#	Measure Title	Submission Methods
IA_PCMH	Patient Centered Medical Home Attestation
ACI_INFBLO_1	Prevention of Information Blocking Attestation
ACI_ONCDIR_1	ONC Direct Review Attestation
ACI_ONCACB_1	ONC-ACB Surveillance Attestation (Optional)
ACI_IACEHRT_1	CEHRT Used
ACI_LVPP_1	E-Prescribing Exclusion
ACI_TRANS_LVPP_1	E-Prescribing Exclusion
ACI_LVOTC_1	Send a Summary of Care Exclusion
ACI_TRANS_LVOTC_1	Health Information Exchange Exclusion
ACI_LVITC_1	Request/Accept Summary of Care Exclusion
CAHPS_1	CAHPS for MIPS SSM: Getting Timely Care, Appointments and Information	Certified Survey Vendor
CAHPS_2	CAHPS for MIPS SSM: How Well Providers Communicate	Certified Survey Vendor
CAHPS_3	CAHPS for MIPS SSM: Patient's Rating of Provider	Certified Survey Vendor
CAHPS_4	CAHPS for MIPS SSM: Access to Specialists	Certified Survey Vendor
CAHPS_5	CAHPS for MIPS SSM: Health Promotion and Education	Certified Survey Vendor
CAHPS_6	CAHPS for MIPS SSM: Shared Decision-Making	Certified Survey Vendor
CAHPS_7	CAHPS for MIPS SSM: Health Status and Functional Status	Certified Survey Vendor
CAHPS_8	CAHPS for MIPS SSM: Care Coordination	Certified Survey Vendor
CAHPS_9	CAHPS for MIPS SSM: Courteous and Helpful Office Staff	Certified Survey Vendor
CAHPS_10	CAHPS for MIPS SSM: Helping You Take Medications as Directed	Certified Survey Vendor
CAHPS_11	CAHPS for MIPS SSM: Stewardship of Patient Resources	Certified Survey Vendor
CAHPS_12	CAHPS for MIPS SSM: Between Visit Communication	Certified Survey Vendor
dmComposite	Diabetes Mellitus (DM) Composite (All or Nothing Scoring)	Cms Web Interface
ACI_PHCDRR_5	Clinical Data Registry Reporting
ACI_HIE_3	Clinical Information Reconciliation
ACI_PHCDRR_3	Electronic Case Reporting
ACI_EP_1	e-Prescribing
ACI_PHCDRR_1	Immunization Registry Reporting
ACI_CCTPE_3	Patient-Generated Health Data
ACI_PEA_2	Patient-Specific Education
ACI_PEA_1	Provide Patient Access
ACI_PHCDRR_4	Public Health Registry Reporting
ACI_HIE_2	Request/Accept Summary of Care
ACI_CCTPE_2	Secure Messaging
ACI_PPHI_1	Security Risk Analysis
ACI_HIE_1	Send a Summary of Care
ACI_PHCDRR_2	Syndromic Surveillance Reporting
ACI_CCTPE_1	View, Download and Transmit (VDT)
ACI_TRANS_EP_1	e-Prescribing
ACI_TRANS_HIE_1	Health Information Exchange
ACI_TRANS_PHCDRR_1	Immunization Registry Reporting
ACI_TRANS_MR_1	Medication Reconciliation
ACI_TRANS_PSE_1	Patient-Specific Education
ACI_TRANS_PEA_1	Provide Patient Access
ACI_TRANS_SM_1	Secure Messaging
ACI_TRANS_PPHI_1	Security Risk Analysis
ACI_TRANS_PHCDRR_3	Specialized Registry Reporting
ACI_TRANS_PHCDRR_2	Syndromic Surveillance Reporting
ACI_TRANS_PEA_2	View, Download, or Transmit (VDT)
IA_EPA_4	Additional improvements in access as a result of QIN/QIO TA
IA_PSPA_4	Administration of the AHRQ Survey of Patient Safety Culture
IA_PSPA_5	Annual registration in the Prescription Drug Monitoring Program
IA_PM_2	Anticoagulant management improvements
IA_CC_12	Care coordination agreements that promote improvements in patient tracking across settings
IA_CC_10	Care transition documentation practice improvements
IA_CC_11	Care transition standard operational improvements
IA_PM_13	Chronic care and preventative care management for empanelled patients
IA_CC_5	CMS partner in Patients Hospital Improvement Innovation Networks
IA_BE_6	Collection and follow-up on patient experience and satisfaction data on beneficiary engagement
IA_EPA_3	Collection and use of patient experience and satisfaction data on access
IA_PSPA_9	Completion of the AMA STEPS Forward program
IA_PSPA_10	Completion of training and receipt of approved waiver for provision opioid medication-assisted treatments
IA_PSPA_6	Consultation of the Prescription Drug Monitoring program
IA_BMH_4	Depression screening
IA_BMH_1	Diabetes screening
IA_BMH_8	Electronic Health Record Enhancements for BH data capture
IA_PM_5	Engagement of community for health status improvement
IA_AHE_1	Engagement of new Medicaid patients and follow-up
IA_BE_15	Engagement of patients, family and caregivers in developing a plan of care
IA_BE_4	Engagement of patients through implementation of improvements in patient portal
IA_BE_3	Engagement with QIN-QIO to implement self-management training programs
IA_BE_14	Engage patients and families to guide improvement in the system of care.
IA_BE_5	Enhancements/regular updates to practice websites/tools that also include considerations for patients with cognitive disabilities
IA_BE_16	Evidenced-based techniques to promote self-management into usual care
IA_PM_4	Glycemic management services
IA_CC_3	Implementation of additional activity as a result of TA for improving care coordination
IA_PSPA_17	Implementation of analytic capabilities to manage total cost of care for practice population
IA_PSPA_15	Implementation of antibiotic stewardship program
IA_BMH_6	Implementation of co-location PCP and MH services
IA_BE_20	Implementation of condition-specific chronic disease self-management support programs
IA_CC_8	Implementation of documentation improvements for practice/process improvements
IA_PM_15	Implementation of episodic care management practice improvements
IA_PSPA_21	Implementation of fall screening and assessment programs
IA_PSPA_19	Implementation of formal quality improvement methods, practice changes or other practice improvement processes
IA_CC_2	Implementation of improvements that contribute to more timely communication of test results
IA_BMH_7	Implementation of integrated PCBH model
IA_PM_16	Implementation of medication management practice improvements
IA_PM_14	Implementation of methodologies for improvements in longitudinal care management for high risk patients
IA_CC_9	Implementation of practices/processes for developing regular individual care plans
IA_CC_1	Implementation of use of specialist reports back to referring clinician or group to close referral loop
IA_BE_21	Improved practices that disseminate appropriate self-management materials
IA_BE_22	Improved practices that engage patients pre-visit
IA_BE_23	Integration of patient coaching practices between visits
IA_PSPA_20	Leadership engagement in regular guidance and demonstrated commitment for implementing practice improvement changes
IA_AHE_4	Leveraging a QCDR for use of standard questionnaires
IA_AHE_3	Leveraging a QCDR to promote use of patient-reported outcome tools
IA_AHE_2	Leveraging a QCDR to standardize processes for screening
IA_BMH_5	MDD prevention and treatment interventions
IA_PSPA_18	Measurement and improvement at the practice and panel level
IA_PSPA_3	Participate in IHI Training/Forum Event; National Academy of Medicine, AHRQ Team STEPPS(R) or other similar activity.
IA_ERP_2	Participation in a 60-day or greater effort to support domestic or international humanitarian needs.
IA_PSPA_1	Participation in an AHRQ-listed patient safety organization.
IA_BE_8	Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.
IA_BE_10	Participation in a QCDR, that promotes implementation of patient self-action plans.
IA_BE_7	Participation in a QCDR, that promotes use of patient engagement tools.
IA_BE_11	Participation in a QCDR, that promotes use of processes and tools that engage patients for adherence to treatment plan.
IA_PSPA_14	Participation in Bridges to Excellence or other similar program
IA_PSPA_11	Participation in CAHPS or other supplemental questionnaire
IA_PM_8	Participation in CMMI models such as Million Hearts Campaign
IA_PSPA_13	Participation in Joint Commission Evaluation Initiative
IA_PSPA_2	Participation in MOC Part IV
IA_PM_9	Participation in population health research
IA_PSPA_12	Participation in private payer CPIA
IA_PM_1	Participation in systematic anticoagulation program
IA_ERP_1	Participation on Disaster Medical Assistance Team, registered for 6 months.
IA_PM_12	Population empanelment
IA_CC_13	Practice improvements for bilateral exchange of patient information
IA_CC_14	Practice improvements that engage community resources to support patient health goals
IA_EPA_1	Provide 24/7 access to eligible clinicians or groups who have real-time access to patient's medical record
IA_BE_18	Provide peer-led support for self-management.
IA_BE_13	Regularly assess the patient experience of care through surveys, advisory councils and/or other mechanisms.
IA_PM_11	Regular review practices in place on targeted patient population needs
IA_CC_7	Regular training in care coordination
IA_PM_3	RHC, IHS or FQHC quality improvement activities
IA_CC_4	TCPI participation
IA_BMH_2	Tobacco use
IA_BMH_3	Unhealthy alcohol use
IA_BE_12	Use evidence-based decision aids to support shared decision-making.
IA_BE_19	Use group visits for common chronic conditions (e.g., diabetes).
IA_BE_1	Use of certified EHR to capture patient reported outcomes
IA_PSPA_16	Use of decision support and standardized treatment protocols
IA_PSPA_8	Use of patient safety tools
IA_PSPA_7	Use of QCDR data for ongoing practice assessment and improvements
IA_PM_10	Use of QCDR data for quality improvement such as comparative analysis reports across patient populations
IA_PM_7	Use of QCDR for feedback reports that incorporate population health
IA_BE_9	Use of QCDR patient experience data to inform and advance improvements in beneficiary engagement.
