{
  "resourceType" : "Measure",
  "id" : "CMS145FHIRCADBBlockerTPMIorLVSD",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm",
    "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b style=\"color: maroon\">Exception generating Narrative: Unable to Parse HTML - node 'td' has unexpected content '=' (last text = 'Moderate or Severe LVSD: LVEF \\' at line 394 column 63</b></p></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" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
        "code" : "confirmed"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
        "code" : "unconfirmed"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
        "code" : "provisional"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
        "code" : "differential"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "active"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "recurrence"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
        "code" : "relapse"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://snomed.info/sct",
        "code" : "134401001",
        "display" : "Left ventricular systolic dysfunction (disorder)"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://snomed.info/sct",
        "code" : "373254001",
        "display" : "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
        "code" : "active"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
        "code" : "confirmed"
      }
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
      "valueCoding" : {
        "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
        "code" : "unconfirmed"
      }
    },
    {
      "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" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "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" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Qualifying Encounter During Measurement Period"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Qualifying Encounter During Measurement Period\":\n  ( [Encounter: \"Office Visit\"]\n    union [Encounter: \"Outpatient Consultation\"]\n    union [Encounter: \"Nursing Facility Visit\"]\n    union [Encounter: \"Care Services in Long Term Residential Facility\"]\n    union [Encounter: \"Home Healthcare Services\"]\n    union [Encounter: \"Patient Provider Interaction\"] ) ValidEncounter\n    where ValidEncounter.period during day of \"Measurement Period\"\n      and ValidEncounter.status = 'finished'"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 2
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Outpatient Encounter During Measurement Period"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Outpatient Encounter During Measurement Period\":\n  ( [Encounter: \"Office Visit\"]\n    union [Encounter: \"Outpatient Consultation\"]\n    union [Encounter: \"Care Services in Long Term Residential Facility\"]\n    union [Encounter: \"Home Healthcare Services\"]\n    union [Encounter: \"Nursing Facility Visit\"] ) QualifyingEncounter\n    where QualifyingEncounter.period during day of \"Measurement Period\"\n      and QualifyingEncounter.status = 'finished'"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 3
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Coronary Artery Disease Encounter"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Coronary Artery Disease Encounter\":\n  \"Outpatient Encounter During Measurement Period\" ValidQualifyingEncounter\n    with ( [ConditionProblemsHealthConcerns: \"Coronary Artery Disease No MI\"]\n      union [ConditionEncounterDiagnosis: \"Coronary Artery Disease No MI\"] ) CoronaryArteryDisease\n      such that CoronaryArteryDisease.overlapsDayOfEncounter ( ValidQualifyingEncounter )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 4
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "History of Cardiac Surgery Prior to Encounter"
      },
      {
        "url" : "statement",
        "valueString" : "define \"History of Cardiac Surgery Prior to Encounter\":\n  \"Outpatient Encounter During Measurement Period\" ValidQualifyingEncounter\n    with [Procedure: \"Cardiac Surgery\"] CardiacSurgeryProcedure\n      such that CardiacSurgeryProcedure.performed.toInterval ( ) starts before end of ValidQualifyingEncounter.period\n        and CardiacSurgeryProcedure.status = 'completed'"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 5
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Qualifying CAD Encounter"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Qualifying CAD Encounter\":\n  \"Coronary Artery Disease Encounter\"\n    union \"History of Cardiac Surgery Prior to Encounter\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 6
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Initial Population"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Initial Population\":\n  AgeInYearsAt(date from start of \"Measurement Period\") >= 18\n    and exists ( \"Qualifying Encounter During Measurement Period\" Encounter1\n        with \"Qualifying Encounter During Measurement Period\" Encounter2\n          such that Encounter2.id !~ Encounter1.id\n    )\n    and exists \"Qualifying CAD Encounter\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 7
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "AHAOverall"
      },
      {
        "url" : "name",
        "valueString" : "Moderate or Severe LVSD Findings"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns a union  of the following:\n                * Observations where the final, amended or correction ejection fraction result is <= 40\n                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active\n*/\ndefine \"Moderate or Severe LVSD Findings\":\n  ( [ObservationClinicalResult: \"Ejection Fraction\"] EjectionFraction\n      where EjectionFraction.value as Quantity <= 40 '%'\n        and EjectionFraction.status in { 'final', 'amended', 'corrected' }\n  )\n    union ( ( ( [Condition: \"Moderate or Severe LVSD\"] )\n      union ( ( [Condition: \"Left ventricular systolic dysfunction (disorder)\"] ) LVSDDiagnosis\n        where LVSDDiagnosis.severity in \"Moderate or Severe\"\n      ) ) ModerateOrSevereLVSD\n      where ModerateOrSevereLVSD.isVerified ( )\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 8
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Qualifying CAD Encounter and Prior MI\":\n  \"Qualifying CAD Encounter\" EncounterWithCADProxy\n    with ( [FHIR.Condition: \"Myocardial Infarction\"] ) MyocardialInfarction\n      such that MyocardialInfarction.prevalenceInterval ( ) starts 3 years or less before day of start of EncounterWithCADProxy.period\n        and not exists AHA.\"Moderate or Severe LVSD Findings\"\n        and MyocardialInfarction.isVerified ( )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 9
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Denominator 2"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator 2\":\n  \"Initial Population\"\n    and exists \"Qualifying CAD Encounter and Prior MI\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 10
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  \"Qualifying CAD Encounter\" EncounterWithCADProxy\n    with AHA.\"Moderate or Severe LVSD Findings\" LVSDFindings\n      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of EncounterWithCADProxy.period"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 11
