Cur - Eng

Medida	Definición	Acontecimiento
Current Avg Dental Member Months	Average number of member months for the current rolling 12 month period for the Dental plan.	Enrollment Overview -Dashlet
Current Avg Dental Member Months - Norm	Average number of member months for the current rolling 12 month period for the Dental plan normative population.	Norm Enrollment Overview -Dashlet
Current Avg Medical Member Months	Average number of member months for the current rolling 12 month period for the medical plan.	Enrollment Overview -Dashlet
Current Avg Medical Member Months - Norm	Average number of member months for the current rolling 12 month period for the medical plan normative population.	Norm Enrollment Overview -Dashlet
Current Avg Pharmacy Member Months	Average number of member months for the current rolling 12 month period for the Pharmacy plan.	Enrollment Overview -Dashlet
Current Avg Pharmacy Member Months - Norm	Average number of member months for the current rolling 12 month period for the Pharmacy plan normative population.	Norm Enrollment Overview -Dashlet
Current Avg Vision Member Months	Average number of member months for the current rolling 12 month period for the Vision plan.	Enrollment Overview -Dashlet
Current Avg Vision Member Months - Norm	Average number of member months for the current rolling 12 month period for the Vision plan normative population.	Norm Enrollment Overview -Dashlet
Current In-Network $	Total	Network Utilization Summary - Action Report
Current Member Month Count	A count of months for which the coverage was in effect for the current reporting period.	Enrollment Detail -Action Report
Current Out-Network $	Total plan paid for out of network benefits.	Network Utilization Summary - Action Report
Current PMPM	Current reporting period plan paid per member per month.	Financial Summary -Action Report
Current Risk	The current condition risk of the population selected. This is an enrollment weighted average of each member's condition risk.	Financial Summary -Action Report
Current Year Grand Total Plan Paid	Total costs (Inpatient/Outpatient Facility, Professional, and Pharmacy) paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Grand Total Plan Paid	Total costs (Inpatient/Outpatient Facility and Professional) paid by the Plan in the current year.	CE Executive Report – Total Medical Cost Page - Action Report
Current Year Inpatient Facility - Admissions	Number of Admissions to Inpatient Facility for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility – Admissions/1000 Members	Admissions per 1000 members to Inpatient Facility for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility – Average Length of Stay	Average Length in days of a patient Inpatient Facility stay for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility – Average Paid Per Admission	Average paid per Inpatient Facility admission for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility – Paid PMPM	Plan Paid Per Member Per Month for Inpatient Facility services for current year. Value includes Capitation and Completion factors.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility – Readmission Percentage	% of patients that were re-admitted to Inpatient Facility less than 30 days between initial discharge and re-admission for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Facility % of Total Plan Paid	% of Total Inpatient Facility costs paid by the Plan in the current year.	CE Executive Report – Total Medical Cost Page, Total Medical & Pharmacy Cost Page - Action Report
Current Year Inpatient Facility Total Plan Paid	Total Inpatient Facility costs paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page, CE Executive Report – Total Medical Cost Page -Action Report
Current Year Inpatient Professional – Average Paid Per Service	Average Paid per service for Inpatient Professional Services for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Professional – Paid PMPM	Plan Paid Per Member Per Month for Inpatient Professional services for current year. Value includes Capitation and Completion factors.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Professional - Services	Number of Services that are for Inpatient Professional Services for previous year for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Inpatient Professional – Services/1000 Members	Number of Inpatient Professional Services per 1000 members for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Medical Member Cost Share - Coinsurance	Total Medical Coinsurance costs that Members are responsible for in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page, CE Executive Report – Total Medical Cost Page -Action Report
Current Year Medical Member Cost Share - Copay	Total Medical Copay costs that Members are responsible for in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page, CE Executive Report – Total Medical Cost Page -Action Report
Current Year Medical Member Cost Share –Deductible	Total Medical Deductible costs that Members are responsible for in the current year.	CE Executive Report – Total Medical Cost Page - Action Report
