Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build

Draft dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2025/ and changes regularly. See the Directory of published versions

: Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR - JSON Representation

Active as of 2026-01-16

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{
  "resourceType" : "Measure",
  "id" : "CMS1154ScreeningPrediabetesFHIR",
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  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR\n</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">1.0.000</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n\n<td class=\"content-container\">CMS1154FHIR</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:d5fabe20-5aaa-4dea-bfb4-2fde59ea40d6</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n\n<td class=\"content-container\">urn:uuid:c116e4ae-6daf-49b2-b415-dd229215c674</td>\n\n\n</tr>\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n\n<td class=\"content-container\">1154FHIR</td>\n\n\n</tr>\n\n  \n\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n\n\n</tr>\n\n  \n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Use Context</th>\n\n\n\n<td class=\"content-container\">\n    Venue\n\n = \n    EC\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n\n<td class=\"content-container\">American Medical Association (AMA)</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n\n<td class=\"content-container\">American Medical Association (AMA)</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n\n<td class=\"content-container\">Health Services Advisory Group</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>Percentage of adult patients with risk factors for type 2 diabetes who are due for glycemic screening for whom the screening process was completed during the measurement period.</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n\n<td class=\"content-container\"><div><p>Prediabetes Quality Measures (C) 2018-2025. American Medical Association. All rights reserved.</p>\n<p>CPT (R) 2025 American Medical Association (&quot;AMA&quot;). All rights reserved. You cannot, without express written permission from the AMA, copy, modify, distribute, display, or use CPT for any commercial purpose, including for productive use in a clinical setting. Any such use requires a separate license from the AMA.</p>\n<p>You agree that you shall not remove, obscure, or alter any proprietary rights notices (including copyright and trademark notices) which may be affixed to or contained within the measure.</p>\n<p>Current Procedural Terminology (CPT [R] code(s) (&quot;CPT Codes&quot;) information provided in the Measures is intended for reference and informational purposes only. Decisions regarding which CPT Code is appropriate must be made by physicians and/or their staff considering the clinical facts, circumstances, applicable coding and published AMA coding guideline and payor policies. The AMA does not dictate payer reimbursement policy and does not substitute for the professional judgment of the practitioner performing a procedure, who remains responsible for correct coding. The AMA is not engaged in the practice of medicine or dispensing medical services. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of the CPT code set, and the AMA is not recommending their use.</p>\n<p>Information contained in the measure includes information protected by intellectual property rights which are owned by the AMA. The Measures may also contain proprietary code sets not owned by the AMA. The AMA disclaims all liability for the use or accuracy of any such information. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC [R] copyright 2004-2025 Regenstrief Institute, Inc., SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2025, The International Health Information Standards Development Organisation (IHTSDO). ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n\n<td class=\"content-container\"><div><p>The Prediabetes Quality Measure set descriptions and specifications (collectively, &quot;Measures&quot;) are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures are not intended to diagnose or treat disease or other conditions. The Measures are not a medical device and have not been evaluated by the Food and Drug Administration. Information provided through the Measures is not intended to direct or substitute for the independent assessment or judgment of a qualified healthcare professional. The American Medical Association (&quot;AMA&quot;) assumes no liability for use of the Measures, or data contained or not contained in the Measures.</p>\n<p>The AMA consents to the use, reproduction and distribution of the Measures for non-commercial purposes only (e.g., for use by health care providers in a professional setting). You cannot, without the express written consent of the AMA, use the Measures for any commercial purpose. Unauthorized commercial use of the Measures is expressly prohibited. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed, or distributed for commercial gain. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.</p>\n<p>To request to make a commercial use of the Measures, please email: AMA.IHO.QualityMeasures@ama-assn.org. Any commercial use of the Measures requires a separate license from the AMA.</p>\n<p>Any use, publication or other dissemination of these Measures shall include the following attribution:</p>\n<p>&quot;This [publication, etc.] was prepared using clinical quality measures developed by the American Medical Association. The content reflects the views of [name of author(s)].&quot;</p>\n<p>USE OF THE MEASURES (INCLUDING ANY CPT CODES) IS AT YOUR SOLE RISK. THE MEASURES ARE PROVIDED &quot;AS IS&quot; WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT. AMA EXPRESSLY DISCLAIMS ANY AND ALL RESPONSIBILITY OR LIABILITY FOR DAMAGES OF ANY KIND ARISING OUT OF USE, REFERENCE TO, OR RELIANCE ON THE MEAUSURES.</p>\n<p>These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.</p>\n<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n\n<td class=\"content-container\"><div><p>This measure is critical to identifying patients with prediabetes who may benefit from interventions to prevent type 2 diabetes and identification of undiagnosed type 2 diabetes. The Centers for Disease Control and Prevention (CDC) estimates that approximately 97.6 million American adults have prediabetes (CDC, 2024). They note that more than 80% of adults with prediabetes are not aware that they have the condition. Regular screening for prediabetes is a critical first step to helping patients avoid the disability and costs associated with progression to type 2 diabetes.</p>\n<p>The measure gives credit for three types of tests that can be used to detect abnormal glucose metabolism: HbA1c, oral glucose tolerance, and fasting plasma glucose. When considering which plasma glucose screening codes to include in the measure, the measure development team carefully considered two potential unintended consequences related to the limited use of accompanying fasting status codes. If the measure specified plasma glucose screening too narrowly, it could incentivize over screening, which would impose added burden on clinicians and increased costs to some patients. Alternatively, if the measure specified plasma glucose screening too broadly, it could give credit for non-fasting plasma glucose tests that are not adequate for diagnostic purposes.</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n\n<td class=\"content-container\"><div><p>The U.S. Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions (B recommendation) (USPSTF, 2021).</p>\n<p>Evidence on the optimal screening interval for adults with an initial normal glucose test result is limited. Cohort and modeling studies suggest that screening every 3 years may be a reasonable approach for adults with normal blood glucose levels (USPSTF, 2021).</p>\n<p>Prediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test. A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour post-load glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes (USPSTF, 2021).</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>Centers for Disease Control and Prevention. (2024, July 23). National Diabetes Statistics Report. Retrieved November 15, 2024, from Diabetes website: https://www.cdc.gov/diabetes/php/data-research/</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <div><p>U.S. Preventive Services Task Force. (2021). Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. JAMA, 326(8), 736--743. https://doi.org/10.1001/jama.2021.12531</p>\n</div>\n    \n    \n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n\n<td class=\"content-container\">The measure is limited to patients aged 35 to 70 with overweight or obesity because it is recommended that all patients with those risk factors be screened for diabetes at least once every three years. However, this measure is not intended to discourage screening at younger ages, which the USPSTF recommends considering for adults with overweight or obesity and any of the following risk factors:\n\n* Race/ethnicity with disproportionately high incidence and prevalence of diabetes (American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons)\n* Family history of diabetes\n* History of gestational diabetes\n* History of polycystic ovarian syndrome\n\nIt is recommended that every patient evaluated by this measure also identify payer, race, ethnicity, and sex.