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Arrhythmia\"] ArrhythmiaDiagnosis\n      where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 12
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Asthma\"] AsthmaDiagnosis\n      where AsthmaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 13
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Bradycardia\"] BradycardiaDiagnosis\n      where BradycardiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 14
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Hypotension\"] HypotensionDiagnosis\n      where HypotensionDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 15
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate\n*/\n\n\ndefine \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( from\n      [\"HeartRateProfile\"] HeartRateExam,\n      \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n      let PriorHeartRateExam: Last([\"HeartRateProfile\"] MostRecentPriorHeartRateExam\n          where MostRecentPriorHeartRateExam.effective.toInterval() during CADEncounterModerateOrSevereLVSD.period\n            and MostRecentPriorHeartRateExam.status in { 'final', 'amended', 'corrected' }\n            and MostRecentPriorHeartRateExam.effective.toInterval() before HeartRateExam.effective.toInterval()\n          sort by start of effective.toInterval()\n      )\n      where HeartRateExam.effective.toInterval ( ) during CADEncounterModerateOrSevereLVSD.period\n        and HeartRateExam.status in { 'final', 'amended', 'corrected' }\n        and HeartRateExam.value < 50 '/min'\n        and PriorHeartRateExam.value < 50 '/min'\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 16
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( ( [AllergyIntolerance: \"Beta Blocker Therapy Ingredient\"]\n      union [AllergyIntolerance: \"Substance with beta adrenergic receptor antagonist mechanism of action (substance)\"] ) BetaBlockerAllergyIntolerance\n      where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 17
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( ( [ConditionProblemsHealthConcerns: \"Allergy to Beta Blocker Therapy\"]\n      union [ConditionProblemsHealthConcerns: \"Intolerance to Beta Blocker Therapy\"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n      where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 18
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD\":\n  exists ( [MedicationNotRequested: medication in \"Beta Blocker Therapy for LVSD\"] NoBetaBlockerForLVSDOrdered\n      with \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" LVSDVisit\n        such that NoBetaBlockerForLVSDOrdered.authoredOn during day of LVSDVisit.period\n      where NoBetaBlockerForLVSDOrdered.status in { 'active', 'completed' }\n        and NoBetaBlockerForLVSDOrdered.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( NoBetaBlockerForLVSDOrdered.reasonCode in \"Medical Reason\"\n            or NoBetaBlockerForLVSDOrdered.reasonCode in \"Patient Reason\"\n        )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 19
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Atrioventricular Block\"] AtrioventricularBlock\n      where AtrioventricularBlock.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 20
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [ConditionProblemsHealthConcerns: \"Cardiac Pacer in Situ\"] CardiacPacerDiagnosis\n      where CardiacPacerDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 21
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD\":\n  exists ( [Procedure: \"Cardiac Pacer\"] ImplantedCardiacPacer\n      with \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n        such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterModerateOrSevereLVSD.period\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 22
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer\":\n  \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    and not \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    and not \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and History of Moderate or Severe LVSD\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 23
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Denominator Exceptions 1"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator Exceptions 1\":\n  \"Has Arrhythmia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Asthma with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Bradycardia with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Hypotension with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and History of Moderate or Severe LVSD\"\n    or \"Has Medical or Patient Reason for Not Ordering Beta Blocker for LVSD\"\n    or \"Has Atrioventricular Block with Qualifying CAD Encounter and History of Moderate or Severe LVSD without Cardiac Pacer\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 24
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Beta Blocker Therapy for LVSD Ordered"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Beta Blocker Therapy for LVSD Ordered\":\n  exists ( [MedicationRequest: medication in \"Beta Blocker Therapy for LVSD\"] BetaBlockerForLVSDOrdered\n      where BetaBlockerForLVSDOrdered.authoredDuringDayOfEncounter ( \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 25
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Is Currently Taking Beta Blocker Therapy for LVSD"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Is Currently Taking Beta Blocker Therapy for LVSD\":\n  exists ( [MedicationRequest: medication in \"Beta Blocker Therapy for LVSD\"] ActiveBetaBlockerForLVSD\n      with \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\" CADEncounterModerateOrSevereLVSD\n        such that First((collapse(ActiveBetaBlockerForLVSD.dosageInstruction.timing.repeat.bounds DoseTime\n              return DoseTime.toInterval()\n          )) DrugPeriod\n            sort by start of $this\n        ) overlaps after day of CADEncounterModerateOrSevereLVSD.period\n      where ActiveBetaBlockerForLVSD.status in { 'active', 'completed' }\n        and ActiveBetaBlockerForLVSD.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 26
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Numerator 1"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Numerator 1\":\n  \"Has Beta Blocker Therapy for LVSD Ordered\"\n    or \"Is Currently Taking Beta Blocker Therapy for LVSD\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 27
      }],
      "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" : 28
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "SDE Payer"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 29
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Beta Blocker Therapy Ordered"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Beta Blocker Therapy Ordered\":\n  exists ( [MedicationRequest: medication in \"Beta Blocker Therapy\"] BetaBlockerOrdered\n      where BetaBlockerOrdered.authoredDuringDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 30
