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1. All-Payer Claims Databases | Agency for Healthcare Research and Quality
   www.cahps.ahrq.gov/data/apcd/index.html
   February 01, 2018 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Overview of All-Payer Claims Databases All-payer claims databases (APCDs) are large State databases … that include medical claims, pharmacy claims, dental claims, and eligibility and provider files collected … in States All-Payer Claims Databases Measurement of Care: Systematic Review and Environmental Scan … Databases Measure Inventory for Use With All-Payer Claims Databases (Final Contract Report)  (PDF,

2. Expanding and Enhancing All Payer Claims Database System Capacity in States | Agency for Healthcare Research and Quality
   www.cahps.ahrq.gov/data/apcd/confrpt.html
   February 01, 2018 - The purpose of the Fifth All Payer Claims Database Conference, “Expanding and Enhancing All Payer Claims … The purpose of the Fifth All Payer Claims Database Conference, "Expanding and Enhancing All Payer Claims … Keywords All payer claims databases. … Since the first APCD system was established in 2003, the number of States collecting claims and other … and Institutional claims that accommodate State reporting needs.

3. 3P-Rd-Data-Dictionary-Geographic-Level (xls file)
   www.cahps.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary-Geographic-Level.xlsx
   February 02, 2023 - State APCD/CMS Claims ZIP_CD X X X X X X X X X X X X X X X STATE 2-Digit alpha state code Char $2. … physicians Char 2 XXXXX: Minimum Patient Age APCD/CMS Claims XXXXX_MIN_AGE X X B, F, G A, G A, G … per Month APCD/CMS Claims XXXXX_MIN_CLMS_PERMONTH X X B, F, G A, G A, G B, C, D, E, F, G A, G A, G … per month across all 3P-RD physicians Num 8 XXXXX: Average Number of Claims per Month APCD/CMS Claims … per month across all 3P-RD physicians Num 8 XXXXX: Maximum Number of Claims per Month APCD/CMS Claims

4. About the Measure | Agency for Healthcare Research and Quality
   www.cahps.ahrq.gov/pqmp/implementation-qi/toolkit/tcd/about.html
   July 01, 2021 - It also required the development of a valid claims-based case definition. … This definition ensured the feasibility of using only administrative claims for this measure. … A lag in claims availability at the state level may create a delay in use of Medicaid claims. … The detailed measure specification may be used on administrative claims in any context. … The lag in claims availability at the state level creates a delay in use of Medicaid claims.

5. 3P_RD_AHRQ_PUF_Data_Dictionary (xls file)
   www.cahps.ahrq.gov/sites/default/files/wysiwyg/data/3P-RD-Data-Dictionary.xlsx
   March 16, 2023 - SECTION IV: Source Claims Files Indicates data element names and availability in claims files for APCD … Organizational NPI APCD/ CMS Claims X X X X X X ORG_NPI Organizational NPI CHAR 10 $10. … Number of 3P-RD physicians associated with the physician practice site X APCD/ CMS Claims X X X X X … X 3P-RD Physician APCD/ CMS Claims X X X X X X SING_SPEC_TYPE If Single Specialty, Which? … State X APCD/ CMS Claims X X X X X X STATE State CHAR 7 $2.

6. Synthetic Healthcare Database for Research (SyH-DR) | Agency for Healthcare Research and Quality
   www.cahps.ahrq.gov/data/innovations/syh-dr.html
   January 01, 2024 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Determinants of Health Synthetic Healthcare Database for Research (SyH-DR) All-Payer Claims … The Synthetic Healthcare Database for Research (SyH-DR) is an all-payer, nationally representative claims … SyH-DR The Agency for Healthcare Research and Quality (AHRQ) created SyH-DR from eligibility and claims … Claims Files Commercial Inpatient File. Commercial Outpatient File.

