99
PQMP QMETRIC SCD Measure 3 U18HS020516 Page 1 Section II: Technical Specifications PDF 2 December 2013 QMETRIC Sickle Cell Disease Measure 3: Appropriate Antibiotic Prophylaxis for Children with Sickle Cell Disease Technical specifications for Section II. Detailed Measure Specifications Sickle Cell Disease Measure 3: Appropriate Antibiotic Prophylaxis for Children with Sickle Cell Disease Description The percentage of children younger than five years of age who were identified as having Sickle Cell Anemia who received appropriate antibiotic prophylaxis during the measurement year. A higher proportion indicates better performance as reflected by appropriate treatment. Calculation This measure requires administrative claims data and is calculated as two rates. The two individual rates are: 1. The percentage of children who received antibiotic prophylaxis for at least 300 days (300-day numerator divided by denominator). 2. The percentage of children who received antibiotic prophylaxis for at least 350 days (350-day numerator divided by denominator). Definitions Intake period January 1 of the measurement year through December 31 of the measurement year. Antibiotic Any type of Penicillin or any type of Erythromycin, two doses daily, for prophylaxis the full 300 (or 350) days (see Table 3-A). Table 3-A: Penicillins and Erythromycins for antibiotic prophylaxis Description Prescription Aminopenicillins Amoxicillin Ampicillin Beta-lactamase inhibitors Amoxicillin-clavulanate Macrolides Azithromycin Erythromycin Erythromycin estolate Erythromycin ethylsuccinate Erythromycin stearate Miscellaneous antibiotics Erythromycin- sulfisoxazole Vancomycin Natural penicillins Penicillin V potassium Penicillin Note: See Table 3-D for a comprehensive list of medications and NDC codes.

Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

  • Upload
    others

  • View
    1

  • Download
    0

Embed Size (px)

Citation preview

Page 1: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

PQMP Q‐METRIC SCD Measure 3  U18HS020516  Page 1 Section II: Technical Specifications  PDF 2  December 2013 

Q‐METRIC Sickle Cell Disease Measure 3: Appropriate Antibiotic Prophylaxis for Children with Sickle Cell Disease Technical specifications for Section II. Detailed Measure Specifications 

Sickle Cell Disease

Measure 3: Appropriate Antibiotic Prophylaxis for Children with Sickle Cell Disease

Description

The percentage of children younger than five years of age who were identified as having Sickle Cell Anemia who received appropriate antibiotic prophylaxis during the measurement year. A higher proportion indicates better performance as reflected by appropriate treatment.

Calculation

This measure requires administrative claims data and is calculated as two rates. The two individual rates are:

1. The percentage of children who received antibiotic prophylaxis for at least 300 days (300-day numerator divided by denominator).

2. The percentage of children who received antibiotic prophylaxis for at least 350 days (350-day numerator divided by denominator).

Definitions

Intake period January 1 of the measurement year through December 31 of the measurement year.

Antibiotic Any type of Penicillin or any type of Erythromycin, two doses daily, for prophylaxis the full 300 (or 350) days (see Table 3-A).

Table 3-A: Penicillins and Erythromycins for antibiotic prophylaxis

Description Prescription

Aminopenicillins Amoxicillin Ampicillin

Beta-lactamase inhibitors Amoxicillin-clavulanate

Macrolides Azithromycin Erythromycin Erythromycin estolate

Erythromycin ethylsuccinate Erythromycin stearate

Miscellaneous antibiotics Erythromycin-sulfisoxazole

Vancomycin

Natural penicillins Penicillin V potassium Penicillin

Note: See Table 3-D for a comprehensive list of medications and NDC codes.

Page 2: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

PQMP Q‐METRIC SCD Measure 3  U18HS020516  Page 2 Section II: Technical Specifications  PDF 2  December 2013 

Eligible Population

Ages Children ≥ 90 days on January 1 of the measurement year but younger than five years on December 31 of the measurement year.

Enrollment Continuous enrollment during the measurement year.

Event/diagnosis Identify members as having sickle cell disease who had appropriate sickle cell disease-related ICD-9 code on three or more separate healthcare encounters (see Table 3-B) during the measurement year.

Table 3-B: Codes to Identify Sickle Cell Disease

Condition Name Hemoglobin Screening Result ICD-9 Code(s)

Hb SS-disease (sickle cell anemia) Hb F,S 282.6, 282.61, 282.62

Specification

Denominator The eligible population.

Numerators

300-day Eligible children who received antibiotic prophylaxis for at least 300 days as determined by administrative record review.

350-day Eligible children who received antibiotic prophylaxis for at least 350 days as determined by administrative record review.

Exclusions

Claims in the administrative records for any of the sickle cell disease variants listed in Table 3-C do not count toward the “three or more separate healthcare encounters” criteria.

Table 3-C: Excluded Initial Hemoglobin Screening Results

Condition Name Hemoglobin Screening Result ICD-9 Code(s)

Hb beta zero-thalassemia Hb F only 282.49 Hb S beta-thalassemia Hb F,S,A 282.41, 282.42 Hb C-disease Hb F,C 282.7 Hb C beta-thalassemia Hb F,C,A 282.49 Hb D beta-thalassemia Hb F,D,A 282.49 Hb E beta-thalassemia Hb F,E,A 282.49 Hb E-disease Hb F,E 282.7 Hb H-disease Hb F,H 282.49 Hb SC-disease Hb F,S,C 282.63, 282.64 Hb SD-disease Hb F,S,D 282.68, 282.69 Hb SE-disease Hb F,S,E 282.68, 282.69 Hb C-carrier Hb F,A,C 282.7 Hb D-carrier Hb F,A,D 282.7 Hb E-carrier Hb F,A,E 282.7 Hb S (sickle)-carrier Hb F,A,S 282.5

Page 3: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

Measure 3Begin

IP2008

OT2008

Select by age and diagnosis,

recode ADMSN_DT to SRVC_BGN_DT

Select by age and diagnosis

PS2008 PS2008_cutSelect by age and eligibility

OT2008_bdayDXcut

IP2008_bdayDXcut

Merge files, eliminate duplicate

claims by date of service for

each ID

IPOT2008_Meas3Had3

Select cases that had 3 or more claims

Merge files using JOIN so

only IDs found in both files are retained

IPOTPS_2008

_Meas3

Merge files using JOIN so

only IDs found in both files are retained

350 or more days

Measure 3End

Select by NDC and count days’ supply

350 NUMER-

ATOR

DENOM-INATOR

Count IDs

Count IDsMerge files,divide NUMERs by DENOM to

calculate percentages

RX2008

300 or more days

300 NUMER-

ATOR

Count IDs

Page 4: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

/*This syntax finds kids of a certain age who have certain SCD diagnoses, asspecified by Measure 3. Cases with 3 or more health care encounters during themeasurement year are retained, the rest are discarded. The retained group is the denominator*/

/**********************************************//***********MEASUREMENT YEAR 2005**************//**********************************************/

LIBNAME MI 'D:\MI only';proc printto log='Z:\MAX data\SYNTAX\LOGS\Meas3 MI 2005.log' new; run;

ODS LISTING CLOSE;/*NOTE: Sheet_Interval MUST be first option*/ODS TAGSETS.EXCELXP FILE='Z:\MAX data\SYNTAX\OUTPUT\Meas3,13 MI 2005-2009.xls' STYLE=minimal OPTIONS (Sheet_Interval='none' EMBEDDED_TITLES='yes' PAGE_ORDER_ACROSS='no' RowColHeading='no') ; title1 'Measures 3 and 13 MI 2005-2009';

/*******It's faster to remove cases from IP and OT files, then merge***********/

/***Identify cases in 2005 data -- ie "measurement year"***/

/*IP - Inpatient*/DATA MI.ip2005_MI_CUT (compress = yes); set MI.ip2005_MI;

IF EL_DOB > '20040930' /*deletes cases who will be less than roughly 90 days old on Jan 1, 2005*/ OR EL_DOB < '20010101' /*deletes cases who turn 5yrs or older before Dec 31, 2005*/ THEN delete;

/*Only include ICD codes specified in Measure 3*//*IP files have up to 9 DIAG_CD variables*/IF DIAG_CD_1 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_2 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_3 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_4 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_5 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_6 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_7 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_8 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_9 in ("02826","2826","28261","28262","D570","D571") THEN DxSCD=1; ELSE DxSCD=0; IF DxSCD=0 THEN delete;

/*Recode admission date so it has the same variable name as the OT files*/ADMSN_DT = SRVC_BGN_DT;

Page 5: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

/*title1 'IP2005_bdayDxCUT';proc freq; tables ADMSN_DT SRVC_BGN_DT DxSCD; run; This frequency is for syntax testing only*/

/*OT*/DATA MI.ot2005_MI_CUT (compress = yes); set MI.ot2005_MI;

IF EL_DOB > '20040930' /*deletes cases who will be less than roughly 90 days old on Jan 1, 2005*/ OR EL_DOB < '20010101' /*deletes cases who turn 5yrs or older before Dec 31, 2005*/ THEN delete;

/*Only include ICD codes specified in Measure 3*//*OT files only have 2 DIAG_CD variables*/IF DIAG_CD_1 in ("02826","2826","28261","28262","D570","D571") OR DIAG_CD_2 in ("02826","2826","28261","28262","D570","D571") THEN DxSCD=1; ELSE DxSCD=0; IF DxSCD=0 THEN delete;

/*title1 'ot2005_bdayDxCUT';proc freq; tables SRVC_BGN_DT DxSCD; run; This frequency is for syntax testing only*/

/*Merge cut versions of IP and OT files*/DATA MI.ipot2005_MI_Meas3_CUT (compress = yes); SET MI.ip2005_MI_CUT MI.ot2005_MI_CUT; run;

/*proc freq; tables DxSCD; run; This frequency is for syntax testing only*/

/*IP and OT visits occuring on the same date are considered to be part of a single Healthcare Encounter (HCE). Therefore, IP and OT files must be mergedBEFORE deleting duplicates by Date of Service.

IP and OT files use different variable names for Date of Service. The IP fileshave had the variable recoded into a variable that matches the variable name for OT*/

/* de-dup source keys by loading into hash */data MI.ipot2005_MI_meas3_dedup; set MI.ipot2005_MI_Meas3_CUT (keep=MSIS_ID SRVC_BGN_DT) end=last; ;

if _n_=1 then

Page 6: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

do; declare hash h0(ordered:'y',multidata:'n',hashexp:8); _rc=h0.defineKey('MSIS_ID','SRVC_BGN_DT'); _rc=h0.defineData('MSIS_ID','SRVC_BGN_DT'); _rc=h0.defineDone(); end;

_rc=h0.ref();

/* write hash to target data set */ if last then h0.output(dataset:'MI.inter'); run;

proc sql; create table MI.ipot2005_MI_Meas3Had3 as select MSIS_ID, count(distinct SRVC_BGN_DT) as numsepvisits from MI.inter group by MSIS_ID having count(distinct SRVC_BGN_DT) >= 3;quit;

/*title1 'ipot2005_MI_Meas3Had3';proc freq; tables numsepvisits MSIS_ID; run;This frequency is for syntax testing only*/

quit;

/*Use Person Summary file to create a list of eligible IDs based on continuous enrollment*/DATA MI.ps2005_MI_CUT (compress = yes); set MI.ps2005_MI;

/*It's not necessary to restrict birth dates for PS files, but it's faster*/IF EL_DOB > '20040930' /*deletes cases who will be less than roughly 90 days old on Jan 1, 2005*/ OR EL_DOB < '20010101' /*deletes cases who turn 5yrs or older before Dec 31, 2005*/ THEN delete;

IF EL_ELGBLTY_MO_CNT < '12' THEN delete; run;

/*title1 'PS2005_CUT';proc freq; tables EL_ELGBLTY_MO_CNT; run; This frequency is for syntax testing only*/

/*Merge ipot2005_MI_Meas3 and ps2005_MI*//*JOIN command only returns cases found in both files*/

Proc SQL; Create Table MI.ipotps2005_MI_Meas3 as Select a.*, b.MSIS_ID

Page 7: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

from MI.ipot2005_MI_Meas3Had3 a JOIN MI.ps2005_MI_CUT b on a.MSIS_ID=b.MSIS_ID; Quit;

/*title1 'ipotps2005_MI_Meas3';proc freq; tables MSIS_ID; run; This frequency is for syntax testing only*/

quit;

/*Count the number of separate MSIS_ID's to find the denominator for Measure 3*//*Assign a row ID to facilitate merge*/ Proc SQL; Create table MI.Meas3_2005Denom as Select Count(MSIS_ID) as DENOM, Case When Count(MSIS_ID)> -1 Then 1 Else 0 End as ROWID From MI.ipotps2005_MI_Meas3; Quit;

/*title1 'Measure 3 denominator';proc freq; tables DENOM ROWID; run; This frequency is for syntax testing only*/quit;

/*Merge in RX data to calculate numerator*//*JOIN command only returns IDs found in both files*/ Proc SQL; Create Table MI.rx2005_MI_Meas3 as Select a.MSIS_ID, b.* from MI.ipotps2005_MI_Meas3 a join MI.rx2005_MI b on a.MSIS_ID=b.MSIS_ID; Quit;

/*title1 'rx2005_MI_Meas3';proc freq; tables MSIS_ID; run; This frequency is for syntax testing only*/

quit;

DATA MI.rx2005_MI_Meas3NDC; set MI.rx2005_MI_Meas3;

/*Identify cases that received antibiotics (identified by NDC code) as specified by Measure 3*/IF NDC in ('00002237237' '00002312542' '00002312642' '00002510501' '00002510516' '00003010120' '00003010150' '00003010160' '00003010920' '00003010955' '00003010960''00003010970' '00003011550' '00003011575' '00003011650' '00003011675' '00003012250' '00003012260' '00003013450' '00003013460' '00003068144' '00003068154''00003068244' '00003068254' '00003096909' '00003096961' '00003097252' '00003097261' '00003173730' '00003173740' '00003173745' '00003173815' '00003173830'