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Is Currently Taking Beta Blocker Therapy"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Is Currently Taking Beta Blocker Therapy\":\n  exists ( [MedicationRequest: medication in \"Beta Blocker Therapy\"] ActiveBetaBlocker\n      with \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n        such that First((collapse(ActiveBetaBlocker.dosageInstruction.timing.repeat.bounds DoseTime\n              return DoseTime.toInterval()\n          )) DrugPeriod\n            sort by start of $this\n        ) overlaps after day of CADEncounterMI.period\n      where ActiveBetaBlocker.status in { 'active', 'completed' }\n        and ActiveBetaBlocker.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 31
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Numerator 2"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Numerator 2\":\n  \"Has Beta Blocker Therapy Ordered\"\n    or \"Is Currently Taking Beta Blocker Therapy\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 32
      }],
      "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" : 33
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "SDE Ethnicity"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 34
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Arrhythmia with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Arrhythmia with Qualifying CAD Encounter and Prior MI\":\n  exists ( [ConditionProblemsHealthConcerns: \"Arrhythmia\"] ArrhythmiaDiagnosis\n      where ArrhythmiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 35
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Asthma with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Asthma with Qualifying CAD Encounter and Prior MI\":\n  exists ( [ConditionProblemsHealthConcerns: \"Asthma\"] AsthmaDiagnosis\n      where AsthmaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 36
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Bradycardia with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Bradycardia with Qualifying CAD Encounter and Prior MI\":\n  exists ( [ConditionProblemsHealthConcerns: \"Bradycardia\"] BradycardiaDiagnosis\n      where BradycardiaDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 37
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Hypotension with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Hypotension with Qualifying CAD Encounter and Prior MI\":\n  exists ( ( [ConditionProblemsHealthConcerns: \"Hypotension\"]\n      union [ConditionEncounterDiagnosis: \"Hypotension\"] ) HypotensionDiagnosis\n      where HypotensionDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 38
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n* @code: Heart rate - 8867-4\n* @profile: http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate \n*/\n\n\ndefine \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI\":\n  exists ( from\n      // TODO: Consider best practice of always qualifying type names\n      [\"HeartRateProfile\"] HeartRateExam,\n      \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n      let PriorHeartRateExam: Last([\"HeartRateProfile\"] MostRecentPriorHeartRateExam\n          where MostRecentPriorHeartRateExam.effective.toInterval() during CADEncounterMI.period\n            and MostRecentPriorHeartRateExam.status in { 'final', 'amended', 'corrected' }\n            and MostRecentPriorHeartRateExam.effective.toInterval() before HeartRateExam.effective.toInterval()\n          sort by start of effective.toInterval()\n      )\n      where HeartRateExam.effective.toInterval ( ) during CADEncounterMI.period\n        and HeartRateExam.status in { 'final', 'amended', 'corrected' }\n        and HeartRateExam.value < 50 '/min'\n        and PriorHeartRateExam.value < 50 '/min'\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 39
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI\":\n  exists ( ( [AllergyIntolerance: \"Beta Blocker Therapy Ingredient\"]\n      union [AllergyIntolerance: \"Substance with beta adrenergic receptor antagonist mechanism of action (substance)\"] ) BetaBlockerAllergyIntolerance\n      where BetaBlockerAllergyIntolerance.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 40
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI\":\n  exists ( ( [ConditionProblemsHealthConcerns: \"Allergy to Beta Blocker Therapy\"]\n      union [ConditionProblemsHealthConcerns: \"Intolerance to Beta Blocker Therapy\"] ) BetaBlockerAllergyOrIntoleranceDiagnosis\n      where BetaBlockerAllergyOrIntoleranceDiagnosis.overlapsAfterDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 41
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy\":\n  exists ( [MedicationNotRequested: medication in \"Beta Blocker Therapy for LVSD\"] NoBetaBlockerForLVSDOrdered\n      with \"Qualifying CAD Encounter and Prior MI\" PriorMIVisit\n        such that NoBetaBlockerForLVSDOrdered.authoredOn during day of PriorMIVisit.period\n      where NoBetaBlockerForLVSDOrdered.status in { 'active', 'completed' }\n        and NoBetaBlockerForLVSDOrdered.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( NoBetaBlockerForLVSDOrdered.reasonCode in \"Medical Reason\"\n            or NoBetaBlockerForLVSDOrdered.reasonCode in \"Patient Reason\"\n        )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 42
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI\":\n  exists ( [ConditionProblemsHealthConcerns: \"Atrioventricular Block\"] AtrioventricularBlockDiagnosis\n      where AtrioventricularBlockDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 43
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI\":\n  exists ( [ConditionProblemsHealthConcerns: \"Cardiac Pacer in Situ\"] CardiacPacerDiagnosis\n      where CardiacPacerDiagnosis.overlapsDayOfEncounter ( \"Qualifying CAD Encounter and Prior MI\" )\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 44
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI\":\n  exists ( [Procedure: \"Cardiac Pacer\"] ImplantedCardiacPacer\n      with \"Qualifying CAD Encounter and Prior MI\" CADEncounterMI\n        such that ImplantedCardiacPacer.performed.toInterval ( ) starts before end of CADEncounterMI.period\n          and ImplantedCardiacPacer.status = 'completed'\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 45
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer\":\n  \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI\"\n    and not \"Has Diagnosis of Cardiac Pacer in Situ with Qualifying CAD Encounter and Prior MI\"\n    and not \"Has Cardiac Pacer Device Implanted with Qualifying CAD Encounter and Prior MI\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 46
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Denominator Exceptions 2"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator Exceptions 2\":\n  \"Has Arrhythmia with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Asthma with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Bradycardia with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Hypotension with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Consecutive Heart Rates Less than 50 with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Allergy or Intolerance to Beta Blocker Therapy Ingredient with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Diagnosis of Allergy or Intolerance to Beta Blocker Therapy with Qualifying CAD Encounter and Prior MI\"\n    or \"Has Medical or Patient Reason for Not Ordering Beta Blocker Therapy\"\n    or \"Has Atrioventricular Block with Qualifying CAD Encounter and Prior MI without Cardiac Pacer\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 47