Current Year Outpatient Facility – Average Paid Per Service	Average Paid per service for Outpatient Facility services for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility – ED Cost/Visit	Outpatient Facility Emergency Department Costs per visit for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility – ED Visits	Number of visits for Outpatient Facility Emergency Department services for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility – ED Visits/1000 Members	Visits per 1,000 members for Outpatient Emergency Department services for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility – Paid PMPM	Plan Paid Per Member Per Month for Outpatient Facility Services for current year. Value includes Capitation and Completion factors.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility – Services/1000 Members	Outpatient Facility Services per 1000 members for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Facility % of Total Plan Paid	% of Total Outpatient Facility costs paid by the Plan in the current year.	CE Executive Report – Total Medical Cost Page, Total Medical & Pharmacy Cost Page - Action Report
Current Year Outpatient Facility Total Plan Paid	Total Outpatient Facility costs paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page, CE Executive Report – Total Medical Cost Page -Action Report
Current Year Outpatient Professional – Average Paid Per Service	Average Paid per service for Outpatient Professional Services for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Professional – Paid PMPM	Plan Paid Per Member Per Month for Outpatient Professional services for current year. Value includes Capitation and Completion factors.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Professional - Services	Number of Services that are for Outpatient Professional Services for previous year for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Outpatient Professional – Services/1000 Members	Number of Outpatient Professional Services per 1000 members for current year.	CE Executive Report – Total Medical Cost Key Metrics Page - Action Report
Current Year Pharmacy % of Total Plan Paid	% of Total Pharmacy costs paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Pharmacy Member Cost Share - Coinsurance	Total Pharmacy Coinsurance costs that Members are responsible for in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Pharmacy Member Cost Share - Copay	Total Pharmacy Copay costs that Members are responsible for in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Pharmacy Member Cost Share –Deductible	Total Pharmacy Deductible costs that Members are responsible for in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Pharmacy Total Plan Paid	Total Pharmacy costs paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Professional % of Total Plan Paid	% of Total Professional costs paid by the Plan in the current year.	CE Executive Report – Total Medical Cost Page,Total Medical & Pharmacy Cost Page - Action Report
Current Year Professional Total Plan Paid	Total Professional costs paid by the Plan in the current year.	CE Executive Report – Total Medical & Pharmacy Cost Page -Action Report
Current Year Professional Total Plan Paid	Total Professional costs paid by the Plan in the current year.	CE Executive Report – Total Medical Cost Page - Action Report
Current Yr Dental PMPM	Dental Cost per member per month for the current rolling 12 month period for the normative Population. Completion Factors are applied.	Norm Comparison - Dashlet
Current Yr Dental PMPM	Dental Cost per member per month for the current rolling 12 month period for the plan. Capitation Payments are included and Completion Factors are applied.	Payment Overview - Dashlet
Current Yr Medical PPMPM	Medical cost per member per month for the current rolling 12 month period for the normative population. Completion factors are applied then capitation payments are included.	Norm Comparison - Dashlet
Current Yr Medical PPMPM	Medical cost per member per month for the current rolling 12 month period for the plan. Completion factors are applied then capitation payments are included.	Payment Overview - Dashlet
Current Yr Pharmacy PMPM	Pharmacy cost per member per month for the current rolling 12 month period for the normative population. Completion factors are applied.	Norm Comparison - Dashlet
Current Yr Vision PMPM	Vision Cost per member per month for the current rolling 12 month period for the normative Population. Completion Factors are applied.	Norm Comparison - Dashlet
Current Yr Vision PMPM	Vision Cost per member per month for the current rolling 12 month period for the plan. Capitation Payments are included and Completion Factors are applied.	Payment Overview - Dashlet
Fecha de servicio	The date the prescription was filled.	Pharmacy Detail -Action Report
Date of Surgery	The date a surgical procedure was performed (applicable to facility claims only).	Inpatient Admission -Action Report