Page 8: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'00003173840' '00003173845' '00015727675' '00015727760' '00015727775' '00015727862' '00015727873' '00015798867' '00015799265' '00015799268' '00015799368''00029600630' '00029600632' '00029600730' '00029600732' '00029600821' '00029600822' '00029600918' '00029600921' '00029600922' '00029600923' '00029603520''00029603839' '00029604412' '00029604420' '00029604512' '00029604520' '00029604612' '00029604620' '00029604625' '00029604712' '00029604720' '00029604725''00029604818' '00029604854' '00029604855' '00029604859' '00029604918' '00029604954' '00029604955' '00029604959' '00029607112' '00029607212' '00029607347''00029607447' '00029607527' '00029607531' '00029608012' '00029608027' '00029608031' '00029608522' '00029608523' '00029608539' '00029608612' '00029608621''00029608729' '00029608739' '00029608751' '00029609022' '00029609023' '00029609039' '00029609229' '00029609239' '00029609251' '00029609422' '00029609424''00029609425' '00029609429' '00029609439' '00029609440' '00029609445' '00029609446' '00029609451' '00029609628' '00029609640' '00029609648' '00029609660''00044020805' '00069305107' '00069305175' '00069306030' '00069306075' '00069306086' '00069307030' '00069307075' '00069307086' '00069308030' '00069311019''00069312019' '00069313019' '00069314019' '00069417021' '00074258913' '00074258953' '00074338913' '00074374716' '00074374816' '00074572911' '00074572913''00074572953' '00074622713' '00074629060' '00074630113' '00074630153' '00074630213' '00074630253' '00074630350' '00074630413' '00074630430' '00074630453''00074630513' '00074630553' '00074630560' '00074630613' '00074630616' '00074631613' '00074632013' '00074632053' '00074632113' '00074632611' '00074632613''00074632653' '00074634619' '00074634620' '00074634653' '00074636902' '00074636910' '00074637313' '00074637316' '00074715613' '00074715643' '00074715653''00074803013' '00074803043' '00074803053' '00074803055' '00074803073' '00093117101' '00093117110' '00093117201' '00093117210' '00093117301' '00093117310''00093117401' '00093117410' '00093202623' '00093202631' '00093202694' '00093202723' '00093226301' '00093226401' '00093226701' '00093226801' '00093226805''00093227034' '00093227234' '00093227434' '00093227534' '00093227773' '00093227973' '00093310701' '00093310705' '00093310756' '00093310905' '00093310953''00093412573' '00093412574' '00093412773' '00093412774' '00093415073' '00093415079' '00093415080' '00093415573' '00093415579' '00093415580' '00093416073''00093416076' '00093416078' '00093416173' '00093416176' '00093416178' '00093514501' '00093514505' '00093514601' '00093514605' '00093519401' '00093519410''00093519501' '00093519505' '00093519873' '00093519874' '00093519973' '00093519974' '00093714609' '00093714618' '00093714656' '00093714756' '00093714823''00093714923' '00093714931' '00093714994' '00093716933' '00093716956' '00093716990' '00093867574' '00093867575' '00093867578' '00143988601' '00143988650''00143988675' '00143988701' '00143988750' '00143988775' '00143988801' '00143988815' '00143988880' '00143988901' '00143988915' '00143988980' '00143993801''00143993805' '00143993901' '00143993905' '00143995101' '00143995120' '00143998101' '00143998150' '00143998175' '00143998201' '00143998250' '00143998275''00168007038' '00168021560' '00168021630' '00168021660' '00172245880' '00172740128' '00172740228' '00172740310' '00172740342' '00172740442' '00172740520''00172740521' '00172740522' '00172740620' '00172740621' '00172740622' '00172740714' '00172740722' '00172740726' '00172740814' '00172740822' '00172740826''00172741142' '00172741160' '00172741170' '00172741470' '00172741642' '00172741660' '00172741723' '00172741821' '00172741823' '00172741921' '00172742020''00172742021' '00172742022' '00182011501' '00182011510' '00182011610' '00182016301' '00182016305' '00182016389' '00182027470' '00182027473' '00182027570''00182027573' '00182027670' '00182027673' '00182030870' '00182030873' '00182053801' '00182053805' '00182053901' '00182064101' '00182064105' '00182064189''00182086901' '00182086910' '00182107001' '00182107089' '00182107105' '00182107119' '00182107189' '00182107270' '00182107272' '00182107370' '00182107372'

Page 9: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'00182137140' '00182139801' '00182139805' '00182148901' '00182148905' '00182153070' '00182153073' '00182153701' '00182153710' '00182156040' '00182177340''00182196205' '00185720370' '00185720670' '00185720969' '00185721268' '00223091201' '00223091205' '00223091401' '00223091405' '00223614001' '00223614101''00223614201' '00223614210' '00223614301' '00223614310' '00228263911' '00228264011' '00228264025' '00228268811' '00228268851' '00228268911' '00228268951''00247000100' '00247000101' '00247000102' '00247000103' '00247000104' '00247000105' '00247000106' '00247000108' '00247000109' '00247000110' '00247000112''00247000115' '00247000120' '00247000121' '00247000124' '00247000125' '00247000128' '00247000130' '00247000133' '00247000140' '00247000142' '00247000156''00247000169' '00247000198' '00247000200' '00247000201' '00247000202' '00247000203' '00247000204' '00247000205' '00247000206' '00247000208' '00247000209''00247000210' '00247000212' '00247000214' '00247000215' '00247000216' '00247000218' '00247000220' '00247000221' '00247000222' '00247000224' '00247000225''00247000227' '00247000228' '00247000230' '00247000232' '00247000233' '00247000236' '00247000240' '00247000242' '00247000250' '00247000269' '00247000280''00247000298' '00247000700' '00247000701' '00247000702' '00247000703' '00247000704' '00247000705' '00247000706' '00247000708' '00247000710' '00247000712''00247000715' '00247000716' '00247000720' '00247000721' '00247000728' '00247000730' '00247000732' '00247000740' '00247000756' '00247000760' '00247000798''00247000800' '00247000802' '00247000803' '00247000804' '00247000805' '00247000806' '00247000809' '00247000810' '00247000815' '00247000818' '00247000820''00247000821' '00247000824' '00247000830' '00247000842' '00247000898' '00247000900' '00247000978' '00247000979' '00247001400' '00247001479' '00247002100''00247002178' '00247002180' '00247002200' '00247002205' '00247002210' '00247002278' '00247002279' '00247002280' '00247002300' '00247002302' '00247002304''00247002306' '00247002308' '00247002315' '00247002320' '00247002321' '00247002328' '00247002330' '00247002340' '00247002398' '00247002500' '00247002575''00247002578' '00247002602' '00247002603' '00247002604' '00247002606' '00247002608' '00247002615' '00247002620' '00247002621' '00247002624' '00247002630''00247002701' '00247002702' '00247002703' '00247002704' '00247002707' '00247002709' '00247002710' '00247002714' '00247002715' '00247002720' '00247002721''00247002730' '00247003500' '00247003575' '00247003578' '00247005600' '00247005679' '00247006801' '00247006802' '00247006803' '00247006804' '00247006806''00247006808' '00247006810' '00247006812' '00247006814' '00247006815' '00247006816' '00247006818' '00247006820' '00247006821' '00247006824' '00247006825''00247006828' '00247006830' '00247006832' '00247006840' '00247006898' '00247006900' '00247006902' '00247006903' '00247006904' '00247006905' '00247006906''00247006908' '00247006909' '00247006910' '00247006912' '00247006915' '00247006916' '00247006920' '00247006921' '00247006924' '00247006928' '00247006930''00247006932' '00247006940' '00247006944' '00247006998' '00247006999' '00247007730' '00247010600' '00247010679' '00247011001' '00247011004' '00247011008''00247011010' '00247011012' '00247011020' '00247011021' '00247011024' '00247011028' '00247011030' '00247011040' '00247011056' '00247011098' '00247011602''00247011603' '00247011604' '00247011605' '00247011606' '00247011609' '00247011615' '00247011620' '00247011621' '00247011628' '00247011630' '00247011640''00247011642' '00247015601' '00247015603' '00247015604' '00247015612' '00247015615' '00247015616' '00247015620' '00247015621' '00247015628' '00247015629''00247015630' '00247015640' '00247015698' '00247015703' '00247015704' '00247015707' '00247015708' '00247015716' '00247015718' '00247015720' '00247015721''00247015728' '00247015730' '00247015740' '00247017500' '00247017502' '00247017503' '00247017504' '00247017507' '00247017509' '00247017510' '00247017512''00247017514' '00247017520' '00247017521' '00247017528' '00247017530' '00247017540' '00247017556' '00247028001' '00247028002' '00247028003' '00247028004'

Page 10: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'00247028005' '00247028006' '00247028010' '00247028011' '00247028050' '00247039040' '00247039500' '00247039560' '00247039577' '00247039579' '00247039590''00247039600' '00247039605' '00247039610' '00247039625' '00247039660' '00247039677' '00247039679' '00247039690' '00247039695' '00247045904' '00247045906''00247045914' '00247045916' '00247045920' '00247045930' '00247046015' '00247046020' '00247046021' '00247046030' '00247052215' '00247052230' '00247056306''00247056320' '00247056321' '00247056330' '00247063730' '00247091106' '00247091114' '00247091120' '00247091130' '00247091140' '00247093520' '00247093530''00247093540' '00247094900' '00247094978' '00247094979' '00247096601' '00247096603' '00247096628' '00247096630' '00247096640' '00247096698' '00247124630''00247128801' '00247128803' '00247128806' '00247133820' '00247133830' '00247133930' '00247133942' '00247136130' '00247136140' '00247141402' '00247141410''00247141414' '00247141420' '00247141424' '00247146601' '00247148815' '00247148915' '00247149092' '00247149130' '00247151209' '00247151230' '00247151805''00247151850' '00247151905' '00247151910' '00247151915' '00247151950' '00247160001' '00247160078' '00247160178' '00247162600' '00247162700' '00247162750''00247164520' '00247164620' '00247166930' '00247172900' '00247172979' '00247195120' '00247199002' '00247199003' '00247199004' '00247199009' '00247199012''00247199015' '00247199020' '00247199021' '00247199030' '00247199100' '00247199102' '00247199104' '00247199106' '00247199114' '00247199120' '00247201800''00247201850' '00247201875' '00247223300' '00247223350' '00247223375' '00247225815' '00247227900' '00247227901' '00247227930' '00247227958' '00247235801''00247235802' '00247235806' '00332310704' '00332310705' '00332310709' '00332311101' '00332311104' '00364204001' '00364204150' '00364207816' '00378010601''00378010605' '00378010701' '00378011101' '00378011110' '00378011201' '00378011210' '00378011501' '00378011505' '00378011601' '00378011605' '00378011702''00378011704' '00378011802' '00378011804' '00378019501' '00378019510' '00378019801' '00378019810' '00378020401' '00378020505' '00378020589' '00378020602''00378020606' '00378020702' '00378020706' '00378120405' '00378120505' '00378153356' '00378153593' '00378211601' '00378640001' '00378640005' '00405227570''00405350060' '00405350070' '00405352560' '00405352570' '00405408301' '00405408302' '00405408402' '00405408450' '00405408601' '00405408602' '00405408901''00405408902' '00405409001' '00405409002' '00405439801' '00405439802' '00405439901' '00405439902' '00405440101' '00405441101' '00405441102' '00405476201''00405476203' '00405476301' '00405476303' '00405476801' '00405476803' '00405476901' '00405476903' '00409433201' '00409650901' '00409653301' '00430069624''00463501101' '00463501110' '00463501201' '00463501210' '00463501501' '00463501515' '00463501601' '00463501615' '00463501710' '00463501901' '00463502055''00463502310' '00472097116' '00472097416' '00472097716' '00472097916' '00536010571' '00555021522' '00555021523' '00555025902' '00555025904' '00555044521''00555044522' '00555044523' '00555058402' '00555058404' '00603120258' '00603120358' '00603120658' '00603120758' '00603227321' '00603227421' '00603229121''00603229128' '00603354821' '00603354828' '00603355121' '00603355221' '00603355228' '00603355328' '00603355421' '00603506821' '00603650084' '00603656366''00603660564' '00603660568' '00603660664' '00603660668' '00615012401' '00615012405' '00615012413' '00615018001' '00677066005' '00677066101' '00677066102''00677066105' '00677130327' '00677130329' '00781109801' '00781120501' '00781120510' '00781149631' '00781149668' '00781149669' '00781149731' '00781161966''00781164366' '00781165501' '00781165510' '00781183120' '00781185001' '00781185220' '00781187301' '00781187431' '00781194101' '00781194131' '00781194133''00781194339' '00781202001' '00781202005' '00781202031' '00781202076' '00781214401' '00781214405' '00781214501' '00781214505' '00781255501' '00781255505''00781261301' '00781261305' '00781261331' '00781261376' '00781299901' '00781299905' '00781340895' '00781341392' '00781506001' '00781506020' '00781506101'

Page 11: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'00781506120' '00781603946' '00781603955' '00781603958' '00781604146' '00781604155' '00781604158' '00781610246' '00781610446' '00781612046' '00781612048''00781612146' '00781612148' '00781613948' '00781613954' '00781613957' '00781615646' '00781615652' '00781615657' '00781615746' '00781615752' '00781615757''00781619146' '00781619155' '00781619546' '00781619555' '00781704346' '00781704348' '00781704355' '00839176606' '00839176616' '00839507906' '00839507916''00839508706' '00839508712' '00839513006' '00839513012' '00839518506' '00839518706' '00839518716' '00839518806' '00839518816' '00839518973' '00839519073''00839519078' '00839603706' '00839603712' '00839603804' '00839603812' '00839611571' '00839611573' '00839611575' '00839611671' '00839611673' '00839611675''00839636273' '00839636278' '00839639306' '00839644578' '00839648269' '00839656869' '00839658806' '00839658812' '00839671469' '00839751473' '00839751475''00839751478' '00839760206' '00839760212' '00839765606' '00839765612' '00839766006' '00839777606' '00839777612' '00904201740' '00904201760' '00904207340''00904207360' '00904244960' '00904245060' '00904245080' '00904245160' '00904245180' '00904245260' '00904245280' '00904245860' '00904245940' '00904245960''00904246216' '00904246316' '00904246439' '00904246440' '00904246460' '00904246540' '00904246560' '00904246860' '00904247016' '00904247116' '00904247240''00904247260' '00904247440' '00904247460' '00904247504' '00904247507' '00904247508' '00904261740' '00904261760' '00904261761' '00904261840' '00904261846''00904261851' '00904261904' '00904261906' '00904261907' '00904262004' '00904262006' '00904262007' '00904265304' '00904265308' '00904400104' '00904400108''00904400404' '00904400408' '00904401004' '00904401008' '00904401404' '00904401408' '00904771340' '00904771360' '00904774340' '00904774360' '00904792638''10631017620' '10631056520' '10631056720' '11584038100' '11584038105' '11584039100' '11584040100' '11584040105' '11584040500' '12280004300' '12280005730''12280008900' '12280010100' '12280010120' '12280010150' '12280010930' '12280011220' '12280022220' '12280026000' '12280026806' '12280026903' '16590001430''16590001533' '16590001615' '16590001630' '16590001720' '16590001730' '16590001833' '16590001920' '16590002020' '16590008828' '16590008830' '16590008840''16590008921' '16590008930' '16590008940' '16590009121' '16590009130' '16590009140' '16590018236' '16590018320' '16590018330' '16590018340' '16714023401''17478007035' '24208091055' '43598020369' '43598020852' '43598021830' '43598022040' '45469292800' '45469293000' '45469295300' '45565000202' '45565003103''45802096694' '45802096696' '48102000835' '49884002747' '49884004101' '49884004107' '49884005301' '49884005307' '49884006047' '49884007247' '49884007269''49884007327' '49884007328' '49884007347' '49884014227' '49884014228' '49884014247' '49884016827' '49884016828' '49884016847' '49884020128' '49884020149''49884020170' '49884029807' '49884029812' '49884029907' '49884029912' '49884036581' '49884057901' '49884057910' '49999001200' '49999001220' '49999001228''49999001230' '49999001240' '49999001400' '49999001410' '49999001421' '49999001430' '49999001500' '49999001506' '49999001508' '49999001512' '49999001514''49999001515' '49999001520' '49999001521' '49999001528' '49999001530' '49999001540' '49999001542' '49999001545' '49999001604' '49999001621' '49999001630''49999001640' '49999002300' '49999002320' '49999002328' '49999002330' '49999002340' '49999003300' '49999003330' '49999006728' '49999006740' '49999008028''49999008030' '49999008040' '49999010121' '49999010140' '49999016800' '49999026015' '49999031500' '49999051500' '49999051600' '49999074328' '49999076628''49999081000' '50111076728' '50111078710' '50111078752' '50111078766' '50111078810' '50111078852' '50111078867' '50111078910' '50111079120' '50111079222''50111079320' '51079026520' '51079026720' '51079059120' '51079060020' '51079060120' '51079061520' '51079061620' '51285044521' '51285044522' '51285044523''51641011164' '51641011166' '51641011168' '51655000929' '51655000951' '51655000952' '51655001051' '51655007524' '51655007528' '51655007551' '51655007587'