\n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1154v1. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n</td>\n\n\n</tr>\n\n\n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n\n<td class=\"content-container\">boolean</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n\n<td class=\"content-container\">\n    Proportion\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n\n<td class=\"content-container\">\n    Increased score indicates improvement\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    Process\n\n\n</td>\n\n\n</tr>\n\n\n\n\n  \n  \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: InitialPopulation_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">All patients with at least two outpatient clinical encounters or one preventive clinical encounter during the measurement period who have the following risk factors for type 2 diabetes:\n\n* Most recent BMI ≥25 kg/m2 (BMI ≥23 kg/m2 for Asian patients) during measurement period, AND\n* Age 35-70 at start of measurement period.\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-InitialPopulation_1\">Initial Population</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Denominator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">All patients in the initial population.\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-Denominator_1\">Denominator</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exclusion</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorExclusion_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">* Patient's pregnancy overlaps measurement period.\n* Patient with diagnosis of advanced illness or limited life expectancy overlaps measurement period.\n* Patient with diagnosis of diabetes overlaps 2-year look-back period.\n* Patient with diagnosis of prediabetes overlaps 2-year look-back period.\n* Patient with glycemic screening performed during 2-year look-back period.\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-DenominatorExclusion_1\">Denominator Exclusions</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n    \n\n    \n      \n        \n  \n    \n    \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Numerator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\">Patients who had a glycemic screening test performed during the measurement period.\n</p>\n        \n        \n          \n            \n              \n              <em>Criteria</em>: <a href=\"#Group_1-Numerator_1\">Numerator</a> \n            \n          \n          \n        \n        \n        \n      </td>\n    </tr>\n  \n\n      \n    \n\n    \n      \n    \n\n  \n\n\n  \n\n\n\n\n\n\n\n  \n    \n    \n    \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\"/>\n\n\n\n<td class=\"content-container\">&lt;p&gt;For every patient evaluated by this measure also identify payer, race, ethnicity and sex.&lt;/p&gt;</td>\n\n\n</tr>\n\n  \n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-ethnicity\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Ethnicity\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms1154screeningprediabetesfhir-sde-ethnicity\">SDE Ethnicity</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-payer\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Payer\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms1154screeningprediabetesfhir-sde-payer\">SDE Payer</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-race\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Race\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms1154screeningprediabetesfhir-sde-race\">SDE Race</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-sex\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Sex\n\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#cms1154screeningprediabetesfhir-sde-sex\">SDE Sex</a> \n        \n      \n    \n  </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n\n<td class=\"content-container\"><code>https://madie.cms.gov/Library/CMS1154ScreeningPrediabetesFHIR</code></td>\n\n\n</tr>\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Contents</th>\n  <td class=\"content-container\">\n    <em><a href=\"#population-criteria\">Population Criteria</a></em>\n    <br/>\n    <em><a href=\"#definitions\">Logic Definitions</a></em>\n    <br/>\n    <em><a href=\"#terminology\">Terminology</a></em>\n    <br/>\n    <em><a href=\"#dependencies\">Dependencies</a></em>\n    <br/>\n    <em><a href=\"#data-requirements\">Data Requirements</a></em>\n    <br/>\n    <em><a href=\"#parameters\">Parameters</a></em>\n    <br/>\n  </td>\n</tr>\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n  \n  \n  \n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Initial Population\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-InitialPopulation_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  &quot;Patients Aged 35 to 70 with an Office Visit During the Measurement Period&quot;\n    and ( &quot;Most Recent BMI Equal to or Greater Than 25 and Is Not Asian&quot;\n        or &quot;Most Recent BMI Equal to or Greater Than 23 and Is Asian&quot;\n    )</code></pre>\n    \n      \n      <a href=\"#cms1154screeningprediabetesfhir-initial-population\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Denominator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-Denominator_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n    \n      \n      <a href=\"#cms1154screeningprediabetesfhir-denominator\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Denominator Exclusion\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-DenominatorExclusion_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  &quot;Has Pregnancy Observation During Measurement Period&quot;\n    or exists &quot;Has Pregnancy Diagnosis During Measurement Period&quot;\n    or exists &quot;Has Advanced Illness or Limited Life Expectancy&quot;\n    or exists &quot;Diabetes Diagnosis Overlaps 2 Year Look Back Period&quot;\n    or exists &quot;Prediabetes Diagnosis Overlaps 2 Year Look Back Period&quot;\n    or &quot;Has Glycemic Laboratory Test Performed During 2 Year Look Back Period&quot;</code></pre>\n    \n      \n      <a href=\"#cms1154screeningprediabetesfhir-denominator-exclusions\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n    \n\n    \n      \n          \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n    Numerator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      \n      <a name=\"Group_1-Numerator_1\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  exists &quot;Glycemic Laboratory Test Performed During Measurement Period&quot;</code></pre>\n    \n      \n      <a href=\"#cms1154screeningprediabetesfhir-numerator\"><em>Definition</em></a>\n    \n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n      \n    \n\n    \n      \n    \n\n  \n\n\n  \n\n\n  \n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n  \n  \n          \n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n    when Patient.sex() = '248153007' then &quot;Male (finding)&quot;\n    when Patient.sex() = '248152002' then &quot;Female (finding)&quot;\n    else null\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  [USQualityCore.Coverage: type in &quot;Payer Type&quot;] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cqmcommon-todateinterval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval of date values extracted from the input interval of date-time values\n@comment: This function returns an interval constructed using the `date from` extractor on the start\nand end values of the input date-time interval. Note that using a precision specifier such as `day of`\nas part of a timing phrase is preferred to communicate intent to perform day-level comparison, as well\nas for general readability.