IA_CC_6	Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination
IA_BE_2	Use of QCDR to support clinical decision making
IA_EPA_2	Use of telehealth services that expand practice access
IA_PM_6	Use of toolsets or other resources to close healthcare disparities across communities
IA_BE_17	Use of tools to assist patient self-management
MSPB_1	Medicare Spending Per Beneficiary (MSPB)	Administrative Claims
TPCC_1	Total Per Capita Costs (TPCC)	Administrative Claims
093	Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy - Avoidance of Inappropriate Use	Claims, Registry
091	Acute Otitis Externa (AOE): Topical Therapy	Claims, Registry
366	ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication	Electronic Health Record, Registry
383	Adherence to Antipsychotic Medications For Individuals with Schizophrenia	Registry
122	Adult Kidney Disease: Blood Pressure Management	Registry
329	Adult Kidney Disease: Catheter Use at Initiation of Hemodialysis	Registry
330	Adult Kidney Disease: Catheter Use for Greater Than or Equal to 90 Days	Registry
403	Adult Kidney Disease: Referral to Hospice	Registry
325	Adult Major Depressive Disorder (MDD): Coordination of Care of Patients with Specific Comorbid Conditions	Registry
107	Adult Major Depressive Disorder (MDD): Suicide Risk Assessment	Electronic Health Record, Registry
384	Adult Primary Rhegmatogenous Retinal Detachment Surgery: No Return to the Operating Room Within 90 Days of Surgery	Registry
385	Adult Primary Rhegmatogenous Retinal Detachment Surgery: Visual Acuity Improvement Within 90 Days of Surgery	Registry
331	Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Overuse)	Registry
332	Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin With or Without Clavulanate Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)	Registry
333	Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)	Registry
334	Adult Sinusitis: More than One Computerized Tomography (CT) Scan Within 90 Days for Chronic Sinusitis (Overuse)	Registry
439	Age Appropriate Screening Colonoscopy	Registry
140	Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement	Claims, Registry
014	Age-Related Macular Degeneration (AMD): Dilated Macular Examination	Claims, Registry
458	All-cause Hospital Readmission	Administrative Claims
386	Amyotrophic Lateral Sclerosis (ALS) Patient Care Preferences	Registry
354	Anastomotic Leak Intervention	Registry
404	Anesthesiology Smoking Abstinence	Registry
387	Annual Hepatitis C Virus (HCV) Screening for Patients who are Active Injection Drug Users	Registry
009	Anti-Depressant Medication Management	Electronic Health Record, Registry
421	Appropriate Assessment of Retrievable Inferior Vena Cava (IVC) Filters for Removal	Registry
405	Appropriate Follow-up Imaging for Incidental Abdominal Lesions	Claims, Registry
406	Appropriate Follow-up Imaging for Incidental Thyroid Nodules in Patients	Claims, Registry
320	Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients	Claims, Registry
066	Appropriate Testing for Children with Pharyngitis	Electronic Health Record, Registry
065	Appropriate Treatment for Children with Upper Respiratory Infection (URI)	Electronic Health Record, Registry
407	Appropriate Treatment of Methicillin-Sensitive Staphylococcus Aureus (MSSA) Bacteremia	Claims, Registry
448	Appropriate Workup Prior to Endometrial Ablation	Registry
326	Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation Therapy	Claims, Registry
116	Avoidance of Antibiotic Treatment in Adults With Acute Bronchitis	Registry
249	Barrett's Esophagus	Claims, Registry
440	Basal Cell Carcinoma (BCC)/Squamous Cell Carcinoma: Biopsy Reporting Time - Pathologist to Clinician	Registry
265	Biopsy Follow-Up	Registry
367	Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use	Electronic Health Record, Registry
099	Breast Cancer Resection Pathology Reporting: pT Category (Primary Tumor) and pN Category (Regional Lymph Nodes) with Histologic Grade	Claims, Registry
112	Breast Cancer Screening	Claims, Electronic Health Record, Cms Web Interface, Registry
321	CAHPS for MIPS Clinician/Group Survey	Certified Survey Vendor
243	Cardiac Rehabilitation Patient Referral from an Outpatient Setting	Registry
322	Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Preoperative Evaluation in Low Risk Surgery Patients	Registry
323	Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI)	Registry
324	Cardiac Stress Imaging Not Meeting Appropriate Use Criteria: Testing in Asymptomatic, Low-Risk Patients	Registry
047	Care Plan	Claims, Registry
191	Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery	Electronic Health Record, Registry
192	Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures	Electronic Health Record, Registry
303	Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery	Registry
304	Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery	Registry
389	Cataract Surgery: Difference Between Planned and Final Refraction	Registry
388	Cataract Surgery with Intra-Operative Complications (Unplanned Rupture of Posterior Capsule Requiring Unplanned Vitrectomy)	Registry
309	Cervical Cancer Screening	Electronic Health Record, Registry
382	Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment	Electronic Health Record, Registry
240	Childhood Immunization Status	Electronic Health Record, Registry
378	Children Who Have Dental Decay or Cavities	Electronic Health Record, Registry
447	Chlamydia Screening and Follow Up	Registry
310	Chlamydia Screening for Women	Electronic Health Record, Registry
052	Chronic Obstructive Pulmonary Disease (COPD): Long-Acting Inhaled Bronchodilator Therapy	Claims, Registry
051	Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation	Claims, Registry
409	Clinical Outcome Post Endovascular Stroke Treatment	Registry
374	Closing the Referral Loop: Receipt of Specialist Report	Electronic Health Record, Registry
185	Colonoscopy Interval for Patients with a History of Adenomatous Polyps - Avoidance of Inappropriate Use	Claims, Registry
100	Colorectal Cancer Resection Pathology Reporting: pT Category (Primary Tumor) and pN Category (Regional Lymph Nodes) with Histologic Grade	Claims, Registry
113	Colorectal Cancer Screening	Claims, Electronic Health Record, Cms Web Interface, Registry
024	Communication with the Physician or Other Clinician Managing On-going Care Post-Fracture for Men and Women Aged 50 Years and Older	Claims, Registry
236	Controlling High Blood Pressure	Claims, Electronic Health Record, Cms Web Interface, Registry
165	Coronary Artery Bypass Graft (CABG): Deep Sternal Wound Infection Rate	Registry
167	Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure	Registry
044	Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery	Registry
164	Coronary Artery Bypass Graft (CABG): Prolonged Intubation	Registry
166	Coronary Artery Bypass Graft (CABG): Stroke	Registry
168	Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration	Registry
043	Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery	Registry
118	Coronary Artery Disease (CAD): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy - Diabetes or Left Ventricular Systolic Dysfunction (LVEF < 40%)	Registry
006	Coronary Artery Disease (CAD): Antiplatelet Therapy	Registry
007	Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)	Electronic Health Record, Registry
288	Dementia: Caregiver Education and Support	Registry
281	Dementia: Cognitive Assessment	Electronic Health Record, Registry
286	Dementia: Counseling Regarding Safety Concerns	Registry
282	Dementia: Functional Status Assessment	Registry
284	Dementia: Management of Neuropsychiatric Symptoms	Registry
283	Dementia: Neuropsychiatric Symptom Assessment	Registry
411	Depression Remission at Six Months	Registry
370	Depression Remission at Twelve Months	Electronic Health Record, Cms Web Interface, Registry
371	Depression Utilization of the PHQ-9 Tool	Electronic Health Record, Registry
117	Diabetes: Eye Exam	Claims, Cms Web Interface, Electronic Health Record, Registry
163	Diabetes: Foot Exam	Electronic Health Record, Registry
001	Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)	Claims, Cms Web Interface, Electronic Health Record, Registry
119	Diabetes: Medical Attention for Nephropathy	Electronic Health Record, Registry
126	Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation	Registry
127	Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear	Registry
019	Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care	Claims, Electronic Health Record, Registry
018	Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy	Electronic Health Record, Registry
130	Documentation of Current Medications in the Medical Record	Claims, Electronic Health Record, Registry
412	Documentation of Signed Opioid Treatment Agreement	Registry
413	Door to Puncture Time for Endovascular Stroke Treatment	Registry
181	Elder Maltreatment Screen and Follow-Up Plan	Claims, Registry
415	Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older	Claims, Registry
416	Emergency Medicine: Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years	Claims, Registry
268	Epilepsy: Counseling for Women of Childbearing Potential with Epilepsy	Claims, Registry
414	Evaluation or Interview for Risk of Opioid Misuse	Registry
155	Falls: Plan of Care	Claims, Registry
154	Falls: Risk Assessment	Claims, Registry
318	Falls: Screening for Future Fall Risk	Electronic Health Record, Cms Web Interface, Registry
391	Follow-Up After Hospitalization for Mental Illness (FUH)	Registry
182	Functional Outcome Assessment	Claims, Registry
376	Functional Status Assessment for Total Hip Replacement	Electronic Health Record, Registry
375	Functional Status Assessment for Total Knee Replacement	Electronic Health Record, Registry
377	Functional Status Assessments for Congestive Heart Failure	Electronic Health Record, Registry
222	Functional Status Change for Patients with Elbow, Wrist or Hand Impairments	Registry
219	Functional Status Change for Patients with Foot or Ankle Impairments	Registry
223	Functional Status Change for Patients with General Orthopaedic Impairments	Registry
218	Functional Status Change for Patients with Hip Impairments	Registry
217	Functional Status Change for Patients with Knee Impairments	Registry
220	Functional Status Change for Patients with Lumbar Impairments	Registry
221	Functional Status Change for Patients with Shoulder Impairments	Registry
005	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)	Electronic Health Record, Registry
008	Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)	Electronic Health Record, Registry
070	Hematology: Chronic Lymphocytic Leukemia (CLL): Baseline Flow Cytometry	Registry
069	Hematology: Multiple Myeloma: Treatment with Bisphosphonates	Registry
067	Hematology: Myelodysplastic Syndrome (MDS) and Acute Leukemias: Baseline Cytogenetic Testing Performed on Bone Marrow	Registry