      }],
      "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" : 48
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "SDE Race"
      },
      {
        "url" : "statement",
        "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 49
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "Denominator 1"
      },
      {
        "url" : "statement",
        "valueString" : "define \"Denominator 1\":\n  \"Initial Population\"\n    and exists \"Qualifying CAD Encounter and History of Moderate or Severe LVSD\""
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 50
      }],
      "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" : 51
      }],
      "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" : 52
      }],
      "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" : 53
      }],
      "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" : 54
      }],
      "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" : 55
      }],
      "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" : 56
      }],
      "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" : 57
      }],
      "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" : 58
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "overlapsDayOfEncounter"
      },
      {
        "url" : "statement",
        "valueString" : "define fluent function overlapsDayOfEncounter(Diagnosis ConditionProblemsHealthConcerns, TheEncounter Encounter):\n  TheEncounter Visit\n    where Diagnosis.isVerified ( )\n    return Diagnosis.prevalenceInterval ( ) overlaps day of Visit.period"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 59
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "isVerified"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential\n*/\ndefine fluent function isVerified(condition FHIR.Condition):\n  condition.verificationStatus is not null implies\n    (condition.verificationStatus ~ \"confirmed\"\n      or condition.verificationStatus ~ \"unconfirmed\"\n      or condition.verificationStatus ~ \"provisional\"\n      or condition.verificationStatus ~ \"differential\"\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 60
      }],
      "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        }"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 61
      }],
      "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" : 62
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "prevalenceInterval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(condition Condition):\nif condition.clinicalStatus ~ \"active\"\n  or condition.clinicalStatus ~ \"recurrence\"\n  or condition.clinicalStatus ~ \"relapse\" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n  (end of condition.abatementInterval()) abatementDate\n    return \n\t  if abatementDate is null then\n        Interval[start of condition.onset.toInterval(), abatementDate)\n      else\n        Interval[start of condition.onset.toInterval(), abatementDate]"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 63
      }],
      "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" : 64
      }],
      "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" : 65
      }],
      "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" : 66
      }],
      "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" : 67
      }],
      "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" : 68
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "abatementInterval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns an interval representing the normalized Abatement of a given Condition resource.\n@comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(condition Condition):\n  if condition.abatement is FHIR.dateTime then\n    Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]\n  else if condition.abatement is FHIR.Period then\n    FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)\n  else if condition.abatement 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 if condition.abatement is FHIR.Age then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)\n  else if condition.abatement is FHIR.Range then\n    Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),\n      FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)\n  else if condition.abatement is FHIR.boolean then\n    Interval[end of condition.onset.toInterval(), condition.recordedDate)\n  else \n    null"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 69
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value ProcedureStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 70
      }],
      "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" : 71
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "overlapsDayOfEncounter"
      },
      {
        "url" : "statement",
        "valueString" : "define fluent function overlapsDayOfEncounter(Diagnosis ConditionProblemsHealthConcerns, EncounterList List<Encounter>):\n  AnyTrue(EncounterList Visit\n      return Diagnosis.overlapsDayOfEncounter(Visit)\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 72
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "overlapsAfterDayOfEncounter"
      },
      {
        "url" : "statement",
        "valueString" : "define fluent function overlapsAfterDayOfEncounter(Event Choice<AllergyIntolerance, ConditionProblemsHealthConcerns>, EncounterList List<Encounter>):\n  AnyTrue(EncounterList Visit\n      return\n      case\n        when Event is AllergyIntolerance then Interval[start of Event.onset.toInterval(), Event.lastOccurrence]overlaps after day of Visit.period\n          and(Event.clinicalStatus is null\n              or Event.clinicalStatus ~ FHIRCommon.\"allergy-active\"\n          )\n          and(Event.verificationStatus is null\n              or Event.verificationStatus ~ FHIRCommon.\"allergy-confirmed\"\n          )\n        when Event is ConditionProblemsHealthConcerns then Event.isVerified()\n          and Event.prevalenceInterval() overlaps after day of Visit.period \n        else false \n      end\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 73
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "isVerified"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential\n*/\ndefine fluent function isVerified(allergyIntolerance FHIR.AllergyIntolerance):\n  allergyIntolerance.verificationStatus is not null implies\n    (allergyIntolerance.verificationStatus ~ \"allergy-confirmed\"\n      or allergyIntolerance.verificationStatus ~ \"allergy-unconfirmed\"\n    )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 74
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "prevalenceInterval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition resource.\n@comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition.\n*/\ndefine fluent function prevalenceInterval(allergyIntolerance AllergyIntolerance):\nif allergyIntolerance.clinicalStatus ~ \"allergy-active\" then\n  Interval[start of allergyIntolerance.onset.toInterval(), end of allergyIntolerance.abatementInterval()]\nelse\n  (end of allergyIntolerance.abatementInterval()) abatementDate\n    return \n      if abatementDate is null then\n        Interval[start of allergyIntolerance.onset.toInterval(), abatementDate)\n      else\n        Interval[start of allergyIntolerance.onset.toInterval(), abatementDate]"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 75
