Datasets:

HHS-Official
/

devautofiletypemeasuredisplaygroups

payload stringclasses 1 value
[{"groupId": 13, "groupType": "File Types", "groupName": "IP File DQ Topics", "order": 91, "measures": [{"measureId": 45, "measureName": "Claims Volume - IP", "order": 31, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total inpatient (IP) header volume as a percentage of the national median, (2) IP line volume as a percentage of the national median, and (3) average number of IP line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 27, "measureName": "Service Users - IP", "order": 35, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one inpatient (IP) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 56, "measureName": "CMC Plan Encounters - IP", "order": 39, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Inpatient (IP) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) IP CMC encounter line record volume as a percentage of the national median, (3) the average number of IP CMC encounter line records per header as a percentage of the national median, and (4) the number of CMC plans with no IP encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 22, "measureName": "Benchmarking Inpatient Stays - IP", "order": 43, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in adult inpatient hospital stays between the T-MSIS Analytic Files (TAF) and the Healthcare Cost and Utilization Project (HCUP) data"}, {"measureId": 68, "measureName": "FFS Inpatient Expenditures", "order": 47, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for inpatient hospital services between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 81, "measureName": "Payment Data Consistency - IP", "order": 59, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) inpatient (IP) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of IP claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 111, "measureName": "Category of Service Code - IP", "order": 63, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of IP lines that have a category of service code consistent with program enrollment"}, {"measureId": 115, "measureName": "Federal Reimbursement Category Code - IP", "order": 67, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of IP lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 49, "measureName": "Diagnosis Code - IP", "order": 71, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 65, "measureName": "Procedure Codes - IP", "order": 74, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of inpatient (IP) header records with a missing primary procedure code, and (2) the percentage of IP header records with any invalid procedure codes in the T-MSIS Analytic Files (TAF)"}, {"measureId": 52, "measureName": "Type of Service - IP", "order": 77, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 41, "measureName": "Admission Date - IP", "order": 82, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 43, "measureName": "Discharge Date - IP", "order": 84, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) records with an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 23, "measureName": "Type of Bill - IP", "order": 86, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 33, "measureName": "Billing Provider NPI - IP", "order": 92, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the IP file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 37, "measureName": "Billing Provider Type, Specialty, and Taxonomy - IP", "order": 99, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 26, "measureName": "Hospital Type - IP", "order": 106, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim header records with an expected type of hospital code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 14, "groupType": "File Types", "groupName": "LT File DQ Topics", "order": 92, "measures": [{"measureId": 46, "measureName": "Claims Volume - LT", "order": 32, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Average number of long-term care (LT) line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 57, "measureName": "CMC Plan Encounters - LT", "order": 40, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) The average number of long-term care (LT) comprehensive managed care (CMC) encounter line records per LT claim header as a percentage of the national median and (2) the number of CMC plans with no LT encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 69, "measureName": "FFS Long-Term Care Expenditures", "order": 48, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for institutional long-term care services between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 80, "measureName": "Payment Data Consistency - LT", "order": 60, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) long-term care (LT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of LT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 112, "measureName": "Category of Service Code - LT", "order": 64, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of LT lines that have a category of service code consistent with program enrollment"}, {"measureId": 116, "measureName": "Federal Reimbursement Category Code - LT", "order": 68, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of LT lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 50, "measureName": "Diagnosis Code - LT", "order": 72, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 54, "measureName": "Type of Service - LT", "order": 78, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 42, "measureName": "Admission Date - LT", "order": 83, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 44, "measureName": "Discharge Date - LT", "order": 85, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: Percentage of long-term care (LT) records with (1) a missing discharge date and (2) an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 24, "measureName": "Type of Bill - LT", "order": 87, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 34, "measureName": "Billing Provider NPI - LT", "order": 93, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the LT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 38, "measureName": "Billing Provider Type, Specialty, and Taxonomy - LT", "order": 100, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 15, "groupType": "File Types", "groupName": "OT File DQ Topics", "order": 93, "measures": [{"measureId": 47, "measureName": "Claims Volume - OT", "order": 33, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total other service (OT) header volume as a percentage of the national median, (2) total OT line volume as a percentage of the national median, and (3) average number of OT line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 28, "measureName": "Service Users - OT", "order": 36, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one other service (OT) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 58, "measureName": "CMC Plan Encounters - OT", "order": 41, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Other service (OT) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) volume of OT CMC encounter line records as a percentage of the national median, (3) the average number of OT CMC line records per header as a percentage of the national median, and (4) the number of CMC plans with no OT encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 72, "measureName": "Total Monthly Beneficiary Payments", "order": 51, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in total monthly Medicaid beneficiary payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 73, "measureName": "CMC Payments", "order": 52, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in comprehensive managed care (CMC) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 74, "measureName": "PHP Payments", "order": 53, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in prepaid health plan (PHP) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 75, "measureName": "PCCM Fees", "order": 54, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in primary care case management plan (PCCM) fees between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 76, "measureName": "Premium Assistance Payments", "order": 55, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in premium assistance payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 79, "measureName": "Payment Data Consistency - OT", "order": 61, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) other service (OT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of OT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 113, "measureName": "Category of Service Code - OT", "order": 65, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of OT lines that have a category of service code consistent with program enrollment"}, {"measureId": 117, "measureName": "Federal Reimbursement Category Code - OT", "order": 69, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of OT lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 51, "measureName": "Diagnosis Code - OT", "order": 73, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) header records for outpatient hospital services, physician services, or clinic services with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 63, "measureName": "Procedure Codes - OT Professional", "order": 75, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) professional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)"}, {"measureId": 64, "measureName": "Procedure Codes - OT Institutional", "order": 76, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) institutional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)"}, {"measureId": 53, "measureName": "Type of Service - OT", "order": 79, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 62, "measureName": "Place of Service", "order": 81, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) header records with the expected combination of type of bill (TOB) code and place of service code (POS) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 25, "measureName": "Type of Bill - OT", "order": 88, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of other service (OT) claim header records with an unexpected or invalid type of bill code and (2) percentage of OT claim header records with a missing type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 35, "measureName": "Billing Provider NPI - OT", "order": 94, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the OT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 30, "measureName": "Servicing Provider NPI - OT", "order": 96, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) line records with a missing servicing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 104, "measureName": "Billing Provider Type, Specialty, and Taxonomy - OT Professional", "order": 101, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of header records on other service (OT) professional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 105, "measureName": "Billing Provider Type, Specialty, and Taxonomy - OT Institutional", "order": 102, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of header records on other service (OT) institutional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 106, "measureName": "Servicing Provider Type, Specialty, and Taxonomy - OT Professional", "order": 104, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of line records on other service (OT) professional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 107, "measureName": "Servicing Provider Type, Specialty, and Taxonomy - OT Institutional", "order": 105, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of line records on other service (OT) institutional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 16, "groupType": "File Types", "groupName": "RX File DQ Topics", "order": 94, "measures": [{"measureId": 48, "measureName": "Claims Volume - RX", "order": 34, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total pharmacy (RX) header volume as a percentage of the national median, (2) total RX line volume as a percentage of the national median, and (3) average number of RX line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 29, "measureName": "Service Users - RX", "order": 37, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one pharmacy (RX) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 59, "measureName": "CMC Plan Encounters - RX", "order": 42, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) The average