068	Hematology: Myelodysplastic Syndrome (MDS): Documentation of Iron Stores in Patients Receiving Erythropoietin Therapy	Registry
390	Hepatitis C: Discussion and Shared Decision Making Surrounding Treatment Options	Registry
401	Hepatitis C: Screening for Hepatocellular Carcinoma (HCC) in Patients with Cirrhosis	Registry
449	HER2 Negative or Undocumented Breast Cancer Patients Spared Treatment with HER2-Targeted Therapies	Registry
160	HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis	Electronic Health Record, Registry
205	HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis	Registry
340	HIV Medical Visit Frequency	Registry
338	HIV Viral Load Suppression	Registry
392	HRS-12: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation	Registry
348	HRS-3: Implantable Cardioverter-Defibrillator (ICD) Complications Rate	Registry
393	HRS-9: Infection within 180 Days of Cardiac Implantable Electronic Device (CIED) Implantation, Replacement, or Revision	Registry
373	Hypertension: Improvement in Blood Pressure	Electronic Health Record, Registry
262	Image Confirmation of Successful Excision of Image-Localized Breast Lesion	Registry
394	Immunizations for Adolescents	Registry
275	Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy	Registry
271	Inflammatory Bowel Disease (IBD): Preventive Care: Corticosteroid Related Iatrogenic Injury - Bone Loss Assessment	Registry
305	Initiation and Engagement of Alcohol and Other Drug Dependence Treatment	Electronic Health Record, Registry
441	Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)	Registry
204	Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet	Claims, Electronic Health Record, Cms Web Interface, Registry
451	KRAS Gene Mutation Testing Performed for Patients with Metastatic Colorectal Cancer who receive Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibody Therapy	Registry
395	Lung Cancer Reporting (Biopsy/Cytology Specimens)	Claims, Registry
396	Lung Cancer Reporting (Resection Specimens)	Claims, Registry
372	Maternal Depression Screening	Electronic Health Record, Registry
335	Maternity Care: Elective Delivery or Early Induction Without Medical Indication at >= 37 and < 39 Weeks (Overuse)	Registry
336	Maternity Care: Post-Partum Follow-Up and Care Coordination	Registry
444	Medication Management for People with Asthma	Registry
046	Medication Reconciliation Post-Discharge	Claims, Cms Web Interface, Registry
137	Melanoma: Continuity of Care - Recall System	Registry
138	Melanoma: Coordination of Care	Registry
224	Melanoma: Overutilization of Imaging Studies in Melanoma	Registry
397	Melanoma Reporting	Claims, Registry
443	Non-Recommended Cervical Cancer Screening in Adolescent Females	Registry
147	Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy	Claims, Registry
143	Oncology: Medical and Radiation - Pain Intensity Quantified	Electronic Health Record, Registry
144	Oncology: Medical and Radiation - Plan of Care for Pain	Registry
156	Oncology: Radiation Dose Limits to Normal Tissues	Claims, Registry
400	One-Time Screening for Hepatitis C Virus (HCV) for Patients at Risk	Registry
446	Operative Mortality Stratified by the Five STS-EACTS Mortality Categories	Registry
408	Opioid Therapy Follow-up Evaluation	Registry
398	Optimal Asthma Control	Registry
364	Optimizing Patient Exposure to Ionizing Radiation: Appropriateness: Follow-up CT Imaging for Incidentally Detected Pulmonary Nodules According to Recommended Guidelines	Registry
362	Optimizing Patient Exposure to Ionizing Radiation: Computed Tomography (CT) Images Available for Patient Follow-up and Comparison Purposes	Registry
360	Optimizing Patient Exposure to Ionizing Radiation: Count of Potential High Dose Radiation Imaging Studies: Computed Tomography (CT) and Cardiac Nuclear Medicine Studies	Registry
361	Optimizing Patient Exposure to Ionizing Radiation: Reporting to a Radiation Dose Index Registry	Registry
363	Optimizing Patient Exposure to Ionizing Radiation: Search for Prior Computed Tomography (CT) Studies Through a Secure, Authorized, Media-Free, Shared Archive	Registry
359	Optimizing Patient Exposure to Ionizing Radiation: Utilization of a Standardized Nomenclature for Computed Tomography (CT) Imaging Description	Registry
109	Osteoarthritis (OA): Function and Pain Assessment	Claims, Registry
418	Osteoporosis Management in Women Who Had a Fracture	Claims, Registry
419	Overuse Of Neuroimaging For Patients With Primary Headache And A Normal Neurological Examination	Claims, Registry
131	Pain Assessment and Follow-Up	Claims, Registry
342	Pain Brought Under Control Within 48 Hours	Registry
291	Parkinson's Disease: Cognitive Impairment or Dysfunction Assessment	Registry
294	Parkinson's Disease: Parkinson's Disease Medical and Surgical Treatment Options Reviewed	Registry
290	Parkinson's Disease: Psychiatric Symptoms Assessment for Patients with Parkinson's Disease	Registry
293	Parkinson's Disease: Rehabilitative Therapy Options	Registry
358	Patient-Centered Surgical Risk Assessment and Communication	Registry
452	Patients with Metastatic Colorectal Cancer and KRAS Gene Mutation Spared Treatment with Anti-epidermal Growth Factor Receptor (EGFR) Monoclonal Antibodies	Registry
327	Pediatric Kidney Disease: Adequacy of Volume Management	Registry
328	Pediatric Kidney Disease: ESRD Patients Receiving Dialysis: Hemoglobin Level < 10 g/dL	Registry
428	Pelvic Organ Prolapse: Preoperative Assessment of Occult Stress Urinary Incontinence	Registry
429	Pelvic Organ Prolapse: Preoperative Screening for Uterine Malignancy	Claims, Registry
422	Performing Cystoscopy at the Time of Hysterectomy for Pelvic Organ Prolapse to Detect Lower Urinary Tract Injury	Claims, Registry
423	Perioperative Anti-platelet Therapy for Patients Undergoing Carotid Endarterectomy	Claims, Registry
021	Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin	Claims, Registry
023	Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)	Claims, Registry
424	Perioperative Temperature Management	Registry
442	Persistence of Beta-Blocker Treatment After a Heart Attack	Registry
425	Photodocumentation of Cecal Intubation	Claims, Registry
111	Pneumococcal Vaccination Status for Older Adults	Claims, Electronic Health Record, Cms Web Interface, Registry
426	Post-Anesthetic Transfer of Care Measure: Procedure Room to a Post Anesthesia Care Unit (PACU)	Registry
427	Post-Anesthetic Transfer of Care: Use of Checklist or Protocol for Direct Transfer of Care from Procedure Room to Intensive Care Unit (ICU)	Registry
369	Pregnant women that had HBsAg testing	Electronic Health Record, Registry
263	Preoperative Diagnosis of Breast Cancer	Registry
076	Prevention of Central Venous Catheter (CVC) - Related Bloodstream Infections	Claims, Registry
430	Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy	Registry
128	Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan	Claims, Electronic Health Record, Cms Web Interface, Registry
110	Preventive Care and Screening: Influenza Immunization	Claims, Electronic Health Record, Cms Web Interface, Registry
134	Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan	Claims, Electronic Health Record, Cms Web Interface, Registry
317	Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented	Claims, Electronic Health Record, Registry
226	Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention	Claims, Electronic Health Record, Cms Web Interface, Registry
431	Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling	Registry
379	Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists	Electronic Health Record, Registry
012	Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation	Claims, Electronic Health Record, Registry
141	Primary Open-Angle Glaucoma (POAG): Reduction of Intraocular Pressure (IOP) by 15% OR Documentation of a Plan of Care	Claims, Registry
457	Proportion Admitted to Hospice for less than 3 days	Registry
455	Proportion Admitted to the Intensive Care Unit (ICU) in the Last 30 Days of Life	Registry
456	Proportion Not Admitted To Hospice	Registry
432	Proportion of Patients Sustaining a Bladder Injury at the Time of any Pelvic Organ Prolapse Repair	Registry
433	Proportion of Patients Sustaining a Bowel Injury at the time of any Pelvic Organ Prolapse Repair	Registry
434	Proportion of Patients Sustaining a Ureter Injury at the Time of any Pelvic Organ Prolapse Repair	Registry
454	Proportion of Patients who Died from Cancer with more than One Emergency Department Visit in the Last 30 Days of Life	Registry
453	Proportion Receiving Chemotherapy in the Last 14 Days of Life	Registry
104	Prostate Cancer: Adjuvant Hormonal Therapy for High Risk or Very High Risk Prostate Cancer	Registry
102	Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients	Electronic Health Record, Registry
410	Psoriasis: Clinical Response to Oral Systemic or Biologic Medications	Claims, Registry
435	Quality of Life Assessment For Patients With Primary Headache Disorders	Claims, Registry
251	Quantitative Immunohistochemical (IHC) Evaluation of Human Epidermal Growth Factor Receptor 2 Testing (HER2) for Breast Cancer Patients	Claims, Registry
436	Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques	Claims, Registry
250	Radical Prostatectomy Pathology Reporting	Claims, Registry
145	Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy	Claims, Registry
146	Radiology: Inappropriate Use of "Probably Benign" Assessment Category in Screening Mammograms	Claims, Registry
225	Radiology: Reminder System for Screening Mammograms	Claims, Registry
195	Radiology: Stenosis Measurement in Carotid Imaging Reports	Claims, Registry
344	Rate of Carotid Artery Stenting (CAS) for Asymptomatic Patients, Without Major Complications (Discharged to Home by Post-Operative Day #2)	Registry
260	Rate of Carotid Endarterectomy (CEA) for Asymptomatic Patients, without Major Complications (Discharged to Home by Post-Operative Day #2)	Registry
347	Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) Who Die While in Hospital	Registry
259	Rate of Endovascular Aneurysm Repair (EVAR) of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post Operative Day #2)	Registry
417	Rate of Open Repair of Small or Moderate Abdominal Aortic Aneurysms (AAA) Where Patients Are Discharged Alive	Registry
258	Rate of Open Repair of Small or Moderate Non-Ruptured Infrarenal Abdominal Aortic Aneurysms (AAA) without Major Complications (Discharged to Home by Post-Operative Day #7)	Registry
345	Rate of Postoperative Stroke or Death in Asymptomatic Patients Undergoing Carotid Artery Stenting (CAS)	Registry
346	Rate of Postoperative Stroke or Death in Asymptomatic Patients Undergoing Carotid Endarterectomy (CEA)	Registry
437	Rate of Surgical Conversion from Lower Extremity Endovascular Revascularization Procedure	Claims, Registry
261	Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness	Claims, Registry