\n*/\ndefine function &quot;ToDateInterval&quot;(period Interval&lt;DateTime&gt;):\n  Interval[date from start of period, date from end of period]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-ext\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n  singleton from domainResource.exts(url)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-exts\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n  domainResource.extension E\n    where E.url = url\n    return E</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):\n  case\n    when choice is FHIR.dateTime then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n    when choice is FHIR.Period then\n      FHIRHelpers.ToInterval(choice as FHIR.Period)\n    when choice is FHIR.instant then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n    when choice is FHIR.Age then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n    when choice is FHIR.Range then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n    when choice is FHIR.Timing then\n      Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n    when choice is FHIR.string then\n      Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n    else\n      null as Interval&lt;DateTime&gt;\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-exts\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n  element.extension E\n    where E.url = url\n    return E</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhircommon-ext\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n  singleton from element.exts(url)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function race(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n    return {\n      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> USCoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"uscorecommon-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function ethnicity(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n    return {\n      ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value string): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.&quot;start&quot; is null then\n            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]\n        else\n            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ObservationStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value EncounterStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todate\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDate(value date): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toquantity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocalendarunit\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value dateTime): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value instant): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocode\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toconcept\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-glycemic-laboratory-test-performed-during-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Glycemic Laboratory Test Performed During Measurement Period&quot;:\n  [LaboratoryResultObservation: &quot;Glycemic Screening Tests&quot;] LabTestPerformed\n    where CQMCommon.ToDateInterval ( LabTestPerformed.effective ) during day of &quot;Measurement Period&quot;\n      and LabTestPerformed.status in { 'final', 'amended', 'corrected' }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-numerator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  exists &quot;Glycemic Laboratory Test Performed During Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-preventive-care-outpatient-visits-during-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Preventive Care Outpatient Visits During Measurement Period&quot;:\n  [Encounter: &quot;Preventative Clinical Encounters&quot;] PreventiveCare\n    where PreventiveCare.period ends during day of &quot;Measurement Period&quot;\n      and PreventiveCare.status = 'finished'</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-office-visit-during-the-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Office Visit During the Measurement Period&quot;:\n  [Encounter: &quot;Outpatient Clinical Encounters&quot;] OfficeVisit\n    where OfficeVisit.period during day of &quot;Measurement Period&quot;\n      and OfficeVisit.status = 'finished'</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-aged-35-to-70-at-start-of-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Aged 35 to 70 at Start of Measurement Period&quot;:\n  &quot;AgeInYearsAt&quot;(date from start of &quot;Measurement Period&quot;) between 35 and 70</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-patients-aged-35-to-70-with-an-office-visit-during-the-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patients Aged 35 to 70 with an Office Visit During the Measurement Period&quot;:\n  ( exists ( &quot;Preventive Care Outpatient Visits During Measurement Period&quot; )\n      or Count(&quot;Office Visit During the Measurement Period&quot;) &gt;= 2\n  )\n    and &quot;Aged 35 to 70 at Start of Measurement Period&quot; is true</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-most-recent-bmi\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent BMI&quot;:\n  First([USCore.BMIProfile] BMI\n      where BMI.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval() desc\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-patient-is-asian\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient is Asian&quot;:\n  exists ( SDE.&quot;SDE Race&quot;.codes C\n      where C ~ &quot;Asian&quot;\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-patient-is-not-asian\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Patient is not Asian&quot;:\n  not ( &quot;Patient is Asian&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-most-recent-bmi-equal-to-or-greater-than-25-and-is-not-asian\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent BMI Equal to or Greater Than 25 and Is Not Asian&quot;:\n  &quot;Most Recent BMI&quot;.value &gt;= 25 'kg/m2'\n    and &quot;Patient is not Asian&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-most-recent-bmi-equal-to-or-greater-than-23-and-is-asian\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Most Recent BMI Equal to or Greater Than 23 and Is Asian&quot;:\n  &quot;Most Recent BMI&quot;.value &gt;= 23 'kg/m2'\n    and &quot;Patient is Asian&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-initial-population\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  &quot;Patients Aged 35 to 70 with an Office Visit During the Measurement Period&quot;\n    and ( &quot;Most Recent BMI Equal to or Greater Than 25 and Is Not Asian&quot;\n        or &quot;Most Recent BMI Equal to or Greater Than 23 and Is Asian&quot;\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-denominator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-has-pregnancy-observation-during-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Pregnancy Observation During Measurement Period&quot;:\n  exists ( [USCore.ObservationPregnancyStatusProfile] PregnantObservation\n      where PregnantObservation.value in &quot;Pregnancy&quot;\n        and PregnantObservation.effective.toInterval ( ) overlaps day of &quot;Measurement Period&quot;\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-has-pregnancy-diagnosis-during-measurement-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Pregnancy Diagnosis During Measurement Period&quot;:\n  ( ( [ConditionProblemsHealthConcerns: &quot;Pregnancy&quot;]\n      union [ConditionEncounterDiagnosis: &quot;Pregnancy&quot;]\n  ).verified ( ) ) PregnancyDx\n    where PregnancyDx.onset.toInterval ( ) overlaps day of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-has-advanced-illness-or-limited-life-expectancy\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Advanced Illness or Limited Life Expectancy&quot;:\n  ( ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Advanced Illness&quot;]\n      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Advanced Illness&quot;]\n      union [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Limited Life Expectancy&quot;]\n      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Limited Life Expectancy&quot;]\n  ).verified ( ) ) AdvancedIllness\n    where &quot;AdvancedIllness&quot;.onset before day of end of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-look-back-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Look Back Period&quot;:\n  Interval[start of &quot;Measurement Period&quot; - 2 years, start of &quot;Measurement Period&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-diabetes-diagnosis-overlaps-2-year-look-back-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Diabetes Diagnosis Overlaps 2 Year Look Back Period&quot;:\n  ( ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Diabetes&quot;]\n      union [ConditionEncounterDiagnosis: &quot;Diabetes&quot;]\n  ).verified ( ) ) PriorDiabetes\n    where &quot;PriorDiabetes&quot;.onset.toInterval ( ) overlaps day of &quot;Look Back Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-prediabetes-diagnosis-overlaps-2-year-look-back-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Prediabetes Diagnosis Overlaps 2 Year Look Back Period&quot;:\n  ( ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Prediabetes (Borderline Diabetes)&quot;]\n      union [ConditionEncounterDiagnosis: &quot;Prediabetes (Borderline Diabetes)&quot;]\n  ).verified ( ) ) PriorPrediabetes\n    where &quot;PriorPrediabetes&quot;.onset.toInterval ( ) overlaps day of &quot;Look Back Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-has-glycemic-laboratory-test-performed-during-2-year-look-back-period\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Glycemic Laboratory Test Performed During 2 Year Look Back Period&quot;:\n  exists ( [LaboratoryResultObservation: &quot;Glycemic Screening