Page 12: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'51655009829' '51655009851' '51655009887' '51655009895' '51655010451' '51655012029' '51655015229' '51655015724' '51655015749' '51655015751' '51655029751''51655048024' '51655051929' '51655051951' '51655067429' '51655067451' '52959001120' '52959001121' '52959001124' '52959001130' '52959001140' '52959002000''52959002004' '52959002005' '52959002006' '52959002018' '52959002020' '52959002021' '52959002024' '52959002028' '52959002030' '52959002040' '52959002042''52959002060' '52959002104' '52959002114' '52959002115' '52959002120' '52959002121' '52959002130' '52959002230' '52959004610' '52959004614' '52959004620''52959005728' '52959005740' '52959005815' '52959005820' '52959005821' '52959005830' '52959005840' '52959006020' '52959006028' '52959006030' '52959006040''52959006056' '52959006115' '52959006118' '52959006120' '52959006121' '52959006124' '52959006128' '52959006130' '52959006140' '52959006142' '52959006210''52959006220' '52959006221' '52959006228' '52959006230' '52959006240' '52959006256' '52959006321' '52959006328' '52959006330' '52959006340' '52959006420''52959006428' '52959006440' '52959013003' '52959016400' '52959016403' '52959016406' '52959018101' '52959021310' '52959021320' '52959021324' '52959021328''52959021330' '52959021340' '52959024010' '52959024203' '52959024619' '52959024621' '52959024630' '52959024640' '52959029605' '52959030300' '52959030303''52959030401' '52959030402' '52959030500' '52959030501' '52959031001' '52959031002' '52959031315' '52959033320' '52959033324' '52959033328' '52959033330''52959033340' '52959034140' '52959034160' '52959034309' '52959034315' '52959034321' '52959034330' '52959038920' '52959038928' '52959038930' '52959038940''52959042728' '52959042740' '52959047030' '52959047810' '52959047814' '52959047815' '52959047820' '52959050420' '52959050440' '52959050506' '52959056000''52959061302' '52959061303' '52959061401' '52959061402' '52959061403' '52959061501' '52959061502' '52959061600' '52959061601' '52959061602' '52959061700''52959065703' '52959065706' '52959066120' '52959066130' '52959070204' '52959070209' '52959070212' '52959070214' '52959070215' '52959070220' '52959070221''52959070230' '52959070240' '52959070710' '52959070714' '52959070715' '52959070720' '52959070730' '52959076501' '52959076502' '52959079328' '52959079340''52959081620' '52959081628' '52959081630' '52959083806' '52959084301' '52959100501' '52959100502' '52959100503' '52959100601' '52959100602' '52959100603''52959101200' '52959101201' '52959117201' '52959117202' '52959143000' '52959143100' '52959146303' '53978125705' '53978500205' '53978500305' '53978502906''53978504206' '53978505506' '54569009300' '54569009400' '54569011700' '54569012000' '54569012100' '54569012101' '54569012103' '54569012300' '54569012302''54569012303' '54569012305' '54569012400' '54569012401' '54569012402' '54569012403' '54569012405' '54569012406' '54569012407' '54569012408' '54569012409''54569012500' '54569012501' '54569012502' '54569012503' '54569012504' '54569012505' '54569012506' '54569012700' '54569012702' '54569012703' '54569012705''54569012800' '54569012902' '54569012903' '54569012909' '54569013101' '54569013102' '54569013200' '54569013400' '54569013500' '54569013601' '54569013603''54569013700' '54569014201' '54569015702' '54569029800' '54569029801' '54569101900' '54569102600' '54569171900' '54569171902' '54569174600' '54569174601''54569174605' '54569174608' '54569174609' '54569186100' '54569186101' '54569186102' '54569186104' '54569186105' '54569186108' '54569186109' '54569195900''54569195901' '54569195903' '54569195904' '54569195905' '54569195906' '54569195908' '54569196200' '54569196201' '54569196202' '54569196203' '54569200000''54569200100' '54569200200' '54569218700' '54569228100' '54569228101' '54569228102' '54569228103' '54569228104' '54569241100' '54569241101' '54569243300''54569243302' '54569250200' '54569250201' '54569250203' '54569250205' '54569250206' '54569250207' '54569250702' '54569250703' '54569250704' '54569250705''54569250707' '54569250709' '54569250800' '54569250801' '54569250802' '54569250803' '54569250804' '54569270200' '54569270202' '54569270203' '54569270204'

Page 13: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'54569270206' '54569270208' '54569271001' '54569271002' '54569271004' '54569271005' '54569271006' '54569282100' '54569292800' '54569292900' '54569293000''54569293100' '54569293300' '54569295201' '54569295300' '54569295400' '54569305700' '54569333504' '54569333505' '54569333506' '54569333507' '54569334700''54569334701' '54569334702' '54569350301' '54569353102' '54569356300' '54569356301' '54569356302' '54569356303' '54569356304' '54569356305' '54569368900''54569368901' '54569368902' '54569368903' '54569368904' '54569368905' '54569368906' '54569387600' '54569398601' '54569423000' '54569423100' '54569423200''54569432500' '54569433700' '54569433800' '54569433801' '54569435200' '54569435300' '54569441700' '54569445800' '54569445801' '54569445802' '54569449700''54569452200' '54569452201' '54569452202' '54569456700' '54569460800' '54569479000' '54569479100' '54569479101' '54569479600' '54569479700' '54569488900''54569489200' '54569518200' '54569519300' '54569531400' '54569534400' '54569544800' '54569551800' '54569552200' '54569575400' '54569575500' '54569580400''54569580600' '54569580700' '54569580800' '54569580900' '54569581000' '54569644800' '54569800400' '54569802100' '54807025120' '54868001800' '54868001801''54868001803' '54868001804' '54868001806' '54868001807' '54868001809' '54868019301' '54868019501' '54868019502' '54868019601' '54868019602' '54868019902''54868019903' '54868020001' '54868022401' '54868022403' '54868022404' '54868022406' '54868022500' '54868022501' '54868030201' '54868030202' '54868033301''54868033302' '54868033304' '54868033306' '54868033307' '54868038700' '54868038701' '54868038702' '54868038703' '54868038800' '54868038801' '54868038802''54868038804' '54868038805' '54868041300' '54868041302' '54868041304' '54868041307' '54868041308' '54868080701' '54868084000' '54868084001' '54868084002''54868084003' '54868084004' '54868097100' '54868097101' '54868098501' '54868104401' '54868114600' '54868117100' '54868117101' '54868117103' '54868117300''54868117301' '54868117302' '54868117304' '54868117305' '54868117306' '54868123100' '54868138601' '54868138602' '54868138603' '54868138604' '54868138605''54868138700' '54868138701' '54868138704' '54868142601' '54868177400' '54868177402' '54868178001' '54868178002' '54868186501' '54868186502' '54868186503''54868188600' '54868188700' '54868188701' '54868284000' '54868284001' '54868301600' '54868301601' '54868310500' '54868310501' '54868310502' '54868310700''54868310701' '54868310702' '54868310703' '54868310706' '54868310707' '54868310708' '54868310709' '54868310900' '54868310901' '54868310902' '54868310904''54868310906' '54868310907' '54868310908' '54868310909' '54868311100' '54868311101' '54868311103' '54868311105' '54868311300' '54868311301' '54868311303''54868311305' '54868311307' '54868311308' '54868311309' '54868324400' '54868364800' '54868390300' '54868390301' '54868390302' '54868390303' '54868407600''54868407800' '54868407801' '54868407802' '54868408000' '54868412501' '54868412502' '54868412901' '54868412902' '54868413101' '54868415000' '54868415001''54868415002' '54868415500' '54868415501' '54868415502' '54868415503' '54868420800' '54868447300' '54868454300' '54868454301' '54868454302' '54868461400''54868461401' '54868464400' '54868464401' '54868464402' '54868510100' '54868510101' '54868547100' '54868547800' '54868547801' '54868547802' '54868548700''54868564700' '54868564800' '54868564801' '54868564802' '55045111300' '55045111301' '55045111303' '55045111307' '55045111309' '55045112200' '55045112201''55045112202' '55045112203' '55045112204' '55045112205' '55045112207' '55045112208' '55045112209' '55045116803' '55045116806' '55045116807' '55045116808''55045122600' '55045122601' '55045122602' '55045122603' '55045122604' '55045122605' '55045122606' '55045122608' '55045122609' '55045127003' '55045127004''55045127005' '55045127006' '55045127008' '55045127009' '55045138104' '55045138105' '55045138106' '55045138108' '55045138109' '55045144201' '55045147100''55045147807' '55045147808' '55045200400' '55045200404' '55045200405' '55045200406' '55045200408' '55045201202' '55045201205' '55045201208' '55045201209'

Page 14: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'55045207602' '55045207603' '55045207604' '55045207606' '55045216204' '55045216207' '55045216208' '55045237205' '55045249206' '55045319401' '55045319403''55045319404' '55045319406' '55045319409' '55045326001' '55045326006' '55045326009' '55045346608' '55045369803' '55045372501' '55045372602' '55045372701''55289001901' '55289001906' '55289001915' '55289001921' '55289001924' '55289001930' '55289001940' '55289001960' '55289001997' '55289002004' '55289002006''55289002009' '55289002014' '55289002015' '55289002021' '55289002024' '55289002028' '55289002030' '55289002040' '55289002042' '55289002050' '55289002056''55289002060' '55289002063' '55289002301' '55289002310' '55289002320' '55289002328' '55289002330' '55289002340' '55289002404' '55289002407' '55289002410''55289002420' '55289002428' '55289002430' '55289002440' '55289002497' '55289002504' '55289002520' '55289002528' '55289002530' '55289002540' '55289002720''55289002801' '55289002830' '55289002850' '55289002921' '55289002930' '55289003328' '55289003340' '55289005040' '55289007540' '55289007556' '55289011003''55289011009' '55289011020' '55289011028' '55289011030' '55289011040' '55289011056' '55289011120' '55289011128' '55289011140' '55289011156' '55289011180''55289011201' '55289011204' '55289011210' '55289011215' '55289011220' '55289011228' '55289011240' '55289011256' '55289011297' '55289011298' '55289012006''55289018206' '55289018209' '55289018214' '55289018230' '55289018240' '55289020610' '55289020620' '55289020628' '55289020630' '55289020640' '55289020697''55289020704' '55289020715' '55289020720' '55289020728' '55289020730' '55289020740' '55289021728' '55289021740' '55289024015' '55289024209' '55289024215''55289024221' '55289029615' '55289029630' '55289031004' '55289031006' '55289031014' '55289039830' '55289042621' '55289042630' '55289051210' '55289051214''55289051228' '55289052521' '55289052530' '55289052540' '55289052542' '55289052563' '55289064501' '55289064520' '55289064528' '55289064530' '55289064540''55289064556' '55289064580' '55289070502' '55289070506' '55289070515' '55289070516' '55289070520' '55289070528' '55289070530' '55289070540' '55289070556''55289070720' '55289072720' '55289076714' '55289076720' '55289084521' '55289084530' '55289091506' '55289091515' '55289091524' '55289091530' '55289096404''55289096414' '55370088007' '55370088008' '55370088107' '55370088108' '55370088213' '55370088240' '55370088313' '55370088340' '55370088407' '55370088408''55370088507' '55370088508' '55370088613' '55370088614' '55370088680' '55370088713' '55370088714' '55370088780' '55887033230' '55887062209' '55887062220''55887062221' '55887062230' '55887062240' '55887074620' '55887074656' '55887074720' '55887076821' '55887076830' '55887078728' '55887079015' '55887079020''55887079030' '55887082314' '55887083020' '55887083028' '55887083030' '55887083040' '55887084928' '55887084930' '55887084940' '55887085520' '55887085528''55887085530' '55887086701' '55887093030' '55887093040' '55887093306' '55887095521' '55887095530' '55887098204' '55887098209' '55887098214' '55887098215''55887098220' '55887098221' '55887098228' '55887098230' '55887098240' '55887098242' '55887098260' '55887099309' '55887099314' '55887099315' '55887099321''55887099330' '55887099340' '55887099342' '55953067347' '55953071670' '55953074770' '56126038711' '56126039111' '56126039711' '57866010601' '57866010602''57866025001' '57866026102' '57866035101' '57866035102' '57866035103' '57866044607' '57866312901' '57866361302' '57866361401' '57866435601' '57866605002''57866605103' '57866721801' '57866721802' '58016008600' '58016008630' '58016008660' '58016008690' '58016010300' '58016010309' '58016010312' '58016010315''58016010318' '58016010320' '58016010321' '58016010324' '58016010330' '58016010340' '58016010400' '58016010409' '58016010412' '58016010414' '58016010415''58016010418' '58016010420' '58016010421' '58016010424' '58016010428' '58016010430' '58016010440' '58016010500' '58016010560' '58016010590' '58016010630''58016010720' '58016012300' '58016012312' '58016012315' '58016012320' '58016012324' '58016012328' '58016012330' '58016012340' '58016012400' '58016012402'

Page 15: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'58016012408' '58016012410' '58016012412' '58016012414' '58016012415' '58016012416' '58016012420' '58016012421' '58016012424' '58016012428' '58016012430''58016012440' '58016012450' '58016012456' '58016012460' '58016012490' '58016012500' '58016012503' '58016012506' '58016012509' '58016012510' '58016012512''58016012514' '58016012515' '58016012520' '58016012521' '58016012524' '58016012528' '58016012530' '58016012540' '58016012560' '58016012600' '58016012615''58016012618' '58016012620' '58016012621' '58016012628' '58016012630' '58016012642' '58016012660' '58016012699' '58016012706' '58016012708' '58016012710''58016012714' '58016012720' '58016012721' '58016012724' '58016012728' '58016012730' '58016012740' '58016012742' '58016012750' '58016012760' '58016014000''58016014518' '58016014600' '58016014602' '58016014603' '58016014610' '58016014612' '58016014616' '58016014620' '58016014621' '58016014624' '58016014628''58016014630' '58016014640' '58016014660' '58016014673' '58016014689' '58016014690' '58016014700' '58016014702' '58016014703' '58016014706' '58016014710''58016014712' '58016014715' '58016014716' '58016014720' '58016014721' '58016014724' '58016014728' '58016014730' '58016014740' '58016014750' '58016014760''58016014773' '58016014789' '58016014790' '58016014800' '58016014808' '58016014809' '58016014810' '58016014812' '58016014814' '58016014815' '58016014820''58016014824' '58016014828' '58016014830' '58016014840' '58016014850' '58016014900' '58016014907' '58016014910' '58016014920' '58016014921' '58016014924''58016014925' '58016014928' '58016014930' '58016014940' '58016016228' '58016016230' '58016016240' '58016016700' '58016016712' '58016016715' '58016016720''58016016730' '58016016740' '58016017530' '58016017540' '58016017640' '58016018400' '58016018412' '58016018415' '58016018418' '58016018424' '58016018430''58016018440' '58016035600' '58016035621' '58016035630' '58016035660' '58016035690' '58016039100' '58016039101' '58016039106' '58016039110' '58016039115''58016039118' '58016039120' '58016039128' '58016039130' '58016039160' '58016039190' '58016051220' '58016064300' '58016064302' '58016064304' '58016064309''58016064312' '58016064315' '58016064318' '58016064320' '58016064321' '58016064324' '58016064330' '58016064340' '58016064350' '58016064360' '58016064389''58016064390' '58016064399' '58016100001' '58016100220' '58016100401' '58016100501' '58016100601' '58016100701' '58016100903' '58016101101' '58016101701''58016101703' '58016101801' '58016101806' '58016102301' '58016102303' '58016102401' '58016102501' '58016102601' '58016102701' '58016102706' '58016102801''58016102901' '58016103101' '58016103201' '58016103301' '58016103401' '58016103601' '58016103701' '58016103706' '58016103801' '58016103901' '58016103906''58016106201' '58016411301' '58016411401' '58016480401' '58016480801' '58016481401' '58016484201' '58016484701' '58016486901' '58016499001' '58864002930''58864002940' '58864019540' '58864019928' '58864019940' '58864019956' '58864037940' '58864061130' '58864061530' '58864063240' '58864067530' '58864067540''58864079106' '58864084530' '58864084540' '59016013410' '59016013412' '59016013414' '59016013415' '59762102101' '59762102202' '59762102204' '59762105005''59762153401' '59762153402' '59762153702' '59762153703' '59762305101' '59762305102' '59762306001' '59762306002' '59762306003' '59762307001' '59762307002''59762308001' '59762311001' '59762312001' '59762313001' '59762314001' '59911587502' '60346008244' '60346036403' '60346036409' '60346036415' '60346036421''60346036444' '60346065506' '60346065510' '60346065515' '60429002130' '60429002230' '60429002340' '60429007040' '60429014740' '60429014840' '60432006500''60432006547' '60432006575' '60432067160' '60760032030' '61392011330' '61392011331' '61392011332' '61392011339' '61392011345' '61392011351' '61392011354''61392011360' '61392011390' '61392011391' '61423082040' '61423082575' '61423083515' '62584023701' '62584023801' '63304017620' '63304050901' '63304050920''63304051401' '63304051501' '63304051504' '63304056520' '63304056720' '63304065401' '63304065405' '63304065501' '63304065505' '63304071320' '63304075320'