179	Rheumatoid Arthritis (RA): Assessment and Classification of Disease Prognosis	Registry
178	Rheumatoid Arthritis (RA): Functional Status Assessment	Registry
180	Rheumatoid Arthritis (RA): Glucocorticoid Management	Registry
177	Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity	Registry
176	Rheumatoid Arthritis (RA): Tuberculosis Screening	Registry
255	Rh Immunoglobulin (Rhogam) for Rh-Negative Pregnant Women at Risk of Fetal Blood Exposure	Claims, Registry
445	Risk-Adjusted Operative Mortality for Coronary Artery Bypass Graft (CABG)	Registry
343	Screening Colonoscopy Adenoma Detection Rate	Registry
039	Screening for Osteoporosis for Women Aged 65-85 Years of Age	Claims, Registry
264	Sentinel Lymph Node Biopsy for Invasive Breast Cancer	Registry
279	Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy	Registry
276	Sleep Apnea: Assessment of Sleep Symptoms	Registry
278	Sleep Apnea: Positive Airway Pressure Therapy Prescribed	Registry
277	Sleep Apnea: Severity Assessment at Initial Diagnosis	Registry
257	Statin Therapy at Discharge after Lower Extremity Bypass (LEB)	Registry
438	Statin Therapy for the Prevention and Treatment of Cardiovascular Disease	Cms Web Interface, Registry
032	Stroke and Stroke Rehabilitation: Discharged on Antithrombotic Therapy	Claims, Registry
187	Stroke and Stroke Rehabilitation: Thrombolytic Therapy	Registry
357	Surgical Site Infection (SSI)	Registry
402	Tobacco Use and Help with Quitting Among Adolescents	Registry
353	Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report	Registry
352	Total Knee Replacement: Preoperative Antibiotic Infusion with Proximal Tourniquet	Registry
350	Total Knee Replacement: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy	Registry
351	Total Knee Replacement: Venous Thromboembolic and Cardiovascular Risk Evaluation	Registry
450	Trastuzumab Received By Patients With AJCC Stage I (T1c) - III And HER2 Positive Breast Cancer Receiving Adjuvant Chemotherapy	Registry
337	Tuberculosis (TB) Prevention for Psoriasis, Psoriatic Arthritis and Rheumatoid Arthritis Patients on a Biological Immune Response Modifier	Registry
254	Ultrasound Determination of Pregnancy Location for Pregnant Patients with Abdominal Pain	Claims, Registry
356	Unplanned Hospital Readmission within 30 Days of Principal Procedure	Registry
355	Unplanned Reoperation within the 30 Day Postoperative Period	Registry
048	Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older	Claims, Registry
050	Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older	Claims, Registry
238	Use of High-Risk Medications in the Elderly	Electronic Health Record, Registry
312	Use of Imaging Studies for Low Back Pain	Electronic Health Record, Registry
420	Varicose Vein Treatment with Saphenous Ablation: Outcome Survey	Registry
239	Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents	Electronic Health Record, Registry
AAAAI2	Asthma: Assessment of Asthma Control – Ambulatory Care Setting	Registry
AAAAI5	Allergen Immunotherapy Treatment: Allergen Specific Immunoglobulin E (IgE) Sensitivity Assessed and Documented Prior to Treatment	Registry
AAAAI6	Documentation of Clinical Response to Allergen Immunotherapy within One Year	Registry
AAAAI8	Achievement of Projected Effective Dose of Standardized Allergens for Patient Treated With Allergen Immunotherapy for at Least One Year	Registry
AAAAI9	Assessment of Asthma Symptoms Prior to Administration of Allergen Immunotherapy Injection(s)	Registry
AAAAI11	Asthma Assessment and Classification	Registry
AAAAI12	Lung Function/Spirometry Evaluation	Registry
AAAAI17	Asthma Control: Minimal Important Difference Improvement	Registry
AAAAI18	Penicillin Allergy: Appropriate Removal or Confirmation	Registry
AAAAI19	Asthma: Pharmacologic Therapy for Persistent Asthma – Ambulatory Care Setting	Registry
AAD1	Psoriasis: Assessment of Psoriasis Disease Activity	Registry
AAD2	Psoriasis: Screening for Psoriatic Arthritis	Registry
AAD3	Basal Cell Carcinoma/Squamous Cell Carcinoma: Mohs Surgery for Superficial Basal Cell Carcinoma of the Trunk for Immune Competent Patients	Registry
AAD4	Basal Cell Carcinoma/Squamous Cell Carcinoma: Mohs Surgery for Squamous Cell Carcinoma in Situ or Keratoacanthoma Type Squamous Cell Carcinoma 1 cm or Smaller on the Trunk	Registry
AAD5	Biopsy Reporting Time - Clinician to Patient	Registry
ARCO11	Head CT or MRI Scan Results for Acute Ischemic Stroke or Hemorrhagic Stroke Patients who Received Head CT or MRI Scan Interpretation within 45 minutes of ED Arrival	Registry
ARCO12	Venous Thromboembolism (VTE) Prophylaxis	Registry
ARCO13	Ischemic stroke patients management -	Registry
ARCO3	Antipsychotic Use in Persons with Dementia	Registry
NOF12	Median Time to Pain Management for Long Bone Fracture	Registry
ARCO7	Laboratory Investigation for Secondary Causes of Fracture	Registry
ACR7	Gout: Serum Urate Target	Registry
ARCO14	Gout: ULT Therapy	Registry
ARCO10	Risk Standardized Mortality Rate within 30 days following Trauma Operation	Registry
ACCCath1	Stroke intra or post PCI procedure in patients without CABG or other major surgeries during admission.	Registry
ACCCath2	New requirement for dialysis post PCI in patients without CABG or other major surgeries during admission.	Registry
ACCCath3	Vascular access site injury requiring treatment or major bleeding post PCI in patients without CABG or other major surgeries during admission.	Registry
ACCCath4	Cardiac tamponade post PCI in patients without CABG or other major surgery during admission.	Registry
ACCCath5	STEMI patients receiving immediate PCI within 90 minutes.	Registry
ACCCath6	ACE-I or ARB prescribed at discharge for patients with an ejection fraction < 40% who had a PCI during the episode of care.	Registry
ACCCath8	Percutaneous Coronary Intervention (PCI): Post-procedural Optimal Medical Therapy	Registry
ACCCath9	PCI procedures that were inappropriate for patients with Acute Coronary Syndrome (ACS).	Registry
ACCCath13	Cardiac Rehabilitation Patient Referral From an Inpatient Setting	Registry
AAN4	Screening for Psychiatric or Behavioral Health Disorders	Registry
AAN9	Querying about Symptoms of Autonomic Dysfunction	Registry
AAN10	Falls screening	Registry
AAN1	Diabetes/Pre-Diabetes Screening for Patients with DSP	Registry
AAN2	Screening for Unhealthy Alcohol Use	Registry
AAN5	MEDICATION PRESCRIBED FOR ACUTE MIGRAINE ATTACK	Registry
AAN11	Overuse of Opioid and Barbiturate Containing Medications for Primary Headache Disorders.	Registry
AAN8	Exercise and Appropriate Physical Activity Counseling for Patients with MS	Registry
IRIS1	Corneal Graft Surgery - Post-operative improvement in visual acuity of 20/40 or greater	Registry
IRIS2	Glaucoma -  Intraocular Pressure (IOP)Reduction	Registry
IRIS3	Glaucoma - Visual Field Progression	Registry
IRIS4	Glaucoma - Intraocular Pressure Reduction Following Laser Trabeculoplasty	Registry
IRIS5	Surgery for Acquired Involutional Ptosis - Patients with an Improvement of Marginal Reflex Distance	Registry
IRIS6	Acquired Involutional Entropion -  Normalized Lid Position After Surgical Repair	Registry
IRIS7	Amblyopia - Interocular Visual Acuity	Registry
IRIS8	Surgical Esotropia - Postoperative Alignment	Registry
IRIS9	Diabetic Retinopathy - Documentation of the Presence or Absence of Macular Edema and the Level of Severity of Retinopathy	Registry
IRIS10	Exudative Age-Related Macular Degeneration - Loss of Visual Acuity	Registry
IRIS11	Nonexudative Age-Related Macular Degeneration - Loss of Visual Acuity	Registry
IRIS13	Diabetic Macular Edema - Loss of Visual Acuity	Registry
IRIS16	Acute Anterior Uveitis - Post-treatment visual acuity	Registry
IRIS17	Acute Anterior Uveitis - Post-treatment Grade 0 anterior chamber cells	Registry
IRIS18	Chronic Anterior Uveitis -  Post-treatment visual acuity	Registry
IRIS19	Chronic Anterior Uveitis -  Post-treatment Grade 0 anterior chamber cells	Registry
IRIS20	Idiopathic Intracranial Hypertension:  No worsening or improvement of mean deviation	Registry
IRIS21	Ocular Myasthenia Gravis:  Improvement of ocular deviation or absence of diplopia or functional improvement	Registry
IRIS22	Giant Cell Arteritis:  Absence of fellow eye involvement after corticosteroid treatment	Registry
IRIS23	Refractive Surgery: Postoperative Improvement in Uncorrected Visual Acuity of 20/20 or better	Registry
IRIS24	Refractive Surgery:  Postoperative correction within + 0.5 Diopter of the Intended Correction	Registry
IRIS25	Adenoviral Conjunctivitis:  Avoidance of Antibiotics	Registry
IRIS26	Intravitreal Injections:  Avoidance of Routine Antibiotic Use	Registry
Q415	Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 18 Years and Older	Registry
Q416	Emergency Department Utilization of CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years	Registry
ACEP21	Coagulation Studies in Patients Presenting with Chest Pain with No Coagulopathy or Bleeding	Registry
ACEP22	Appropriate Emergency Department Utilization of CT for Pulmonary Embolism	Registry
ACEP24	Pregnancy Test for Female Abdominal Pain Patients	Registry
ACEP25	Tobacco Use: Screening and Cessation Intervention	Registry
ACEP26	Sepsis Management: Septic Shock: Lactate Level Measurement	Registry
ACEP27	Sepsis Management: Septic Shock: Antibiotics Ordered	Registry
ACEP28	Sepsis Management: Septic Shock: Fluid Resuscitation	Registry
ACEP29	Sepsis Management: Septic Shock: Repeat Lactate Level Measurement	Registry
ACEP30	Sepsis Management: Septic Shock: Lactate Clearance Rate ≥ 10%	Registry
ACEP31	Emergency Medicine: Appropriate Foley Catheter Use in the Emergency Department	Registry
ACEP32	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients	Registry
ACEP33	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Supercenter EDs (80k +)	Registry
ACEP35	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in High Volume EDs (60k-79,999)	Registry
ACEP36	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Average Volume EDs (40k-59,999)	Registry
ACEP37	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Moderate Volume EDs (20k-39,999)	Registry
ACEP38	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Low Volume EDs (19,999 and less)	Registry
ACEP39	ED Median Time from ED arrival to ED departure for discharged ED patients for Adult Patients in Freestanding Eds	Registry
ACEP40	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients	Registry
ACEP41	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Supercenter EDs (80k +)	Registry
ACEP43	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in High Volume EDs (60k-79,999)	Registry
ACEP44	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Average Volume EDs (40k-59,999)	Registry
ACEP45	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Moderate Volume EDs (20k-39,999)	Registry
ACEP46	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Low Volume EDs (19,999 and less)	Registry