Tests&quot;] LabTestPerformed\n      where CQMCommon.ToDateInterval ( LabTestPerformed.effective ) during day of &quot;Look Back Period&quot;\n        and LabTestPerformed.status in { 'final', 'amended', 'corrected' }\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-denominator-exclusions\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  &quot;Has Pregnancy Observation During Measurement Period&quot;\n    or exists &quot;Has Pregnancy Diagnosis During Measurement Period&quot;\n    or exists &quot;Has Advanced Illness or Limited Life Expectancy&quot;\n    or exists &quot;Diabetes Diagnosis Overlaps 2 Year Look Back Period&quot;\n    or exists &quot;Prediabetes Diagnosis Overlaps 2 Year Look Back Period&quot;\n    or &quot;Has Glycemic Laboratory Test Performed During 2 Year Look Back Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS1154ScreeningPrediabetesFHIR</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"cms1154screeningprediabetesfhir-verified\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define fluent function verified(conditions List&lt;Choice&lt;ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis&gt;&gt;):\n  conditions C\n    where C.verificationStatus is not null implies ( C.verificationStatus ~ &quot;confirmed&quot;\n        or C.verificationStatus ~ &quot;unconfirmed&quot;\n        or C.verificationStatus ~ &quot;provisional&quot;\n        or C.verificationStatus ~ &quot;differential&quot;\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n  \n  \n  \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system SNOMEDCT\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/R4/codesystem-snomedct.html\">SNOMED CT (all versions)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system CDCREC\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-CDCREC.html\">CDC Race and Ethnicity</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>urn:oid:2.16.840.1.113883.6.238</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system ConditionVerificationStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-condition-ver-status.html\">ConditionVerificationStatus</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Glycemic Screening Tests\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.5/expansion\">Glycemic Screening Tests</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.5</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Preventative Clinical Encounters\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.13/expansion\">Preventative Care Encounter to Screen for for Diabetes</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Outpatient Clinical Encounters\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.24/expansion\">Office Visit Encounter to Screen for Diabetes</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Payer Type\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Pregnancy\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Advanced Illness\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion\">Advanced Illness</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Limited Life Expectancy\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1259/expansion\">Limited Life Expectancy</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1259</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Diabetes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion\">Diabetes</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Prediabetes (Borderline Diabetes)\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1222.419/expansion\">Prediabetes (Borderline Diabetes)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1222.419</tt>\n    \n  </td>\n</tr>\n \n\n\n  \n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Male (finding)\n        <br/>\n      \n      <em>Code</em>: 248153007\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Female (finding)\n        <br/>\n      \n      <em>Code</em>: 248152002\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Asian\n        <br/>\n      \n      <em>Code</em>: 2028-9\n      <br/>\n      <em>System</em>: <tt>urn:oid:2.16.840.1.113883.6.238</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Confirmed\n        <br/>\n      \n      <em>Code</em>: confirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Unconfirmed\n        <br/>\n      \n      <em>Code</em>: unconfirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Provisional\n        <br/>\n      \n      <em>Code</em>: provisional\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Differential\n        <br/>\n      \n      <em>Code</em>: differential\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n  \n  \n  \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: USQualityCore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <code>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</code>\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: USCore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/us/cql/2026May/Library-USCore-ModelInfo.html\">http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: FHIR model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html\">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library SDE\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-SupplementalDataElements.html\">SupplementalDataElements</a> version: 6.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|6.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRHelpers\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html\">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library USCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/us/cql/2026May/Library-USCoreCommon.html\">http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRCommon.html\">http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library CQMCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-CQMCommon.html\">CQMCommon</a> version: 5.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/CQMCommon|5.1.000</tt>\n    \n  </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n  \n  \n\n\n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n  \n  \n  \n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: ombCategory, detailed, text\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-lab</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, effective, effective.low, effective.lowClosed, effective.high, effective.highClosed, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.5/expansion\">Glycemic Screening Tests</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.13/expansion\">Preventative Care Encounter to Screen for for Diabetes</a>\n    <br/> \n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Path</em>: status</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      [not stated]: finished (finished)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1160.24/expansion\">Office Visit Encounter to Screen for Diabetes</a>\n    <br/> \n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Path</em>: status</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      [not stated]: finished (finished)\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: birthDate\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-bmi.html\">US Core BMI Profile</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: status, value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Coverage\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-observation-pregnancystatus.html\">US Core Observation Pregnancy Status Profile</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: value, effective\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: value</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion\">Advanced Illness</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1259/expansion\">Limited Life Expectancy</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion\">Diabetes</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1222.419/expansion\">Prediabetes (Borderline Diabetes)</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion\">Pregnancy</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion\">Advanced Illness</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1259/expansion\">Limited Life Expectancy</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion\">Diabetes</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis</code>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1222.419/expansion\">Prediabetes (Borderline Diabetes)</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n  \n  \n  <tr>\n  \n\n<th scope=\"row\" class=\"row-header\"/>\n\n\n  <td class=\"content-container\">\n    <table>\n      <thead>\n        <tr>\n          <td><em>Name</em></td>\n          <td><em>Use</em></td>\n          <td><em>Card.</em></td>\n          <td><em>Type</em></td>\n          <td><em>Documentation</em></td>\n        </tr>\n      </thead>\n      <tbody>\n      \n        <tr>\n          <td>Measurement Period</td>\n          <td>In</td>\n          <td>0..1</td>\n          <td>Period</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Sex</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Coding</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Numerator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Payer</td>\n          <td>Out</td>\n          <td>0..*</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Initial Population</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Ethnicity</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator Exclusions</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Race</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n      </tbody>\n    </table>\n  </td>\n</tr>\n\n  \n  \n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248153007",