number of pharmacy (RX) comprehensive managed care (CMC) encounter line records per RX claim header as a percentage of the national median and (2) the number of CMC plans with no RX encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 71, "measureName": "FFS Prescription Drug Expenditures", "order": 50, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for prescription drugs between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 78, "measureName": "Payment Data Consistency - RX", "order": 62, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) pharmacy (RX) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of RX claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 114, "measureName": "Category of Service Code - RX", "order": 66, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of RX lines that have a category of service code consistent with program enrollment"}, {"measureId": 118, "measureName": "Federal Reimbursement Category Code - RX", "order": 70, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of RX lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 55, "measureName": "Type of Service - RX", "order": 80, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) claim line records with a missing or invalid type of service code (TOS) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 40, "measureName": "Generic Indicator - RX", "order": 89, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: See Background and Methods"}, {"measureId": 89, "measureName": "National Drug Code - RX", "order": 90, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of pharmacy (RX) line records with a missing or invalid National Drug Code (NDC) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 90, "measureName": "Days' Supply, Quantity, and Units - RX", "order": 91, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of pharmacy (RX) line records with either (1) a days' supply value that is missing, invalid, or greater than 180, or (2) a missing or unusable National Drug Code (NDC) quantity in the T-MSIS Analytic Files (TAF)"}, {"measureId": 36, "measureName": "Billing Provider NPI - RX", "order": 95, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the RX file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 31, "measureName": "Prescribing Provider NPI - RX", "order": 97, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) header records with a missing prescribing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 32, "measureName": "Dispensing Provider NPI - RX", "order": 98, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) header records with a missing dispensing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 103, "measureName": "Billing Provider Specialty and Taxonomy - RX", "order": 103, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of RX header records with an expected billing provider specialty or taxonomy code"}]}, {"groupId": 17, "groupType": "File Types", "groupName": "APR File DQ Topics", "order": 95, "measures": [{"measureId": 92, "measureName": "Linking Claims to Providers", "order": 3, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of unique provider IDs on medical claims in the T-MSIS Analytic Files (TAF) that link to a provider ID on the TAF Annual Provider (APR) file "}, {"measureId": 91, "measureName": "Active Enrollment Status Indicator", "order": 107, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of unique Annual Provider (APR) file provider IDs where the active enrollment status indicator aligns with the claims in the T-MSIS Analytic Files (TAF)"}, {"measureId": 94, "measureName": "Facility/Group/Individual Code", "order": 108, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Multiple criteria: (1) Percentage of providers that are facility providers, (2) percentage of providers that are group providers, (3) percentage of providers that are individual providers, and (4) percentage of providers with a valid facility/group/individual code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 95, "measureName": "Group and Individual Providers - Classification Types", "order": 109, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of individual and group providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)"}, {"measureId": 97, "measureName": "Facilities - Classification Types", "order": 110, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of facility providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)"}, {"measureId": 96, "measureName": "Facility Characteristics", "order": 111, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of facility providers with a valid value reported for ownership code and profit status code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 102, "measureName": "Provider Location", "order": 112, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of participating providers without a usable service or practice location: ZIP code or county code"}, {"measureId": 109, "measureName": "National Provider Identifier", "order": 113, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of TAF Annual Provider Files (APR) records with a valid NPI"}]}, {"groupId": 18, "groupType": "File Types", "groupName": "APL File DQ Topics", "order": 96, "measures": [{"measureId": 88, "measureName": "Linking Beneficiaries to Managed Care Plans", "order": 4, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of beneficiary-plan combinations in the T-MSIS Analytic Files (TAF) Demographic and Eligibility (DE) file that link to a plan ID in the TAF Annual Managed Care Plan (APL) file"}, {"measureId": 98, "measureName": "Managed Care Plan Program and Population Characteristics", "order": 117, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing key managed care plan program and population characteristics in the T-MSIS Analytic Files (TAF)"}, {"measureId": 99, "measureName": "Managed Care Plan Operational Characteristics", "order": 118, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing key managed care plan operational characteristics in the T-MSIS Analytic Files (TAF)"}, {"measureId": 100, "measureName": "Plan Name and Type", "order": 119, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing managed care plan name or type in the T-MSIS Analytic Files (TAF)"}]}]