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "abatementInterval"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns an interval representing the normalized abatement of a given AllergyIntolerance resource.\n@comment: This function uses the abatement extension, if present, otherwise the resolutionAge.\nIf the abatement of the AllergyIntolerance is a DateTime, the result is an interval beginning and ending on that DateTime.\nIf the abatement is a Period, the result is the Period converted to an Interval of DateTime.\nIf the abatement is an Age, the result is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is a Range, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\nIf the resolutionAge is present, the result is an interval from the date the patient turned that age to immediately before one year later.\n\nNOTE: Due to the complexity of determining an interval from a String, this function will throw\na run-time exception if used with a Condition instance that has a String as the abatement value.\n*/\ndefine fluent function abatementInterval(allergyIntolerance AllergyIntolerance):\n  allergyIntolerance A\n    let \n      abatement: A.abatement(),\n      resolutionAge: A.resolutionAge()\n    return\n      if abatement is FHIR.dateTime then\n        Interval[FHIRHelpers.ToDateTime(abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(abatement as FHIR.dateTime)]\n      else if abatement is FHIR.Period then\n        FHIRHelpers.ToInterval(abatement as FHIR.Period)\n      else if abatement 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 if abatement is FHIR.Age then\n        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(abatement as FHIR.Age),\n          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(abatement as FHIR.Age) + 1 year)\n      else if abatement is FHIR.Range then\n        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((abatement as FHIR.Range).low),\n          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((abatement as FHIR.Range).high) + 1 year)\n      else if abatement is FHIR.boolean then\n        Interval[end of A.onset.toInterval(), A.recordedDate)\n      else if resolutionAge is not null then\n        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(resolutionAge),\n          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(resolutionAge) + 1 year)\n      else \n        null"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 76
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "abatement"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns the abatement of the given AllergyIntolerance, if present\n*/\ndefine fluent function abatement(allergyIntolerance AllergyIntolerance):\n  allergyIntolerance.ext('http://hl7.org/fhir/StructureDefinition/allergyintolerance-abatement').value\n    as Choice<dateTime, Age, Period, Range, string>"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 77
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRCommon"
      },
      {
        "url" : "name",
        "valueString" : "resolutionAge"
      },
      {
        "url" : "statement",
        "valueString" : "/*\n@description: Returns the resolutionAge of the given AllergyIntolerance, if present\n*/\ndefine fluent function resolutionAge(allergyIntolerance AllergyIntolerance):\n  allergyIntolerance.ext('http://hl7.org/fhir/StructureDefinition/allergyintolerance-resolutionAge').value\n    as Age"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 78
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value MedicationRequestStatus): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 79
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToString"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToString(value MedicationRequestIntent): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 80
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "CMS145FHIRCADBBlockerTPMIorLVSD"
      },
      {
        "url" : "name",
        "valueString" : "authoredDuringDayOfEncounter"
      },
      {
        "url" : "statement",
        "valueString" : "define fluent function authoredDuringDayOfEncounter(Order Choice<MedicationRequest, MedicationNotRequested>, EncounterList List<Encounter>):\n  AnyTrue(EncounterList Visit\n      return\n      case\n        when Order is MedicationRequest then Order.authoredOn during day of Visit.period\n          and Order.status in { 'active', 'completed' }\n          and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n          and Order.doNotPerform is not true\n        when Order is MedicationNotRequested then Order.authoredOn during day of Visit.period\n          and Order.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' } \n        else false \n      end\n  )"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 81
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension" : [{
        "url" : "libraryName",
        "valueString" : "FHIRHelpers"
      },
      {
        "url" : "name",
        "valueString" : "ToBoolean"
      },
      {
        "url" : "statement",
        "valueString" : "define function ToBoolean(value boolean): value.value"
      },
      {
        "url" : "displaySequence",
        "valueInteger" : 82
      }],
      "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" : 83
      }],
      "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" : 84
      }],
      "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" : 85
      }],
      "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" : 86
      }],
      "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    }],
    "name" : "EffectiveDataRequirements",
    "status" : "active",
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/library-type",
        "code" : "module-definition"
      }]
    },
    "relatedArtifact" : [{
      "type" : "depends-on",
      "display" : "USQualityCore model information",
      "resource" : "https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild"
    },
    {
      "type" : "depends-on",
      "display" : "USCore model information",
      "resource" : "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"
    },
    {
      "type" : "depends-on",
      "display" : "FHIR model information",
      "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
    },
    {
      "type" : "depends-on",
      "display" : "Library SDE",
      "resource" : "https://madie.cms.gov/Library/SupplementalDataElements|6.1.000"
    },
    {
      "type" : "depends-on",
      "display" : "Library FHIRHelpers",
      "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
    },
    {
      "type" : "depends-on",
      "display" : "Library USCommon",
      "resource" : "http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot"
    },
    {
      "type" : "depends-on",
      "display" : "Library FHIRCommon",
      "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0"
    },
    {
      "type" : "depends-on",
      "display" : "Library AHA",
      "resource" : "https://madie.cms.gov/Library/AHAOverall|5.1.000"
    },
    {
      "type" : "depends-on",
      "display" : "Code system SNOMEDCT",
      "resource" : "http://snomed.info/sct"
    },
    {
      "type" : "depends-on",
      "display" : "Code system ConditionVerificationStatusCodes",
      "resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