            "display" : "Male (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248152002",
            "display" : "Female (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "urn:oid:2.16.840.1.113883.6.238",
            "code" : "2028-9",
            "display" : "Asian"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "confirmed",
            "display" : "Confirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "unconfirmed",
            "display" : "Unconfirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "provisional",
            "display" : "Provisional"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "differential",
            "display" : "Differential"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.sex() = '248153007' then \"Male (finding)\"\n    when Patient.sex() = '248152002' then \"Female (finding)\"\n    else null\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  SDE.\"SDE Sex\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Glycemic Laboratory Test Performed During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Glycemic Laboratory Test Performed During Measurement Period\":\n  [LaboratoryResultObservation: \"Glycemic Screening Tests\"] LabTestPerformed\n    where CQMCommon.ToDateInterval ( LabTestPerformed.effective ) during day of \"Measurement Period\"\n      and LabTestPerformed.status in { 'final', 'amended', 'corrected' }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Numerator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator\":\n  exists \"Glycemic Laboratory Test Performed During Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Preventive Care Outpatient Visits During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Preventive Care Outpatient Visits During Measurement Period\":\n  [Encounter: \"Preventative Clinical Encounters\"] PreventiveCare\n    where PreventiveCare.period ends during day of \"Measurement Period\"\n      and PreventiveCare.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Office Visit During the Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Office Visit During the Measurement Period\":\n  [Encounter: \"Outpatient Clinical Encounters\"] OfficeVisit\n    where OfficeVisit.period during day of \"Measurement Period\"\n      and OfficeVisit.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Aged 35 to 70 at Start of Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Aged 35 to 70 at Start of Measurement Period\":\n  \"AgeInYearsAt\"(date from start of \"Measurement Period\") between 35 and 70"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Patients Aged 35 to 70 with an Office Visit During the Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Patients Aged 35 to 70 with an Office Visit During the Measurement Period\":\n  ( exists ( \"Preventive Care Outpatient Visits During Measurement Period\" )\n      or Count(\"Office Visit During the Measurement Period\") >= 2\n  )\n    and \"Aged 35 to 70 at Start of Measurement Period\" is true"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Most Recent BMI"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Most Recent BMI\":\n  First([USCore.BMIProfile] BMI\n      where BMI.status in { 'final', 'amended', 'corrected' }\n      sort by start of effective.toInterval() desc\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  (Patient.race()) R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Patient is Asian"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Patient is Asian\":\n  exists ( SDE.\"SDE Race\".codes C\n      where C ~ \"Asian\"\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Patient is not Asian"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Patient is not Asian\":\n  not ( \"Patient is Asian\" )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 11
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Most Recent BMI Equal to or Greater Than 25 and Is Not Asian"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Most Recent BMI Equal to or Greater Than 25 and Is Not Asian\":\n  \"Most Recent BMI\".value >= 25 'kg/m2'\n    and \"Patient is not Asian\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 12
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Most Recent BMI Equal to or Greater Than 23 and Is Asian"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Most Recent BMI Equal to or Greater Than 23 and Is Asian\":\n  \"Most Recent BMI\".value >= 23 'kg/m2'\n    and \"Patient is Asian\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 13
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\":\n  \"Patients Aged 35 to 70 with an Office Visit During the Measurement Period\"\n    and ( \"Most Recent BMI Equal to or Greater Than 25 and Is Not Asian\"\n        or \"Most Recent BMI Equal to or Greater Than 23 and Is Asian\"\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 14
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Denominator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator\":\n  \"Initial Population\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 15
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  [USQualityCore.Coverage: type in \"Payer Type\"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 16
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 17
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  (Patient.ethnicity()) E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 18
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 19
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Has Pregnancy Observation During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Pregnancy Observation During Measurement Period\":\n  exists ( [USCore.ObservationPregnancyStatusProfile] PregnantObservation\n      where PregnantObservation.value in \"Pregnancy\"\n        and PregnantObservation.effective.toInterval ( ) overlaps day of \"Measurement Period\"\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 20
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Has Pregnancy Diagnosis During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Pregnancy Diagnosis During Measurement Period\":\n  ( ( [ConditionProblemsHealthConcerns: \"Pregnancy\"]\n      union [ConditionEncounterDiagnosis: \"Pregnancy\"]\n  ).verified ( ) ) PregnancyDx\n    where PregnancyDx.onset.toInterval ( ) overlaps day of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 21
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Has Advanced Illness or Limited Life Expectancy"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Advanced Illness or Limited Life Expectancy\":\n  ( ( [\"ConditionProblemsHealthConcerns\": \"Advanced Illness\"]\n      union [\"ConditionEncounterDiagnosis\": \"Advanced Illness\"]\n      union [\"ConditionProblemsHealthConcerns\": \"Limited Life Expectancy\"]\n      union [\"ConditionEncounterDiagnosis\": \"Limited Life Expectancy\"]\n  ).verified ( ) ) AdvancedIllness\n    where \"AdvancedIllness\".onset before day of end of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 22
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Look Back Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Look Back Period\":\n  Interval[start of \"Measurement Period\" - 2 years, start of \"Measurement Period\" )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 23
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Diabetes Diagnosis Overlaps 2 Year Look Back Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Diabetes Diagnosis Overlaps 2 Year Look Back Period\":\n  ( ( [\"ConditionProblemsHealthConcerns\": \"Diabetes\"]\n      union [ConditionEncounterDiagnosis: \"Diabetes\"]\n  ).verified ( ) ) PriorDiabetes\n    where \"PriorDiabetes\".onset.toInterval ( ) overlaps day of \"Look Back Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 24
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Prediabetes Diagnosis Overlaps 2 Year Look Back Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Prediabetes Diagnosis Overlaps 2 Year Look Back Period\":\n  ( ( [\"ConditionProblemsHealthConcerns\": \"Prediabetes (Borderline Diabetes)\"]\n      union [ConditionEncounterDiagnosis: \"Prediabetes (Borderline Diabetes)\"]\n  ).verified ( ) ) PriorPrediabetes\n    where \"PriorPrediabetes\".onset.toInterval ( ) overlaps day of \"Look Back Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 25