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[{"groupId": 13, "groupType": "File Types", "groupName": "IP File DQ Topics", "order": 91, "measures": [{"measureId": 45, "measureName": "Claims Volume - IP", "order": 31, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total inpatient (IP) header volume as a percentage of the national median, (2) IP line volume as a percentage of the national median, and (3) average number of IP line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 27, "measureName": "Service Users - IP", "order": 35, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one inpatient (IP) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 56, "measureName": "CMC Plan Encounters - IP", "order": 39, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Inpatient (IP) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) IP CMC encounter line record volume as a percentage of the national median, (3) the average number of IP CMC encounter line records per header as a percentage of the national median, and (4) the number of CMC plans with no IP encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 22, "measureName": "Benchmarking Inpatient Stays - IP", "order": 43, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in adult inpatient hospital stays between the T-MSIS Analytic Files (TAF) and the Healthcare Cost and Utilization Project (HCUP) data"}, {"measureId": 68, "measureName": "FFS Inpatient Expenditures", "order": 47, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for inpatient hospital services between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 81, "measureName": "Payment Data Consistency - IP", "order": 59, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) inpatient (IP) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of IP claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 111, "measureName": "Category of Service Code - IP", "order": 63, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of IP lines that have a category of service code consistent with program enrollment"}, {"measureId": 115, "measureName": "Federal Reimbursement Category Code - IP", "order": 67, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of IP lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 49, "measureName": "Diagnosis Code - IP", "order": 71, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 65, "measureName": "Procedure Codes - IP", "order": 74, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of inpatient (IP) header records with a missing primary procedure code, and (2) the percentage of IP header records with any invalid procedure codes in the T-MSIS Analytic Files (TAF)"}, {"measureId": 52, "measureName": "Type of Service - IP", "order": 77, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 41, "measureName": "Admission Date - IP", "order": 82, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 43, "measureName": "Discharge Date - IP", "order": 84, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) records with an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 23, "measureName": "Type of Bill - IP", "order": 86, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 33, "measureName": "Billing Provider NPI - IP", "order": 92, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the IP file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 37, "measureName": "Billing Provider Type, Specialty, and Taxonomy - IP", "order": 99, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 26, "measureName": "Hospital Type - IP", "order": 106, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of inpatient (IP) claim header records with an expected type of hospital code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 14, "groupType": "File Types", "groupName": "LT File DQ Topics", "order": 92, "measures": [{"measureId": 46, "measureName": "Claims Volume - LT", "order": 32, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Average number of long-term care (LT) line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 57, "measureName": "CMC Plan Encounters - LT", "order": 40, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) The average number of long-term care (LT) comprehensive managed care (CMC) encounter line records per LT claim header as a percentage of the national median and (2) the number of CMC plans with no LT encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 69, "measureName": "FFS Long-Term Care Expenditures", "order": 48, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for institutional long-term care services between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 80, "measureName": "Payment Data Consistency - LT", "order": 60, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) long-term care (LT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of LT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 112, "measureName": "Category of Service Code - LT", "order": 64, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of LT lines that have a category of service code consistent with program enrollment"}, {"measureId": 116, "measureName": "Federal Reimbursement Category Code - LT", "order": 68, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of LT lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 50, "measureName": "Diagnosis Code - LT", "order": 72, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) header records with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 54, "measureName": "Type of Service - LT", "order": 78, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 42, "measureName": "Admission Date - LT", "order": 83, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) records with a missing or invalid admission date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 44, "measureName": "Discharge Date - LT", "order": 85, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: Percentage of long-term care (LT) records with (1) a missing discharge date and (2) an unexpectedly missing or invalid discharge date in the T-MSIS Analytic Files (TAF)"}, {"measureId": 24, "measureName": "Type of Bill - LT", "order": 87, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) claim header records with an expected type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 34, "measureName": "Billing Provider NPI - LT", "order": 93, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the LT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 38, "measureName": "Billing Provider Type, Specialty, and Taxonomy - LT", "order": 100, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of long-term care (LT) header records with an expected billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 15, "groupType": "File Types", "groupName": "OT File DQ Topics", "order": 93, "measures": [{"measureId": 47, "measureName": "Claims Volume - OT", "order": 33, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total other service (OT) header volume as a percentage of the national median, (2) total OT line volume as a percentage of the national median, and (3) average number of OT