7. Asthma 1 Measure Calculation Steps (pdf file)
   www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/flow-diagrams.pdf
   March 11, 2021 - Asthma 1 Measure Calculation Steps Medicaid/APCD claims data Eligibility Table (summary of continuous … (all medical claims during time frame) Pharmacy Claims Data HEDIS ASM-C/MMA-A NDC Lists2 … Import into SAS data format Medical Claims Data (long format medical claims during time frame with … Data Medical Claims Data (long format medical claims during time frame) Asthma_Meds: Evaluation … DEC_IDENT_CE 10 4 Comorbidity Claims (all medical claims during time frame) PMCA v3 Algorithm

8. United States Health Information Knowledgebase | Agency for Healthcare Research and Quality
   www.cahps.ahrq.gov/data/ushik.html
   July 01, 2022 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … The All-Payer Claims Databases portal contained APCD File Submission Specifications from 14 states. … APCDs are large-scale databases that systematically collect healthcare claims data from a variety of … , pharmacy claims, eligibility files, provider (physician and facility) files, and dental claims from … leveraging data from within the insurance claims and reimbursement system.

9. Tables 1-7 (pdf file)
   www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-195-tables%201-7.pdf
   December 18, 2019 - Contingency Table for Presence of Seizure in Administrative Claims and Charts Seizure in Claims … Contingency Table for Presence of Indicators of Increased Intracranial Pressure in Administrative Claims … and Charts Indicators of Increased Intracranial Pressure in Claims Based on ICD-9-CM Codes … Sensitivity Analysis with Variation in Claims-Based Exclusion Criteria among Children with Neuroimaging … Overuse Percentage within the Chart Review Sample using Claims or Chart Review Criteria Chart Review

10. CHIPRA 194: Section 7, Tables 15-18 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-194-section-7-tables-15-18.pdf
    April 17, 2019 - (8.1) 7.6 (12.2) 0.1 (0.2) 80.6 (16.7) 2.5 (1.4) 3.7 (6.0) Subset following claims … (8.0) 7.7 (12.1) 0.1 (0.2) 81.1 (16.4) 2.5 (1.4) 3.4 (5.6) Subset following claims … missing or unmatched ZIP code, yielding n=4,312 (98.2%). *** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=2,626 (98.2%). **** Among the subset of children following claims … denominator exclusions (n=2,626)*** 9.1 (12.7) Subset following claims numerator exclusions (n=2,156

11. Overuse of Computed Tomography Scans for the Evaluation of Children with a First Generalized Afebrile, Atraumatic Seizure: Tables 14-17 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0198-tables14-17.pdf
    October 16, 2019 - 522)** 0.5 (1.4) 5.5 (8.8) 8.5 (13.2) 0.1 (0.5) 78.2 (17.8) 2.8 (2.0) 4.3 (6.6) Subset following claims … (7.0) 7.9 (12.1) 0.1 (0.3) 80.6 (15.7) 2.6 (1.5) 4.0 (5.8) Subset following claims … missing or unmatched ZIP code, yielding n=522 (98.1%). *** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=293 (99.0%). **** Among the subset of children following claims … denominator exclusions (n=293)*** 10.5 (14.5) Subset following claims numerator exclusions (n=243)*

12. Tables 11-14 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-196-section-7.pdf
    December 18, 2019 - 1,585)*** 0.4 (0.7) 5.7 (8.6) 6.9 (10.5) 0.1 (0.2) 80.4 (16.0) 2.6 (1.4) 3.9 (6.1) Subset following claims … (7.2) 8.4 (13.1) 0.1 (0.2) 81.5 (16.6) 2.4 (1.4) 3.0 (4.9) Subset following claims … missing or unmatched ZIP code, yielding n=1,585 (98.3%). **** Among the subset of children following claims … a CT scan (n=2,977)** 9.4 (13.3) Subset who had an MRI (n=1,585)*** 10.2 (13.2) Subset following claims … CT exclusions (n=1,781)**** 8.2 (11.8) Subset following claims MRI exclusions (n=1,363)***** 10.0 (

13. Asthma 1: Emergency Room Visits for Children between 3 and 21 with identifiable asthma (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/sas-code.pdf
    October 31, 2018 - Claims will be filtered by time, diagnosis code, and age at service but can be pre-filtered to cut … Table: All (unfiltered) medical claims for at least the patients in the measure cohort. … These claims are in wide form and have 1 record per claim. … The Process: 1) 'Claims' dataset: claims are read in. 2) The program identifies whether … with that body system indicated (sum across claims). */ *indicator y/n; *sum across claims; if