    },
    {
      "type" : "depends-on",
      "display" : "Code system ConditionClinicalStatusCodes",
      "resource" : "http://terminology.hl7.org/CodeSystem/condition-clinical"
    },
    {
      "type" : "depends-on",
      "display" : "Code system AllergyIntoleranceClinicalStatusCodes",
      "resource" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
    },
    {
      "type" : "depends-on",
      "display" : "Code system AllergyIntoleranceVerificationStatusCodes",
      "resource" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Office Visit",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Outpatient Consultation",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Nursing Facility Visit",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Care Services in Long Term Residential Facility",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Home Healthcare Services",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Patient Provider Interaction",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Coronary Artery Disease No MI",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.369"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Cardiac Surgery",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.371"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Myocardial Infarction",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.403"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Ejection Fraction",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Moderate or Severe LVSD",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Moderate or Severe",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Arrhythmia",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.366"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Asthma",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.362"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Bradycardia",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.412"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Hypotension",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Beta Blocker Therapy Ingredient",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Allergy to Beta Blocker Therapy",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Intolerance to Beta Blocker Therapy",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1178"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Beta Blocker Therapy for LVSD",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Medical Reason",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Patient Reason",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Atrioventricular Block",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Cardiac Pacer in Situ",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Cardiac Pacer",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Payer Type",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
    },
    {
      "type" : "depends-on",
      "display" : "Value set Beta Blocker Therapy",
      "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1174"
    }],
    "parameter" : [{
      "name" : "Measurement Period",
      "use" : "in",
      "min" : 0,
      "max" : "1",
      "type" : "Period"
    },
    {
      "name" : "SDE Sex",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Coding"
    },
    {
      "name" : "Denominator 2",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "Denominator Exceptions 1",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "Numerator 1",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "SDE Payer",
      "use" : "out",
      "min" : 0,
      "max" : "*",
      "type" : "Resource"
    },
    {
      "name" : "Numerator 2",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "Initial Population",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "SDE Ethnicity",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Resource"
    },
    {
      "name" : "Denominator Exceptions 2",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    },
    {
      "name" : "SDE Race",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "Resource"
    },
    {
      "name" : "Denominator 1",
      "use" : "out",
      "min" : 0,
      "max" : "1",
      "type" : "boolean"
    }],
    "dataRequirement" : [{
      "type" : "Patient",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient"],
      "mustSupport" : ["ombCategory",
      "detailed",
      "text"]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012"
      }]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
      }]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"
      }]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"
      }]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
      }]
    },
    {
      "type" : "Encounter",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Encounter"],
      "mustSupport" : ["type",
      "period",
      "status",
      "id"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"
      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"],
      "mustSupport" : ["verificationStatus",
      "abatement",
      "onset",
      "recordedDate",
      "clinicalStatus"]
    },
    {
      "type" : "Condition",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"],
      "mustSupport" : ["code",
      "severity"],
      "codeFilter" : [{
        "path" : "code",
        "code" : [{
          "system" : "http://snomed.info/sct",
          "code" : "134401001",
          "display" : "Left ventricular systolic dysfunction (disorder)"
        }]
      },
      {
        "path" : "severity",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092"
      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Condition"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
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      }]
    },
    {
      "type" : "Condition",
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      "mustSupport" : ["code"],
      "codeFilter" : [{
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      }]
    },
    {
      "type" : "Patient",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Patient"],
      "mustSupport" : ["birthDate"]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
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    },
    {
      "type" : "Condition",
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      }]
    },
    {
      "type" : "Condition",
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      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370"
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    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1177"
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    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
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      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.367"
      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-problems-health-concerns"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.368"
      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.369"
      }]
    },
    {
      "type" : "Condition",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-condition-encounter-diagnosis"],
      "mustSupport" : ["code"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.370"
      }]