line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 28, "measureName": "Service Users - OT", "order": 36, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one other service (OT) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 58, "measureName": "CMC Plan Encounters - OT", "order": 41, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Other service (OT) comprehensive managed care (CMC) encounter header record volume as a percentage of the national median, (2) volume of OT CMC encounter line records as a percentage of the national median, (3) the average number of OT CMC line records per header as a percentage of the national median, and (4) the number of CMC plans with no OT encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 72, "measureName": "Total Monthly Beneficiary Payments", "order": 51, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in total monthly Medicaid beneficiary payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 73, "measureName": "CMC Payments", "order": 52, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in comprehensive managed care (CMC) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 74, "measureName": "PHP Payments", "order": 53, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in prepaid health plan (PHP) capitation payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 75, "measureName": "PCCM Fees", "order": 54, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in primary care case management plan (PCCM) fees between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 76, "measureName": "Premium Assistance Payments", "order": 55, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in premium assistance payments between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 79, "measureName": "Payment Data Consistency - OT", "order": 61, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) other service (OT) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of OT claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 113, "measureName": "Category of Service Code - OT", "order": 65, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of OT lines that have a category of service code consistent with program enrollment"}, {"measureId": 117, "measureName": "Federal Reimbursement Category Code - OT", "order": 69, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of OT lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 51, "measureName": "Diagnosis Code - OT", "order": 73, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) header records for outpatient hospital services, physician services, or clinic services with a valid ICD-10 primary diagnosis code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 63, "measureName": "Procedure Codes - OT Professional", "order": 75, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) professional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)"}, {"measureId": 64, "measureName": "Procedure Codes - OT Institutional", "order": 76, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) institutional claim line records with missing or invalid values in the procedure code field in the T-MSIS Analytic Files (TAF)"}, {"measureId": 53, "measureName": "Type of Service - OT", "order": 79, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) claim line records with a missing or invalid type of service (TOS) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 62, "measureName": "Place of Service", "order": 81, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of all other service (OT) header records with the expected combination of type of bill (TOB) code and place of service code (POS) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 25, "measureName": "Type of Bill - OT", "order": 88, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of other service (OT) claim header records with an unexpected or invalid type of bill code and (2) percentage of OT claim header records with a missing type of bill code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 35, "measureName": "Billing Provider NPI - OT", "order": 94, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the OT file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 30, "measureName": "Servicing Provider NPI - OT", "order": 96, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of other service (OT) line records with a missing servicing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 104, "measureName": "Billing Provider Type, Specialty, and Taxonomy - OT Professional", "order": 101, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of header records on other service (OT) professional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 105, "measureName": "Billing Provider Type, Specialty, and Taxonomy - OT Institutional", "order": 102, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of header records on other service (OT) institutional claims with a valid billing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 106, "measureName": "Servicing Provider Type, Specialty, and Taxonomy - OT Professional", "order": 104, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of line records on other service (OT) professional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 107, "measureName": "Servicing Provider Type, Specialty, and Taxonomy - OT Institutional", "order": 105, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of line records on other service (OT) institutional claims with a valid servicing provider type, specialty, state-reported taxonomy, or NPPES primary taxonomy code in the T-MSIS Analytic Files (TAF)"}]}, {"groupId": 16, "groupType": "File Types", "groupName": "RX File DQ Topics", "order": 94, "measures": [{"measureId": 48, "measureName": "Claims Volume - RX", "order": 34, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Total pharmacy (RX) header volume as a percentage of the national median, (2) total RX line volume as a percentage of the national median, and (3) average number of RX line records per header as a percentage of the national median in the T-MSIS Analytic Files (TAF)"}, {"measureId": 29, "measureName": "Service Users - RX", "order": 37, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of non-dually eligible beneficiaries with at least one pharmacy (RX) claim record in the T-MSIS Analytic Files (TAF), as a proportion of the national median"}, {"measureId": 59, "measureName": "CMC Plan Encounters - RX", "order": 42, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) The average number of pharmacy (RX) comprehensive managed care (CMC) encounter line records per RX claim header as a percentage of the national median and (2) the number of CMC plans with no RX encounter header records in the T-MSIS Analytic Files (TAF)"}, {"measureId": 71, "measureName": "FFS Prescription Drug Expenditures", "order": 50, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percent difference in Medicaid fee-for-service (FFS) expenditures for prescription drugs between the T-MSIS Analytic Files (TAF) and the CMS-64 data"}, {"measureId": 78, "measureName": "Payment Data Consistency - RX", "order": 62, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: (1) Percentage of fee-for-service (FFS) pharmacy (RX) claims with a header payment equal to the sum of its associated claim line payments and (2) percentage of RX claims with an unknown payment level in the T-MSIS Analytic Files (TAF)"}, {"measureId": 114, "measureName": "Category of Service Code - RX", "order": 66, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of RX lines that have a category of service code consistent with program enrollment"}, {"measureId": 118, "measureName": "Federal Reimbursement Category Code - RX", "order": 70, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of RX lines that have a federal reimbursement category consistent with program enrollment"}, {"measureId": 55, "measureName": "Type of Service - RX", "order": 80, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) claim line records with a missing or invalid type of service code (TOS) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 40, "measureName": "Generic Indicator - RX", "order": 89, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Multiple criteria: See Background and Methods"}, {"measureId": 89, "measureName": "National Drug Code - RX", "order": 90, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of pharmacy (RX) line records with a missing or invalid National Drug Code (NDC) code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 90, "measureName": "Days' Supply, Quantity, and Units - RX", "order": 91, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of pharmacy (RX) line records with either (1) a days' supply value that is missing, invalid, or greater than 180, or (2) a missing or unusable National Drug Code (NDC) quantity in the T-MSIS Analytic Files (TAF)"}, {"measureId": 36, "measureName": "Billing Provider NPI - RX", "order": 95, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of records in the RX file with a missing billing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 31, "measureName": "Prescribing Provider NPI - RX", "order": 97, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) header records with a missing prescribing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 32, "measureName": "Dispensing Provider NPI - RX", "order": 98, "availableTafVersionIDs": [13, 14, 15, 16, 17, 18, 23, 24, 25, 32, 35, 38, 41, 43, 6, 7, 8], "description": "Percentage of pharmacy (RX) header records with a missing dispensing provider National Provider Identifier (NPI) in the T-MSIS Analytic Files (TAF)"}, {"measureId": 103, "measureName": "Billing Provider Specialty and Taxonomy - RX", "order": 103, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of RX header records with an expected billing provider specialty or taxonomy code"}]}, {"groupId": 17, "groupType": "File Types", "groupName": "APR File DQ Topics", "order": 95, "measures": [{"measureId": 92, "measureName": "Linking Claims to Providers", "order": 3, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of unique provider IDs on medical claims in the T-MSIS Analytic Files (TAF) that link to a provider ID on the TAF Annual Provider (APR) file "}, {"measureId": 91, "measureName": "Active Enrollment Status Indicator", "order": 107, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of unique Annual Provider (APR) file provider IDs where the active enrollment status indicator aligns with the claims in the T-MSIS Analytic Files (TAF)"}, {"measureId": 94, "measureName": "Facility/Group/Individual Code", "order": 108, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Multiple criteria: (1) Percentage of providers that are facility providers, (2) percentage of providers that are group providers, (3) percentage of providers that are individual providers, and (4) percentage of providers with a valid facility/group/individual code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 95, "measureName": "Group and Individual Providers - Classification Types", "order": 109, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of individual and group providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)"}, {"measureId": 97, "measureName": "Facilities - Classification Types", "order": 110, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of facility providers with a valid, usable, and applicable value reported for at least one classification type in the T-MSIS Analytic Files (TAF)"}, {"measureId": 96, "measureName": "Facility Characteristics", "order": 111, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of facility providers with a valid value reported for ownership code and profit status code in the T-MSIS Analytic Files (TAF)"}, {"measureId": 102, "measureName": "Provider Location", "order": 112, "availableTafVersionIDs": [24, 25, 32, 35, 38, 41, 43], "description": "Percentage of participating providers without a usable service or practice location: ZIP code or county code"}, {"measureId": 109, "measureName": "National Provider Identifier", "order": 113, "availableTafVersionIDs": [25, 32, 35, 38, 41, 43], "description": "Percentage of TAF Annual Provider Files (APR) records with a valid NPI"}]}, {"groupId": 18, "groupType": "File Types", "groupName": "APL File DQ Topics", "order": 96, "measures": [{"measureId": 88, "measureName": "Linking Beneficiaries to Managed Care Plans", "order": 4, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of beneficiary-plan combinations in the T-MSIS Analytic Files (TAF) Demographic and Eligibility (DE) file that link to a plan ID in the TAF Annual Managed Care Plan (APL) file"}, {"measureId": 98, "measureName": "Managed Care Plan Program and Population Characteristics", "order": 117, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing key managed care plan program and population characteristics in the T-MSIS Analytic Files (TAF)"}, {"measureId": 99, "measureName": "Managed Care Plan Operational Characteristics", "order": 118, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing key managed care plan operational characteristics in the T-MSIS Analytic Files (TAF)"}, {"measureId": 100, "measureName": "Plan Name and Type", "order": 119, "availableTafVersionIDs": [23, 24, 25, 32, 35, 38, 41, 43], "description": "Percentage of records missing managed care plan name or type in the T-MSIS Analytic Files (TAF)"}]}]

devAuto_fileType_measureDisplayGroups

Description

This is a dataset created for use by the DQ Atlas website, and is not intended for use outside that application. For more information on the DQ Atlas and the information contained in this dataset see https://www.medicaid.gov/dq-atlas/welcome

Dataset Details

Publisher: Centers for Medicare & Medicaid Services
Last Modified: 2025-01-15
Contact: DataConnect Support Team ([email protected])

Source

Original data can be found at: https://healthdata.gov/d/gyk2-ne97

Usage

You can load this dataset using:

from datasets import load_dataset
 dataset = load_dataset('HHS-Official/devautofiletypemeasuredisplaygroups')

License

This dataset is licensed under http://opendefinition.org/licenses/odc-odbl/

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