Page 16: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'63304075420' '63304076020' '63304076101' '63304076120' '63304076220' '63304076301' '63304076305' '63304076320' '63304076801' '63304076802' '63304076807''63304096901' '63304096903' '63304096904' '63304097001' '63304097003' '63304097004' '63304097701' '63304097703' '63304097704' '63304097901' '63304097903''63304097904' '63304907004' '63323028420' '63323031461' '63629175905' '63629183401' '63629183402' '63629183403' '63629183501' '63629183502' '63629188301''63629188302' '63629268501' '63629268502' '63629275501' '63629275502' '63629287101' '63629289501' '63629294001' '63874010101' '63874010103' '63874010105''63874010109' '63874010115' '63874010118' '63874010120' '63874010121' '63874010124' '63874010128' '63874010130' '63874010140' '63874010145' '63874010150''63874010201' '63874010203' '63874010204' '63874010205' '63874010209' '63874010210' '63874010212' '63874010214' '63874010215' '63874010218' '63874010220''63874010221' '63874010224' '63874010228' '63874010230' '63874010240' '63874010245' '63874010250' '63874010301' '63874010321' '63874010330' '63874011001''63874011020' '63874011028' '63874011030' '63874011040' '63874011050' '63874011301' '63874011303' '63874011308' '63874011309' '63874011310' '63874011312''63874011314' '63874011315' '63874011320' '63874011321' '63874011324' '63874011328' '63874011330' '63874011340' '63874011350' '63874011401' '63874011403''63874011407' '63874011410' '63874011420' '63874011421' '63874011424' '63874011425' '63874011428' '63874011430' '63874011440' '63874011450' '63874011501''63874011508' '63874011510' '63874011512' '63874011514' '63874011515' '63874011520' '63874011521' '63874011530' '63874011612' '63874011615' '63874011620''63874011621' '63874011630' '63874011710' '63874011712' '63874011714' '63874011715' '63874011720' '63874011730' '63874012628' '63874012630' '63874012640''63874012701' '63874012705' '63874012718' '63874012720' '63874012721' '63874012728' '63874012730' '63874012740' '63874012742' '63874012901' '63874012904''63874012908' '63874012910' '63874012912' '63874012914' '63874012915' '63874012916' '63874012920' '63874012921' '63874012924' '63874012928' '63874012930''63874012940' '63874012950' '63874012956' '63874012960' '63874013001' '63874013003' '63874013006' '63874013009' '63874013010' '63874013012' '63874013014''63874013015' '63874013020' '63874013021' '63874013024' '63874013028' '63874013030' '63874013040' '63874013060' '63874014310' '63874014315' '63874014380''63874014410' '63874014415' '63874014510' '63874014520' '63874014610' '63874014615' '63874014620' '63874014710' '63874014715' '63874014775' '63874014810''63874014815' '63874014875' '63874015910' '63874015920' '63874016010' '63874016020' '63874016048' '63874023101' '63874023110' '63874023112' '63874023114''63874023115' '63874023120' '63874023121' '63874023128' '63874023130' '63874023140' '63874023201' '63874023202' '63874023203' '63874023210' '63874023212''63874023216' '63874023220' '63874023221' '63874023224' '63874023228' '63874023230' '63874023240' '63874023250' '63874023301' '63874023302' '63874023306''63874023310' '63874023312' '63874023315' '63874023316' '63874023320' '63874023324' '63874023328' '63874023330' '63874023336' '63874023340' '63874023350''63874023360' '63874023901' '63874023920' '63874023930' '63874024001' '63874024020' '63874024030' '63874024050' '63874024604' '63874024606' '63874024610''63874024615' '63874024910' '63874024920' '63874024930' '63874111202' '64679096101' '64679096104' '64679096105' '64679096401' '64679096403' '64679096405''65862001401' '65862001405' '65862001501' '65862001505' '65862001601' '65862001605' '65862001705' '65862007001' '65862007101' '66116024030' '66116024330''66116024440' '66116024928' '66116026230' '66116027230' '66116027460' '66116028930' '66267002121' '66267002130' '66267002230' '66267002321' '66267002330''66267002340' '66267008628' '66267008640' '66267008815' '66267008821' '66267008830' '66267008920' '66267008928' '66267009020' '66267009028' '66267009040''66267009120' '66267009128' '66267009130' '66267009140' '66267015920' '66267015930' '66267015940' '66267016020' '66267016028' '66267016040' '66267044415'

Page 17: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

'66267071203' '66267071210' '66267085703' '66267085704' '66267085903' '66267085904' '66267092700' '66267092806' '66267099120' '66267099220' '66267099315''66267099400' '66267100101' '66267100201' '66336001720' '66336001728' '66336003703' '66336003706' '66336003720' '66336003728' '66336003740' '66336007420''66336007706' '66336007720' '66336007728' '66336007740' '66336009506' '66336009510' '66336009520' '66336009528' '66336009530' '66336009540' '66336009803''66336009815' '66336009821' '66336009830' '66336010828' '66336010840' '66336011330' '66336029330' '66336041420' '66336041428' '66336041440' '66336058028''66336058030' '66336059330' '66336059340' '66336061730' '66336061740' '66336063408' '66336063415' '66336063421' '66336063430' '66336063440' '66336063442''66336064430' '66336064440' '66336064528' '66336065521' '66336065530' '66593312502' '66593312602' '66685100100' '66685100101' '66685100200' '66685100202''66685101100' '66685101101' '66685101102' '66685101200' '66685101201' '66685101202' '67046002021' '67046002030' '67046057621' '67046057628' '67046057630''67253014010' '67253014050' '67253014110' '67253014150' '67253014208' '67253014210' '67253014215' '67253014308' '67253014310' '67253014315' '67253018010''67253018050' '67253018110' '67253018150' '67253018210' '67253018220' '67253018310' '67253018320' '67253020010' '67253020011' '67253020110' '67253020150''67253020210' '67253020220' '67253020310' '67253020320' '68071006330' '68084027889' '68115002530' '68115002604' '68115002606' '68115002609' '68115002615''68115002621' '68115002630' '68115002640' '68115002721' '68115002730' '68115002830' '68115002900' '68115002904' '68115002906' '68115002908' '68115002909''68115002918' '68115002920' '68115002921' '68115002930' '68115002940' '68115002942' '68115003010' '68115003014' '68115003321' '68115012606' '68115012628''68115012630' '68115012640' '68115012656' '68115013106' '68115013115' '68115013121' '68115013130' '68115013140' '68115013220' '68115013228' '68115013320''68115013340' '68115013406' '68115013420' '68115013428' '68115013440' '68115013506' '68115013520' '68115013530' '68115013540' '68115013628' '68115013640''68115026830' '68115026904' '68115026912' '68115026920' '68115026921' '68115026928' '68115036404' '68115036450' '68115038620' '68115044522' '68115046320''68115048840' '68115054150' '68115058220' '68115090400' '68115090450' '68115090480' '68115093106' '68115099020' '68115099120' '68115099350' '68115099400''68387043030' '68387043040' '68387058015')

THEN NDCflag=1; ELSE NDCflag=0; IF NDCflag=0 THEN delete;

/*title1 'NDCflag';proc freq; tables NDCflag MSIS_ID NDC; run; This frequency is for syntax testing only*/

/*Add up days supply to find MSIS_IDs that received 300 or 350 days of antibiotics*//*NOTE: this syntax does not distinguish between types of antibiotics when counting300 or 350 days. So a child may have started on one antibiotic and then switched toanother over the course of the year, but this syntax would still identify that caseassuming that both were on the list of approved antibiotics*/

Proc SQL; Create Table MI.Meas3_2005MI_300days as Select Distinct

Page 18: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

MSIS_ID, sum(DAYS_SUPPLY) as DAYS_Total, Case When sum(DAYS_SUPPLY)>=300 Then 1 Else 0 End as DAYS_300 From MI.rx2005_MI_Meas3NDC Group by MSIS_ID; Quit; Proc SQL; DELETE From MI.Meas3_2005MI_300days WHERE DAYS_300=0; Quit;

/*title1 'DAYS_Total'; proc freq; tables DAYS_Total DAYS_300; run;This frequency is for syntax testing only*/

/*Count the number of separate MSIS_ID's to find the 300 numerator for Measure 3*//*Assign a row ID to facilitate merge*/

Proc SQL; Create table MI.Meas3_2005MI_Numer300 as Select Count(MSIS_ID) as NUMER300, Case When Count(MSIS_ID)> -1 Then 1 Else 0 End as ROWID From MI.Meas3_2005MI_300days; Quit;

/*title1 'Measure 3 NUMERATOR 300';proc freq; tables NUMER300 ROWID; run; This frequency is for syntax testing only*/quit;

Proc SQL; Create Table MI.Meas3_2005MI_350days as Select Distinct MSIS_ID, sum(DAYS_SUPPLY) as DAYS_Total, Case When sum(DAYS_SUPPLY)>=350 Then 1 Else 0 End as DAYS_350 From MI.rx2005_MI_Meas3NDC Group by MSIS_ID; Quit;

Proc SQL; DELETE From MI.Meas3_2005MI_350days

Page 19: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

file:///Z|/MAX%20data/SYNTAX/!!FINAL%20versions%20Meas3%20and%2013/Meas3%202005%20MI.txt[12/10/2013 1:24:37 PM]

WHERE DAYS_350=0; Quit;

/*title1 'Measure 3 NUMERATOR 350'; proc freq; tables DAYS_Total DAYS_350; run;This frequency is for syntax testing only*/

/*Count the number of separate MSIS_ID's to find the numerator for Measure 3*//*Assign a row ID to facilitate merge*/

Proc SQL; Create table MI.Meas3_2005MI_Numer350 as Select Count(MSIS_ID) as NUMER350, Case When Count(MSIS_ID)> -1 Then 1 Else 0 End as ROWID From MI.Meas3_2005MI_350days; Quit;

/*title1 'Measure 3 NUMERATOR 350';proc freq; tables NUMER350 ROWID; run; This frequency is for syntax testing only*/quit;

DATA MI.Measure3percent2005MI; MERGE MI.Meas3_2005Denom MI.Meas3_2005MI_Numer300 MI.Meas3_2005MI_Numer350; BY ROWID;

Meas3Percent300 = NUMER300/DENOM;format Meas3Percent300 percent8.2;

Meas3Percent350 = NUMER350/DENOM;format Meas3Percent350 percent8.2; run;

title1 'Measure 3 MI results 2005';proc freq; tables NUMER300 DENOM Meas3Percent300 NUMER350 DENOM Meas3Percent350; run; /*This frequency provides the denominator, numerator, and percentage.*/quit;

Page 20: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

ndc_code brand_name generic_product_name category

00002237237 Vancocin HCl vancomycin 500 mg/6 mL oral liquid miscellaneous antibiotics

00002312542 Vancocin HCl Pulvules vancomycin 125 mg oral capsule miscellaneous antibiotics

00002312642 Vancocin HCl Pulvules vancomycin 250 mg oral capsule miscellaneous antibiotics

00002510501 Vancocin HCl vancomycin 250 mg/5 mL oral liquid miscellaneous antibiotics

00002510516 Vancocin HCl vancomycin 250 mg/5 mL oral liquid miscellaneous antibiotics

00003010120 Trimox amoxicillin 250 mg oral capsule aminopenicillins

00003010150 Trimox amoxicillin 250 mg oral capsule aminopenicillins

00003010160 Trimox amoxicillin 250 mg oral capsule aminopenicillins

00003010920 Trimox amoxicillin 500 mg oral capsule aminopenicillins

00003010955 Trimox amoxicillin 500 mg oral capsule aminopenicillins

00003010960 Trimox amoxicillin 500 mg oral capsule aminopenicillins

00003010970 Trimox amoxicillin 500 mg oral capsule aminopenicillins

00003011550 Veetids penicillin V potassium 250 mg oral tablet natural penicillins

00003011575 Veetids penicillin V potassium 250 mg oral tablet natural penicillins

00003011650 Veetids penicillin V potassium 500 mg oral tablet natural penicillins

00003011675 Veetids penicillin V potassium 500 mg oral tablet natural penicillins

00003012250 Principen ampicillin 250 mg oral capsule aminopenicillins

00003012260 Principen ampicillin 250 mg oral capsule aminopenicillins

00003013450 Principen ampicillin 500 mg oral capsule aminopenicillins

00003013460 Principen ampicillin 500 mg oral capsule aminopenicillins

00003068144 Veetids penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00003068154 Veetids penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00003068244 Veetids penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00003068254 Veetids penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00003096909 Principen ampicillin 125 mg/5 mL oral liquid aminopenicillins

00003096961 Principen ampicillin 125 mg/5 mL oral liquid aminopenicillins

00003097252 Principen ampicillin 250 mg/5 mL oral liquid aminopenicillins

00003097261 Principen ampicillin 250 mg/5 mL oral liquid aminopenicillins

00003173730 Trimox amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00003173740 Trimox amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00003173745 Trimox amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00003173815 Trimox amoxicillin 50 mg/mL oral liquid aminopenicillins

00003173830 Trimox amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00003173840 Trimox amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00003173845 Trimox amoxicillin 250 mg/5 mL oral liquid aminopenicillins

Page 21: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00015727675 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00015727760 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00015727775 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00015727862 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00015727873 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00015798867 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00015799265 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00015799268 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00015799368 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00029600630 Amoxil amoxicillin 250 mg oral capsule aminopenicillins

00029600632 Amoxil amoxicillin 250 mg oral capsule aminopenicillins

00029600730 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

00029600732 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

00029600821 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00029600822 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00029600918 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00029600921 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00029600922 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00029600923 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00029603520 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

00029603839 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

00029604412 Amoxil amoxicillin 200 mg oral tablet, chewable aminopenicillins

00029604420 Amoxil amoxicillin 200 mg oral tablet, chewable aminopenicillins

00029604512 Amoxil amoxicillin 400 mg oral tablet, chewable aminopenicillins

00029604520 Amoxil amoxicillin 400 mg oral tablet, chewable aminopenicillins

00029604612 Amoxil amoxicillin 500 mg oral tablet aminopenicillins

00029604620 Amoxil amoxicillin 500 mg oral tablet aminopenicillins

00029604625 Amoxil amoxicillin 500 mg oral tablet aminopenicillins

00029604712 Amoxil amoxicillin 875 mg oral tablet aminopenicillins

00029604720 Amoxil amoxicillin 875 mg oral tablet aminopenicillins

00029604725 Amoxil amoxicillin 875 mg oral tablet aminopenicillins

00029604818 Amoxil amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00029604854 Amoxil amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00029604855 Amoxil amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00029604859 Amoxil amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00029604918 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

Page 22: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00029604954 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00029604955 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00029604959 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00029607112 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

00029607212 Augmentin amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

00029607347 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

00029607447 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

00029607527 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00029607531 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00029608012 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00029608027 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00029608031 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00029608522 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00029608523 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00029608539 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00029608612 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00029608621 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00029608729 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029608739 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029608751 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029609022 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029609023 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029609039 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00029609229 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00029609239 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00029609251 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00029609422 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609424 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609425 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609429 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609439 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609440 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609445 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609446 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00029609451 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

