Datasets:

HHS-Official
/

devautofiletypemeasuredisplaygroups

Dataset card Data Studio Files Files and versions Community

Split (1)

train · 1 rows

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)"}]}]

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