Claims Data

The risk-adjusted relative resource use by health plan members with asthma during the measurement year.

The risk-adjusted relative resource use by health plan members with specific cardiovascular conditions during the measurement year.

The risk-adjusted relative resource use by health plan members with COPD during the measurement year.

The risk-adjusted relative resource use by health plan members with diabetes (type 1 and type 2) during the measurement year.

The number of hospital discharges with a retained surgical item or unretrieved device fragment (secondary diagnosis) among surgical and medical patients ages 17 years and younger. Excludes normal newborns, newborns with birth weight less than 500 grams, cases with principal diagnosis of retained surgical item or unretrieved device fragment, cases with a secondary diagnosis of retained surgical item or unretrieved device fragment present on admission, and obstetric cases.

The number of hospital discharges with a retained surgical item or unretrieved device fragment (secondary diagnosis) among surgical and medical patients ages 18 years and older or obstetric patients. Excludes cases with principal diagnosis of retained surgical item or unretrieved device fragment and cases with a secondary diagnosis of retained surgical item or unretrieved device fragment present on admission.

Percent of Rh negative pregnant women at risk of fetal blood exposure who receive Rhogam the ED.

This measure identifies adult patients with a history of rheumatoid arthritis who have received erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) lab tests during the measurement year.

This measure identifies adult patients with a diagnosis of rheumatoid arthritis who received appropriate baseline complete blood count (CBC) testing within 90 days before to 14 days after the new start of sulfasalazine, methotrexate, leflunomide, azathioprine, D-Penicillamine, intramuscular gold, oral gold, cyclosporine, or cyclophosphamide during the measurement year.

This measure identifies adult patients with a diagnosis of rheumatoid arthritis who received appropriate baseline liver function testing (AST or ALT) within 90 days before to 14 days after the new start of sulfasalazine, methotrexate, leflunomide, azathioprine, cyclosporine or cyclophosphamide during the measurement year.