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MEDICAL [NON UDS]

 

QUARTERLY

 

DATA SHARING REPORT

 

QUARTER Four| 01/1/20 - 03/31/20

Please complete the data below.  If you are unable to answer a question you can leave the space blank and submit the form.  All fields with a red asterisk are required.

 

No Show Numerator

 

Number of appointments where the patient cancels on the same day (after 8am) or does not show up for their scheduled face-to-face appointment within the reporting period. 

 

 

No Show Denominator

 

Total number of scheduled face-to-face appointments within the reporting period

 

Adolescent Well Visit

 

Total number of patients who were 12-21 years during the measurement period and had at least 1 comprehensive well-care visit with a PCP or OB/GYN during the measurement year.