EXM125-FHIR
type: Measure
node role: treeRoot
resource.id:
  value: EXM125-FHIR
resource.meta:
  meta.profile:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure
    index: -1
    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure
  meta.profile:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure
    index: -1
    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure
  meta.profile:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure
    index: -1
    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure
  meta.profile:
    value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure
    index: -1
    link: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure
resource.language:
  value: en
domain resource.text:
  narrative.status:
    value: extensions
  narrative.div: Metadata Title EXM125 - Breast Cancer Screening Version 8.0.000 Identifier 125 Identifier 112 Identifier urn:oid:2.16.840.1.113883.4.642.40.61.29.5 Effective Period 2018-01-01 through 2018-12-31 Approval Date 2016-01-01 Last Review Date 2016-09-01 Experimental true Use Context Clinical Venue = EC Jurisdiction 001 from http://unstats.un.org/unsd/methods/m49/m49.htm Topic Health Quality Measure Document Steward (Publisher) HL7 International / Clinical Quality Information Description Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer Purpose This measure has been developed to support improvement in clinical care. Copyright This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in t…
domain resource.contained: Library
  index: -1
  resource.id:
    value: effective-data-requirements
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding: http://snomed.info/id/428361000124107
      coding.system:
        value: http://snomed.info/sct
      coding.version:
        value: http://snomed.info/sct/731000124108/version/201709
      coding.code:
        value: 428361000124107
      coding.display:
        value: Discharge to home for hospice care (procedure)
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding: http://snomed.info/id/428371000124100
      coding.system:
        value: http://snomed.info/sct
      coding.version:
        value: http://snomed.info/sct/731000124108/version/201709
      coding.code:
        value: 428371000124100
      coding.display:
        value: Discharge to healthcare facility for hospice care (procedure)
  domain resource.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode
    extension.value coding:
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/condition-clinical
      coding.code:
        value: active
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: SupplementalDataElements
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: SDE Sex
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "SDE Sex": case when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' } when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' } else null end
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 0
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: EXM125
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: SDE Sex
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "SDE Sex": SDE."SDE Sex"
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 1
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: EXM125
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: Numerator
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "Numerator": exists ( [DiagnosticReport: "Mammography"] Mammogram where ( Global."Normalize Interval"(Mammogram.effective) ends 27 months or less before day of end of "Measurement Period" ) and Mammogram.status in { 'final', 'amended', 'corrected', 'appended' } )
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 2
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: AdultOutpatientEncounters
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: Qualifying Encounters
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "Qualifying Encounters": ([Encounter: "Office Visit"] union [Encounter: "Annual Wellness Visit"] union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"] union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"] union [Encounter: "Home Healthcare Services"] ) ValidEncounter where ValidEncounter.period during "Measurement Period" and ValidEncounter.status = 'finished'
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 3
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  domain resource.extension:
    index: -1
    element.extension:
      index: -1
      extension.url:
        value: libraryName
      extension.value string:
        value: EXM125
    element.extension:
      index: -1
      extension.url:
        value: name
      extension.value string:
        value: Initial Population
    element.extension:
      index: -1
      extension.url:
        value: statement
      extension.value string:
        value: define "Initial Population": Patient.gender = 'female' and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[51, 74] and exists AdultOutpatientEncounters."Qualifying Encounters"
    element.extension:
      index: -1
      extension.url:
        value: displaySequence
      extension.value integer:
        value: 4