Days Supply Count	Number of days for which the prescribed drug has been dispensed.	Pharmacy Detail -Action Report
Deducible	Total Deductible Amount for Dental claims in the current rolling 12 month period	Dental Payment Summary -Action Report
Deducible	Total Deductible Amount for Vision claims in the current rolling 12 month period.	Vision Payment Summary -Action Report
Deductible - Dental	Total Deductible Amount for Dental claims in the current rolling 12 month period.	Member Responsibility Overview -Dashlet
Deductible - Medical	Total Deductible Amount for Medical claims in the current rolling 12 month period.	Member Responsibility Overview -Dashlet
Deductible - Pharmacy	Total Deductible Amount for Pharmacy claims in the current rolling 12 month period.	Member Responsibility Overview -Dashlet
Deductible - Vision	Total Deductible Amount for Vision claims in the current rolling 12 month period.	Member Responsibility Overview -Dashlet
Demographic Risk Score (Puntaje de riesgo demográfico)	A member-level risk score calculated based upon the member's demographic age and gender.	Member Summary -Action Report
Dental Actual PMPM	Dental services cost per member per month for the plan population for the current rolling 12 month period.	Cost Overview -Dashlet
Dental Actual PMPM	Dental cost per member per month for the actual population for the current rolling 12 month period. Completion factors are applied and capitation payments are included.	Cost Overview -Dashlet
Dental Current	The total adjusted paid amount for dental services in the current rolling 12 month period. Completion factors are applied then capitation payments are included.	Payment Summary -Dashlet
Dental Norm PMPM	Dental services cost per member per month for the normative population for the current rolling 12 month period.	Cost Overview -Dashlet
Dental Norm PMPM	Dental cost per member per month for the normative population for the current rolling 12 month period. Completion factors are applied and capitation payments are included.	Cost Overview -Dashlet
Dental Previous	The total adjusted paid amount for dental services in the previous rolling 12 month period. Completion factors are applied then capitation payments are included.	Payment Summary -Dashlet
Dental Variance	The variance in the total adjusted paid amount for dental services from the current period versus the previous one. Completion factors are applied then capitation payments are included.	Payment Summary -Dashlet
Dependent Count	Number of dependents associated with the enrollment record.	Enrollment Summary -Action Report
Dependent Member Month	Sum of member months for dependents associated with the enrollment record.	Enrollment Summary -Action Report
Dependent Paid Amount	Plan payments made on behalf of dependents of subscribers.	Enrollment Summary -Action Report
Dependents Membership Count	Membership Count of all members who are dependents of employees.	Executive Report- Action Report
Diagnosis 2 Code	The secondary diagnosis code associated with the service.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Diagnosis 2 Description	The description of the secondary diagnosis code associated with the service.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Diagnosis 3 Code	The tertiary diagnosis code associated with the service.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Diagnosis 3 Description	The description of the tertiary diagnosis code associated with the service.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Discharge Date	The date a member left a facility.	Inpatient Admission -Action Report
Discharge Status	Status of the patient at time of discharge.	Inpatient Admission -Action Report
Discharge Status Code	Status of the patient at time of discharge.	Claim Detail, Claim Summary - Action Report (Detalle de la reclamación, Resumen de la reclamación - Informe de acción)
Discharge Status Description	Status of the patient at time of discharge.	Claim Detail, Claim Summary - Action Report (Detalle de la reclamación, Resumen de la reclamación - Informe de acción)
Discharged in Last 10 Days	Number of members discharged from an inpatient facility within the last 10 days (based on discharge date). Este número de actualiza todos los días.	Discharged in Last 10 Days -Population Measures
Dispensed Unit of Measure	Description of the units used to measure the dispensed amount of the prescribed medication.	Pharmacy Detail -Action Report
DRG Código	Diagnostic Related Group code - A grouping of like inpatient claims. Used by CMS to determine payment.	Claim Summary, Inpatient Admission - Action Report (Resumen de la reclamación, Hospitalización - Informe de acción)
DRG Descripción	A description of the Diagnostic Related Group.	Claim Summary, Inpatient Admission - Action Report (Resumen de la reclamación, Hospitalización - Informe de acción)
DRG Peso	A number indicative of the resources needed to treat the DRG.	Claim Summary - Action Report (Resumen de la reclamación - Informe de acción)