ACEP47	ED Median Time from ED arrival to ED departure for discharged ED patients for Pediatric Patients in Freestanding Eds	Registry
ACEP48	Sepsis Management: Septic Shock: Blood Cultures Ordered	Registry
ACEP49	Emergency Medicine: Appropriate Use of Imaging for Recurrent Renal Colic	Registry
ACPGR1	High Risk Pneumococcal Vaccination	Registry
PPRNET20	Herpes Zoster (Shingles) Vaccination	Registry
ACPGR2	Tdap (Tetanus, Diphtheria, Acellular Pertussis) Vaccination	Registry
ACPGR3	Fixed-dose Combination of Hydralazine and Isosorbide Dinitrate Therapy for Self-identified Black or African American Patients with Heart Failure and LVEF <40% on ACEI or ARB and Beta-blocker Therapy	Registry
Q408	Opioid Therapy Follow-up Evaluation (Q408)	Registry
Q414	Evaluation or Interview for Risk of Opioid Misuse (Q414)	Registry
ACRad26	Appropriate venous access for hemodialysis	Registry
ACRad2	CT Colonography Clinically Significant Extracolonic Findings (Inverse Measure)	Registry
ACRad1	CT Colonography True Positive Rate	Registry
ACRad23	Lung Cancer Screening Abnormal Interpretation Rate	Registry
ACRad21	Lung Cancer Screening Cancer Detection Rate (CDR)	Registry
ACRad22	Lung Cancer Screening Positive Predictive Value (PPV)	Registry
ACRad31	Percent of CT Abdomen-pelvis exams with contrast (single phase scan) for which Dose Length Product is at or below the size-specific diagnostic reference level.	Registry
ACRad32	Percent of CT Chest exams without contrast (single phase scan) for which Dose Length Product is at or below the size-specific diagnostic reference level.	Registry
ACRad33	Percent of CT Head/Brain exams without contrast (single phase scan) for which Dose Length Product is at or below the size-specific diagnostic reference level	Registry
ACRad30	Rate of Inadequate Percutaneous Image-Guided Biopsy	Registry
ACRad28	Rate of early peristomal infection following fluoroscopically guided gastrostomy tube placement	Registry
ACRad29	Rate of percutaneous nephrostomy tube replacement within 30 days secondary to dislodgement	Registry
ACRad18	Report Turnaround Time: CT (Inverse Measure)	Registry
ACRad25	Report Turnaround Time: Mammography	Registry
ACRad17	Report Turnaround Time: MRI (Inverse Measure)	Registry
ACRad19	Report Turnaround Time: PET (Inverse Measure)	Registry
ACRad15	Report Turnaround Time: Radiography (modified) (Inverse Measure)	Registry
ACRad16	Report Turnaround Time: Ultrasound (Excluding Breast US) (Inverse Measure)	Registry
ACRad5	Screening Mammography Abnormal Interpretation Rate (Recall Rate) (inverse Measure)	Registry
ACRad3	Screening Mammography Cancer Detection Rate (CDR)	Registry
ACRad8	Screening Mammography Minimal Cancer Rate	Registry
ACRad7	Screening Mammography Node Negativity Rate	Registry
ACRad6	Screening Mammography Positive Predictive Value 2 (PPV2 - Biopsy Recommended)	Registry
ACRad27	Uterine artery embolization technique: Documentation of angiographic endpoints and interrogation of ovarian arteries	Registry
ACS15	Preoperative Composite	Registry
ACS16	Preventative Care and Screening: Tobacco Screening and Cessation Intervention	Registry
ACS17	Preoperative Key Medications Review for Anticoagulation Medication	Registry
ACS18	Patient Frailty Evaluation	Registry
ACS19	Intraoperative Composite	Registry
ACS20	Optimal Postoperative Communication Plan and Patient Care Coordination Composite	Registry
ACS21	Post-Acute Recovery Composite	Registry
ACS22	Unplanned Reoperation within the 30 Day Postoperative Period	Registry
ACS23	Unplanned Hospital Readmission within 30 Days of Principal Procedure	Registry
Pinc51	Surgical Site Infection (SSI)	Registry
APMA1	Comprehensive Diabetic Foot Examination	Registry
CDR2	Diabetic Foot Ulcer (DFU) Healing or Closure	Registry
ASNC1	Cardiac Stress Nuclear Imaging Not Meeting Appropriate Use Criteria: Preoperative Evaluation in Low Risk Surgery Patients	Registry
ASNC2	Cardiac Stress Nuclear Imaging Not Meeting Appropriate Use Criteria: Routine Testing After Percutaneous Coronary Intervention (PCI)	Registry
ASNC3	Cardiac Stress Nuclear Imaging Not Meeting Appropriate Use Criteria: Testing in Asymptomatic, Low-Risk Patients	Registry
ASNC4	Utilization of standardized nomenclature and reporting for nuclear cardiology imaging studies	Registry
ASNC13	SPECT-MPI studies meeting appropriate use criteria	Registry
ASNC14	PET-MPI studies meeting appropriate use criteria	Registry
ASNC17	SPECT-MPI studies not Equivocal	Registry
ASNC18	PET-MPI studies not Equivocal	Registry
ASNC19	Imaging Protocols for SPECT and PET MPI studies - Use of stress only protocol	Registry
ASNC20	SPECT-MPI studies performed without the use of thallium	Registry
ASNC21	SPECT-MPI study appropriate imaging protocol selection for morbidly obese patients	Registry
ASNC22	SPECT and PET MPI studies reporting Left Ventricular Ejection Fraction	Registry
ASNC23	SPECT-MPI study clinical utilization of Attenuation Correction image acquisition	Registry
ASNC24	SPECT-MPI study utilization of exercise as a stressor	Registry
ASNC25	SPECT-MPI study adequate exercise testing performed	Registry
CDR1	Adequate Off-loading of Diabetic Foot Ulcer at each treatment visit	Registry
ASPS5	Breast Reconstruction: Return to OR	Registry
ASPS6	Breast Reconstruction: Flap Loss	Registry
AUGS1	Complete assessment and evaluation of patient’s pelvic organ prolapse prior to surgical repair	Registry
AUGS2	Preoperative utilization of pessary prior to Pelvic Organ Prolapse surgery	Registry
AUGS3	Preoperative assessment of sexual function prior to pelvic organ prolapse repair	Registry
AUGS4	Performing an intraoperative rectal examination at the time of prolapse repair	Registry
AUGS5	Performing vaginal apical suspension at the time of hysterectomy to address pelvic organ prolapse	Registry
AUGS6	Route of Hysterectomy	Registry
AUGS7	Documentation that conservative management was offered prior to fecal incontinence surgery or procedures.	Registry
AUGS8	Documentation of weight loss counseling prior to surgery for stress urinary incontinence procedures for obese women	Registry
AUGS9	Over-utilization of synthetic mesh in the posterior compartment	Registry
AQUA5	Benign Prostate Hyperplasia: Do not order creatinine lab for patients	Registry
AQUA6	Benign Prostate Hyperplasia: Do not order upper-tract imaging	Registry
AQUA12	Benign Prostate Hyperplasia: IPSS improvement after diagnosis	Registry
AQUA3	Cryptorchidism: Inappropriate use of scrotal/groin ultrasound on boys	Registry
AQUA8	Hospital re-admissions/complications within 30 days of TRUS Biopsy	Registry
AQUA4	Hypogonadism: Testosterone lab ordered/reported within 6 months of starting testosterone replacement	Registry
AQUA11	Prostate Cancer: Patient Report of Sexual function after treatment	Registry
AQUA10	Prostate Cancer: Patient Report of Urinary function after treatment	Registry
MUSIC4	Prostate Cancer: Active Surveillance/Watchful Waiting for Low Risk Prostate Cancer Patients	Registry
AQUA14	Stones: Repeat Shock Wave Lithotripsy (SWL) within 6 months of treatment	Registry
AQUA13	Stress Urinary Incontinence (SUI): Revision surgery within 12 months of incontinence procedure	Registry
AQUA15	Stones: Urinalysis documented 30 days before surgical stone procedures	Registry
AQUA16	Non-Muscle Invasive Bladder Cancer: Repeat Transurethal Resection of Bladder Tumor (TURBT) for T1 disease	Registry
AQUA17	Non-Muscle Invasive Bladder Cancer: Initiation of BCG 3 months of diagnosis of high-grade T1 bladder cancer and/or CIS	Registry
AQUA18	Non-Muscle Invasive Bladder Cancer: Early surveillance cystoscopy within 4 months of initial diagnosis	Registry
AHSQC1	Ventral Hernia Repair: Surgical Site Occurrence Requiring Procedural Intervention within the 30 Day Postoperative Period	Registry
AHSQC2	Unplanned Hospital Readmission or Observation Visit within the 30 Day Postoperative Period	Registry
AHSQC6	Abdominal Wall Reconstruction Surgical Site Occurrence Requiring Procedural Intervention within the 30 Day Postoperative Period	Registry
AHSQC7	Abdominal Wall Reconstruction Preoperative Diabetes Assessment	Registry
AHSQC8	Ventral Hernia Repair: Biologic Mesh Prosthesis Use in Low Risk Patients	Registry
AHSQC9	Ventral Hernia Repair: Pain and Functional Status Assessment	Registry
ABG28	Pre-Operative Screening for GERD	Registry
ABG29	Pre-Operative Screening for Glaucoma	Registry
ABG30	Pre-Operative Screening for PONV Risk	Registry
ABG31	Pre-Operative Screening for Excessive Alcohol and Recreational Drug Use	Registry
ABG32	Pain Related Quality of Life Interference	Registry
ABG33	Lower Body Functional Impairment (LBI)	Registry
ABG34	Mood Assessment Screening and treatment	Registry
ABG1	Intra-operative anesthesia safety	Registry
AQI35	Perioperative Mortality Rate - INVERSE MEASURE	Registry
ABG4	PACU tracheal intubation Rate	Registry
ABG5	Composite Procedural Safety for All Vascular Access Procedures	Registry
ABG7	Immediate Adult Post-Operative Pain Management	Registry
AQI48	Anesthesia: Patient Experience Survey	Registry
ABG14	Corneal Abrasion	Registry
ABG15	Dental Injury	Registry
ABG16	Planned use of difficult airway equipment	Registry
ABG21	Pre-operative OSA assessment	Registry
AQI49	Adherence to Blood Conservation Guidelines for Cardiac Operations using Cardiopulmonary Bypass (CPB) – Composite	Registry
AQI50	Application of Lung-Protective Ventilation during General Anesthesia	Registry
AQI51	Assessment of Patients for Obstructive Sleep Apnea	Registry
AQI42	Coronary Artery Bypass Graft (CABG): Post-Operative Renal Failure - INVERSE MEASURE	Registry
AQI18	Coronary Artery Bypass Graft (CABG): Prolonged Intubation - INVERSE MEASURE	Registry
AQI41	Coronary Artery Bypass Graft (CABG): Stroke - INVERSE MEASURE	Registry
AQI28	New Corneal Injury Not Diagnosed in the Postanesthesia Care Unit/Recovery Area after Anesthesia Care	Registry
AQI34	Perioperative Cardiac Arrest - INVERSE MEASURE	Registry
AQI31	Postanesthesia Care Unit (PACU) Re-intubation Rate - INVERSE MEASURE	Registry
AQI29	Prevention of Post-Operative Vomiting (POV) – Combination Therapy (Pediatrics)	Registry
AQI32	Procedural Safety for Central Line Placement	Registry
AQI37	Surgical Safety Checklist – Applicable Safety Checks Completed Before Induction of Anesthesia	Registry
AQI52	Treatment of Hyperglycemia with Insulin	Registry
ASPIRE4	Administration of insulin or glucose recheck for patients with hyperglycemia	Registry
ASPIRE3	Administration of Neostigmine before Extubation for Cases with Nondepolarizing Neuromuscular Blockade	Registry
ASPIRE19	Avoiding acute kidney injury	Registry
ASPIRE6	Avoiding excessively high tidal volumes during positive pressure ventilation	Registry
ASPIRE16	Avoiding intraoperative hypotension	Registry
ASPIRE22	Avoiding medication overdose	Registry
ASPIRE18	Avoiding myocardial Injury	Registry
ASPIRE8	Core temperature measurement for all general anesthetics	Registry