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Denominator
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Denominator": "Initial Population"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 5
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Payer
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Payer": [Coverage: type in "Payer"] Payer return { code: Payer.type, period: Payer.period }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 6
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Payer
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Payer": SDE."SDE Payer"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 7
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Ethnicity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Ethnicity": (flatten ( Patient.extension Extension where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity' return Extension.extension )) E where E.url = 'ombCategory' or E.url = 'detailed' return E.value as Coding
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 8
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Ethnicity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Ethnicity": SDE."SDE Ethnicity"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 9
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: Hospice
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Has Hospice
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Has Hospice": exists ( [Encounter: "Encounter Inpatient"] DischargeHospice where DischargeHospice.status = 'finished' and ( DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)" or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)" ) and DischargeHospice.period ends during "Measurement Period" ) or exists ( [ServiceRequest: "Hospice care ambulatory"] HospiceOrder where HospiceOrder.intent = 'order' and HospiceOrder.authoredOn in "Measurement Period" ) or exists ( [Procedure: "Hospice care ambulatory"] HospicePerformed where HospicePerformed.status = 'completed' and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period" )
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 10
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Unilateral Mastectomy Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Unilateral Mastectomy Procedure": [Procedure: "Unilateral Mastectomy"] UnilateralMastectomyProcedure where Global."Normalize Interval"(UnilateralMastectomyProcedure.performed) ends before day of end of "Measurement Period" and UnilateralMastectomyProcedure.status = 'completed'
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 11
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Right Mastectomy
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Right Mastectomy": ( ( [Condition: "Status Post Right Mastectomy"] C where C.clinicalStatus ~ ToConcept(Global."active") ) union ( [Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis where UnilateralMastectomyDiagnosis.bodySite in "Right" and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active") ) ) RightMastectomy where Global."Normalize Interval"(RightMastectomy.onset) starts before day of end of "Measurement Period"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 12
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Left Mastectomy
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Left Mastectomy": ( ( [Condition: "Status Post Left Mastectomy"] C where C.clinicalStatus ~ ToConcept(Global."active") ) union ( [Condition: "Unilateral Mastectomy, Unspecified Laterality"] UnilateralMastectomyDiagnosis where UnilateralMastectomyDiagnosis.bodySite in "Left" and UnilateralMastectomyDiagnosis.clinicalStatus ~ ToConcept(Global."active") ) ) LeftMastectomy where Global."Normalize Interval"(LeftMastectomy.onset) starts before day of end of "Measurement Period"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 13
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: History Bilateral Mastectomy
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "History Bilateral Mastectomy": [Condition: "History of bilateral mastectomy"] BilateralMastectomyHistory where Global."Normalize Interval"(BilateralMastectomyHistory.onset) starts before day of end of "Measurement Period" and BilateralMastectomyHistory.clinicalStatus ~ ToConcept(Global."active")
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 14
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Bilateral Mastectomy Procedure
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Bilateral Mastectomy Procedure": [Procedure: "Bilateral Mastectomy"] BilateralMastectomyPerformed where Global."Normalize Interval"(BilateralMastectomyPerformed.performed) ends before day of end of "Measurement Period" and BilateralMastectomyPerformed.status = 'completed'
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 15
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Denominator Exclusion
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "Denominator Exclusion": Hospice."Has Hospice" or ( Count("Unilateral Mastectomy Procedure") = 2 ) or ( exists "Right Mastectomy" and exists "Left Mastectomy" ) or exists "History Bilateral Mastectomy" or exists "Bilateral Mastectomy Procedure"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 16
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: SupplementalDataElements
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Race
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Race": (flatten ( Patient.extension Extension where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race' return Extension.extension )) E where E.url = 'ombCategory' or E.url = 'detailed' return E.value as Coding
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 17
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: EXM125
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: SDE Race
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define "SDE Race": SDE."SDE Race"
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 18
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value AdministrativeGender): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 19
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: Normalize Interval
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* * * CQFMeasures Common Logic * */ define function "Normalize Interval"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>): case when choice is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)] when choice is FHIR.Period then FHIRHelpers.ToInterval(choice as FHIR.Period) when choice is FHIR.instant then Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)] when choice is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year) when choice is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year) when choice is FHIR.Timing then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type') when choice is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else null as Interval<DateTime> end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 20
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDateTime
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDateTime(value dateTime): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 21
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToInterval
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period) value to a CQL DateTime Interval @comment: If the start value of the given period is unspecified, the starting boundary of the resulting interval will be open (meaning the start of the interval is unknown, as opposed to interpreted as the beginning of time). */ define function ToInterval(period FHIR.Period): if period is null then null else if period."start" is null then Interval(period."start".value, period."end".value] else Interval[period."start".value, period."end".value]
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 22
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDateTime
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDateTime(value instant): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 23
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDate
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToDate(value date): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 24
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToQuantity
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Quantity @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`) an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used. @seealso: ToCalendarUnit */ define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 25
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToCalendarUnit
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts a UCUM definite duration unit to a CQL calendar duration unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) topic of the CQL specification. @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate */ define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 26
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value DiagnosticReportStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 27
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: CalendarAgeInYearsAt
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime): years between ToDate(BirthDateTime)and ToDate(AsOf)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 28
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: MATGlobalCommonFunctions
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToDate
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function "ToDate"(Value DateTime): DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 29
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value EncounterStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 30
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value uri): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 31
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToConcept
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept. */ define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 32
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToCode
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: /* @description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code. */ define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 33
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ServiceRequestIntent): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 34
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

