Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build

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

## : Controlling High Blood PressureFHIR - XML Representation

Active as of 2026-01-16

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    <Measure xmlns="http://hl7.org/fhir">
      <id value="CMS165FHIRControllingHighBP"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
        <profile
                 value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml">
      <table class="narrative-table">
        <tbody>
    <tr>

    <th colspan="2" scope="row" class="row-header">Metadata</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Title</th>

    <td class="content-container">Controlling High Blood PressureFHIR</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Version</th>

    <td class="content-container">1.1.000</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Short Name</th>

    <td class="content-container">CMS165FHIR</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">GUID (Version Independent)</th>

    <td class="content-container">urn:uuid:9017d914-6748-45a9-bff1-8392ed644a7b</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">GUID (Version Specific)</th>

    <td class="content-container">urn:uuid:6f830f33-ed81-4f34-ba8e-97f3810563bd</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">CMS Identifier</th>

    <td class="content-container">165FHIR</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Effective Period</th>

    <td class="content-container">2026-01-01 through 2026-12-31</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Steward (Publisher)</th>

    <td class="content-container">National Committee for Quality Assurance</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Developer</th>

    <td class="content-container">National Committee for Quality Assurance</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Description</th>

    <td class="content-container"><div><p>Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (&lt;140/90 mmHg) during the measurement period</p>
    </div></td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Copyright</th>

    <td class="content-container"><div><p>This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International.</p>
    </div></td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Disclaimer</th>

    <td class="content-container"><div><p>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>
    </div></td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Rationale</th>

    <td class="content-container"><div><p>High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2023). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults &gt;= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in National Health and Nutrition Examination Survey (NHANES), the estimated age-adjusted proportion with controlled blood pressure (BP) increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022). HBP increases risks of heart disease and stroke which are two of the leading causes of death in the US (CDC, 2023). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2021). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022). HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures (SBP) of &gt;= 160 mmHg could be effective and cost-saving (Moran et al., 2015). Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of &lt;120 mmHg compared to a SBP goal of &lt;140 mmHg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015). Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established.</p>
    </div></td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Clinical Recommendation Statement</th>

