# Sample files

All data here is **synthetic**. Member IDs, dates, NPIs and results are generated; they do not
describe any real person, plan or provider. HEDIS® is a registered trademark of NCQA; measure
specifications are licensed from NCQA and are not reproduced.

## hedis-results-sample.csv — plan-level measure results

One row per measure indicator and age stratum, the shape a plan reviews before it is entered in
NCQA's IDSS (Interactive Data Submission System) and, for Medicare Advantage contracts, before
the audited results flow to CMS for Star Ratings.

| column | meaning |
|---|---|
| `measurement_year` | the year the care happened; reported the following June |
| `product_line` | Commercial, Medicaid or Medicare |
| `submission_id` | the reporting unit (an MA contract, a Medicaid plan, a commercial product) |
| `measure_abbr`, `measure_name`, `indicator` | NCQA measure and the specific rate within it |
| `data_collection_method` | Admin, Hybrid or ECDS — determines what evidence is allowed |
| `eligible_population` | members meeting the denominator criteria before exclusions |
| `required_exclusions` | members removed for a required exclusion (hospice, palliative care, etc.) |
| `denominator`, `numerator`, `rate_pct` | for Hybrid measures the denominator is the sampled n (411) |
| `audit_designation` | Reportable, Not Reportable, Biased Rate, or Not Applicable — set by the HEDIS Compliance Audit |

Inverse measures (lower is better) and ratio measures (PCR observed-to-expected) are flagged in `notes`;
`rate_pct` carries the O/E ratio for PCR rows.

## hedis-member-level-sample.csv — member-level evidence

One row per member per indicator with the evidence that supports numerator compliance. This is
the record an auditor asks for: which event, from which source system, coded how. `source_type`
tells you whether the evidence is allowed under the measure's collection method — an EHR result
counts for an ECDS measure; for an Admin-only measure only the claim does.

`in_numerator` is the derived outcome. `exclusion_reason` is populated only when the member was
removed from the denominator.

## What is not here

Enrollment (834), encounter (837) and pharmacy (NCPDP) source files, the ECDS supplemental-data
feeds, and the IDSS XML itself. Those follow in the full product.