14. Section 6, Tables 2 and 3 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/section-6-table-2-3.pdf
    June 28, 2017 - Other ≥ 1 claim per body system for 2 different body systems during the measurement period* ≥ 2 claims … claim for a single body system not flagged as progressive during the measurement period* ≥ 2 claims … specificity for PMCA in Seattle Children’s Hospital (SCH) discharge and Washington State (WA) Medicaid claims

15. Materials X (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-164-materials-x.pdf
    March 09, 2017 - A: Dental Prophy -­‐ 2 claims PREV_A_3 Prev. Grp. A: Dental Prophy -­‐ 3+ claims PREV_A_CLM Prev. … B: Fluoride  Tx -­‐ 2 claims PREV_B_3 Prev. Grp. B: Fluoride  Tx -­‐ 3 claims PREV_B_4 Prev. … B: Fluoride  Tx -­‐ 4+ claims PREV_B_CLM Prev. Grp. … B: Fluoride  Tx -­‐ Count of claims PREV_B_DENT Prev. Grp. … B: Fluoride Tx -­‐ (Med Prov) 2 claims PREV_B_MED_3 Prev. Grp.

16. Exploring Learning Health Systems’ Needs | Agency for Healthcare Research and Quality
    www.cahps.ahrq.gov/learning-health-systems/exploring-needs.html
    September 01, 2022 - Data Data Infographics Data Visualizations Data Tools Data Innovations All-Payer Claims … Multiple claims-based frailty indexes (CFIs) have been developed and validated over the past few years … ; however, healthcare providers often do not have access to the insurance claims records of their entire … This project focused on validating an established CFI using linked claims-EHR databases of multiple large … Developing and Assessing the Validity of Claims-based Indicators of Frailty & Functional Disabilities

17. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 11 & 12 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables11-12.pdf
    October 17, 2019 - 546)*** 0.4 (0.4) 5.6 (8.6) 8.0 (11.8) 0.1 (0.2) 79.7 (16.8) 2.6 (1.5) 3.7 (6.1) Subset following claims … (8.2) 8.1 (12.3) 0.1 (0.5) 79.3 (16.9) 2.7 (2.1) 4.1 (6.2) Subset following claims … missing or unmatched ZIP code, yielding n=546 (98.0%). **** Among the subset of children following claims … missing or unmatched ZIP code, yielding n=426 (98.2%). ***** Among the subset of children following claims … CT exclusions (n=426)**** 10.8 (14.9) Subset following claims MRI exclusions (n=489)***** 9.6 (13.4

18. Ratio of Magnetic Resonance Imaging Scans to Computed Tomography Scans for the Evaluation of Children with Atraumatic Seizure: Tables 13 & 14 (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-0197-tables13-14.pdf
    October 17, 2019 - Min 25th Percentile Median 75th Percentile Max Subset following claims … $66,899 $29,432 $24,260 $44,612 59,082 $82,679 $191,200 Subset following claims … ZIP code or missing census data, yielding n=546 (98.0%). **** Among the subset of children following claims … code or missing census data, yielding n=426 (98.2%). ***** Among the subset of children following claims … 94.1 100 100 Subset who had an MRI (n=546)*** 77.6 33.2 0 68.5 95.4 100 100 Subset following claims

19. 1b.4_Input_File_Specifications_508 (xls file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/input-file-specifications.xlsx
    January 01, 2014 - Medical Claims Reference Name Concept Description Variable Type Note claim_header_id Claim level … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … unique identifier text or numeric Can be derived, just need a way to uniquely identify claims. … Note: Comorbidity source table is in wide form, unlike the medical claims source table DX2 The ICD9 … End of Table Pharmacy Claims Pharmacy Claims Reference Name Concept Description Required Variable

20. Transcranial Doppler (TCD) Ultrasonography Screening for Children with SCD; and Appropriate Antibiotic Prophylaxis (pdf file)
    www.cahps.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-1416-p007-2-ef.pdf
    November 01, 2015 - Claims data. … Claims data. … (MAX) administrative claims data from six States with a moderate to high prevalence of SCD … ● This measure was also tested using administrative claims acquired directly from the respective … Caveats These measures are based on administrative claims; incomplete reporting of claims or SCD diagnosis