    <td class="content-container"><div><p>U.S. Preventive Services Task Force (USPSTF) (2021): - The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation. American College of Cardiology/American Heart Association (2017): - For adults with confirmed hypertension and known cardiovascular disease (CVD) or 10-year atherosclerotic cardiovascular disease (ASCVD) event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure)) - For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)). American Academy of Family Physicians (2022): - Treat adults who have hypertension to a standard blood pressure target (less than 140/90 mm Hg) to reduce the risk of all-cause and cardiovascular mortality (strong recommendation; high-quality evidence). Treating to a lower blood pressure target (less than 135/85 mm Hg) does not provide additional benefit at preventing mortality; however, a lower blood pressure target could be considered based on patient preferences and values. (Grade: strong recommendation, Quality of evidence: high) - Consider treating adults who have hypertension to a lower blood pressure target (less than 135/85 mm Hg) to reduce risk of myocardial infarction (weak recommendation; moderate-quality evidence). Although treatment to a standard blood pressure target (less than 140/90 mm Hg) reduced the risk of myocardial infarction, there was a small additional benefit observed with a lower blood pressure target. There was no observed additional benefit in preventing stroke with the lower blood pressure target. (Grade: weak recommendation, Quality of evidence: low) American Diabetes Association (2022): - For individuals with diabetes and hypertension at higher cardiovascular risk (existing atherosclerotic cardiovascular disease or 10-year atherosclerotic cardiovascular disease risk &gt;=15 percent), a blood pressure target of &lt;130/80 mmHg may be appropriate, if it can be safely attained (Level of evidence: B) - For individuals with diabetes and hypertension at lower risk for cardiovascular disease (10-year atherosclerotic cardiovascular disease risk &lt;15 percent), treat to a blood pressure target of &lt;140/90 mmHg (Level of evidence: A)</p>
    </div></td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>American Diabetes Association. (2022). 10. Cardiovascular disease and risk management: Standards of medical care in diabetes—2022. Diabetes Care 2022, 44(Suppl. 1), S144-S175. https://doi.org/10.2337/dc22-S010</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Centers for Disease Control and Prevention, National Center for Health Statistics. (2022). About Multiple Cause of Death, 1999–2020. CDC WONDER Online Database website. Atlanta, GA: Centers for Disease Control and Prevention. Available from http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm#Mortality_Multiple</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Centers for Disease Control and Prevention. (2021). Team-based care for high blood pressure. Retrieved from https://www.cdc.gov/policy/polaris/healthtopics/highbloodpressure/tbctool.html</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Centers for Disease Control and Prevention. (2023). Facts about hypertension. Retrieved from https://www.cdc.gov/bloodpressure/facts.htm</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Coles, S., Fisher, L., Lin, K. W., Lyon, C., Vosooney, A. A., &amp; Bird, M. D. (2022). Blood Pressure Targets in Adults With Hypertension: A Clinical Practice Guideline From the AAFP. American family physician, 106(6). Retrieved from https://www.aafp.org/pubs/afp/issues/2022/1200/practice-guidelines-aafp-hypertension-full-guideline.html</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>James, P.A., Oparil, S., Carter, B.L., et al. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. doi: 10.1001/jama.2013.284427</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N.,...Moran, W. P. (2018). Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003–2014. Journal of the American Heart Association, 7(11), e008731. https://doi.org/10.1161/JAHA.118.008731</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Moran, A. E., Odden, M. C., Thanataveerat, A., et al. (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. [published correction appears in N Engl J. Med. 2015;372:1677]. New England Journal of Medicine. 2015;372, 447-455. doi: 10.1056/NEJMsa1406751. [published correction appears on page 1677]</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Patel, S. A., Winkel, M., Ali, M. K., et al. (2015). Cardiovascular mortality associated with 5 leading risk factors: National and state preventable fractions estimated from survey data. Annals of Internal Medicine, 163(4), 245-253. doi: 10.7326/M14-1753</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Qaseem, A., Wilt, T. J., Rich, R., et al. (2017). Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 166(6), 430-437. Retrieved from https://annals.org/aim/fullarticle/2598413/pharmacologic-treatment-hypertension-adults-aged-60-years-older-higher-versus</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>SPRINT Research Group, Wright, J. T., Jr., Williamson, J. D., et al. (2015). A randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine, 373(22), 2103–2116.</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S.,...Kissela, B. M. (2022). Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation, 145(8), e153–e639. https://doi.org/10.1161/CIR.0000000000001052</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>U.S. Preventive Services Task Force. Screening for hypertension in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. JAMA, 325(16), 1650. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Virani, S.S., Alonso, A., Aparicio, H.J., et al.; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2021). Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation. 2021;143:e254–e743. doi: 10.1161/CIR.0000000000000950</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Citation</th>

      <td class="content-container">

        <div><p>Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2017). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. Hypertension. 71(6). https://doi.org/10.1161/HYP.0000000000000065</p>
    </div>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Guidance (Usage)</th>

    <td class="content-container">In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an emergency department (ED) visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed &quot;not controlled&quot;. If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS165v14. 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).</td>

    </tr>

        <tr>

    <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Basis</th>

    <td class="content-container">boolean</td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Scoring</th>

    <td class="content-container">
        Proportion

    </td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Improvement Notation</th>

    <td class="content-container">
        Increased score indicates improvement

    </td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Type</th>

    <td class="content-container">
        Intermediate Outcome

    </td>

    </tr>

    <tr>

    <th scope="row" class="row-header">Rate Aggregation</th>

    <td class="content-container">None</td>

    </tr>

        <tr>

    <th scope="row" class="row-header">Initial Population</th>

          <td class="content-container">

            <em>ID</em>: InitialPopulation_1
            <br/>

              <em>Description</em>:
              <p style="white-space: pre-line" class="tab-one">Patients 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period</p>

                  <em>Criteria</em>: <a href="#Group_1-InitialPopulation_1">Initial Population</a>

          </td>
        </tr>

        <tr>

    <th scope="row" class="row-header">Denominator</th>

          <td class="content-container">

            <em>ID</em>: Denominator_1
            <br/>

              <em>Description</em>:
              <p style="white-space: pre-line" class="tab-one">Equals Initial Population</p>