Page 23: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00029609628 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

00029609640 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

00029609648 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

00029609660 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

00044020805 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

00069305107 Zithromax azithromycin 1 g oral liquid macrolides

00069305175 Zithromax azithromycin 1 g oral liquid macrolides

00069306030 Zithromax azithromycin 250 mg oral tablet macrolides

00069306075 Zithromax Z-Pak azithromycin 250 mg oral tablet macrolides

00069306086 Zithromax azithromycin 250 mg oral tablet macrolides

00069307030 Zithromax azithromycin 500 mg oral tablet macrolides

00069307075 Zithromax TRI-PAK azithromycin 500 mg oral tablet macrolides

00069307086 Zithromax azithromycin 500 mg oral tablet macrolides

00069308030 Zithromax azithromycin 600 mg oral tablet macrolides

00069311019 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

00069312019 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00069313019 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00069314019 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00069417021 Zmax azithromycin 2 g oral liquid, extended release macrolides

00074258913 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00074258953 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00074338913 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00074374716 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00074374816 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00074572911 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

00074572913 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

00074572953 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

00074622713 Erythromycin Base erythromycin 500 mg oral tablet macrolides

00074629060 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

00074630113 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00074630153 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00074630213 EryPed 200 erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00074630253 EryPed 200 erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

Page 24: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00074630350 EryPed erythromycin ethylsuccinate 100 mg/2.5 mL oral liquid macrolides

00074630413 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

00074630430 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

00074630453 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

00074630513 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00074630553 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00074630560 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00074630613 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00074630616 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00074631613 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

00074632013 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00074632053 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00074632113 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00074632611 Erythromycin Base erythromycin 250 mg oral tablet macrolides

00074632613 Erythromycin Base erythromycin 250 mg oral tablet macrolides

00074632653 Erythromycin Base erythromycin 250 mg oral tablet macrolides

00074634619 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

00074634620 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

00074634653 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

00074636902 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00074636910 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00074637313 E.E.S.-400 erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00074637316 E.E.S.-400 erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00074715613 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074715643 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074715653 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074803013 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074803043 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074803053 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074803055 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00074803073 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00093117101 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093117110 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093117201 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093117210 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093117301 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

Page 25: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00093117310 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00093117401 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00093117410 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00093202623 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093202631 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093202694 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093202723 Azithromycin azithromycin 100 mg/5 ml susp macrolides

00093226301 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

00093226401 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00093226701 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

00093226801 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00093226805 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00093227034 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

00093227234 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

00093227434 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00093227534 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00093227773 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00093227973 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00093310701 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00093310705 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00093310756 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00093310905 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00093310953 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00093412573 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00093412574 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00093412773 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00093412774 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00093415073 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00093415079 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00093415080 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00093415573 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00093415579 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00093415580 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00093416073 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00093416076 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00093416078 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

Page 26: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00093416173 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00093416176 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00093416178 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00093514501 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00093514505 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00093514601 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00093514605 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00093519401 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093519410 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00093519501 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00093519505 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00093519873 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00093519874 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00093519973 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00093519974 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00093714609 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

00093714618 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

00093714656 Azithromycin azithromycin 250 mg oral tablet macrolides

00093714756 Azithromycin azithromycin 600 mg oral tablet macrolides

00093714823 Azithromycin azithromycin 100 mg/5 ml susp macrolides

00093714923 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093714931 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093714994 Azithromycin azithromycin 200 mg/5 ml susp macrolides

00093716933 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

00093716956 Azithromycin azithromycin 500 mg oral tablet macrolides

00093716990 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

00093867574 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00093867575 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00093867578 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00143988601 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00143988650 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00143988675 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00143988701 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00143988750 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00143988775 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00143988801 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

Page 27: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00143988815 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00143988880 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00143988901 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00143988915 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00143988980 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00143993801 Amoxicillin amoxicillin 250 mg capsule aminopenicillins

00143993805 Amoxicillin amoxicillin 250 mg capsule aminopenicillins

00143993901 Amoxicillin amoxicillin 500 mg capsule aminopenicillins

00143993905 Amoxicillin amoxicillin 500 mg capsule aminopenicillins

00143995101 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00143995120 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00143998101 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00143998150 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00143998175 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00143998201 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00143998250 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00143998275 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00168021560 Erythromycin erythromycin 2% solution macrolides

00172245880 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00172740128 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

00172740228 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

00172740310 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00172740342 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00172740442 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00172740520 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00172740521 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00172740522 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00172740620 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00172740621 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00172740622 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00172740714 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00172740722 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00172740726 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00172740814 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00172740822 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00172740826 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

Page 28: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00172741142 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00172741160 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00172741170 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00172741470 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00172741642 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

00172741660 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

00172741723 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00172741821 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00172741823 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00172741921 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00172742020 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00172742021 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00172742022 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00182011501 Pen-V penicillin V potassium 500 mg oral tablet natural penicillins

00182011510 Pen-V penicillin V potassium 500 mg oral tablet natural penicillins

00182011610 Pen-V penicillin V potassium 250 mg oral tablet natural penicillins

00182016301 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00182016305 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00182016389 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00182027470 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00182027473 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00182027570 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00182027573 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00182027670 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00182027673 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00182030870 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00182030873 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00182053801 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00182053805 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00182053901 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00182064101 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00182064105 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00182064189 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00182086901 Pen-V penicillin V potassium 250 mg oral tablet natural penicillins

00182086910 Pen-V penicillin V potassium 250 mg oral tablet natural penicillins

00182107001 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 29: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00182107089 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00182107105 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00182107119 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00182107189 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00182107270 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00182107272 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00182107370 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00182107372 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00182137140 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00182139801 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00182139805 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00182148901 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00182148905 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00182153070 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00182153073 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00182153701 Pen-V penicillin V potassium 500 mg oral tablet natural penicillins

00182153710 Pen-V penicillin V potassium 500 mg oral tablet natural penicillins

00182156040 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00182177340 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00182196205 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00185720370 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

00185720670 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00185720969 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00185721268 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00223091201 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00223091205 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00223091401 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00223091405 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00223614001 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00223614101 Erythromycin Estolate erythromycin 333 mg oral tablet, coated particles macrolides

00223614201 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00223614210 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00223614301 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00223614310 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00228263911 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

00228264011 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

Page 30: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00228264025 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00228268811 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00228268851 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00228268911 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00228268951 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000100 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000101 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000102 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000103 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000104 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000105 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000106 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000108 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000109 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000110 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000112 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000115 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000120 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000121 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000124 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000125 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000128 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000130 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000133 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000140 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000142 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000156 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000169 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000198 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00247000200 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000201 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000202 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000203 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000204 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000205 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000206 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

Page 31: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247000208 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000209 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000210 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000212 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000214 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000215 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000216 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000218 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000220 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000221 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000222 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000224 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000225 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000227 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000228 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000230 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000232 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000233 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000236 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000240 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000242 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000250 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000269 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000280 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000298 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00247000700 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000701 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000702 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000703 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000704 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000705 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000706 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000708 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000710 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000712 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000715 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

Page 32: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247000716 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000720 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000721 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000728 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000730 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000732 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000740 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000756 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000760 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000798 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

00247000800 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000802 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000803 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000804 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000805 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000806 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000809 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000810 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000815 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000818 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000820 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000821 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000824 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000830 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000842 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000898 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

00247000900 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247000978 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247000979 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247001400 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00247001479 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00247002100 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247002178 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247002180 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247002200 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247002205 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

Page 33: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247002210 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247002278 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247002279 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247002280 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247002300 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002302 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002304 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002306 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002308 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002315 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002320 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002321 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002328 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002330 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002340 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002398 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247002500 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247002575 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247002578 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247002602 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002603 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002604 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002606 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002608 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002615 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002620 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002621 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002624 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002630 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00247002701 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002702 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002703 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002704 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002707 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002709 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002710 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

Page 34: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247002714 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002715 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002720 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002721 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247002730 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247003500 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00247003575 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00247003578 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

00247005600 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00247005679 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

00247006801 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006802 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006803 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006804 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006806 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006808 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006810 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006812 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006814 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006815 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006816 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006818 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006820 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006821 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006824 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006825 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006828 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006830 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006832 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006840 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006898 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00247006900 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006902 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006903 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006904 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006905 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

Page 35: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247006906 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006908 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006909 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006910 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006912 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006915 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006916 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006920 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006921 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006924 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006928 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006930 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006932 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006940 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006944 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006998 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247006999 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00247007730 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

00247010600 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00247010679 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00247011001 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011004 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011008 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011010 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011012 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011020 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011021 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011024 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011028 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011030 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011040 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011056 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011098 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00247011602 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011603 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011604 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

Page 36: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247011605 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011606 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011609 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011615 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011620 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011621 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011628 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011630 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011640 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247011642 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00247015601 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015603 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015604 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015612 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015615 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015616 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015620 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015621 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015628 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015629 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015630 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015640 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015698 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00247015703 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015704 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015707 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015708 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015716 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015718 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015720 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015721 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015728 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015730 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247015740 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00247017500 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017502 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

Page 37: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247017503 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017504 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017507 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017509 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017510 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017512 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017514 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017520 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017521 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017528 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017530 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017540 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247017556 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

00247028001 Zithromax azithromycin 250 mg oral tablet macrolides

00247028002 Zithromax azithromycin 250 mg oral tablet macrolides

00247028003 Zithromax azithromycin 250 mg oral tablet macrolides

00247028004 Zithromax azithromycin 250 mg oral tablet macrolides

00247028005 Zithromax azithromycin 250 mg oral tablet macrolides

00247028006 Zithromax azithromycin 250 mg oral tablet macrolides

00247028010 Zithromax azithromycin 250 mg oral tablet macrolides

00247028011 Zithromax azithromycin 250 mg oral tablet macrolides

00247028050 Zithromax azithromycin 250 mg oral tablet macrolides

00247039040 Eryc erythromycin 250 mg oral delayed release capsule macrolides

00247039500 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00247039560 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00247039577 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00247039579 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00247039590 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00247039600 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039605 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039610 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039625 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039660 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039677 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039679 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247039690 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

Page 38: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247039695 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247045904 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247045906 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247045914 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247045916 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247045920 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247045930 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

00247046015 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

00247046020 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

00247046021 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

00247046030 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

00247052215 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

00247052230 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

00247056306 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247056320 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247056321 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247056330 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00247063730 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

00247091106 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00247091114 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00247091120 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00247091130 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00247091140 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00247093520 EryPed erythromycin ethylsuccinate 200 mg oral tablet, chewable macrolides

00247093530 EryPed erythromycin ethylsuccinate 200 mg oral tablet, chewable macrolides

00247093540 EryPed erythromycin ethylsuccinate 200 mg oral tablet, chewable macrolides

00247094900 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247094978 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247094979 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00247096601 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247096603 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247096628 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247096630 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247096640 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247096698 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00247124630 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

Page 39: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247128801 Zithromax azithromycin 1 g oral liquid macrolides

00247128803 Zithromax azithromycin 1 g oral liquid macrolides

00247128806 Zithromax azithromycin 1 g oral liquid macrolides

00247133820 Amoxil amoxicillin 250 mg oral capsule aminopenicillins

00247133830 Amoxil amoxicillin 250 mg oral capsule aminopenicillins

00247133930 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

00247133942 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

00247136130 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

00247136140 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

00247141402 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247141410 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247141414 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247141420 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247141424 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247146601 Zithromax azithromycin 600 mg oral tablet macrolides

00247148815 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

00247148915 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00247149092 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00247149130 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

00247151209 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

00247151230 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

00247151805 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247151850 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247151905 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247151910 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247151915 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247151950 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247160001 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247160078 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00247160178 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00247162600 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247162700 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00247162750 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00247164520 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

00247164620 Augmentin amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

00247166930 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

Page 40: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00247172900 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247172979 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00247195120 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00247199002 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199003 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199004 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199009 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199012 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199015 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199020 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199021 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199030 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00247199100 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247199102 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247199104 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247199106 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247199114 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247199120 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00247201800 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00247201850 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00247201875 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00247223300 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247223350 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247223375 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00247225815 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00247227900 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00247227901 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00247227930 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00247227958 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

00247235801 Azithromycin azithromycin 1 g oral liquid macrolides

00247235802 Azithromycin azithromycin 1 g oral liquid macrolides

00247235806 Azithromycin azithromycin 1 g oral liquid macrolides

00332310704 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00332310705 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00332310709 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00332311101 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

Page 41: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00332311104 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00364204001 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00364204150 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00364207816 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00378010601 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00378010605 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00378010701 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00378011101 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00378011110 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00378011201 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00378011210 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00378011501 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00378011505 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00378011601 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00378011605 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00378011702 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00378011704 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00378011802 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00378011804 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00378019501 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00378019510 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00378019801 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00378019810 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00378020401 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00378020505 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00378020589 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00378020602 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00378020606 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00378020702 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00378020706 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00378120405 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00378120505 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00378153356 Azithromycin azithromycin 250 mg tablet macrolides

00378153593 Azithromycin azithromycin 600 mg oral tablet macrolides

00378211601 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00378640001 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

Page 42: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00378640005 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00405227570 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00405350060 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00405350070 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00405352560 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00405352570 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00405408301 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00405408302 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00405408402 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00405408450 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00405408601 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00405408602 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00405408901 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00405408902 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00405409001 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00405409002 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00405439801 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

00405439802 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

00405439901 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00405439902 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00405440101 Erythromycin Estolate erythromycin estolate 250 mg oral capsule macrolides

00405441101 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00405441102 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00405476201 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00405476203 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00405476301 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00405476303 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00405476801 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00405476803 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00405476901 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00405476903 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00430069624 Eryc erythromycin 250 mg oral delayed release capsule macrolides

00463501101 Amficot ampicillin 250 mg oral capsule aminopenicillins

00463501110 Amficot ampicillin 250 mg oral capsule aminopenicillins

00463501201 Erythrocot erythromycin stearate 250 mg oral tablet macrolides

00463501210 Erythrocot erythromycin stearate 250 mg oral tablet macrolides

Page 43: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00463501501 Amoxicot amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00463501515 Amoxicot amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00463501601 Amoxicot amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00463501615 Amoxicot amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00463501710 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00463501901 Amoxicot amoxicillin 250 mg oral capsule aminopenicillins

00463502055 Amoxicot amoxicillin 500 mg oral capsule aminopenicillins

00463502310 Truxcillin VK penicillin V potassium 500 mg oral tablet natural penicillins

00472097116 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00472097416 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00472097716 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00472097916 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

00536010571 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00555021522 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00555021523 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00555025902 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00555025904 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00555044521 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00555044522 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00555044523 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00555058402 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00555058404 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00603120258 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00603120358 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

00603120658 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00603120758 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00603227321 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

00603227421 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00603229121 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00603229128 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00603354821 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00603354828 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00603355121 Erythromycin Estolate erythromycin estolate 250 mg oral capsule macrolides

00603355221 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00603355228 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00603355328 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

Page 44: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00603355421 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00603506821 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00603650084 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00603656366 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00603660564 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00603660568 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00603660664 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00603660668 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00615012401 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00615012405 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00615012413 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00615018001 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00677066005 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00677066101 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00677066102 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00677066105 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00677130327 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00677130329 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00781109801 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00781120501 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00781120510 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00781149631 Azithromycin azithromycin 250 mg oral tablet macrolides

00781149668 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

00781149669 Azithromycin azithromycin 250 mg oral tablet macrolides

00781149731 Azithromycin azithromycin 600 mg oral tablet macrolides

00781161966 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

00781164366 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

00781165501 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00781165510 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00781183120 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

00781185001 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00781185220 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

00781187301 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00781187431 Amoxicillin-Clavulanate amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

00781194101 Azithromycin azithromycin 500 mg oral tablet macrolides

00781194131 Azithromycin azithromycin 500 mg oral tablet macrolides

Page 45: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00781194133 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