index: -1
element.extension:
  index: -1
  extension.url:
    value: libraryName
  extension.value string:
    value: FHIRHelpers
element.extension:
  index: -1
  extension.url:
    value: name
  extension.value string:
    value: ToString
element.extension:
  index: -1
  extension.url:
    value: statement
  extension.value string:
    value: define function ToString(value ProcedureStatus): value.value
element.extension:
  index: -1
  extension.url:
    value: displaySequence
  extension.value integer:
    value: 35
extension.url:
  value: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition

value: EffectiveDataRequirements

value: active

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/library-type
  coding.code:
    value: module-definition

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: FHIR model information
related artifact.resource:
  value: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1
  link: 4.0
  link: .1

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library SDE
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000
  link: 2.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library FHIRHelpers
related artifact.resource:
  value: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1
  link: 4.0
  link: .1

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library Global
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000
  link: 5.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library AdultOutpatientEncounters
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000
  link: 2.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Library Hospice
related artifact.resource:
  value: http://hl7.org/fhir/uv/cqm/Library/Hospice|2.0.000
  link: 2.0
  link: .000

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Code system SNOMEDCT:2017-09
related artifact.resource:
  value: http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709
  link: 731000124108
  link: 201709

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Code system ConditionClinicalStatusCodes
related artifact.resource:
  value: http://terminology.hl7.org/CodeSystem/condition-clinical
  link: http://terminology.hl7.org/CodeSystem/condition-clinical

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Mammography
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Office Visit
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Annual Wellness Visit
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Preventive Care Services - Established Office Visit, 18 and Up
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Preventive Care Services-Initial Office Visit, 18 and Up
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Home Healthcare Services
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Payer
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Encounter Inpatient
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Hospice care ambulatory
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Unilateral Mastectomy
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Status Post Right Mastectomy
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Unilateral Mastectomy, Unspecified Laterality
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Right
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1035

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Status Post Left Mastectomy
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Left
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.122.12.1036

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set History of bilateral mastectomy
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068

index: -1
related artifact.type:
  value: depends-on
related artifact.display:
  value: Value set Bilateral Mastectomy
related artifact.resource:
  value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005
  link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005

index: -1
parameter definition.name:
  value: Measurement Period
parameter definition.use:
  value: in
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: Period

index: -1
parameter definition.name:
  value: SDE Sex
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: Coding

index: -1
parameter definition.name:
  value: Numerator
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: boolean

index: -1
parameter definition.name:
  value: Denominator
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: boolean

index: -1
parameter definition.name:
  value: SDE Payer
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: *
parameter definition.type:
  value: Resource

index: -1
parameter definition.name:
  value: Initial Population
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: boolean

index: -1
parameter definition.name:
  value: SDE Ethnicity
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: *
parameter definition.type:
  value: Coding

index: -1
parameter definition.name:
  value: Denominator Exclusion
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: 1
parameter definition.type:
  value: boolean