                  <em>Criteria</em>: <a href="#Group_1-Denominator_1">Denominator</a>

          </td>
        </tr>

        <tr>

    <th scope="row" class="row-header">Denominator Exclusion</th>

          <td class="content-container">

            <em>ID</em>: DenominatorExclusion_1
            <br/>

              <em>Description</em>:
              <p style="white-space: pre-line" class="tab-one">Exclude patients who are in hospice care for any part of the measurement period. Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period. Exclude patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period.</p>

                  <em>Criteria</em>: <a href="#Group_1-DenominatorExclusion_1">Denominator Exclusions</a>

          </td>
        </tr>

        <tr>

    <th scope="row" class="row-header">Numerator</th>

          <td class="content-container">

            <em>ID</em>: Numerator_1
            <br/>

              <em>Description</em>:
              <p style="white-space: pre-line" class="tab-one">Patients whose most recent blood pressure is adequately controlled (systolic blood pressure &amp;lt; 140 mmHg and diastolic blood pressure &amp;lt; 90 mmHg) during the measurement period</p>

                  <em>Criteria</em>: <a href="#Group_1-Numerator_1">Numerator</a>

          </td>
        </tr>

    <tr>

    <th scope="row" class="row-header">Supplemental Data Guidance Guidance</th>

    <td class="content-container">For every patient evaluated by this measure also identify payer, race, ethnicity and sex</td>

    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Supplemental Data Element</th>

      <td class="content-container">

          <em>ID</em>: sde-sex

          <br/>

              <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>

            <br/>

          <em>Description</em>: SDE Sex

            <br/>

              <em>Logic Definition</em>: <a href="#cms165fhircontrollinghighbp-sde-sex">SDE Sex</a>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Supplemental Data Element</th>

      <td class="content-container">

          <em>ID</em>: sde-race

          <br/>

              <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>

            <br/>

          <em>Description</em>: SDE Race

            <br/>

              <em>Logic Definition</em>: <a href="#cms165fhircontrollinghighbp-sde-race">SDE Race</a>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Supplemental Data Element</th>

      <td class="content-container">

          <em>ID</em>: sde-payer

          <br/>

              <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>

            <br/>

          <em>Description</em>: SDE Payer

            <br/>

              <em>Logic Definition</em>: <a href="#cms165fhircontrollinghighbp-sde-payer">SDE Payer</a>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Supplemental Data Element</th>

      <td class="content-container">

          <em>ID</em>: sde-ethnicity

          <br/>

              <em>Usage Code</em>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}">Supplemental Data</span>

            <br/>

          <em>Description</em>: SDE Ethnicity

            <br/>

              <em>Logic Definition</em>: <a href="#cms165fhircontrollinghighbp-sde-ethnicity">SDE Ethnicity</a>

      </td>
    </tr>

    <tr>

    <th colspan="2" scope="row" class="row-header">Measure Logic</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Primary Library</th>

    <td class="content-container"><a href="Library-CMS165FHIRControllingHighBP.html">CMS165FHIRControllingHighBP</a></td>

    </tr>

    <tr>
      <th scope="row" class="row-header">Contents</th>
      <td class="content-container">
        <em><a href="#population-criteria">Population Criteria</a></em>
        <br/>
        <em><a href="#definitions">Logic Definitions</a></em>
        <br/>
        <em><a href="#terminology">Terminology</a></em>
        <br/>
        <em><a href="#dependencies">Dependencies</a></em>
        <br/>
        <em><a href="#data-requirements">Data Requirements</a></em>
        <br/>
        <em><a href="#parameters">Parameters</a></em>
        <br/>
      </td>
    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>

    </tr>

        <tr>

    <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>

    </tr>

                <tr>
      <th scope="row" rowspan="2" class="row-header">

        Initial Population

      </th>
    </tr>
    <tr>

      <td>

          <a name="Group_1-InitialPopulation_1"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
      AgeInYearsAt(date from
        end of &quot;Measurement Period&quot;
      ) in Interval[18, 85]
        and exists &quot;Essential Hypertension Diagnosis&quot;
        and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>

          <a href="#cms165fhircontrollinghighbp-initial-population"><em>Definition</em></a>