00781194339 Amoxicillin-Clavulanate ER amoxicillin-clav er 1,000-62.5

00781202001 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00781202005 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00781202031 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00781202076 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00781214401 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00781214405 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00781214501 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00781214505 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00781255501 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00781255505 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00781261301 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00781261305 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00781261331 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00781261376 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00781299901 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00781299905 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00781506001 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

00781506020 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

00781506101 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00781506120 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

00781603946 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781603955 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781603958 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781604146 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00781604155 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00781604158 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00781610246 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

00781610446 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

00781612046 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00781612048 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00781612146 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00781612148 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00781613948 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00781613954 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

Page 46: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00781613957 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

00781615646 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00781615652 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00781615657 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

00781615746 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00781615752 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00781615757 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

00781619146 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781619155 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00781619546 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781619555 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00781704346 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00781704348 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00781704355 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00839176606 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00839176616 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00839507906 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00839507916 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00839508706 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00839508712 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00839513006 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00839513012 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00839518506 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00839518706 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00839518716 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00839518806 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00839518816 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00839518973 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00839519073 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00839519078 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00839603706 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00839603712 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00839603804 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00839603812 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00839611571 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00839611573 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

Page 47: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00839611575 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00839611671 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00839611673 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00839611675 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00839636273 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00839636278 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00839639306 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00839644578 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00839648269 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00839656869 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00839658806 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00839658812 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00839671469 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

00839751473 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00839751475 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00839751478 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00839760206 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00839760212 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00839765606 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

00839765612 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

00839766006 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

00839777606 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00839777612 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00904201740 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00904201760 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

00904207340 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00904207360 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

00904244960 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00904245060 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00904245080 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

00904245160 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00904245180 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00904245260 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00904245280 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

00904245860 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

00904245940 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

Page 48: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00904245960 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

00904246216 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

00904246316 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

00904246439 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00904246440 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00904246460 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

00904246540 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00904246560 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00904246860 Erythromycin Estolate erythromycin estolate 250 mg oral capsule macrolides

00904247016 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

00904247116 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

00904247240 Erythromycin Base erythromycin 333 mg oral tablet, coated particles macrolides

00904247260 Erythromycin Base erythromycin 333 mg oral tablet, coated particles macrolides

00904247440 Erythromycin Base erythromycin 333 mg oral tablet, coated particles macrolides

00904247460 Erythromycin Base erythromycin 333 mg oral tablet, coated particles macrolides

00904247504 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00904247507 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00904247508 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

00904261740 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00904261760 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00904261761 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

00904261840 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00904261846 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00904261851 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

00904261904 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00904261906 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00904261907 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

00904262004 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00904262006 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00904262007 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

00904265304 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00904265308 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

00904400104 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00904400108 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

00904400404 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

00904400408 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

Page 49: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

00904401004 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00904401008 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

00904401404 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00904401408 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

00904771340 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00904771360 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

00904774340 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

00904774360 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

10631017620 Dispermox amoxicillin 600 mg oral tablet, dispersible aminopenicillins

10631056520 Dispermox amoxicillin 200 mg oral tablet, dispersible aminopenicillins

10631056720 Dispermox amoxicillin 400 mg oral tablet, dispersible aminopenicillins

11584038100 Biomox amoxicillin 250 mg/5 mL oral liquid aminopenicillins

11584038105 Biomox amoxicillin 250 mg/5 mL oral liquid aminopenicillins

11584039100 Biomox amoxicillin 250 mg oral capsule aminopenicillins

11584040100 Biomox amoxicillin 500 mg oral capsule aminopenicillins

11584040105 Moxilin amoxicillin 500 mg oral capsule aminopenicillins

11584040500 Biomox amoxicillin 500 mg oral capsule aminopenicillins

12280004300 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

12280005730 Zithromax azithromycin 600 mg oral tablet macrolides

12280008900 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

12280010100 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

12280010120 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

12280010150 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

12280010930 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

12280011220 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

12280022220 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

12280026000 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

12280026806 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

12280026903 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

16590001430 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

16590001533 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

16590001615 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

16590001630 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

16590001720 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

16590001730 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

16590001833 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

Page 50: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

16590001920 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

16590002020 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

16590008828 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

16590008830 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

16590008840 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

16590008921 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

16590008930 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

16590008940 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

16590009121 Erythromycin Base erythromycin 250 mg oral tablet macrolides

16590009130 Erythromycin Base erythromycin 250 mg oral tablet macrolides

16590009140 Erythromycin Base erythromycin 250 mg oral tablet macrolides

16590018236 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

16590018320 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

16590018330 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

16590018340 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

16714023401 Penicillin V Potassium penicillin vk 250 mg tablet natural penicillins

43598020369 Amox Tr-Potassium Clavulanate amox tr-k clv 600-42.9/5 susp

43598020852 Amox Tr-Potassium Clavulanate amox tr-k clv 400-57/5 susp

43598021830 Amox Tr-Potassium Clavulanate amox tr-k clv 250-125 mg tab

43598022040 Amoxicillin-Clavulanate ER amoxicillin-clav er 1,000-62.5

45469292800 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

45469293000 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

45469295300 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

45565000202 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

45565003103 PC Pen VK penicillin V potassium 250 mg oral tablet natural penicillins

49884002747 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

49884004101 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

49884004107 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

49884005301 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

49884005307 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

49884006047 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

49884007247 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

49884007269 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

49884007327 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

49884007328 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

49884007347 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

Page 51: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

49884014227 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

49884014228 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

49884014247 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

49884016827 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

49884016828 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

49884016847 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

49884020128 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

49884020149 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

49884020170 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

49884029807 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

49884029812 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

49884029907 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

49884029912 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

49884036581 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

49884057901 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

49884057910 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

49999001200 Erythromycin Base erythromycin 500 mg oral tablet macrolides

49999001220 Erythromycin Base erythromycin 500 mg oral tablet macrolides

49999001228 Erythromycin Base erythromycin 500 mg oral tablet macrolides

49999001230 Erythromycin Base erythromycin 500 mg oral tablet macrolides

49999001240 Erythromycin Base erythromycin 500 mg oral tablet macrolides

49999001400 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

49999001410 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

49999001421 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

49999001430 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

49999001500 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001506 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001508 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001512 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001514 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001515 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001520 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001521 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001528 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001530 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001540 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

Page 52: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

49999001542 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001545 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

49999001604 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

49999001621 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

49999001630 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

49999001640 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

49999002300 Erythromycin Base erythromycin 250 mg oral tablet macrolides

49999002320 Erythromycin Base erythromycin 250 mg oral tablet macrolides

49999002328 Erythromycin Base erythromycin 250 mg oral tablet macrolides

49999002330 Erythromycin Base erythromycin 250 mg oral tablet macrolides

49999002340 Erythromycin Base erythromycin 250 mg oral tablet macrolides

49999003300 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

49999003330 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

49999006728 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

49999006740 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

49999008028 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

49999008030 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

49999008040 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

49999010121 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

49999010140 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

49999016800 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

49999026015 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

49999031500 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

49999051500 E.E.S.-400 erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

49999051600 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

49999074328 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

49999076628 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

49999081000 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

50111076728 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

50111078710 Azithromycin azithromycin 250 mg oral tablet macrolides

50111078752 Azithromycin azithromycin 250 mg oral tablet macrolides

50111078766 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

50111078810 Azithromycin azithromycin 500 mg oral tablet macrolides

50111078852 Azithromycin azithromycin 500 mg oral tablet macrolides

50111078867 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

50111078910 Azithromycin azithromycin 600 mg oral tablet macrolides

Page 53: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

50111079120 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

50111079222 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

50111079320 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

51079026520 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

51079026720 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

51079059120 Azithromycin azithromycin 250 mg oral tablet macrolides

51079060020 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

51079060120 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

51079061520 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

51079061620 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

51285044521 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51285044522 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51285044523 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51641011164 Eryzole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51641011166 Eryzole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51641011168 Eryzole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

51655000929 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

51655000951 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

51655000952 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

51655001051 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

51655007524 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

51655007528 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

51655007551 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

51655007587 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

51655009829 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

51655009851 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

51655009887 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

51655009895 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

51655010451 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

51655012029 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

51655015229 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

51655015724 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

51655015749 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

51655015751 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

51655029751 Erythromycin Base erythromycin 500 mg oral tablet macrolides

51655048024 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

Page 54: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

51655051929 Erythromycin Base erythromycin 250 mg oral tablet macrolides

51655051951 Erythromycin Base erythromycin 250 mg oral tablet macrolides

51655067429 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

51655067451 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

52959001120 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

52959001121 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

52959001124 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

52959001130 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

52959001140 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

52959002000 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002004 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002005 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002006 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002018 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002020 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002021 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002024 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002028 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002030 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002040 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002042 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002060 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

52959002104 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002114 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002115 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002120 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002121 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002130 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959002230 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

52959004610 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959004614 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959004620 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959005728 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

52959005740 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

52959005815 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

52959005820 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

Page 55: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

52959005821 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

52959005830 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

52959005840 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

52959006020 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

52959006028 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

52959006030 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

52959006040 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

52959006056 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

52959006115 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006118 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006120 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006121 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006124 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006128 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006130 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006140 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006142 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

52959006210 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006220 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006221 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006228 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006230 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006240 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006256 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

52959006321 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

52959006328 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

52959006330 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

52959006340 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

52959006420 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

52959006428 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

52959006440 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

52959013003 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

52959016400 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

52959016403 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

52959016406 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

52959018101 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

Page 56: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

52959021310 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959021320 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959021324 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959021328 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959021330 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959021340 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

52959024010 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

52959024203 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

52959024619 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

52959024621 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

52959024630 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

52959024640 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

52959029605 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

52959030300 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

52959030303 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

52959030401 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

52959030402 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

52959030500 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

52959030501 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

52959031001 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

52959031002 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

52959031315 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

52959033320 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

52959033324 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

52959033328 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

52959033330 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

52959033340 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

52959034140 Eryc erythromycin 250 mg oral delayed release capsule macrolides

52959034160 Eryc erythromycin 250 mg oral delayed release capsule macrolides

52959034309 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

52959034315 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

52959034321 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

52959034330 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

52959038920 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

52959038928 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

52959038930 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

Page 57: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

52959038940 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

52959042728 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

52959042740 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

52959047030 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

52959047810 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959047814 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959047815 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959047820 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959050420 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

52959050440 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

52959050506 Zithromax Z-Pak azithromycin 250 mg oral tablet macrolides

52959056000 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

52959061302 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

52959061303 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

52959061401 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959061402 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959061403 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959061501 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959061502 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959061600 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

52959061601 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

52959061602 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

52959061700 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

52959065703 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

52959065706 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

52959066120 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

52959066130 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

52959070204 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070209 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070212 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070214 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070215 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070220 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070221 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070230 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

52959070240 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

Page 58: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

52959070710 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959070714 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959070715 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959070720 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959070730 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

52959076501 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

52959076502 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

52959079328 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

52959079340 Augmentin XR amoxicillin-clavulanate 1000 mg-62.5 mg oral tablet, extended release beta-lactamase inhibitors

52959081620 Erythromycin Base erythromycin 500 mg oral tablet macrolides

52959081628 Erythromycin Base erythromycin 500 mg oral tablet macrolides

52959081630 Erythromycin Base erythromycin 500 mg oral tablet macrolides

52959083806 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

52959084301 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

52959100501 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959100502 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959100503 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

52959100601 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

52959100602 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

52959100603 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

52959101200 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

52959101201 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

52959117201 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

52959117202 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

52959143000 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

52959143100 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

52959146303 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

53978125705 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

53978500205 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

53978500305 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

53978502906 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

53978504206 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

53978505506 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569009300 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54569009400 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

Page 59: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569011700 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

54569012000 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

54569012100 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54569012101 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54569012103 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54569012300 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

54569012302 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

54569012303 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

54569012305 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

54569012400 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012401 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012402 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012403 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012405 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012406 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012407 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012408 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012409 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54569012500 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012501 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012502 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012503 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012504 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012505 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012506 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569012700 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569012702 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569012703 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569012705 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569012800 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

54569012902 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

54569012903 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

54569012909 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

54569013101 Eryc erythromycin 250 mg oral delayed release capsule macrolides

54569013102 Eryc erythromycin 250 mg oral delayed release capsule macrolides

54569013200 E.E.S.-400 erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

Page 60: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569013400 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

54569013500 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

54569013601 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569013603 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569013700 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

54569014201 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

54569015702 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

54569029800 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

54569029801 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

54569101900 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

54569102600 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54569171900 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54569171902 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54569174600 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569174601 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569174605 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569174608 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569174609 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569186100 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186101 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186102 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186104 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186105 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186108 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569186109 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569195900 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195901 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195903 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195904 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195905 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195906 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569195908 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54569196200 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

54569196201 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

54569196202 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

54569196203 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

Page 61: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569200000 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54569200100 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54569200200 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54569218700 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

54569228100 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54569228101 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54569228102 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54569228103 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54569228104 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54569241100 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54569241101 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54569243300 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54569243302 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54569250200 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250201 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250203 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250205 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250206 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250207 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54569250702 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250703 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250704 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250705 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250707 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250709 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569250800 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54569250801 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54569250802 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54569250803 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54569250804 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54569270200 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54569270202 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54569270203 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54569270204 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54569270206 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54569270208 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

Page 62: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569271001 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569271002 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569271004 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569271005 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569271006 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569282100 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

54569292800 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54569292900 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54569293000 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54569293100 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54569293300 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

54569295201 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

54569295300 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54569295400 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54569305700 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

54569333504 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569333505 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569333506 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569333507 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54569334700 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569334701 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569334702 Erythrocin Stearate Filmtab erythromycin stearate 500 mg oral tablet macrolides

54569350301 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54569353102 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54569356300 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569356301 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569356302 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569356303 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569356304 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569356305 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

54569368900 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569368901 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569368902 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569368903 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569368904 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569368905 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

Page 63: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569368906 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54569387600 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569398601 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54569423000 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54569423100 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54569423200 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

54569432500 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54569433700 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

54569433800 Augmentin amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

54569433801 Augmentin amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

54569435200 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

54569435300 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

54569441700 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54569445800 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54569445801 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54569445802 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54569449700 Zithromax Z-Pak azithromycin 250 mg oral tablet macrolides

54569452200 Zithromax azithromycin 250 mg oral tablet macrolides

54569452201 Zithromax azithromycin 250 mg oral tablet macrolides

54569452202 Zithromax azithromycin 250 mg oral tablet macrolides

54569456700 Zithromax azithromycin 1 g oral liquid macrolides

54569460800 Amoxil amoxicillin 875 mg oral tablet aminopenicillins

54569479000 Amoxil amoxicillin 200 mg oral tablet, chewable aminopenicillins

54569479100 Amoxil amoxicillin 400 mg oral tablet, chewable aminopenicillins

54569479101 Amoxil amoxicillin 400 mg oral tablet, chewable aminopenicillins

54569479600 Amoxil amoxicillin 200 mg/5 mL oral liquid aminopenicillins

54569479700 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

54569488900 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

54569489200 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

54569518200 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

54569519300 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

54569531400 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

54569534400 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

54569544800 Zithromax TRI-PAK azithromycin 500 mg oral tablet macrolides

54569551800 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

54569552200 Augmentin ES-600 amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

Page 64: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54569575400 Azithromycin azithromycin 250 mg oral tablet macrolides

54569575500 Azithromycin azithromycin 250 mg oral tablet macrolides

54569580400 Azithromycin azithromycin 600 mg oral tablet macrolides

54569580600 Azithromycin azithromycin 1 g oral liquid macrolides

54569580700 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

54569580800 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

54569580900 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

54569581000 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

54569644800 Azithromycin azithromycin 500 mg oral tablet macrolides

54569800400 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

54569802100 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54807025120 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868001800 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001801 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001803 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001804 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001806 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001807 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868001809 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868019301 Amoxil amoxicillin 250 mg oral capsule aminopenicillins