index: -1
parameter definition.name:
  value: SDE Race
parameter definition.use:
  value: out
parameter definition.min:
  value: 0
parameter definition.max:
  value: *
parameter definition.type:
  value: Coding

index: -1
data requirement.type:
  value: Patient
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Patient
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Patient
data requirement.must support:
  value: url
  index: -1
data requirement.must support:
  value: extension
  index: -1
data requirement.must support:
  value: value
  index: -1

index: -1
data requirement.type:
  value: DiagnosticReport
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/DiagnosticReport
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/DiagnosticReport
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: effective
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1018

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016

index: -1
data requirement.type:
  value: Encounter
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Encounter
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Encounter
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: hospitalization
  index: -1
data requirement.must support:
  value: hospitalization.dischargeDisposition
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307

index: -1
data requirement.type:
  value: Coverage
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Coverage
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Coverage
data requirement.must support:
  value: type
  index: -1
data requirement.must support:
  value: period
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: type
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591

index: -1
data requirement.type:
  value: ServiceRequest
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/ServiceRequest
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/ServiceRequest
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: intent
  index: -1
data requirement.must support:
  value: authoredOn
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15

index: -1
data requirement.type:
  value: Procedure
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Procedure
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Procedure
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.must support:
  value: performed
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15

index: -1
data requirement.type:
  value: Procedure
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Procedure
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Procedure
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: performed
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1020

index: -1
data requirement.type:
  value: Procedure
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Procedure
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Procedure
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: performed
  index: -1
data requirement.must support:
  value: status
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1005

index: -1
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: clinicalStatus
  index: -1
data requirement.must support:
  value: onset
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1070

index: -1
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: clinicalStatus
  index: -1
data requirement.must support:
  value: onset
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1069

index: -1
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: bodySite
  index: -1
data requirement.must support:
  value: clinicalStatus
  index: -1
data requirement.must support:
  value: onset
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1071

index: -1
data requirement.type:
  value: Condition
data requirement.profile:
  value: http://hl7.org/fhir/StructureDefinition/Condition
  index: -1
  link: http://hl7.org/fhir/StructureDefinition/Condition
data requirement.must support:
  value: code
  index: -1
data requirement.must support:
  value: onset
  index: -1
data requirement.must support:
  value: clinicalStatus
  index: -1
data requirement.code filter:
  index: -1
  data requirement.code filter.path:
    value: code
  data requirement.code filter.value set:
    value: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068
    link: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1068

index: -1
extension.url:
  value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis
extension.value code:
  value: boolean

index: -1
extension.url:
  value: http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-renderMissingElements
extension.value boolean:
  value: true

index: -1
extension.url:
  value: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
extension.value canonical:
  value: #effective-data-requirements

index: -1
identifier.use:
  value: official
identifier.system:
  value: http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms
identifier.value:
  value: 125

index: -1
identifier.use:
  value: official
identifier.system:
  value: http://example.org/fhir/cqi/ecqm/Measure/Identifier/mips
identifier.value:
  value: 112

index: -1
identifier.system:
  value: urn:ietf:rfc:3986
identifier.value:
  value: urn:oid:2.16.840.1.113883.4.642.40.61.29.5

value: 8.0.000

value: EXM125

value: EXM125 - Breast Cancer Screening

value: active

value: true

value: 2025-08-13

value: HL7 International / Clinical Quality Information

index: -1
contact detail.telecom:
  index: -1
  contact point.system:
    value: url
  contact point.value:
    value: http://www.hl7.org/Special/committees/cqi

value: Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

index: -1
usage context.code:
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/usage-context-type
  coding.code:
    value: venue
  coding.display:
    value: Clinical Venue
usage context.value codeable concept:
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes
    coding.code:
      value: ec
    coding.display:
      value: EC

index: -1
codeable concept.coding:
  index: -1
  coding.system:
    value: http://unstats.un.org/unsd/methods/m49/m49.htm
  coding.code:
    value: 001

value: This measure has been developed to support improvement in clinical care.