ASPIRE2	Train of Four Monitor Documented After Last Dose of Non-depolarizing Neuromuscular Blocker	Registry
ASPIRE13	Transfusion goal of hematocrit less than 30 or hemoglobin less than 10.	Registry
BNS1	Preoperative notification of risk of developing ischemic optic neuropathy (ION) during prone spine procedures	Registry
CCOME1	1-Year Patient-Reported Pain and Function Improvement after Total Knee Arthroplasty	Registry
CCOME2	1-Year Patient-Reported Pain and Function Improvement after Total Hip Arthroplasty	Registry
CCOME3	1-Year Patient-Reported Pain and Function Improvement after Total Shoulder Arthroplasty	Registry
CCOME4	1-Year Patient-Reported Pain and Function Improvement after ACLR Surgery	Registry
CCOME5	Extent of Osteoarthritis Observed in Arthroscopic Partial Meniscectomy	Registry
CODE6	Improved Functional Outcome Assessment for Hip Replacement	Registry
CODE7	Improved Functional Outcome Assessment for Knee Replacement	Registry
CODE1	Improved Global Physical Health Outcome Assessment for Shoulder Replacement	Registry
CODE3	Improved Functional Outcome Assessment for Foot/Ankle Repair	Registry
CODE8	Improved Global Physical Health Outcome Assessment for Cervical Surgery	Registry
CODE9	Improved Global Physical Health Outcome Assessment for Hand/Wrist/Elbow Repair	Registry
CODE5	Improved Global Physical Health Outcome Assessment for Spine Surgery	Registry
CODE10	Improved Global Physical Health Outcome Assessment for Shoulder Arthroscopy	Registry
CODE11	Improved Functional Outcome Assessment for Knee Arthroscopy	Registry
CODE2	Improved Functional Outcome Assessment for ACL Repair	Registry
CODE12	Improved Functional Outcome Assessment for Hip Arthroscopy	Registry
CESQIP6	Evaluation and Integration of anti-coagulant medication prior to surgery	Registry
CESQIP4	Persistent hypercalcemia	Registry
CESQIP1	Post operative hypocalcemia after thyroidectomy surgery	Registry
CESQIP3	Pre operative ultrasound exam of patients with thyroid cancer	Registry
CESQIP5	Related readmission for adrenal related problems	Registry
CESQIP2	Related readmission for thyroid or parathyroid related problems	Registry
CUHSM3	CAHPS Clinician/Group Surveys - (Adult Primary Care, Pediatric Care, and Specialist Care Surveys)	Registry
CUHSM4	CAHPS Health Plan Survey v 4.0 - Adult questionnaire	Registry
CUHSM6	Adherence to Mood Stabilizers for Individuals with Bipolar I Disorder	Registry
CUHSM8	Cardiovascular Health Screening for People With Schizophrenia or Bipolar Disorder Who Are Prescribed Antipsychotic Medications	Registry
EPREOP4	Short-term Pain Management/Maximum Pain Score	Registry
EPREOP9	Prophylactic Antibiotic Administration	Registry
EPREOP14	Dental Injury	Registry
EPREOP26	Ultrasound Guidance for Central Venous Catheter Placement	Registry
EPREOP27	Ultrasound Guidance for Peripheral Nerve Block	Registry
FORCE4	Improvement in Function after Knee Replacement	Registry
FORCE5	Improvement in Pain after Knee Replacement	Registry
FORCE9	Improvement in Function after Hip Replacement	Registry
FORCE10	Measure Improvement in Pain after Hip Replacement	Registry
FORCE17	Functional Status Assessment for Patients with musculoskeletal disease	Registry
FORCE18	Pain Status Assessment for Patients with musculoskeletal disease	Registry
FORCE19	Mental Health Assessment for Patients with orthopedic conditions	Registry
GIQIC15	Appropriate follow-up interval of 3 years recommended based on pathology findings from screening colonoscopy in average-risk patients	Registry
GIQIC12	Appropriate indication for colonoscopy	Registry
GIQIC10	Appropriate management of anticoagulation in the peri-procedural period rate – EGD	Registry
NHCR4	Repeat screening or surveillance colonoscopy recommended within one year due to inadequate/poor bowel preparation	Registry
HF1	Knee Arthroscopy for Meniscectomy	Registry
HF2	Surgical Reconstruction for Anterior Cruciate Ligament (ACL) Injury	Registry
HF3	Shoulder Instability - Labral Reconstruction: Change in Validated Shoulder Patient Reported Outcome Measure Following Labral Reconstruction for Shoulder	Registry
HF4	Shoulder Arthroscopy: Measure of Change in a Validated Shoulder Patient Reported Outcome Following Shoulder Arthroscopy	Registry
HF5	Shoulder Arthroplasty: Change in a Validated Shoulder Patient Reported Outcome Measure Following Shoulder Arthroplasty	Registry
HF6	Knee Arthroscopy for Meniscal Repair: Change in a Validated Knee Patient Reported Outcome Measure Following Knee Arthroscopy for Meniscal Repair	Registry
HF7	Surgical Repair for Rotator Cuff Tear: Change in a Validated Shoulder Patient Reported Outcome Measure Following Surgical Rotator Cuff Repair	Registry
HAdv1	Use of high risk sleep medications in the elderly	Registry
HAdv2	Atrial fibrillation (afib) prevention and treatment: Patients with afib who are assessed for lifestyle and disease factors that contribute to uncontrolled afib	Registry
M2S16	Absence of unplanned reoperation after major lower extremity amputation	Registry
M2S17	Absence of serious technical complications during peripheral arterial intervention	Registry
M2S18	Venous clinical severity score (VCSS) assessment before varicose vein treatment	Registry
M2S19	Proper patient selection for perforator vein ablation	Registry
M2S1	Procedures with statin and antiplatelet agents prescribed at discharge	Registry
M2S2	Amputation-free survival assessed at least 9 months following Infra-Inguinal Bypass for intermittent claudication	Registry
M2S3	Infra-inguinal bypass for claudication patency assessed at least 9 months following surgery	Registry
M2S4	Amputation-free survival assessed at least 9 months following Supra-Inguinal Bypassfor claudication	Registry
M2S5	Amputation-free survival at assessed at least 9 months following Peripheral Vascular Interventionfor intermittent claudication	Registry
M2S6	Peripheral Vascular Intervention patency assessed at least 9 months following infrainguinal PVI for claudication	Registry
M2S7	Ipsilateral stroke-free survival at assessed at least 9 months following Carotid Artery Stenting for asymptomatic procedures	Registry
M2S8	Ipsilateral stroke-free survival assessed at least 9 months following isolated Carotid Endarterectomy for asymptomatic procedures	Registry
M2S9	Imaging-based maximum aortic diameter assessed at least 9 months following Thoracic and Complex EVAR procedures	Registry
M2S10	Survival at least 9 months after elective repair of small thoracic aortic aneurysms	Registry
M2S11	Imaging-based maximum aortic diameter assessed at least 9 months following Endovascular AAA Repair procedures	Registry
M2S12	Survival at least 9 months after elective repair Endovascular AAA Repair of small abdominal aortic aneurysms	Registry
M2S13	Survival at least 9 months after elective Open AAA repair of small abdominal aortic aneurysms	Registry
BIVARUS27	Patient Reported Comprehensive Assessment of Safety	Registry
BIVARUS28	Patient Reported Experience and Care Coordination	Registry
BIVARUS32	Patient Reported Care Team Communication	Registry
BIVARUS30	Patient Reported Pain Treatment Effectiveness	Registry
BIVARUS31	Patient Reported Communication and Care Coordination	Registry
MOA 1	Objectifying pain and/or functionality to determine manipulative medicine efficacy with correlative treatment adjustment.	Registry
MOA 2	Appropriate use of advanced imaging by ordering provider with glucocorticoid management to spare motor neuron loss when physical findings suggest neuropathic etiology.	Registry
MOA 7	Appropriate controlled substance prescribing (definitive diagnosis(es)) via adherence to Controlled Substance Agreements (CSA) or (OA's) with corrective action taken for pain and/or substance use disorder patients when violations occur.	Registry
MOA 13	Urine Drug Screen Utilization in Pain Management and Substance Use Disorders; no less than quarterly for pain and no less than monthly for substance use disorders.	Registry
MOA 14	Addressing anxiety in pain patients with SNRI and SSRIs and reducing/eliminating benzodiazepines for chronic anxiety.	Registry
MOA 15	Weight loss in pain patients with BMI >30 with opiate utilization for weight related pain conditions rather than opiate dose escalation for improved pain control.	Registry
MOA 12	Treatment of spinal stenosis with manipulative medicine and alternative medicine modalities.	Registry
MeHC1	Hemoglobin A1c Test for Pediatric Patients	Registry
ECPR39	Avoid Head CT for Patients with Uncomplicated Syncope	Registry
ECPR43	Coagulation Studies in Patients Presenting with Chest Pain with No Coagulopathy or Bleeding	Registry
ECPR2	Door to Diagnostic Evaluation by a Provider – Emergency Department (ED) Patients	Registry
ECPR44	Door to Diagnostic Evaluation by a Provider – Urgent Care Patients	Registry
ECPR40	Initiation of the Initial Sepsis Bundle	Registry
ECPR6	Mean Time from Emergency Department (ED) Arrival to ED Departure for Discharged Higher Acuity ED Patients	Registry
ECPR5	Mean Time from Emergency Department (ED) Arrival to ED Departure for Discharged Lower Acuity ED Patients	Registry
ECPR42	Restrictive Use of Blood Transfusions	Registry
ECPR41	Rh Status Evaluation and Treatment of Pregnant Women at Risk of Fetal Blood Exposure	Registry
ECPR11	Three Day All Cause Return ED Visit Rate – All Patients	Registry
ECPR38	Three Day All Cause Return ED Visit Rate with Admission on Re-Visit	Registry
HCPR19	30 Day All Cause Readmission Rate for Discharged Inpatients	Registry
HCPR4	Mean Length of Stay for Inpatients – CHF	Registry
HCPR5	Mean Length of Stay for Inpatients – COPD	Registry
HCPR3	Mean Length of Stay for Inpatients – Pneumonia	Registry
HCPR16	Physician’s Orders for Life-Sustaining Treatment (POLST) Form	Registry
HCPR17	Pressure Ulcers – Risk Assessment and Plan of Care	Registry
HCPR13	Stroke Venous Thromboembolism (VTE) Prophylaxis	Registry
HCPR18	Unintentional Weight Loss – Risk Assessment and Plan of Care	Registry
HCPR14	Venous Thromboembolism (VTE) Prophylaxis	Registry
AQI30	Anesthesia Safety	Registry
MA1	Case Delay	Registry
MA2	Corneal Abrasion	Registry
MIRAMED3	Dental Injury	Registry
MICS1	General Health Postoperative Improvement	Registry
MICS2	Surgery Specific Postoperative Improvement in Pain Levels	Registry
MICS3	Surgery Specific Postoperative Improvement in Function Levels	Registry
MEX1	Heel Pain Treatment Outcomes for Adults	Registry
MEX2	Heel Pain Treatment Outcomes for Pediatric Patients	Registry
MEX3	Identification of Flat Foot in Pediatric Patients	Registry
MBSAQIP1	Risk standardized rate of patients who experienced a postoperative complication within 30 days	Registry
MBSAQIP2	Risk standardized rate of patients who experienced an unplanned readmission within 30 days	Registry
MBSAQIP3	Risk standardized rate of patients who experienced a reoperation within 30 days	Registry
MBSAQIP4	Risk standardized rate of patients who experienced an anastomotic/staple line leak within 30 days	Registry