54868019501 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54868019502 Amoxil amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54868019601 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868019602 Amoxil amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868019902 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

54868019903 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

54868020001 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

54868022401 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54868022403 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54868022404 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54868022406 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

54868022500 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

54868022501 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

54868030201 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54868030202 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54868033301 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

Page 65: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54868033302 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868033304 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868033306 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868033307 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

54868038700 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54868038701 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54868038702 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54868038703 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

54868038800 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54868038801 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54868038802 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54868038804 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54868038805 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

54868041300 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

54868041302 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

54868041304 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

54868041307 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

54868041308 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

54868080701 Amoxil amoxicillin 250 mg oral tablet, chewable aminopenicillins

54868084000 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

54868084001 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

54868084002 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

54868084003 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

54868084004 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

54868097100 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

54868097101 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

54868098501 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

54868104401 Amoxil amoxicillin 125 mg oral tablet, chewable aminopenicillins

54868114600 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

54868117100 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54868117101 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54868117103 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

54868117300 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54868117301 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54868117302 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54868117304 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

Page 66: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54868117305 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54868117306 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

54868123100 E.E.S.-400 erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

54868138601 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54868138602 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54868138603 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54868138604 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54868138605 Erythromycin Base erythromycin 250 mg oral tablet macrolides

54868138700 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54868138701 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54868138704 Erythromycin Base erythromycin 500 mg oral tablet macrolides

54868142601 E.E.S. Granules erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

54868177400 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

54868177402 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

54868178001 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

54868178002 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

54868186501 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54868186502 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54868186503 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

54868188600 EryPed erythromycin ethylsuccinate 100 mg/2.5 mL oral liquid macrolides

54868188700 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

54868188701 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

54868284000 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54868284001 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

54868301600 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

54868301601 Amoxil Pediatric Drops amoxicillin 50 mg/mL oral liquid aminopenicillins

54868310500 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54868310501 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54868310502 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

54868310700 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310701 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310702 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310703 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310706 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310707 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310708 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 67: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54868310709 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

54868310900 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310901 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310902 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310904 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310906 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310907 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310908 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868310909 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

54868311100 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54868311101 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54868311103 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54868311105 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

54868311300 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311301 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311303 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311305 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311307 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311308 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868311309 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

54868324400 Zithromax TRI-PAK azithromycin 500 mg oral tablet macrolides

54868364800 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

54868390300 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54868390301 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54868390302 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54868390303 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

54868407600 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

54868407800 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54868407801 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54868407802 Zithromax azithromycin 200 mg/5 mL oral liquid macrolides

54868408000 Augmentin amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

54868412501 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

54868412502 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

54868412901 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

54868412902 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

54868413101 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

Page 68: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

54868415000 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54868415001 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54868415002 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

54868415500 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868415501 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868415502 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868415503 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

54868420800 Augmentin amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

54868447300 Amoxil amoxicillin 400 mg/5 mL oral liquid aminopenicillins

54868454300 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

54868454301 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

54868454302 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

54868461400 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

54868461401 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

54868464400 Zithromax azithromycin 250 mg oral tablet macrolides

54868464401 Zithromax azithromycin 250 mg oral tablet macrolides

54868464402 Zithromax azithromycin 250 mg oral tablet macrolides

54868510100 Amoxicillin amoxicillin 400 mg/5 ml susp aminopenicillins

54868510101 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

54868547100 Azithromycin azithromycin 250 mg oral tablet macrolides

54868547800 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

54868547801 Azithromycin azithromycin 250 mg oral tablet macrolides

54868547802 Azithromycin azithromycin 250 mg oral tablet macrolides

54868548700 Azithromycin azithromycin 500 mg oral tablet macrolides

54868564700 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

54868564800 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

54868564801 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

54868564802 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

55045111300 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55045111301 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55045111303 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55045111307 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55045111309 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55045112200 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112201 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112202 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 69: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55045112203 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112204 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112205 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112207 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112208 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045112209 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045116803 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55045116806 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55045116807 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55045116808 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55045122600 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122601 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122602 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122603 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122604 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122605 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122606 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122608 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045122609 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045127003 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045127004 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045127005 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045127006 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045127008 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045127009 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55045138104 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045138105 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045138106 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045138108 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045138109 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045144201 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

55045147100 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

55045147807 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

55045147808 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

55045200400 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55045200404 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

Page 70: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55045200405 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55045200406 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55045200408 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55045201202 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

55045201205 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

55045201208 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

55045201209 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

55045207602 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55045207603 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55045207604 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55045207606 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55045216204 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

55045216207 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

55045216208 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

55045237205 Zithromax azithromycin 100 mg/5 mL oral liquid macrolides

55045249206 Zithromax Z-Pak azithromycin 250 mg oral tablet macrolides

55045319401 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045319403 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045319404 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045319406 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045319409 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55045326001 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045326006 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045326009 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55045346608 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55045369803 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

55045372501 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

55045372602 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

55045372701 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

55289001901 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001906 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001915 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001921 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001924 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001930 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001940 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 71: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55289001960 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289001997 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289002004 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002006 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002009 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002014 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002015 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002021 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002024 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002028 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002030 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002040 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002042 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002050 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002056 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002060 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002063 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002301 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002310 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002320 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002328 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002330 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002340 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55289002404 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002407 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002410 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002420 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002428 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002430 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002440 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002497 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289002504 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55289002520 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55289002528 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55289002530 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55289002540 Erythromycin Base erythromycin 500 mg oral tablet macrolides

Page 72: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55289002720 PCE Dispertab erythromycin 500 mg oral tablet, coated particles macrolides

55289002801 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289002830 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289002850 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55289002921 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289002930 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55289003328 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289003340 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55289005040 Erythrocin Stearate Filmtab erythromycin stearate 250 mg oral tablet macrolides

55289007540 Erythromycin Base erythromycin 250 mg oral tablet macrolides

55289007556 Erythromycin Base erythromycin 250 mg oral tablet macrolides

55289011003 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011009 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011020 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011028 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011030 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011040 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011056 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55289011120 Eryc erythromycin 250 mg oral delayed release capsule macrolides

55289011128 Eryc erythromycin 250 mg oral delayed release capsule macrolides

55289011140 Eryc erythromycin 250 mg oral delayed release capsule macrolides

55289011156 Eryc erythromycin 250 mg oral delayed release capsule macrolides

55289011180 Eryc erythromycin 250 mg oral delayed release capsule macrolides

55289011201 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011204 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011210 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011215 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011220 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011228 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011240 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011256 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011297 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289011298 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

55289012006 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

55289018206 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55289018209 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

Page 73: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55289018214 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55289018230 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55289018240 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55289020610 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020620 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020628 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020630 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020640 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020697 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55289020704 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289020715 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289020720 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289020728 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289020730 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289020740 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

55289021728 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

55289021740 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

55289024015 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

55289024209 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

55289024215 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

55289024221 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

55289029615 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55289029630 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55289031004 Zithromax azithromycin 250 mg oral tablet macrolides

55289031006 Zithromax azithromycin 250 mg oral tablet macrolides

55289031014 Zithromax azithromycin 250 mg oral tablet macrolides

55289039830 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

55289042621 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

55289042630 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

55289051210 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

55289051214 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

55289051228 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

55289052521 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55289052530 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55289052540 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55289052542 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

Page 74: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55289052563 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55289064501 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064520 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064528 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064530 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064540 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064556 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289064580 Erythromycin Base erythromycin 250 mg oral enteric coated tablet macrolides

55289070502 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070506 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070515 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070516 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070520 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070528 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070530 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070540 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070556 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55289070720 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

55289072720 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

55289076714 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

55289076720 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

55289084521 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55289084530 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55289091506 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

55289091515 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

55289091524 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

55289091530 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

55289096404 Azithromycin azithromycin 250 mg oral tablet macrolides

55289096414 Azithromycin azithromycin 250 mg oral tablet macrolides

55370088007 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55370088008 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

55370088107 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55370088108 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

55370088213 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

55370088240 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

55370088313 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

Page 75: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55370088340 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

55370088407 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55370088408 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55370088507 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55370088508 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55370088613 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

55370088614 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

55370088680 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

55370088713 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

55370088714 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

55370088780 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

55887033230 Zithromax azithromycin 600 mg oral tablet macrolides

55887062209 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55887062220 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55887062221 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55887062230 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55887062240 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

55887074620 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55887074656 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55887074720 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

55887076821 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55887076830 Erythromycin Base erythromycin 500 mg oral tablet macrolides

55887078728 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

55887079015 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55887079020 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55887079030 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

55887082314 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

55887083020 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887083028 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887083030 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887083040 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887084928 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55887084930 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55887084940 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

55887085520 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55887085528 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

Page 76: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

55887085530 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

55887086701 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

55887093030 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887093040 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

55887093306 Zithromax azithromycin 250 mg oral tablet macrolides

55887095521 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55887095530 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

55887098204 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098209 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098214 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098215 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098220 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098221 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098228 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098230 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098240 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098242 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887098260 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55887099309 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099314 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099315 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099321 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099330 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099340 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55887099342 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

55953067347 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

55953071670 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

55953074770 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

56126038711 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

56126039111 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

56126039711 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

57866010601 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

57866010602 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

57866025001 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

57866026102 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

57866035101 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

Page 77: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

57866035102 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

57866035103 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

57866044607 Zithromax azithromycin 250 mg oral tablet macrolides

57866312901 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

57866361302 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

57866361401 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

57866435601 Azithromycin azithromycin 250 mg oral tablet macrolides

57866605002 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

57866605103 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

57866721801 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

57866721802 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016008600 Azithromycin azithromycin 250 mg oral tablet macrolides

58016008630 Azithromycin azithromycin 250 mg oral tablet macrolides

58016008660 Azithromycin azithromycin 250 mg oral tablet macrolides

58016008690 Azithromycin azithromycin 250 mg oral tablet macrolides

58016010300 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010309 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010312 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010315 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010318 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010320 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010321 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010324 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010330 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010340 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

58016010400 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010409 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010412 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010414 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010415 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010418 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010420 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010421 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010424 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010428 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010430 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

Page 78: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016010440 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58016010500 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

58016010560 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

58016010590 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

58016010630 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

58016010720 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

58016012300 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012312 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012315 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012320 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012324 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012328 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012330 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012340 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

58016012400 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012402 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012408 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012410 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012412 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012414 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012415 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012416 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012420 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012421 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012424 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012428 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012430 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012440 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012450 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012456 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012460 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012490 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58016012500 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012503 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012506 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012509 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

Page 79: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016012510 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012512 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012514 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012515 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012520 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012521 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012524 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012528 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012530 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012540 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012560 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

58016012600 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012615 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012618 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012620 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012621 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012628 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012630 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012642 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012660 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012699 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58016012706 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012708 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012710 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012714 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012720 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012721 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012724 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012728 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012730 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012740 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012742 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012750 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016012760 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016014000 E-Mycin erythromycin 250 mg oral enteric coated tablet macrolides

58016014518 PCE Dispertab erythromycin 333 mg oral tablet, coated particles macrolides

Page 80: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016014600 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014602 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014603 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014610 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014612 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014616 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014620 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014621 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014624 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014628 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014630 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014640 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014660 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014673 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014689 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014690 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58016014700 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014702 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014703 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014706 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014710 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014712 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014715 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014716 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014720 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014721 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014724 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014728 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014730 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014740 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014750 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014760 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014773 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014789 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014790 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

58016014800 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

Page 81: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016014808 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014809 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014810 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014812 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014814 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014815 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014820 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014824 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014828 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014830 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014840 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014850 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

58016014900 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014907 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014910 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014920 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014921 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014924 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014925 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014928 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014930 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016014940 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

58016016228 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

58016016230 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

58016016240 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

58016016700 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016016712 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016016715 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016016720 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016016730 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016016740 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

58016017530 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

58016017540 Erythromycin Estolate erythromycin estolate 250 mg/5 mL oral suspension macrolides

58016017640 Erythromycin Estolate erythromycin estolate 125 mg/5 mL oral suspension macrolides

58016018400 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016018412 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

Page 82: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016018415 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016018418 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016018424 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016018430 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016018440 E-Mycin erythromycin 333 mg oral enteric coated tablet macrolides

58016035600 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

58016035621 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

58016035630 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

58016035660 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

58016035690 Amoxil amoxicillin 500 mg oral capsule aminopenicillins

58016039100 Zithromax azithromycin 250 mg oral tablet macrolides

58016039101 Zithromax Z-Pak azithromycin 250 mg oral tablet macrolides

58016039106 Zithromax azithromycin 250 mg oral tablet macrolides

58016039110 Zithromax azithromycin 250 mg oral tablet macrolides

58016039115 Zithromax azithromycin 250 mg oral tablet macrolides

58016039118 Zithromax azithromycin 250 mg oral tablet macrolides

58016039120 Zithromax azithromycin 250 mg oral tablet macrolides

58016039128 Zithromax azithromycin 250 mg oral tablet macrolides

58016039130 Zithromax azithromycin 250 mg oral tablet macrolides

58016039160 Zithromax azithromycin 250 mg oral tablet macrolides

58016039190 Zithromax azithromycin 250 mg oral tablet macrolides

58016051220 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

58016064300 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064302 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064304 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064309 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064312 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064315 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064318 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064320 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064321 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064324 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064330 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064340 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064350 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064360 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

Page 83: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016064389 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064390 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016064399 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

58016100001 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

58016100220 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

58016100401 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

58016100501 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

58016100601 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

58016100701 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

58016100903 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

58016101101 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

58016101701 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016101703 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016101801 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016101806 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016102301 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016102303 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016102401 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016102501 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016102601 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

58016102701 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

58016102706 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

58016102801 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

58016102901 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

58016103101 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

58016103201 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

58016103301 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

58016103401 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

58016103601 EryPed 200 erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016103701 EryPed 200 erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016103706 EryPed 200 erythromycin ethylsuccinate 200 mg/5 mL oral liquid macrolides

58016103801 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

58016103901 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

58016103906 EryPed 400 erythromycin ethylsuccinate 400 mg/5 mL oral liquid macrolides

58016106201 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

58016411301 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

Page 84: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

58016411401 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016480401 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

58016480801 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

58016481401 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

58016484201 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

58016484701 Pediazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

58016486901 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

58016499001 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

58864002930 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58864002940 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

58864019540 Erythromycin Base erythromycin 500 mg oral tablet macrolides

58864019928 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58864019940 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58864019956 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