value: This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation. ICD-10 copyright 2016 World Health Organization. All Rights Reserved. The American Hospital Association holds a copyright to the National Uniform Billing Committee (NUBC) codes contained in the measure specifications. The NUBC codes in the specifications are included with the permission of the AHA. The NUBC codes contained in the spec…

value: 2016-01-01

value: 2016-09-01

period.start:
  value: 2018-01-01
period.end:
  value: 2018-12-31

index: -1
codeable concept.coding: http://loinc.org/rdf#57024-2
  index: -1
  coding.system:
    value: http://loinc.org
  coding.code:
    value: 57024-2
  coding.display:
    value: Health Quality Measure Document

value: http://hl7.org/fhir/uv/cqm/Library/EXM125
index: -1
link: http://hl7.org/fhir/uv/cqm/Library/EXM125

value: The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-scoring
  coding.code:
    value: proportion
  coding.display:
    value: Proportion

index: -1
codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-type
  coding.code:
    value: process

value: Breast cancer is one of the most common types of cancers, accounting for a quarter of all new cancer diagnoses for women in the U.S. (BreastCancer.Org, 2011). It ranks as the second leading cause of cancer-related mortality in women, accounting for nearly 40,000 estimated deaths in 2013 (American Cancer Society, 2011). According to the National Cancer Institute's Surveillance Epidemiology and End Results program, the chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 30, it is one in 2,212. By age 40, the chances increase to one in 235, by age 50, it becomes one in 54, and, by age 60, it is one in 25. From 2004 to 2008, the median age at the time of breast cancer diagnosis was 61 years among adult women (Tangka et al, 2010). In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits, and varying procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (Lavigne et al, 2008; Boykoff et al, 2009).

value: The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation). The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms (C recommendation). The Task Force concludes the evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years and older (I statement). U.S. Preventive Services Task Force (2009) Grade: B recommendation. The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. Grade: C recommendation. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient's values regarding specific benefits and harms. Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older. Grade: D recommendation. The USPSTF recommends against teaching breast self-examination (BSE). Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older. Grade: I Statement. The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.

codeable concept.coding:
  index: -1
  coding.system:
    value: http://terminology.hl7.org/CodeSystem/measure-improvement-notation
  coding.code:
    value: increase
  coding.display:
    value: Increased score indicates improvement

value: Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1. Patient self-report is not allowed for laboratory tests. This measure evaluates primary screening. Do not count biopsies, breast ultrasounds, MRIs or tomosynthesis (3D mammography), because they are not appropriate methods for primary breast cancer screening.

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId
  extension.value string:
    value: primary
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm125-initial-population
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: initial-population
      coding.display:
        value: Initial Population
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Initial Population
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm125-numerator
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: numerator
      coding.display:
        value: Numerator
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Numerator
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm125-denominator
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: denominator
      coding.display:
        value: Denominator
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Denominator
measure.group.population:
  index: -1
  element.extension:
    index: -1
    extension.url:
      value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId
    extension.value string:
      value: primary-exm125-denominator-exclusion
  measure.group.population.code:
    codeable concept.coding:
      index: -1
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/measure-population
      coding.code:
        value: denominator-exclusion
      coding.display:
        value: Denominator Exclusion
  measure.group.population.criteria:
    expression.language:
      value: text/cql-identifier
    expression.expression:
      value: Denominator Exclusion

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-ethnicity
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Ethnicity

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-payer
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Payer

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-race
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Race

index: -1
element.extension:
  index: -1
  extension.url:
    value: http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId
  extension.value string:
    value: primary-sde-sex
measure.supplemental data.usage:
  index: -1
  codeable concept.coding:
    index: -1
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/measure-data-usage
    coding.code:
      value: supplemental-data
measure.supplemental data.criteria:
  expression.language:
    value: text/cql-identifier
  expression.expression:
    value: SDE Sex