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Has Glycemic Laboratory Test Performed During 2 Year Look Back Period"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Glycemic Laboratory Test Performed During 2 Year Look Back Period\":\n  exists ( [LaboratoryResultObservation: \"Glycemic Screening Tests\"] LabTestPerformed\n      where CQMCommon.ToDateInterval ( LabTestPerformed.effective ) during day of \"Look Back Period\"\n        and LabTestPerformed.status in { 'final', 'amended', 'corrected' }\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 26
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exclusions"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exclusions\":\n  \"Has Pregnancy Observation During Measurement Period\"\n    or exists \"Has Pregnancy Diagnosis During Measurement Period\"\n    or exists \"Has Advanced Illness or Limited Life Expectancy\"\n    or exists \"Diabetes Diagnosis Overlaps 2 Year Look Back Period\"\n    or exists \"Prediabetes Diagnosis Overlaps 2 Year Look Back Period\"\n    or \"Has Glycemic Laboratory Test Performed During 2 Year Look Back Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 27
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS1154ScreeningPrediabetesFHIR"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 28
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value string): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 29
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "USCoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "sex"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the sex element as defined for the USCore patient profile\n*/\ndefine fluent function sex(patient Patient):\n  patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 30
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRCommon"
            },
            {
              "url" : "name",
              "valueString" : "ext"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the single extension (if present) on the given resource with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine fluent function ext(domainResource DomainResource, url String):\n  singleton from domainResource.exts(url)"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 31
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRCommon"
            },
            {
              "url" : "name",
              "valueString" : "exts"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns any extensions defined on the given resource with the specified url\n*/\ndefine fluent function exts(domainResource DomainResource, url String):\n  domainResource.extension E\n    where E.url = url\n    return E"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 32
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value uri): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 33
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "ToDateInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns an interval of date values extracted from the input interval of date-time values\n@comment: This function returns an interval constructed using the `date from` extractor on the start\nand end values of the input date-time interval. Note that using a precision specifier such as `day of`\nas part of a timing phrase is preferred to communicate intent to perform day-level comparison, as well\nas for general readability.\n*/\ndefine function \"ToDateInterval\"(period Interval<DateTime>):\n  Interval[date from start of period, date from end of period]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 34
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 35
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value ObservationStatus): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 36
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value EncounterStatus): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 37
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToDate"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToDate(value date): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 38
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToQuantity"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n    end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 39
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToCalendarUnit"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 40
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRCommon"
            },
            {
              "url" : "name",
              "valueString" : "toInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in FHIR, allowing this function to be used across any resource.\n\nThe input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.\nIf the input is a Period, the result is a DateTime Interval.\nIf the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.\nIf the input is an instant, the result is a DateTime Interval beginning and ending on that instant.\nIf the input is a string, an error is raised indicating a single interval cannot be computed from a string.\nIf the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,\nand ending immediately prior to when the patient was the given Age plus one year.\nIf the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given\nby the low end of the Range, and ending immediately prior to when the patient was the Age given by the\nhigh end of the Range plus one year.\n\nNOTE: Due to the\ncomplexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used\nwith a Timing or String.\n*/\ndefine fluent function toInterval(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n  case\n    when choice is FHIR.dateTime then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n    when choice is FHIR.Period then\n      FHIRHelpers.ToInterval(choice as FHIR.Period)\n    when choice is FHIR.instant then\n      Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n    when choice is FHIR.Age then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n    when choice is FHIR.Range then\n      Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n        FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n    when choice is FHIR.Timing then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')\n    when choice is FHIR.string then\n      Message(null as Interval<DateTime>, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')\n    else\n      null as Interval<DateTime>\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 41
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToDateTime"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToDateTime(value dateTime): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 42
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToDateTime"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToDateTime(value instant): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 43
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "USCoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "race"
            },
            {
              "url" : "statement",
              "valueString" : "define fluent function race(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E\n    return {\n      ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 44
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRCommon"
            },
            {
              "url" : "name",
              "valueString" : "exts"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns any extensions defined on the given element with the specified url.\n*/\ndefine fluent function exts(element Element, url String):\n  element.extension E\n    where E.url = url\n    return E"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 45
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRCommon"
            },
            {
              "url" : "name",
              "valueString" : "ext"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the single extension (if present) on the given element with the specified url.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given element with the specified url.\n*/\ndefine fluent function ext(element Element, url String):\n  singleton from element.exts(url)"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 46
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToCode"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 47
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "USCoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define fluent function ethnicity(patient Patient):\n  (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E\n    return {\n      ombCategory: E.ext('ombCategory').value as FHIR.Coding,\n      detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,\n      text: E.ext('text').value as FHIR.string\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 48
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToConcept"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
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            {
              "url" : "displaySequence",