58864037940 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

58864061130 Trimox amoxicillin 500 mg oral capsule aminopenicillins

58864061530 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

58864063240 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

58864067530 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

58864067540 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

58864079106 Azithromycin azithromycin 250 mg oral tablet macrolides

58864084530 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

58864084540 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

59016013410 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

59016013412 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

59016013414 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

59016013415 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

59762102101 Amoxicillin amoxicillin 500 mg capsule aminopenicillins

59762102202 Amoxicillin amoxicillin 200 mg/5 ml susp aminopenicillins

59762102204 Amoxicillin amoxicillin 200 mg/5 ml susp aminopenicillins

59762105005 Amoxicillin amoxicillin 875 mg tablet aminopenicillins

59762153401 Penicillin V Potassium penicillin vk 250 mg tablet natural penicillins

59762153402 Penicillin V Potassium penicillin vk 250 mg tablet natural penicillins

59762153702 Penicillin V Potassium penicillin vk 500 mg tablet natural penicillins

59762153703 Penicillin V Potassium penicillin vk 500 mg tablet natural penicillins

59762305101 Azithromycin azithromycin 1 g oral liquid macrolides

Page 85: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

59762305102 Azithromycin azithromycin 1 g oral liquid macrolides

59762306001 Azithromycin 5 Day Dose Pack azithromycin 250 mg oral tablet macrolides

59762306002 Azithromycin azithromycin 250 mg oral tablet macrolides

59762306003 Azithromycin azithromycin 250 mg oral tablet macrolides

59762307001 Azithromycin 3 Day Dose Pack azithromycin 500 mg oral tablet macrolides

59762307002 Azithromycin azithromycin 500 mg oral tablet macrolides

59762308001 Azithromycin azithromycin 600 mg oral tablet macrolides

59762311001 Azithromycin azithromycin 100 mg/5 mL oral liquid macrolides

59762312001 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

59762313001 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

59762314001 Azithromycin azithromycin 200 mg/5 mL oral liquid macrolides

59911587502 Vancomycin Hydrochloride vancomycin 250 mg/5 mL oral liquid miscellaneous antibiotics

60346008244 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

60346036403 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

60346036409 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

60346036415 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

60346036421 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

60346036444 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

60346065506 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

60346065510 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

60346065515 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

60429002130 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

60429002230 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

60429002340 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

60429007040 Erythromycin Base erythromycin 250 mg oral tablet macrolides

60429014740 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

60429014840 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

60432006500 Amox Tr-Potassium Clavulanate amox tr-k clv 250-62.5/5 susp

60432006547 Amox Tr-Potassium Clavulanate amox tr-k clv 250-62.5/5 susp

60432006575 Amox Tr-Potassium Clavulanate amox tr-k clv 250-62.5/5 susp

60432067160 Erythromycin erythromycin 2% solution macrolides

60760032030 Erythromycin Base erythromycin 333 mg oral enteric coated tablet macrolides

61392011330 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011331 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011332 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011339 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

Page 86: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

61392011345 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011351 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011354 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011360 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011390 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61392011391 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

61423082040 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

61423082575 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

61423083515 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

62584023701 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

62584023801 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63304017620 Dispermox amoxicillin 600 mg oral tablet, dispersible aminopenicillins

63304050901 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

63304050920 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

63304051401 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

63304051501 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63304051504 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63304056520 Dispermox amoxicillin 200 mg oral tablet, dispersible aminopenicillins

63304056720 Dispermox amoxicillin 400 mg oral tablet, dispersible aminopenicillins

63304065401 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63304065405 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63304065501 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63304065505 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63304071320 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63304075320 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg oral tablet, chewable beta-lactamase inhibitors

63304075420 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg oral tablet, chewable beta-lactamase inhibitors

63304076020 Amoxicillin amoxicillin 200 mg oral tablet, chewable aminopenicillins

63304076101 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

63304076120 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

63304076220 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

63304076301 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

63304076305 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

63304076320 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

63304076801 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

63304076802 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

63304076807 Amoxicillin-Clavulanate amoxicillin-clavulanate 600 mg-42.9 mg/5 mL oral liquid beta-lactamase inhibitors

Page 87: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63304096901 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

63304096903 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

63304096904 Amoxicillin amoxicillin 200 mg/5 mL oral liquid aminopenicillins

63304097001 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

63304097003 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

63304097004 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

63304097701 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

63304097703 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

63304097704 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

63304097901 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

63304097903 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

63304097904 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

63304907004 Amoxicillin amoxicillin 400 mg/5 mL oral liquid aminopenicillins

63629175905 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63629183401 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63629183402 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63629183403 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63629183501 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63629183502 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63629188301 Erythromycin erythromycin 333 mg oral tablet, coated particles macrolides

63629188302 Erythromycin erythromycin 333 mg oral tablet, coated particles macrolides

63629268501 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

63629268502 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

63629275501 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

63629275502 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

63629287101 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

63629289501 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63629294001 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874010101 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010103 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010105 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010109 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010115 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010118 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010120 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010121 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 88: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874010124 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010128 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010130 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010140 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010145 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010150 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

63874010201 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010203 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010204 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010205 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010209 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010210 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010212 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010214 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010215 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010218 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010220 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010221 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010224 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010228 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010230 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010240 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010245 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010250 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

63874010301 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

63874010321 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

63874010330 Augmentin amoxicillin-clavulanate 250 mg-125 mg oral tablet beta-lactamase inhibitors

63874011001 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011020 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011028 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011030 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011040 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011050 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg oral tablet macrolides

63874011301 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011303 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011308 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

Page 89: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874011309 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011310 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011312 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011314 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011315 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011320 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011321 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011324 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011328 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011330 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011340 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011350 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

63874011401 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011403 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011407 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011410 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011420 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011421 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011424 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011425 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011428 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011430 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011440 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011450 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

63874011501 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011508 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011510 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011512 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011514 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011515 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011520 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011521 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011530 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

63874011612 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

63874011615 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

63874011620 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

Page 90: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874011621 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

63874011630 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg oral tablet, chewable beta-lactamase inhibitors

63874011710 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874011712 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874011714 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874011715 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874011720 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874011730 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg oral tablet, chewable beta-lactamase inhibitors

63874012628 Erythromycin Base erythromycin 250 mg oral tablet macrolides

63874012630 Erythromycin Base erythromycin 250 mg oral tablet macrolides

63874012640 Erythromycin Base erythromycin 250 mg oral tablet macrolides

63874012701 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012705 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012718 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012720 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012721 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012728 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012730 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012740 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012742 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

63874012901 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012904 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012908 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012910 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012912 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012914 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012915 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012916 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012920 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012921 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012924 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012928 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012930 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012940 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012950 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874012956 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

Page 91: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874012960 Erythromycin Stearate erythromycin stearate 250 mg oral tablet macrolides

63874013001 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013003 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013006 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013009 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013010 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013012 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013014 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013015 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013020 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013021 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013024 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013028 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013030 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013040 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874013060 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

63874014310 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

63874014315 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

63874014380 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

63874014410 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

63874014415 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

63874014510 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

63874014520 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

63874014610 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

63874014615 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

63874014620 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

63874014710 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

63874014715 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

63874014775 Augmentin amoxicillin-clavulanate 250 mg-62.5 mg/5 mL oral liquid beta-lactamase inhibitors

63874014810 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

63874014815 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

63874014875 Augmentin amoxicillin-clavulanate 125 mg-31.25 mg/5 mL oral liquid beta-lactamase inhibitors

63874015910 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

63874015920 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

63874016010 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

63874016020 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

Page 92: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874016048 Erythromycin Ethylsuccinate erythromycin ethylsuccinate 400 mg/5 mL oral suspension macrolides

63874023101 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023110 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023112 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023114 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023115 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023120 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023121 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023128 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023130 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023140 Erythromycin Base erythromycin 500 mg oral tablet macrolides

63874023201 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023202 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023203 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023210 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023212 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023216 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023220 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023221 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023224 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023228 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023230 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023240 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023250 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

63874023301 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023302 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023306 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023310 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023312 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023315 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023316 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023320 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023324 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023328 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023330 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023336 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

Page 93: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

63874023340 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023350 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023360 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

63874023901 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

63874023920 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

63874023930 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

63874024001 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63874024020 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63874024030 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63874024050 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

63874024604 Zithromax azithromycin 250 mg oral tablet macrolides

63874024606 Zithromax azithromycin 250 mg oral tablet macrolides

63874024610 Zithromax azithromycin 250 mg oral tablet macrolides

63874024615 Zithromax azithromycin 250 mg oral tablet macrolides

63874024910 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

63874024920 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

63874024930 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

63874111202 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

64679096101 Azithromycin azithromycin 250 mg tablet macrolides

64679096104 Azithromycin azithromycin 250 mg tablet macrolides

64679096105 Azithromycin azithromycin 250 mg tablet macrolides

64679096401 Azithromycin azithromycin 500 mg tablet macrolides

64679096403 Azithromycin azithromycin 500 mg tablet macrolides

64679096405 Azithromycin azithromycin 500 mg tablet macrolides

65862001401 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

65862001405 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

65862001501 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

65862001505 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

65862001601 Amoxicillin amoxicillin 250 mg capsule aminopenicillins

65862001605 Amoxicillin amoxicillin 250 mg capsule aminopenicillins

65862001705 Amoxicillin amoxicillin 500 mg capsule aminopenicillins

65862007001 Amoxicillin amoxicillin 200 mg/5 ml susp aminopenicillins

65862007101 Amoxicillin amoxicillin 400 mg/5 ml susp aminopenicillins

66116024030 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66116024330 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66116024440 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

Page 94: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

66116024928 Principen ampicillin 500 mg oral capsule aminopenicillins

66116026230 Trimox amoxicillin 500 mg oral capsule aminopenicillins

66116027230 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

66116027460 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66116028930 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66267002121 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

66267002130 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

66267002230 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

66267002321 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66267002330 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66267002340 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66267008628 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

66267008640 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

66267008815 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66267008821 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66267008830 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66267008920 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

66267008928 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

66267009020 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66267009028 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66267009040 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66267009120 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66267009128 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66267009130 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66267009140 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66267015920 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66267015930 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66267015940 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66267016020 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66267016028 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66267016040 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66267044415 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66267071203 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66267071210 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66267085703 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66267085704 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

Page 95: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

66267085903 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66267085904 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66267092700 E.E.S.-200 erythromycin ethylsuccinate 200 mg/5 mL oral suspension macrolides

66267092806 Zithromax azithromycin 250 mg oral tablet macrolides

66267099120 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66267099220 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66267099315 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

66267099400 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

66267100101 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66267100201 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66336001720 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

66336001728 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

66336003703 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336003706 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336003720 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336003728 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336003740 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336007420 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

66336007706 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66336007720 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66336007728 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66336007740 Erythromycin Base erythromycin 500 mg oral tablet macrolides

66336009506 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009510 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009520 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009528 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009530 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009540 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

66336009803 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66336009815 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66336009821 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66336009830 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

66336010828 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

66336010840 Ery-Tab erythromycin 250 mg oral enteric coated tablet macrolides

66336011330 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

66336029330 Amoxicillin amoxicillin 500 mg oral tablet aminopenicillins

Page 96: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

66336041420 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66336041428 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66336041440 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

66336058028 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336058030 Erythromycin Base erythromycin 250 mg oral tablet macrolides

66336059330 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

66336059340 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

66336061730 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

66336061740 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

66336063408 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336063415 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336063421 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336063430 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336063440 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336063442 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

66336064430 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

66336064440 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

66336064528 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

66336065521 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

66336065530 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

66593312502 Vancocin HCl Pulvules vancomycin 125 mg oral capsule miscellaneous antibiotics

66593312602 Vancocin HCl Pulvules vancomycin 250 mg oral capsule miscellaneous antibiotics

66685100100 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66685100101 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

66685100200 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66685100202 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

66685101100 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

66685101101 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

66685101102 Amoxicillin-Clavulanate amoxicillin-clavulanate 200 mg-28.5 mg/5 mL oral liquid beta-lactamase inhibitors

66685101200 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

66685101201 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

66685101202 Amoxicillin-Clavulanate amoxicillin-clavulanate 400 mg-57 mg/5 mL oral liquid beta-lactamase inhibitors

67046002021 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

67046002030 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

67046057621 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

67046057628 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

Page 97: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

67046057630 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

67253014010 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

67253014050 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

67253014110 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

67253014150 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

67253014208 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

67253014210 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

67253014215 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

67253014308 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

67253014310 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

67253014315 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

67253018010 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

67253018050 Ampicillin ampicillin 250 mg oral capsule aminopenicillins

67253018110 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

67253018150 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

67253018210 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

67253018220 Ampicillin ampicillin 125 mg/5 mL oral liquid aminopenicillins

67253018310 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

67253018320 Ampicillin ampicillin 250 mg/5 mL oral liquid aminopenicillins

67253020010 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

67253020011 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

67253020110 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

67253020150 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

67253020210 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

67253020220 Penicillin V Potassium penicillin V potassium 125 mg/5 mL oral liquid natural penicillins

67253020310 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

67253020320 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

68071006330 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

68084027889 Azithromycin azithromycin 250 mg tablet macrolides

68115002530 Amoxicillin amoxicillin 125 mg oral tablet, chewable aminopenicillins

68115002604 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002606 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002609 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002615 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002621 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002630 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

Page 98: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

68115002640 Amoxicillin amoxicillin 250 mg oral capsule aminopenicillins

68115002721 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

68115002730 Amoxicillin amoxicillin 250 mg oral tablet, chewable aminopenicillins

68115002830 Amoxicillin amoxicillin 400 mg oral tablet, chewable aminopenicillins

68115002900 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002904 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002906 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002908 Trimox amoxicillin 500 mg oral capsule aminopenicillins

68115002909 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002918 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002920 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002921 Trimox amoxicillin 500 mg oral capsule aminopenicillins

68115002930 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002940 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68115002942 Trimox amoxicillin 500 mg oral capsule aminopenicillins

68115003010 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

68115003014 Amoxicillin amoxicillin 875 mg oral tablet aminopenicillins

68115003321 Ampicillin ampicillin 500 mg oral capsule aminopenicillins

68115012606 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

68115012628 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

68115012630 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

68115012640 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

68115012656 E.E.S.-400 Filmtab erythromycin ethylsuccinate 400 mg oral tablet macrolides

68115013106 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

68115013115 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

68115013121 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

68115013130 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

68115013140 Ery-Tab erythromycin 333 mg oral enteric coated tablet macrolides

68115013220 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

68115013228 Ery-Tab erythromycin 500 mg oral enteric coated tablet macrolides

68115013320 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

68115013340 Erythromycin Base erythromycin 250 mg oral delayed release capsule macrolides

68115013406 Erythromycin Base erythromycin 250 mg oral tablet macrolides

68115013420 Erythromycin Base erythromycin 250 mg oral tablet macrolides

68115013428 Erythromycin Base erythromycin 250 mg oral tablet macrolides

68115013440 Erythromycin Base erythromycin 250 mg oral tablet macrolides

Page 99: Section 2, Technical Specifications...PQMP Q‐METRIC SCD Measure 3 U18HS020516 Page 2 Section II: Technical Specifications PDF 2 December 2013 Eligible Population Ages Children ≥

68115013506 Erythromycin Base erythromycin 500 mg oral tablet macrolides

68115013520 Erythromycin Base erythromycin 500 mg oral tablet macrolides

68115013530 Erythromycin Base erythromycin 500 mg oral tablet macrolides

68115013540 Erythromycin Base erythromycin 500 mg oral tablet macrolides

68115013628 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

68115013640 Erythromycin Stearate erythromycin stearate 500 mg oral tablet macrolides

68115026830 Penicillin V Potassium penicillin V potassium 250 mg oral tablet natural penicillins

68115026904 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

68115026912 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

68115026920 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

68115026921 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

68115026928 Penicillin V Potassium penicillin V potassium 500 mg oral tablet natural penicillins

68115036404 Zithromax azithromycin 250 mg oral tablet macrolides

68115036450 Zithromax azithromycin 250 mg oral tablet macrolides

68115038620 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

68115044522 Erythromycin-Sulfisoxazole erythromycin-sulfisoxazole 200 mg-600 mg/5 mL oral liquid miscellaneous antibiotics

68115046320 Amoxicillin-Clavulanate amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

68115048840 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

68115054150 Zithromax azithromycin 250 mg oral tablet macrolides

68115058220 Penicillin V Potassium penicillin V potassium 250 mg/5 mL oral liquid natural penicillins

68115090400 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

68115090450 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

68115090480 Amoxicillin amoxicillin 125 mg/5 mL oral liquid aminopenicillins

68115093106 Zithromax azithromycin 250 mg oral tablet macrolides

68115099020 Augmentin amoxicillin-clavulanate 875 mg-125 mg oral tablet beta-lactamase inhibitors

68115099120 Augmentin amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors

68115099350 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

68115099400 Amoxicillin amoxicillin 250 mg/5 mL oral liquid aminopenicillins

68387043030 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68387043040 Amoxicillin amoxicillin 500 mg oral capsule aminopenicillins

68387058015 Amoxicillin-Clavulanate amoxicillin-clavulanate 500 mg-125 mg oral tablet beta-lactamase inhibitors