    },
    {
      "type" : "Procedure",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"],
      "mustSupport" : ["code",
      "performed",
      "status"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.371"
      },
      {
        "path" : "status",
        "code" : [{
          "code" : "completed"
        }]
      }]
    },
    {
      "type" : "Procedure",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"],
      "mustSupport" : ["code",
      "performed"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53"
      }]
    },
    {
      "type" : "Procedure",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/Procedure"],
      "mustSupport" : ["code",
      "performed",
      "status"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.53"
      },
      {
        "path" : "status",
        "code" : [{
          "code" : "completed"
        }]
      }]
    },
    {
      "type" : "Observation",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-clinical-result"],
      "mustSupport" : ["code",
      "value",
      "status"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134"
      }]
    },
    {
      "type" : "Observation",
      "profile" : ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate"],
      "mustSupport" : ["effective",
      "status",
      "value"]
    },
    {
      "type" : "AllergyIntolerance",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"],
      "mustSupport" : ["verificationStatus",
      "onset",
      "recordedDate",
      "clinicalStatus"]
    },
    {
      "type" : "AllergyIntolerance",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"],
      "mustSupport" : ["code",
      "onset",
      "recordedDate"],
      "codeFilter" : [{
        "path" : "code",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1493"
      }]
    },
    {
      "type" : "AllergyIntolerance",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"],
      "mustSupport" : ["code",
      "onset",
      "recordedDate"],
      "codeFilter" : [{
        "path" : "code",
        "code" : [{
          "system" : "http://snomed.info/sct",
          "code" : "373254001",
          "display" : "Substance with beta adrenergic receptor antagonist mechanism of action (substance)"
        }]
      }]
    },
    {
      "type" : "MedicationRequest",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-medicationnotrequested"],
      "mustSupport" : ["medication",
      "authoredOn",
      "status",
      "intent",
      "reasonCode"],
      "codeFilter" : [{
        "path" : "medication",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184"
      }]
    },
    {
      "type" : "MedicationRequest",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/MedicationRequest"],
      "mustSupport" : ["medication",
      "dosageInstruction",
      "status",
      "intent"],
      "codeFilter" : [{
        "path" : "medication",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1184"
      }]
    },
    {
      "type" : "MedicationRequest",
      "profile" : ["http://hl7.org/fhir/StructureDefinition/MedicationRequest"],
      "mustSupport" : ["medication",
      "dosageInstruction",
      "status",
      "intent"],
      "codeFilter" : [{
        "path" : "medication",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1174"
      }]
    },
    {
      "type" : "Coverage",
      "profile" : ["http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage"],
      "mustSupport" : ["type",
      "period"],
      "codeFilter" : [{
        "path" : "type",
        "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
      }]
    }]
  }],
  "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"
  },
  {
    "extension" : [{
      "url" : "term",
      "valueString" : "Moderate or Severe LVSD"
    },
    {
      "url" : "definition",
      "valueMarkdown" : "LVEF \\<=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:\n\n1. that provides a numerical value of LVSD or\n\n2. that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.\n\n"
    }],
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
  },
  {
    "extension" : [{
      "url" : "term",
      "valueString" : "Prescribed"
    },
    {
      "url" : "definition",
      "valueMarkdown" : "Denotes that a prescription has been given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR that the patient is already taking an ACE inhibitor or ARB or ARNI therapy as documented in their current medication list\n"
    }],
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
  },
  {
    "extension" : [{
      "url" : "term",
      "valueString" : "Prior Myocardial Infarction (MI)"
    },
    {
      "url" : "definition",
      "valueMarkdown" : "Prior Myocardial Infarction (MI) for Denominator 2 is limited to those occurring within the past 3 years\n"
    }],
    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm"
  },
  {
    "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/CMS145FHIRCADBBlockerTPMIorLVSD",
  "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" : "CMS145FHIR"
  },
  {
    "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:466e5d36-1e01-478b-9dcb-edac33594dd5"
  },
  {
    "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:1d9adbb1-6f66-47d1-b97e-9e7593117c18"
  },
  {
    "use" : "official",
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
        "code" : "endorser",
        "display" : "Endorser"
      }]
    },
    "system" : "https://madie.cms.gov/measure/cbeId",
    "value" : "0070e",
    "assigner" : {
      "display" : "CMS Consensus Based Entity"
    }
  },
  {
    "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" : "145FHIR",
    "assigner" : {
      "display" : "CMS"
    }
  }],
  "version" : "1.0.000",
  "name" : "CMS145FHIRCADBBlockerTPMIorLVSD",
  "title" : "Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF less than or equal to 40%)FHIR\n",
  "status" : "active",
  "experimental" : false,
  "date" : "2026-01-16T18:18:13+00:00",
  "publisher" : "American Heart Association",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.heart.org/"
    }]
  }],
  "description" : "Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior left ventricular ejection fraction (LVEF) \\<=40% who were prescribed beta-blocker therapy\n",
  "usage" : "Beta-blocker therapy:\n\n* For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents.\n\n* For patients with prior LVEF \\<=40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate.\n\nThe requirement of two or more visits is to establish that the eligible clinician has an existing relationship with the patient.\n\nA range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.\n\nIn order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of \"below 40%\" or \"ejection fraction between 35 and 40%\" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as \"Moderate or Severe.\"\n\nIf a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF \\<=40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1.\n\nThis eCQM is a patient-based measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS145v14. 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" : "Copyright 2025 American College of Cardiology and American Heart Association. All Rights Reserved.\n",
  "effectivePeriod" : {
    "start" : "2026-01-01",
    "end" : "2026-12-31"
  },
  "author" : [{