ED Actual PMPM	Emergency department services cost per member per month for the plan population for the current rolling 12 month period. Completion factors are applied and capitation payments are included.	Cost Overview -Dashlet
ED Actual PMPM	Emergency department Services cost per member per month for the plan for the current rolling 12 month period where the cost does not exceed a threshold. Capitation payments are included and completion factors are applied.	Cost Overview w/o Outliers -Dashlet
ED Actual PMPM	Emergency department services cost per member per month for the plan population for the current rolling 12 month period where the cost exceeds a threshold. Capitation payments are included and completion factors are applied.	Cost Overview w/o Outliers -Dashlet
ED Norm PMPM	Emergency department services cost per member per month for the normative population for the current rolling 12 month period. Capitation payments are included and completion factors are applied.	Cost Overview -Dashlet
ED Norm PMPM	Emergency department services cost per member per month for the normative population for the current rolling 12 month period where the cost does not exceed a threshold. Capitation payments are included and completion factors are applied.	Cost Overview w/o Outliers -Dashlet
ED Norm PMPM	Emergency department services cost per member per month for the normative population for the current rolling 12 month period where the cost exceeds a threshold. Capitation payments are included and completion factors are applied.	Cost Overview w/o Outliers -Dashlet
ED Visits/1000 Count	Utilization per 1,000 members for Emergency Department services for the plan population. Completion factors are applied.	Cost and Utilization Summary by Cost Bucket - Action Report
ED-All PMPM	Emergency Department services cost per member per month for the plan for the current rolling 12 month period. Completion factors are applied and capitation payments are included.	Cost and Utilization Summary by Cost Bucket - Action Report
ED-Outliers Only PMPM	Emergency Department services cost per member per month for the plan for the current rolling 12 month period. This measure includes only those members who have exceeded a client configured threshold. Completion factors are applied and capitation payments	Cost and Utilization Summary by Cost Bucket - Action Report
ED-w/o Outliers PMPM	Emergency Department services cost per member per month for the plan for the current rolling 12 month period. This measure excludes those members who have exceeded a client configured threshold. Completion factors are applied and capitation payments are i	Cost and Utilization Summary by Cost Bucket - Action Report
Eligibility End Date	The last day a member's eligibility for coverage is in force.	Enrollment Detail -Action Report
Eligibility Start Date	The day a member's eligibility for coverage enters into force.	Enrollment Detail -Action Report
Eligible Participant	Whether or not the member is eligible to participate in the disease or condition management program.	Program Detail - Action Report (Detalle del programa - Informe de acción)
Employee Membership Count	Membership Count of all members who are employees.	Executive Report- Action Report
Employer Group	A concatenation of Group Name and Group Number	Cost and Utilization Summary by Cost Bucket - Action Report
Employer Group	A concatenation of Group Name and Group Number	Financial Summary -Action Report
Employer Group ID	Carrier assigned number uniquely identifying an employer group.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Employer Group ID	The Group Number assigned by the carrier.	Claim Summary, Enrollment Detail, Enrollment Summary, Inpatient Admission, Pharmacy Detail - Action Report
Employer Group Name	Description of Clinical Classification Software Level 3 code.	Claim Detail - Action Report (Detalle de la reclamación - Informe de acción)
Employer Group Name	The Group Name associated with the Group Number.	Claim Summary, Enrollment Detail, Enrollment Summary, Inpatient Admission, Pharmacy Detail - Action Report
Engaged End Date	The date the member agreed to end their participation in the medical care coordination program.	Program Detail - Action Report (Detalle del programa - Informe de acción)
Engaged Indicator (Indicador de participación)	Indica el estado actual del miembro en el programa de coordinación de atención médica.	Program Detail - Action Report (Detalle del programa - Informe de acción)
Engaged Member Count	Of those members enrolled in the program, the subset of individuals who have chosen to participated (i.e. Those that are engaged in the program).	Program Summary -Action Report
Engaged Member Percentage	The percentage of enrolled members who chose to engage with the program.	Program Summary -Action Report
Engaged Start Date (Fecha de inicio de participación)	La fecha en que el miembro aceptó participar en el programa de coordinación de atención médica.	Program Detail - Action Report (Detalle del programa - Informe de acción)