HEDIS 2016 Final NDC Lists

Notes:

  • Several NDC lists and medication tables are used for multiple products. The NDC lists reference the medication table names used in the Volume 2 Technical Specifications for Health Plans and the Technical Specifications for Physician Measurement. When a list/table applies to additional products, it is noted below.
  • Changes that have been made to the medication tables are summarized in the HEDIS 2016 NDC List Technical Update. Please review all items in this update and incorporate them into your implementation processes.
  • Other NDC codes that are not included in the HEDIS lists may be mapped for use in HEDIS reporting if its generic name, strength/dose and route match those of an NDC code in the HEDIS list. Please refer to the general guidelines for Mapping Proprietary or Other Codes section in the publications for additional information.



HEDIS 2016 NDC LISTS

HEDIS 2016 NDC List Technical Update (.pdf)

HEDIS 2016 NDC Lists (.zip)
(Updated December 4, 2015)

Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)

 

Table SAA-A: Antipsychotic Medications

Table SAA-A.xls

Annual Monitoring for Patients on Persistent Medications (MPM)

 

Table MPM-B: Drugs to Identify Members on Digoxin

Note: This table is also used for:

  • Accountable Care Organizations: Table AMPM-B.

Table MPM-B.xls

Table MPM-C: Drugs to Identify Members on Diuretics

Note: This table is also used for:

  • Accountable Care Organizations: Table AMPM-C.

Table MPM-C.xls

Antibiotic Utilization (ABX)

 

Table ABX-A: Antibiotic Medications

Table ABX-A.xls

Table ABX-B: Antibiotic of Concern by NCQA Drug Class

Table ABX-B.xls

Table ABX-C: All Other Antibiotics by NCQA Drug Class

Table ABX-C.xls

Antidepressant Medications Management (AMM)

 

Table AMM-C : Antidepressant Medications

Note: This table is also used for:

  • Accountable Care Organizations: Table AAMM-C.

Table AMM-C.xls

Appropriate Treatment for Children with Pharyngitis (CWP)

 

Table CWP-C: Antibiotic Medications

Note: This table is also used for:

  • Accountable Care Organizations: Table ACWP-C.

Table CWP-C.xls

Asthma Medication Ratio (AMR)

 

Table AMR-A: Asthma Controller and Reliever Medications

Table AMR-A.xls

Avoidance of Antibiotic Treatment for Adults with Acute Bronchitis (AAB)

 

Table AAB-D: Antibiotic Medications

Note: This table is also used for:

  • Accountable Care Organizations: Table AAAB-D.

Table AAB-D.xls

Chlamydia Screening in Women (CHL)

 

Table CHL-A: Prescriptions to Identify Contraceptives

Note: This table is also used for:

  • Accountable Care Organizations: Table ACHL-A.

Table CHL-A.xls

Table CHL-E: Medication to Identify Exclusions

Note: This table is also used for:

  • Accountable Care Organizations: Table ACHL-D.

Table CHL-E.xls

Comprehensive Diabetes Care (CDC)

 

Table CDC-A: Prescriptions to Identify Members with Diabetes

Note: This table is also used for:

  • Accountable Care Organizations: Table ACDC-A.

Table CDC-A.xls

Table CDC-L: ACE Inhibitors/ARBs

Note: This table is also used for:

  • Accountable Care Organizations: Table ACDC-M.

Table CDC-L.xls

Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)

 

Table SSD-D: Antipsychotic Medications
(Updated November 6, 2015)

Table SSD-D.xls

Disease Modifying Anti-Rheumatic Drug Therapy (ART)

 

Table ART-C: DMARDs

Note: This table is also used for:

  • Accountable Care Organizations: Table AART-D.

Table ART-C.xls

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

 

Table ADD-A: ADHD Medications

Note: This table is also used for:

  • Accountable Care Organizations: Table AADD-A. 

Table ADD-A.xls

Medication Management for People With Asthma (MMA)

 

Table MMA-A: Asthma Medications

Table MMA-A.xls

Table MMA-B: Asthma Controller Medications

Table MMA-B.xls

Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)

 

Table APM-A: Antipsychotic Medications

Table APM-A.xls

Non-Recommended PSA-Based Screening in Older Men (PSA)

 

Table PSA-A: 5-ARIs

Table PSA-A.xls

Osteoporosis Management in Women Who had a Fracture (OMW)

 

Table OMW-C: Osteoporosis Therapies

Note: This table is also used for:

  • Accountable Care Organizations: Table AOMW-D.

Table OMW-C.xls

Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)

 

Table PBH-B: Beta-Blocker Medications

Table PBH-B.xls

Table PBH-D: Medications to Identify Exclusion (History of Asthma)

Table PBH-D.xls

Pharmacotherapy Management of COPD Exacerbation (PCE)

 

Table PCE-C: Systemic Corticosteroids

Table PCE-C.xls

Table PCE-D: Bronchodilators

Table PCE-D.xls

Potentially Harmful Drug-Disease Interactions in the Elderly (DDE)

 

Table DDE-A: Potentially Harmful Drugs—Rate 1 

Note: This table is also used for:

  • Accountable Care Organizations: Table ADDE-C. 

Table DDE-A.xls

Table DDE-B: Potentially Harmful Drugs—Rate 1 and Rate 2

Note: This table is also used for:

  • Accountable Care Organizations: Table ADDE-D.

Table DDE-B.xls

Table DDE-C: Prescriptions to Identify Members With Dementia

Note: This table is also used for:

  • Accountable Care Organizations: Table ADDE-F.

Table DDE-C.xls

Table DDE-D: Potentially Harmful Drugs—Rate 2

Note: This table is also used for:

  • Accountable Care Organizations: Table ADDE-G.

Table DDE-D.xls

Table DDE-E: Cox-2 Selective NSAIDs and Nonaspirin NSAIDs

Note: This table is also used for:

  • Accountable Care Organizations: Table ADDE-I.

Table DDE-E.xls

Statin Therapy for Patients With Cardiovascular Disease (SPC)

 

Table SPC-A: Medications to Identify Exclusions

Table SPC-A.xls

Table SPC-B: High and Moderate-Intensity Statin Medications

Table SPC-B.xls

Statin Therapy for Patients With Diabetes (SPD)

 

Table SPD-A: High, Moderate and Low-Intensity Statin Prescriptions

Table SPD-A.xls

Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)

 

Table APP-A: Antipsychotic Medications

Table APP-A.xls

Use of High-Risk Medications in the Elderly (DAE)

 

Table DAE-A: High-Risk Medications

Note: This table is also used for:

  • Accountable Care Organizations: Table ADAE-A.

Table DAE-A.xls

Table DAE-B: High-Risk Medications with Days Supply Criteria

Note: This table is also used for:

  • Accountable Care Organizations: Table ADAE-B.

Table DAE-B.xls

Table DAE-C: High-Risk Medications with Average Daily Dose Criteria

Note: This table is also used for:

  • Accountable Care Organizations: Table ADAE-C.
(Updated December 4, 2015)

Table DAE-C.xls

Use of Multiple Concurrent Antipsychotics in Children and Adolescents (APC)

 

Table APC-A: Antipsychotic Medications

Table APC-A.xls