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        },
        {
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            },
            {
              "url" : "name",
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            },
            {
              "url" : "statement",
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        },
        {
          "type" : "depends-on",
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          "resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Glycemic Screening Tests",
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Preventative Clinical Encounters",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.13"
        },
        {
          "type" : "depends-on",
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          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1160.24"
        },
        {
          "type" : "depends-on",
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        },
        {
          "type" : "depends-on",
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        },
        {
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          "display" : "Value set Advanced Illness",
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        {
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        },
        {
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        },
        {
          "type" : "depends-on",
          "display" : "Value set Prediabetes (Borderline Diabetes)",
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        }
      ],
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        {
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            {
              "path" : "status",
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          "mustSupport" : [
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        },
        {
          "type" : "Coverage",
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        {
          "type" : "Observation",
          "profile" : [
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          "mustSupport" : [
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          "codeFilter" : [
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        },
        {
          "type" : "Condition",
          "profile" : [
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        },
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        },
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        },
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          ]
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      ]
    }
  ],
  "extension" : [
    {
      "id" : "supplementalDataGuidance",
      "extension" : [
        {
          "url" : "guidance",
          "valueString" : "<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex.</p>"
        },
        {
          "url" : "usage",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                "code" : "supplemental-data",
                "display" : "Supplemental Data"
              }
            ],
            "text" : "Supplemental Data Guidance"
          }
        }
      ],
      "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance"
    },
    {
      "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference" : {
        "reference" : "Device/cqf-tooling"
      }
    },
    {
      "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical" : "#effective-data-requirements"
    }
  ],
  "url" : "https://madie.cms.gov/Measure/CMS1154ScreeningPrediabetesFHIR",
  "identifier" : [
    {
      "use" : "usual",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "short-name",
            "display" : "Short Name"
          }
        ]
      },
      "system" : "https://madie.cms.gov/measure/shortName",
      "value" : "CMS1154FHIR"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "version-independent",
            "display" : "Version Independent"
          }
        ]
      },
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:uuid:d5fabe20-5aaa-4dea-bfb4-2fde59ea40d6"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "version-specific",
            "display" : "Version Specific"
          }
        ]
      },
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:uuid:c116e4ae-6daf-49b2-b415-dd229215c674"
    },
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
            "code" : "publisher",
            "display" : "Publisher"
          }
        ]
      },
      "system" : "https://madie.cms.gov/measure/cmsId",
      "value" : "1154FHIR",
      "assigner" : {
        "display" : "CMS"
      }
    }
  ],
  "version" : "1.0.000",
  "name" : "CMS1154ScreeningPrediabetesFHIR",
  "title" : "Screening for Abnormal Glucose Metabolism in Patients at Risk of Developing DiabetesFHIR\n",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-01-16T18:18:12+00:00",
  "publisher" : "American Medical Association (AMA)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.ama-assn.org/"
        }
      ]
    }
  ],
  "description" : "Percentage of adult patients with risk factors for type 2 diabetes who are due for glycemic screening for whom the screening process was completed during the measurement period.\n",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "venue",
        "display" : "Venue"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/cqfmeasures/CodeSystem/intended-venue-codes",
            "code" : "ec",
            "display" : "EC"
          }
        ]
      }
    }
  ],
  "usage" : "The measure is limited to patients aged 35 to 70 with overweight or obesity because it is recommended that all patients with those risk factors be screened for diabetes at least once every three years. However, this measure is not intended to discourage screening at younger ages, which the USPSTF recommends considering for adults with overweight or obesity and any of the following risk factors:\n\n* Race/ethnicity with disproportionately high incidence and prevalence of diabetes (American Indian/Alaska Native, Asian American, Black, Hispanic/Latino, or Native Hawaiian/Pacific Islander persons)\n* Family history of diabetes\n* History of gestational diabetes\n* History of polycystic ovarian syndrome\n\nIt is recommended that every patient evaluated by this measure also identify payer, race, ethnicity, and sex.\n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS1154v1. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).\n",
  "copyright" : "Prediabetes Quality Measures (C) 2018-2025. American Medical Association. All rights reserved.\n\nCPT (R) 2025 American Medical Association (\"AMA\"). All rights reserved. You cannot, without express written permission from the AMA, copy, modify, distribute, display, or use CPT for any commercial purpose, including for productive use in a clinical setting. Any such use requires a separate license from the AMA.\n\nYou agree that you shall not remove, obscure, or alter any proprietary rights notices (including copyright and trademark notices) which may be affixed to or contained within the measure.\n\nCurrent Procedural Terminology (CPT \\[R\\] code(s) (\"CPT Codes\") information provided in the Measures is intended for reference and informational purposes only. Decisions regarding which CPT Code is appropriate must be made by physicians and/or their staff considering the clinical facts, circumstances, applicable coding and published AMA coding guideline and payor policies. The AMA does not dictate payer reimbursement policy and does not substitute for the professional judgment of the practitioner performing a procedure, who remains responsible for correct coding. The AMA is not engaged in the practice of medicine or dispensing medical services. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of the CPT code set, and the AMA is not recommending their use.\n\nInformation contained in the measure includes information protected by intellectual property rights which are owned by the AMA. The Measures may also contain proprietary code sets not owned by the AMA. The AMA disclaims all liability for the use or accuracy of any such information. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. LOINC \\[R\\] copyright 2004-2025 Regenstrief Institute, Inc., SNOMED CLINICAL TERMS (SNOMED CT\\[R\\]) copyright 2004-2025, The International Health Information Standards Development Organisation (IHTSDO). ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.\n",
  "effectivePeriod" : {
    "start" : "2026-01-01",
    "end" : "2026-12-31"
  },
  "author" : [
    {
      "name" : "American Medical Association (AMA)",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.ama-assn.org/"
        }
      ]
    },
    {
      "name" : "Health Services Advisory Group",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.hsag.com/en/"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "citation",
      "citation" : "Centers for Disease Control and Prevention. (2024, July 23). National Diabetes Statistics Report. Retrieved November 15, 2024, from Diabetes website: https://www.cdc.gov/diabetes/php/data-research/\n"