MBSAQIP6	Risk standardized rate of patients who experienced a postoperative surgical site infection (SSI) within 30 days	Registry
MBSAQIP7	Risk standardized rate of patients who experienced postoperative nausea, vomiting or fluid/electrolyte/nutritional depletion within 30 days	Registry
MBSAQIP8	Risk standardized rate of patients who experienced extended length of stay (> 7 days)	Registry
MSSIC2	Assessment of back or neck pain	Registry
MSSIC3	Assessment of leg or arm pain	Registry
MSSIC4	Assessment of pain-related disability (ODI/NDI)	Registry
MSSIC5	Follow-up (90 day) assessment of myelopathy (cervical only)	Registry
MSSIC8	Percent of patients achieving MCID for back or neck pain	Registry
MSSIC9	Percent of patients achieving MCID for leg or arm pain	Registry
MSSIC10	Percent of patients achieving MCID for pain-related disability (ODI/NDI)	Registry
MSSIC6	Percent same-day ambulation	Registry
MSSIC11	Percent Satisfied with Result	Registry
MSSIC1	Pre-surgical screening for depression	Registry
MSSIC7	Rate of use of Pre-op skin preparation/wash	Registry
MSSIC12	Risk-adjusted rate of hospital readmission	Registry
MSSIC13	Risk-adjusted rate of surgical site infection	Registry
MSSIC14	Risk-adjusted rate of urinary retention	Registry
MSSIC15	Unplanned Return to OR Rate	Registry
MUSIC1	Prostate Biopsy Antibiotic Compliance	Registry
MUSIC6	Prostate Cancer: Unplanned Hospital Readmission After Radical Prostatectomy	Registry
MUSIC5	Prostate Cancer: Radical Prostatectomy Cases LOS	Registry
MUSIC3	Prostate Cancer: Avoidance of Overuse of CT Scan for Staging Low Risk Prostate Cancer Patients	Registry
MUSIC2	Prostate Biopsy: Unplanned Hospital Admission within 30 Days of TRUS Biopsy	Registry
MUSIC9	Prostate Biopsy: Repeat Biopsy for Patients with Atypical Small Acinar Proliferation (ASAP)	Registry
MUSIC10	Prostate Cancer: Confirmation Testing in low risk AS eligible patients	Registry
MUSIC11	Prostate Cancer: Follow-Up Testing for patients on active surveillance for at least 30 months	Registry
MIRAMED5	Adult PACU Pain Management	Registry
MIRAMED9	Case Delay Rate	Registry
MIRAMED7	New Corneal Injury Not Diagnosed in the Postanesthesia Care Unit/Recovery Area after Anesthesia Care	Registry
ABG12	Patient Experience Survey	Registry
MIRAMED4	Perioperative Mortality Rate	Registry
MIRAMED16	Perioperative Pain Plan	Registry
MIRAMED13	Screening and patient education for high risk patients meeting guidelines for Abdominal Aortic Ultrasound Screening	Registry
MIRAMED14	Screening and patient education for high risk patients meeting guidelines for Breast Cancer screening with MRI	Registry
MIRAMED12	Screening and patient education for high risk patients meeting guidelines for Lung Cancer Screening with CT	Registry
MIRAMED15	Screening and patient education for high risk patients meeting guidelines for osteoporosis screening	Registry
MIRAMED11	Screening and patient education for patients meeting guidelines for Colorectal Cancer screening	Registry
MNCM1	Optimal Diabetes Care	Registry
MNCM2	Optimal Vascular Care	Registry
MNCM3	Optimal Asthma Control	Registry
MNCM4	Diabetes Hemoglobin A1c Poor Control (>9.0%)	Registry
MNCM5	Ischemic (IVD): Use of Aspirin or Another Antiplatelet	Registry
MSN6	Report Turnaround Time: Facility CT	Registry
MSN11	Report Turnaround Time: Non-Facility CT	Registry
MSN5	Report Turnaround Time: Facility MRI	Registry
MSN10	Report Turnaround Time: Non-Facility MRI	Registry
MSN7	Report Turnaround Time: Facility PET	Registry
MSN12	Report Turnaround Time: Non-Facility PET	Registry
MSN8	Report Turnaround Time: Non-Facility Radiography (Excluding Mammography)	Registry
MSN3	Report Turnaround Time: Facility Radiography (Excluding Mammography)	Registry
MSN4	Report Turnaround Time: Facility Ultrasound (Excluding Breast US)	Registry
MSN9	Report Turnaround Time: Non-Facility Ultrasound (Excluding Breast US)	Registry
MHAN1	Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate	Registry
MHAN2	Heart Failure Admission Rate	Registry
MHAN3	Plan All Cause Readmissions	Registry
NHBPC15	A Functional Assessment (Basic and Instrumental Activities of Daily Living [ADL]) for Home-Based Primary Care and Palliative Care Patients (Multiperformance Measure)	Registry
NHBPC2	Alcohol Problem Use Assessment for Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC14	Cognitive Assessment for Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC7	Delirium Assessment in Home-Based Primary Care and Palliative Care Patients: Medication List Reviewed & Offending Medications Discontinued (Multiperformance-Rate Measure)	Registry
NHBPC3	Depression Symptom Assessment for Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC5	Depression Treatment Plan for Home-Based Primary Care and Palliative Care Patients Who Screen Positive for Depression	Registry
NHBPC13	Interdisciplinary Team Assessment for Home-Based Primary care and Palliative Care Patients	Registry
NHBPC11	Medication Reconciliation Within 2 Weeks of Hospital Discharge of Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC4	Pain Screen for Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC16	Patient Reported Outcome for Home-Based Primary Care and Palliative Care Practices	Registry
NHBPC9	Referral to Hospice for Appropriate Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC6	Screen for Risk of Future Fall for Home-Based Primary Care and Palliative Care Patients	Registry
NHBPC10	Telephone Contact, Virtual, or In-person Visit Within 48 Hours of Hospital Discharge of Home-Based Primary Care and Palliative Care Patients	Registry
NOF6	Hip Fracture Mortality Rate (IQI 19)	Registry
NOF7	Osteoporosis: percentage of patients, any age, with a diagnosis of osteoporosis who are either receiving both calcium & vitamin D intake, & exercise at least once within 12 months.	Registry
NOF13	Osteoporosis: Management Following Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 Years and Older	Registry
NPA6	Spine-Related Procedure Site Infection	Registry
NPA7	Complication Following Spine-Related Procedure	Registry
NPA9	Referral for Post-Acute Care Rehabilitation Following Spine Procedure	Registry
NPA11	Unplanned Readmission Following Spine Procedure within the 30-day Postoperative Period	Registry
NPA12	Selection of Prophylactic Antibiotic Prior to Spine Procedure	Registry
NPA14	Medicine Reconciliation Following Spine Related Procedure	Registry
NPA15	Risk Assessment for Elective Spine Procedure	Registry
NPA16	Depression and Anxiety Assessment Prior to Spine-Related Therapies	Registry
NPA17	Narcotic Pain Medicine Management Following Elective Spine Procedure	Registry
NPA18	Smoking Assessment and Cessation Coincident with Spine-Related Therapies	Registry
NPA19	Body Mass Assessment and Follow-up Coincident with Spine-Related Therapies	Registry
NPA20	Unhealthy Alcohol Use Assessment Coincident with Spine Care	Registry
NPA22	Spine/Extremity Pain Assessment	Registry
NPA3	Functional Outcome Assessment for Spine Intervention	Registry
NPA4	Quality-of-Life Assessment for Spine Intervention	Registry
NPA5	Patient Satisfaction with Spine Care	Registry
NPAGSC6	Depression and Anxiety Assessment Prior to Spine-Related Therapies	Registry
NPAGSC9	Unplanned Admission to Hospital Following Percutaneous Spine Procedure within the 30-Day Post-procedure Period	Registry
NPAGSC3	Functional Outcome Assessment for Spine Intervention	Registry
NPAGSC7	Narcotic Pain Medicine Management Prior to and Following Spine Therapy	Registry
NPAGSC8	Complication Following Percutaneous Spine-Related Procedure	Registry
NPAGSC4	Quality-of-Life Assessment for Spine Intervention	Registry
NPAGSC5	Patient Satisfaction with Spine Care	Registry
NPAGSC10	Spine/Extremity Pain Assessment	Registry
NHCR5	Colonoscopy: Repeat colonoscopy recommended due to piecemeal resection	Registry
NJIISMD7	Critical test: Aortic Dissection	Registry
NJIISMD6	Critical test: Intracranial Hemorrhage	Registry
NJIISMD4	Critical test: OR Foreign Body	Registry
NJIISMD5	Critical test: Stroke	Registry
NJIISMD22	Critical Finding: Acute Ocular injury	Registry
NJIISMD3	Critical Result: Aortic Dissection	Registry
NJIISMD19	Critical Finding: Cord Compression	Registry
NJIISMD12	Critical Result: Ectopic Pregnancy	Registry
NJIISMD20	Critical Finding: CTA of GI bleed	Registry
NJIISMD2	Critical Result: ICH	Registry
NJIISMD11	Critical Result: New Deep Venous Thrombosis (DVT)	Registry
NJIISMD8	Critical Result: Occlusive Intracranial Stroke	Registry
NJIISMD9	Critical Result: Placental abruption	Registry
NJIISMD21	Critical Finding: Positive bleeding scan	Registry
NJIISMD1	Critical Result: Pulmonary Embolism	Registry
NJIISMD10	Critical Result: Ruptured Ectopic Pregnancy	Registry
NJIISMD14	Critical Result Protocol	Registry
NJIISMD17	Result Requiring Follow Up Protocol	Registry
NJIISMD16	Unexpected Result Protocol	Registry
NJIISMD15	Urgent Result Protocol	Registry
NJIISMD13	Critical Test Protocol	Registry
NNEPTN1	Substance Use Screening	Registry
NNEPTN2	Transforming Clinical Practice Initiative Common Measure Name: Substance Use Screening and Intervention Composite	Registry
NNEPTN3	Transforming Clinical Practice Initiative Common Measure Name: TCPI 01: Documentation of a Comprehensive Health and Life Plan Developed Collaboratively by the Patient and the Health Professional Team	Registry
NNEPTN4	Transforming Clinical Practice Initiative Common Measure Name: TCPI 02: Referral of At-Risk Patients to Community Based Prevention and Support Resources	Registry
OEIS1	Optimal vascular care	Registry
OEIS2	Emergent transfer from an outpatient, ambulatory surgical center, or office setting	Registry
OEIS3	Antiplatelet Therapy	Registry
OEIS4	Lipid-Lowering Medications for Patients with PAD	Registry
OEIS5	Appropriate non-invasive arterial testing for patients with critical limb ischemia who are undergoing a LE peripheral vascular intervention	Registry
OEIS6	Appropriate non-invasive arterial testing for patients with intermittent claudication who are undergoing a LE peripheral vascular intervention	Registry
ONSQIR15	Assessment and Intervention for Psychosocial Distress in Adults Receiving Cancer Treatment	Registry
ONSQIR16	Recommendation for Exercise to Adult Cancer Survivors	Registry
ONSQIR17	Assessment and Intervention for Sleep-Wake Disturbance During Cancer Treatment	Registry
ONSQIR6	Education on Neutropenia Precautions	Registry
ONSQIR18	Goal Setting and Attainment for Cancer Survivors	Registry
ONSQIR19	Post-Treatment Education	Registry
ONSQIR20	Fatigue Improvement	Registry
WCHQ32	Controlling High Blood Pressure: eGFR Test Annually	Registry
WCHQ10	Diabetes Care All or None Outcome Measure: Optimal Control	Registry
WCHQ9	Diabetes Care All or None Process Measure: Optimal Testing	Registry
WCHQ13	Ischemic Vascular Disease Care Blood Pressure Control	Registry
WCHQ15	Screening For Osteoporosis	Registry
ACCPin1	Hypertension: Blood Pressure Control	Registry
