

UOS520-0380 Identification of Alcohol and Other Drug Services: Day/Night, 0-12, Percent of Females

UOS520-0390 Identification of Alcohol and Other Drug Services: Day/Night, 0-12, Total Percent

UOS520-0400 Identification of Alcohol and Other Drug Services: Day/Night, 13-17, Percent of Males

UOS520-0410 Identification of Alcohol and Other Drug Services: Day/Night, 13-17, Percent of Females

UOS520-0420 Identification of Alcohol and Other Drug Services: Day/Night, 13-17, Total Percent

UOS520-0430 Identification of Alcohol and Other Drug Services: Day/Night, 18-64, Percent of Males

UOS520-0440 Identification of Alcohol and Other Drug Services: Day/Night, 18-64, Percent of Females

UOS520-0450 Identification of Alcohol and Other Drug Services: Day/Night, 18-64, Total Percent

UOS520-0460 Identification of Alcohol and Other Drug Services: Day/Night, 65+, Percent of Males

UOS520-0470 Identification of Alcohol and Other Drug Services: Day/Night, 65+, Percent of Females

UOS520-0480 Identification of Alcohol and Other Drug Services: Day/Night, 65+, Total Percent

UOS520-0490 Identification of Alcohol and Other Drug Services: Day/Night, Unk, Percent of Males

UOS520-0500 Identification of Alcohol and Other Drug Services: Day/Night, Unk, Percent of Females

UOS520-0510 Identification of Alcohol and Other Drug Services: Day/Night, Unk, Total Percent

UOS520-0520 Identification of Alcohol and Other Drug Services: Day/Night, Total Percentber of Males

UOS520-0530 Identification of Alcohol and Other Drug Services: Day/Night, Total Percentber of Females

UOS520-0540 Identification of Alcohol and Other Drug Services: Day/Night, Total Percent

UOS520-0550 Identification of Alcohol and Other Drug Services: Ambulatory, 0-12, Percent of Males

UOS520-0560 Identification of Alcohol and Other Drug Services: Ambulatory, 0-12, Percent of Females

UOS520-0570 Identification of Alcohol and Other Drug Services: Ambulatory, 0-12, Total Percent

UOS520-0580 Identification of Alcohol and Other Drug Services: Ambulatory, 13-17, Percent of Males

UOS520-0590 Identification of Alcohol and Other Drug Services: Ambulatory, 13-17, Percent of Females

UOS520-0600 Identification of Alcohol and Other Drug Services: Ambulatory, 13-17, Total Percent

UOS520-0610 Identification of Alcohol and Other Drug Services: Ambulatory, 18-64, Percent of Males

UOS520-0620 Identification of Alcohol and Other Drug Services: Ambulatory, 18-64, Percent of Females

UOS520-0630 Identification of Alcohol and Other Drug Services: Ambulatory, 18-64, Total Percent

UOS520-0640 Identification of Alcohol and Other Drug Services: Ambulatory, 65+, Percent of Males

UOS520-0650 Identification of Alcohol and Other Drug Services: Ambulatory, 65+, Percent of Females

UOS520-0660 Identification of Alcohol and Other Drug Services: Ambulatory, 65+, Total Percent

UOS520-0670 Identification of Alcohol and Other Drug Services: Ambulatory, Unk, Percent of Males

UOS520-0680 Identification of Alcohol and Other Drug Services: Ambulatory, Unk, Percent of Females

UOS520-0690 Identification of Alcohol and Other Drug Services: Ambulatory, Unk, Total Percent

UOS520-0700 Identification of Alcohol and Other Drug Services: Ambulatory, Total, Percent of Males

UOS520-0710 Identification of Alcohol and Other Drug Services: Ambulatory, Total, Percent of Females

UOS520-0720 Identification of Alcohol and Other Drug Services: Ambulatory, Total Percent