    "name" : "American Heart Association",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.heart.org/"
    }]
  },
  {
    "name" : "American Medical Association (AMA)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://www.ama-assn.org/"
    }]
  }],
  "relatedArtifact" : [{
    "type" : "citation",
    "citation" : "Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., ... Williams, S. V. (2012). 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease. Circulation, 126(25), e354--e471. doi: 10.1161/cir.0b013e318277d6a0\n"
  },
  {
    "type" : "citation",
    "citation" : "Gibbons, R. J., Abrams, J., Chatterjee, K., Daley, J., Deedwania, P.K, Douglas J.S., ... Smith Jr., S.C. (2002). ACC/AHA 2002 Guideline update for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to update the 1999 guidelines for the management of patients with chronic stable angina). Circulation, 107(1), 149-158. doi:10.1161/01.CIR.0000047041.66447.29\n"
  },
  {
    "type" : "citation",
    "citation" : "Virani, S.S., Newby, L.K., Arnold, S.V., Bittner, V., Brewer, L.C., Demeter, S.H., ... Dixon, D.L. (2023). 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the management for patients with chronic coronary disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Practice Guidelines. Circulation, 148, e9-e119. doi: 10.1161/CIR.0000000000001168\n"
  }],
  "library" : ["https://madie.cms.gov/Library/CMS145FHIRCADBBlockerTPMIorLVSD"],
  "disclaimer" : "The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.\n\nThe Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.\n\nCommercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.\n\nACC and AHA encourage use of the Measure by other health care professionals, where appropriate.\n\nTHE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT\\[R\\]) or other coding contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.\n\nThe American Medical Association's and the PCPI(R) Foundation's significant past efforts and contributions to the performance measure are gratefully acknowledged.\n\nDue to technical limitations, registered trademarks are indicated by (R) or \\[R\\].\n",
  "rationale" : "For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol which have been shown to reduce risk of death, are recommended indefinitely for patients with CAD and LV systolic dysfunction. These agents have proven efficacy in reducing angina onset and improving the ischemic threshold during exercise. In patients who have suffered an MI, beta-blockers significantly reduce deaths and recurrent MIs (Fihn et al., 2012).\n\nNonadherence to cardioprotective medications is prevalent among outpatients with CAD and can be associated with a broad range of adverse outcomes, including all-cause and cardiovascular mortality, cardiovascular hospitalizations, and the need for revascularization procedures (Gibbons et al., 2002).\n\nThis measure is intended to promote beta-blocker usage in select patients with CAD.\n",
  "clinicalRecommendationStatement" : "Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or acute coronary syndrome (ACS) (Class I, Level of Evidence: B) (Fihn et al., 2012).\n\nBeta-blocker therapy should be used in all patients with LV systolic dysfunction (EF \\<= 40%) with heart failure or prior MI, unless contraindicated. (Use should be limited to carvedilol, metoprolol succinate, or bisoprolol, which have been shown to reduce risk of death.) (Class I, Level of Evidence: A) (Fihn et al., 2012).\n\nIn patients with chronic coronary disease (CCD) and LVEF ≤40% with or without previous MI, the use of beta-blocker therapy is recommended to reduce the risk of future Major Adverse Cardiac Events (MACE), including cardiovascular death. (Class 1, Level of Evidence: A) (Virani et al., 2023)\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-rateAggregation",
      "valueString" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes:\n\n* Population 1: Patients with left ventricular systolic dysfunction (LVEF \\<=40%)\n\n* Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2)/ \\[(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)\\]\n"
    },
    {
      "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 aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease\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" : "Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF \\<=40%\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator 1"
      }
    },
    {
      "id" : "Numerator_1",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "numerator",
          "display" : "Numerator"
        }]
      },
      "description" : "Patients who were prescribed beta-blocker therapy\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Numerator 1"
      }
    },
    {
      "id" : "DenominatorException_1",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator-exception",
          "display" : "Denominator Exception"
        }]
      },
      "description" : "Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates \\<50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator Exceptions 1"
      }
    }]
  },
  {
    "id" : "Group_2",
    "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-rateAggregation",
      "valueString" : "This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes:\n\n* Population 1: Patients with left ventricular systolic dysfunction (LVEF \\<=40%)\n\n* Population 2: Patients with a prior (within the past 3 years) myocardial infarction\n\nFor the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2)/ \\[(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)\\]\n"
    },
    {
      "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_2",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "initial-population",
          "display" : "Initial Population"
        }]
      },
      "description" : "All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Initial Population"
      }
    },
    {
      "id" : "Denominator_2",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator",
          "display" : "Denominator"
        }]
      },
      "description" : "Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF \\<=40%\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator 2"
      }
    },
    {
      "id" : "Numerator_2",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "numerator",
          "display" : "Numerator"
        }]
      },
      "description" : "Patients who were prescribed beta-blocker therapy\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Numerator 2"
      }
    },
    {
      "id" : "DenominatorException_2",
      "code" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
          "code" : "denominator-exception",
          "display" : "Denominator Exception"
        }]
      },
      "description" : "Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates \\<50, allergy, intolerance, other medical reasons).\n\nDocumentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "Denominator Exceptions 2"
      }
    }]
  }],
  "supplementalData" : [{
    "id" : "sde-sex",
    "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"
    }
  },
  {
    "id" : "sde-race",
    "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-payer",
    "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-ethnicity",
    "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"
    }
  }]
}