ACCPin2	CAD: Blood Pressure Control	Registry
ACCPin3	HF: Patient Self Care Education	Registry
ACCPin4	AFIB: CHA2DS2–VASc Score Risk Score Documented	Registry
PPRNET8	Antiplatelet Medication for High Risk Patients	Registry
PPRNET32	Screening for albuminuria in patients at risk for CKD (DM and/or HTN)	Registry
PPRNET13	Chronic Kidney Disease (CKD): eGFR Monitoring	Registry
PPRNET14	Chronic Kidney Disease (CKD): Hemoglobin Monitoring	Registry
PPRNET31	Screening for Type 2 Diabetes	Registry
PPRNET33	Avoiding Use of CNS Depressants in Patients on Long-Term Opioids	Registry
PPRNET27	Use of Benzodiazepines in the Elderly	Registry
PPRNET28	NSAID or Cox 2 Inhibitor Use in Patients with Heart Failure (HF) or Chronic Kidney Disease (CKD)	Registry
PPRNET29	Monitoring Serum Creatinine	Registry
PPRNET30	Treatment of Hypokalemia	Registry
PPRNET24	Appropriate Treatment for Adults with Upper Respiratory Infection	Registry
Pinc1	Risk-adjusted 30 day Readmission for Acute Myocardial Infarction	Registry
Pinc2	Risk-adjusted 30 day Readmission for Heart Failure	Registry
Pinc3	Risk-adjusted 30 day Readmission for Pneumonia	Registry
Pinc4	Risk-adjusted Mortality for Acute Myocardial Infarction	Registry
Pinc5	Risk-adjusted Mortality for Heart Failure	Registry
Pinc6	Risk-adjusted Mortality for Pneumonia	Registry
Pinc33	Risk-Adjusted Average Length of Inpatient Hospital Stay for Acute Myocardial Infarction (AMI)	Registry
Pinc34	Risk-Adjusted Average Length of Inpatient Hospital Stay for Heart Failure (HF)	Registry
Pinc35	Risk-Adjusted Average Length of Inpatient Hospital Stay for Pneumonia (PN)	Registry
Pinc53	Postoperative Sepsis Rate	Registry
Pinc54	Iatrogenic Pneumothorax	Registry
PP1	Annual Monitoring for Patients on Persistent Medications (MPM)	Registry
PP2	Follow-Up After Hospitalization for Schizophrenia (7- and 30-day)	Registry
QOPI5	Chemotherapy administered to patients with metastatic solid tumors and performance status of 3,4, or undocumented (lower score-better)	Registry
QOPI11	Combination chemotherapy received within 4 months of diagnosis by women under 70 with AJCC stage IA (T1c) to III ER/PR negative breast cancer	Registry
QOPI15	GCSF administered to patients who received chemotherapy for metastatic cancer (Lower score-better)	Registry
QUANTUM41	Case Cancellation on Day of Surgery	Registry
QUANTUM31	Central Line Ultrasound Guidance	Registry
QUANTUM37	Gastric Aspiration	Registry
QUANTUM42	Unplanned Hospital Admission After An Intended Outpatient Procedure	Registry
QUANTUM51	Unplanned ICU Admission	Registry
AAO8	Otitis Media with Effusion: Antihistamines or Decongestants – Avoidance of Inappropriate Use	Registry
AAO9	Otitis Media with Effusion: Systemic Corticosteroids – Avoidance of Inappropriate Use	Registry
AAO10	Otitis Media with Effusion: Systemic Antimicrobials – Avoidance of Inappropriate Use	Registry
AAO11	Otitis Media with Effusion: Avoidance of Topical Intranasal Corticosteroids	Registry
RPAQIR11	Hospitalization Rate Following Procedures Performed under Procedure Sedation Analgesia	Registry
RPAQIR12	Arterial Complication Rate Following Arteriovenous Access Intervention	Registry
RPAQIR13	Rate of Timely Documentation Transmission to Dialysis Unit/Referring Physician	Registry
RPAQIR14	Arteriovenious Graft Thrombectomy Success Rate	Registry
RPAQIR15	Arteriovenous Fistulae Thrombectomy Success Rate	Registry
RCOIR1	CKD 3-5 Patients Seen at the Recommended Frequency Levels	Registry
RCOIR2	Patients with a Visit to a Nephrologists Prior to 6 Months of Dialysis Onset	Registry
RCOIR3	CKD 3-5 Patients with a Urine ACR or Urine PCR Lab Test	Registry
RCOIR4	CKD 4-5 Patients with Transplant Referral	Registry
RCOIR5	End Stage Renal Disease (ESRD) Initiation of Home Dialysis or Self-Care	Registry
RCOIR6	End Stage Renal Disease (ESRD) Missed Dialysis Treatments	Registry
RCOIR7	Improved Access Site Bleeding	Registry
RCOIR8	Post Procedure Bleeding	Registry
RCOIR9	Post Procedure Infection	Registry
RCOIR10	Upper Extremity Edema Improvement	Registry
RPAQIR1	Angiotensin Converting Enzyme (ACE) Inhibitor or AngiotensinReceptor Blocker (ARB) Therapy	Registry
RPAQIR2	Adequacy of Volume Management	Registry
RPAQIR4	Arteriovenous Fistula Rate	Registry
RPAQIR5	Transplant Referral	Registry
RPAQIR9	Advance Care Planning (Pediatric Kidney Disease)	Registry
RPAQIR16	Peritoneal Dialysis Catheter Success Rate	Registry
RPAQIR17	Peritoneal Dialysis Catheter Exit Site Infection Rate	Registry
RPAQIR18	Advance Directives Completed	Registry
ICLOPS15	Excess Days Rate and Degree of Excess (Including Physician Response)	Registry
ICLOPS17	Rate of Follow Up Visits Within 7 Days of Discharge (Including Physician Response)	Registry
RHI1	Diabetic patients with significant change in HgbA1C level or overall change in HgbA1C	Registry
RHI2	Hypertensive patients with significant change in systolic blood pressure or overall change in systolic pressure	Registry
RHI3	Patients who have a change in tobacco use status (Improvement)	Registry
RHI4	Patients with Change in BMI	Registry
RHI5	Low back pain patients who undergo an operative procedure on the spine within 12 weeks after a referral from a primary care physician	Registry
RHI6	Breast Mass Follow Up: Percent of patients with a breast mass who do not have follow-up physician contact	Registry
RHI7	Uncontrolled chronic disease patients without a follow-up office visit	Registry
SCG1	Evaluation of High Risk Pain Medications for Morphine Milligram Equivalents (MME)	Registry
SCG2	Outcome Assessment for Patients Prescribed Ankle Orthosis for Ambulation and Functional Improvement	Registry
SCG3	Outcome Assessment for Patients Prescribed Foot Orthosis for Ambulation and Functional Improvement	Registry
SCG4	Prevention of Antibiotic or Natural Herbal Supplement Impairment of Anesthesia	Registry
SCG05	Improvement in Quality of Life from Partial Foot, Prosthetics	Registry
SDPAD1	Education of patients with inflammatory diseases regarding increased cardiovascular risk and the need for PCP evaluation	Registry
SDPAD2	HCV testing in Lichen Planus	Registry
SDPAD3	Avoiding antibiotic use in ruptured epidermal inclusion cyst	Registry
SDPAD4	Appropriate Testing and Treatment of Nail tinea infection	Registry
STS1	Prolonged Length of Stay Following Coronary Artery Bypass Grafting	Registry
STS3	Prolonged Length of Stay for Coronary Artery Bypass Grafting (CABG) + Valve Replacement	Registry
STS5	Prolonged Length of Stay following Valve Surgery	Registry
STS7	Patient Centered Surgical Risk Assessment and Communication for Cardiac Surgery	Registry
SMX1	Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia	Registry
SMX2	Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications	Registry
SMX3	Use of Multiple Concurrent Antipsychotics in Children and Adolescents	Registry
SMX4	Metabolic Monitoring for Children and Adolescents on Antipsychotics	Registry
AJRR4	Hip Arthroplasty: Venous Thromboembolic and Cardiovascular Risk Evaluation	Registry
AJRR2	Hip Arthroplasty: Health and Functional Improvement	Registry
AJRR3	Hip Arthroplasty: Shared Decision-Making: Trial of Conservative (Non-surgical) Therapy	Registry
AJRR1	Hip Arthroplasty: Postoperative Complications within 90 Days Following the Procedure	Registry
ASBS10	Management of the axilla in breast cancer patients undergoing breast conserving surgery with a positive sentinel node biopsy	Registry
ASBS1	Surgeon assessment for hereditary cause of breast cancer	Registry
ASBS7	Unplanned 30 day re-operation after mastectomy	Registry
NIPM4	APPROPRIATE PATIENT SELECTION FOR DIAGNOSTIC FACET JOINT PROCEDURES	Registry
NIPM5	APPROPRIATE PATIENT SELECTION FOR TRIAL SPINAL CORD STIMULATION	Registry
NIPM6	APPROPRIATE PATIENT SELECTION FOR USE OF EPIDURAL INJECTIONS IN MANAGING PAIN ORIGINATING IN THE SACRAL, LUMBAR, THORACIC OR CERVICAL SPINE	Registry
NIPM8	AVOIDING EXCESSIVE USE OF EPIDURAL INJECTIONS IN MANAGING CHRONIC PAIN ORIGINATING IN THE CERVICAL AND THORACIC SPINE (Measure 18)	Registry
NIPM1	AVOIDING EXCESSIVE USE OF EPIDURAL INJECTIONS IN MANAGING CHRONIC PAIN ORIGINATING IN THE LUMBOSACRAL SPINE	Registry
NIPM9	AVOIDING EXCESSIVE USE OF THERAPEUTIC FACET JOINT INTERVENTIONS IN MANAGING CHRONIC CERVICAL AND THORACIC SPINAL PAIN (Measure 19)	Registry
NIPM3	AVOIDING EXCESSIVE USE OF THERAPEUTIC FACET JOINT INTERVENTIONS IN MANAGING CHRONIC LUMBAR SPINAL PAIN	Registry
NIPM2	RATE OF CAUDAL AND INTERLAMINAR EPIDURAL INJECTIONS WITHOUT DURAL PUNCTURE	Registry
NIPM7	SHARED DECISION MAKING REGARDING ANTICOAGULANT AND ANTITHROMBOTIC USE IN THE SETTING OF CAUDAL OR INTERLAMINAR EPIDURAL INJECTIONS	Registry
CAP1	Topic: Turnaround time (TAT) for standard biopsies	Registry
CAP2	Cancer Protocol Elements for Carcinoma of the Endometrium Completed	Registry
CAP3	Cancer Protocol Elements for Invasive Carcinoma of Renal Tubular Origin Completed	Registry
CAP4	Cancer Protocol Elements for Carcinoma of the Intrahepatic Bile Ducts Completed	Registry
CAP5	Cancer Protocol Elements for Hepatocellular Carcinoma Completed	Registry
CAP6	Cancer Protocol Elements for Carcinoma of the Pancreas Completed	Registry
SPINEIQ1	Change in Functional Outcomes	Registry
SPINEIQ2	Change in Pain Intensity	Registry
SPINEIQ3	Repeated X-ray Imaging	Registry
OBERD22	Post-Stroke Outcome and Follow-up	Registry
OBERD23	Health Related Quality of Life: Patient Defined Outcomes	Registry
OBERD24	Inflamatory Bowel Disease: Follow-up and Outcomes	Registry
OBERD12	Patient Satisfaction: CG-CAHPS Composite Tracking v	Registry
OBERD25	Patient Satisfaction: Tracking Satisfaction Improvement with CG-CAHPS	Registry
CDR5	Adequate Compression of Venous Leg Ulcers at each treatment visit	Registry
CDR9	Appropriate use of Cellular and/or Tissue Based Product (CTP) in diabetic foot ulcers (DFUs) or venous leg ulcers (VLUs)	Registry
CDR8	Appropriate use of hyperbaric oxygen therapy for patients with diabetic foot ulcers	Registry
USWR15	Healing or Closure of Wagner Grade 3, 4 or 5 Diabetic Foot Ulcers (DFUs) Treated with HBOT	Registry
USWR16	Major Amputation in Wagner Grade 3, 4 or 5 Diabetic Foot Ulcers (DFUs) Treated with HBOT	Registry
USWR20	Nutritional Screening and Intervention Plan in Patients with Chronic Wounds and Ulcers	Registry
USWR22	Patient Reported Nutritional Assessment in Patients with Wounds and Ulcers	Registry
USWR13	Patient Vital Sign Assessment and Blood Glucose Check Prior to Hyperbaric Oxygen Therapy (HBOT) Treatment	Registry
CDR3	Plan of Care Creation for Diabetic Foot Ulcers (DFU) not Achieving 30% Closure at 4 Weeks	Registry
CDR7	Plan of Care for Venous Leg Ulcers not Achieving 30% Closure at 4 Weeks	Registry
CDR10	Vascular Assessment of patients with chronic leg ulcers	Registry
CDR6	Venous Leg Ulcer outcome measure: Healing or Closure	Registry
USWR21	Wound Outcome	Registry
WCQIC16	Nutritional Screening and Intervention Plan in Patients with Chronic Wounds and Ulcers	Registry