define "Initial Population":
	Patient.gender = 'female'
		and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
		and exists AdultOutpatientEncounters."Qualifying Encounters"

define "Numerator":
	exists "Cervical Cytology Within 3 Years"
		or exists "HPV Test Within 5 Years for Women Age 30 and Older"

define "Denominator":
	"Initial Population"

define "Denominator Exclusion":
	Hospice."Has Hospice"
		or exists "Absence of Cervix"

define "Qualifying Encounters":
	(
    [Encounter: "Office Visit"]
  		union [Encounter: "Annual Wellness Visit"]
  		union [Encounter: "Preventive Care Services - Established Office Visit, 18 and Up"]
  		union [Encounter: "Preventive Care Services-Initial Office Visit, 18 and Up"]
  		union [Encounter: "Home Healthcare Services"]
  ) ValidEncounter
		where ValidEncounter.period during "Measurement Period"
  		and ValidEncounter.status  = 'finished'

define "Has Hospice":
	exists (
    [Encounter: "Encounter Inpatient"] DischargeHospice
			where DischargeHospice.status = 'finished'
		    and (
	        DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
				    or DischargeHospice.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
	    	)
				and DischargeHospice.period ends during "Measurement Period"
	)
    or exists (
      [ServiceRequest: "Hospice care ambulatory"] HospiceOrder
        where HospiceOrder.intent = 'order'
            and HospiceOrder.authoredOn in "Measurement Period"
    )
    or exists (
      [Procedure: "Hospice care ambulatory"] HospicePerformed
        where HospicePerformed.status = 'completed'
          and Global."Normalize Interval"(HospicePerformed.performed) overlaps "Measurement Period"
    )

define "SDE Sex":
  case
      when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }
      when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }
      else null
    end

define "SDE Payer":
  [Coverage: type in "Payer"] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }

define "SDE Ethnicity":
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding

define "SDE Race":
  (flatten (
      Patient.extension Extension
        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'
          return Extension.extension
    )) E
      where E.url = 'ombCategory'
        or E.url = 'detailed'
      return E.value as Coding

define "SDE Sex":
  SDE."SDE Sex"

define "Cervical Cytology Within 3 Years":
	[Observation: "Pap Test"] CervicalCytology
		where CervicalCytology.value is not null
			and CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }
		  and Global."Normalize Interval"(CervicalCytology.effective) ends 3 years or less on or before end of "Measurement Period"

define "HPV Test Within 5 Years for Women Age 30 and Older":
	[Observation: "HPV Test"] HPVTest
      where HPVTest.value is not null
        and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }
        and  Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of Global."Normalize Interval"(HPVTest.effective))>= 30
        and Global."Normalize Interval"(HPVTest.effective) ends 5 years or less on or before end of "Measurement Period"

define "Numerator":
	exists "Cervical Cytology Within 3 Years"
		or exists "HPV Test Within 5 Years for Women Age 30 and Older"

define "Initial Population":
	Patient.gender = 'female'
		and Global."CalendarAgeInYearsAt"(FHIRHelpers.ToDate(Patient.birthDate), start of "Measurement Period") in Interval[23, 64]
		and exists AdultOutpatientEncounters."Qualifying Encounters"

define "Denominator":
	"Initial Population"

define "SDE Payer":
  SDE."SDE Payer"

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "Absence of Cervix":
  ([Procedure: "Hysterectomy with No Residual Cervix"] NoCervixProcedure
   where Global."Normalize Interval"(NoCervixProcedure.performed) ends on or before end of "Measurement Period"
     and NoCervixProcedure.status = 'completed'
     )
  union [Condition : "Congenital absence of cervix (disorder)"] NoCervixBirth
		where Global."Normalize Interval"(NoCervixBirth.onset) starts on or before end of "Measurement Period"

define "Denominator Exclusion":
	Hospice."Has Hospice"
		or exists "Absence of Cervix"

define "SDE Race":
  SDE."SDE Race"

define function "CalendarAgeInYearsAt"(BirthDateTime DateTime, AsOf DateTime):
	years between ToDate(BirthDateTime)and ToDate(AsOf)

define function "ToDate"(Value DateTime):
	DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)

define function ToString(value AdministrativeGender): value.value

define function ToString(value ObservationStatus): value.value

define function ToDate(value date): value.value

/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]

define function ToString(value EncounterStatus): value.value

define function ToString(value uri): value.value

/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }

/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }

define function ToString(value ServiceRequestIntent): value.value

define function ToDateTime(value dateTime): value.value

define function ToString(value ProcedureStatus): value.value