    },
    {
      "type" : "citation",
      "citation" : "U.S. Preventive Services Task Force. (2021). Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement. JAMA, 326(8), 736--743. https://doi.org/10.1001/jama.2021.12531\n"
    }
  ],
  "library" : [
    "https://madie.cms.gov/Library/CMS1154ScreeningPrediabetesFHIR"
  ],
  "disclaimer" : "The Prediabetes Quality Measure set descriptions and specifications (collectively, \"Measures\") are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures are not intended to diagnose or treat disease or other conditions. The Measures are not a medical device and have not been evaluated by the Food and Drug Administration. Information provided through the Measures is not intended to direct or substitute for the independent assessment or judgment of a qualified healthcare professional. The American Medical Association (\"AMA\") assumes no liability for use of the Measures, or data contained or not contained in the Measures.\n\nThe AMA consents to the use, reproduction and distribution of the Measures for non-commercial purposes only (e.g., for use by health care providers in a professional setting). You cannot, without the express written consent of the AMA, use the Measures for any commercial purpose. Unauthorized commercial use of the Measures is expressly prohibited. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed, or distributed for commercial gain. These requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.\n\nTo request to make a commercial use of the Measures, please email: AMA.IHO.QualityMeasures@ama-assn.org. Any commercial use of the Measures requires a separate license from the AMA.\n\nAny use, publication or other dissemination of these Measures shall include the following attribution:\n\n\"This \\[publication, etc.\\] was prepared using clinical quality measures developed by the American Medical Association. The content reflects the views of \\[name of author(s)\\].\"\n\nUSE OF THE MEASURES (INCLUDING ANY CPT CODES) IS AT YOUR SOLE RISK. THE MEASURES ARE PROVIDED \"AS IS\" WITHOUT EXPRESS OR IMPLIED WARRANTIES OF ANY KIND, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NONINFRINGEMENT. AMA EXPRESSLY DISCLAIMS ANY AND ALL RESPONSIBILITY OR LIABILITY FOR DAMAGES OF ANY KIND ARISING OUT OF USE, REFERENCE TO, OR RELIANCE ON THE MEAUSURES.\n\nThese requirements apply to both you as an individual and to the corporate entity that you represent as an employee or agent, to the extent applicable.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\] and unregistered trademarks are indicated by (TM) or \\[TM\\].\n",
  "rationale" : "This measure is critical to identifying patients with prediabetes who may benefit from interventions to prevent type 2 diabetes and identification of undiagnosed type 2 diabetes. The Centers for Disease Control and Prevention (CDC) estimates that approximately 97.6 million American adults have prediabetes (CDC, 2024). They note that more than 80% of adults with prediabetes are not aware that they have the condition. Regular screening for prediabetes is a critical first step to helping patients avoid the disability and costs associated with progression to type 2 diabetes.\n\nThe measure gives credit for three types of tests that can be used to detect abnormal glucose metabolism: HbA1c, oral glucose tolerance, and fasting plasma glucose. When considering which plasma glucose screening codes to include in the measure, the measure development team carefully considered two potential unintended consequences related to the limited use of accompanying fasting status codes. If the measure specified plasma glucose screening too narrowly, it could incentivize over screening, which would impose added burden on clinicians and increased costs to some patients. Alternatively, if the measure specified plasma glucose screening too broadly, it could give credit for non-fasting plasma glucose tests that are not adequate for diagnostic purposes.\n",
  "clinicalRecommendationStatement" : "The U.S. Preventive Services Task Force (USPSTF) recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity. Clinicians should offer or refer patients with prediabetes to effective preventive interventions (B recommendation) (USPSTF, 2021).\n\nEvidence on the optimal screening interval for adults with an initial normal glucose test result is limited. Cohort and modeling studies suggest that screening every 3 years may be a reasonable approach for adults with normal blood glucose levels (USPSTF, 2021).\n\nPrediabetes and type 2 diabetes can be detected by measuring fasting plasma glucose or HbA1c level, or with an oral glucose tolerance test. A fasting plasma glucose level of 126 mg/dL (6.99 mmol/L) or greater, an HbA1c level of 6.5% or greater, or a 2-hour post-load glucose level of 200 mg/dL (11.1 mmol/L) or greater are consistent with the diagnosis of type 2 diabetes. A fasting plasma glucose level of 100 to 125 mg/dL (5.55-6.94 mmol/L), an HbA1c level of 5.7% to 6.4%, or a 2-hour post-load glucose level of 140 to 199 mg/dL (7.77-11.04 mmol/L) are consistent with prediabetes (USPSTF, 2021).\n",
  "group" : [
    {
      "id" : "Group_1",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                "code" : "proportion",
                "display" : "Proportion"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
          "valueCode" : "boolean"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                "code" : "process",
                "display" : "Process"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                "code" : "increase",
                "display" : "Increased score indicates improvement"
              }
            ]
          }
        }
      ],
      "population" : [
        {
          "id" : "InitialPopulation_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "description" : "All patients with at least two outpatient clinical encounters or one preventive clinical encounter during the measurement period who have the following risk factors for type 2 diabetes:\n\n* Most recent BMI ≥25 kg/m2 (BMI ≥23 kg/m2 for Asian patients) during measurement period, AND\n* Age 35-70 at start of measurement period.\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "Denominator_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "description" : "All patients in the initial population.\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        },
        {
          "id" : "DenominatorExclusion_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exclusion",
                "display" : "Denominator Exclusion"
              }
            ]
          },
          "description" : "* Patient's pregnancy overlaps measurement period.\n* Patient with diagnosis of advanced illness or limited life expectancy overlaps measurement period.\n* Patient with diagnosis of diabetes overlaps 2-year look-back period.\n* Patient with diagnosis of prediabetes overlaps 2-year look-back period.\n* Patient with glycemic screening performed during 2-year look-back period.\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exclusions"
          }
        },
        {
          "id" : "Numerator_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "description" : "Patients who had a glycemic screening test performed during the measurement period.\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "individual"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "subject-list"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "summary"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "data-collection"
        }
      ],
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Ethnicity\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-payer",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "individual"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "subject-list"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "summary"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "data-collection"
        }
      ],
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Payer\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-race",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "individual"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "subject-list"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "summary"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "data-collection"
        }
      ],
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Race\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-sex",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "individual"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "subject-list"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "summary"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType",
          "valueCode" : "data-collection"
        }
      ],
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Sex\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}