      </td>

    </tr>

                <tr>
      <th scope="row" rowspan="2" class="row-header">

        Denominator

      </th>
    </tr>
    <tr>

      <td>

          <a name="Group_1-Denominator_1"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
      &quot;Initial Population&quot;</code></pre>

          <a href="#cms165fhircontrollinghighbp-denominator"><em>Definition</em></a>

      </td>

    </tr>

                <tr>
      <th scope="row" rowspan="2" class="row-header">

        Denominator Exclusion

      </th>
    </tr>
    <tr>

      <td>

          <a name="Group_1-DenominatorExclusion_1"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
      Hospice.&quot;Has Hospice Services&quot;
        or exists ( &quot;Pregnancy or Renal Diagnosis&quot; )
        or exists ( &quot;End Stage Renal Disease Procedures&quot; )
        or exists ( &quot;End Stage Renal Disease Encounter&quot; )
        or AIFrailLTCF.&quot;Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;</code></pre>

          <a href="#cms165fhircontrollinghighbp-denominator-exclusions"><em>Definition</em></a>

      </td>

    </tr>

                <tr>
      <th scope="row" rowspan="2" class="row-header">

        Numerator

      </th>
    </tr>
    <tr>

      <td>

          <a name="Group_1-Numerator_1"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
      &quot;Has Systolic Blood Pressure Less Than 140&quot;
        and &quot;Has Diastolic Blood Pressure Less Than 90&quot;</code></pre>

          <a href="#cms165fhircontrollinghighbp-numerator"><em>Definition</em></a>

      </td>

    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdultOutpatientEncounters</td>

    </tr>
    <tr>

      <td>

          <a name="adultoutpatientencounters-qualifying-encounters"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">// NOTE: The USQualityCore encounter here is not introducing any constraints, and so could be expressed directly using US Core
    define &quot;Qualifying Encounters&quot;:
      ( (
        [USQualityCore.Encounter: &quot;Office Visit&quot;]
          union [USQualityCore.Encounter: &quot;Annual Wellness Visit&quot;]
          union [USQualityCore.Encounter: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
          union [USQualityCore.Encounter: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
          union [USQualityCore.Encounter: &quot;Home Healthcare Services&quot;]
          union [USQualityCore.Encounter: &quot;Virtual Encounter&quot;]
          union [USQualityCore.Encounter: &quot;Telephone Visits&quot;]
        ).isEncounterPerformed()
      ) ValidEncounter
        where ValidEncounter.period during day of &quot;Measurement Period&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Hospice</td>

    </tr>
    <tr>

      <td>

          <a name="hospice-has-hospice-services"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Hospice Services&quot;:
      exists ((([USQualityCore.Encounter: &quot;Encounter Inpatient&quot;]).isEncounterPerformed()) InpatientEncounter
          where (InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
              or InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
          )
            and InpatientEncounter.period ends during day of &quot;Measurement Period&quot;
      )
        or exists ((([USQualityCore.Encounter: &quot;Hospice Encounter&quot;]).isEncounterPerformed()) HospiceEncounter
            where HospiceEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)
        or exists ((([USQualityCore.ObservationScreeningAssessment: code ~ &quot;Hospice care [Minimum Data Set]&quot;]).isAssessmentPerformed()) HospiceAssessment
            where HospiceAssessment.value ~ &quot;Yes (qualifier value)&quot;
              and HospiceAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.ServiceRequest: &quot;Hospice Care Ambulatory&quot;]).isInterventionOrder()) HospiceOrder
            where HospiceOrder.authoredOn during day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Procedure: &quot;Hospice Care Ambulatory&quot;]).isInterventionPerformed()) HospicePerformed
            where HospicePerformed.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
        )
        // TODO: Consider whether to keep this as the union of Problems and EncounterDiagnosis
        or exists ((([FHIR.Condition: &quot;Hospice Diagnosis&quot;]).verified()) HospiceCareDiagnosis
            where HospiceCareDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdvancedIllnessandFrailty</td>

    </tr>
    <tr>

      <td>

          <a name="advancedillnessandfrailty-has-criteria-indicating-frailty"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Criteria Indicating Frailty&quot;:
      exists ( (([USQualityCore.DeviceRequest: &quot;Frailty Device&quot;]).isDeviceOrderPersonalUseDevices()) FrailtyDeviceOrder
          where FrailtyDeviceOrder.authoredOn.toInterval() during day of &quot;Measurement Period&quot;
      )
        or exists ( (([ObservationScreeningAssessment: &quot;Medical equipment used&quot;]).isAssessmentPerformed()) EquipmentUsed
            where EquipmentUsed.value as CodeableConcept in &quot;Frailty Device&quot;
            and EquipmentUsed.effective.toInterval() ends during day of &quot;Measurement Period&quot;
        )
        // TODO: Consider whether to keep this as the union of problems and encounter diagnoses
        or exists ( (([FHIR.Condition: &quot;Frailty Diagnosis&quot;]).verified()) FrailtyDiagnosis
            where FrailtyDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ( (([USQualityCore.Encounter: &quot;Frailty Encounter&quot;]).isEncounterPerformed()) FrailtyEncounter
            where FrailtyEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        or exists ( (([USQualityCore.SimpleObservation: &quot;Frailty Symptom&quot;]).isSymptom()) FrailtySymptom
            where FrailtySymptom.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
        )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdvancedIllnessandFrailty</td>

    </tr>
    <tr>

      <td>

          <a name="advancedillnessandfrailty-has-advanced-illness-in-year-before-or-during-measurement-period"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;:
    // TODO: Consider whether to keep this as the union of problems and encounter diagnoses
    exists ((([Condition: &quot;Advanced Illness&quot;]).verified()) AdvancedIllnessDiagnosis
    where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of &quot;Measurement Period&quot; - 1 year, end of &quot;Measurement Period&quot;])</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdvancedIllnessandFrailty</td>

    </tr>
    <tr>

      <td>

          <a name="advancedillnessandfrailty-has-dementia-medications-in-year-before-or-during-measurement-period"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;:
      exists (( ([FHIR.MedicationRequest: &quot;Dementia Medications&quot;]).isMedicationActive()) DementiaMedication
          where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of &quot;Measurement Period&quot; - 1 year,
            end of &quot;Measurement Period&quot;]
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdvancedIllnessandFrailty</td>

    </tr>
    <tr>

      <td>

          <a name="advancedillnessandfrailty-is-age-66-to-80-with-advanced-illness-and-frailty-or-is-age-81-or-older-with-frailty"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty&quot;:
      ( AgeInYearsAt(date from end of &quot;Measurement Period&quot;) in Interval[66, 80]
          and &quot;Has Criteria Indicating Frailty&quot;
          and ( &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;
              or &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;
          )
      )
        or ( AgeInYearsAt(date from end of &quot;Measurement Period&quot;)&gt;= 81
            and &quot;Has Criteria Indicating Frailty&quot;
        )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> AdvancedIllnessandFrailty</td>

    </tr>
    <tr>

      <td>

          <a name="advancedillnessandfrailty-is-age-66-or-older-living-long-term-in-a-nursing-home"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;:
      AgeInYearsAt(date from end of &quot;Measurement Period&quot;) &gt;= 66
        and ( ( Last( (([ObservationScreeningAssessment: &quot;Housing status&quot;]).isAssessmentPerformed()) HousingStatus
              where HousingStatus.effective.toInterval() ends on or before
              day of end of &quot;Measurement Period&quot;
              sort by
              end of effective.toInterval() asc
          )) LastHousingStatus
            where LastHousingStatus.value ~ &quot;Lives in nursing home (finding)&quot;
        ) is not null</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> PalliativeCare</td>

    </tr>
    <tr>

      <td>

          <a name="palliativecare-has-palliative-care-in-the-measurement-period"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Palliative Care in the Measurement Period&quot;:
      // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)
      exists ((([USQualityCore.ObservationScreeningAssessment: code ~ &quot;Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)&quot;]).isAssessmentPerformed()) PalliativeAssessment
          where PalliativeAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
      )
        // TODO: Consider whether to keep this as the union of the problems and encounter diagnosis list? Anything enforced by the profiles that is expected but isn't stated here?
        or exists ((([FHIR.Condition: &quot;Palliative Care Diagnosis&quot;]).verified()) PalliativeDiagnosis
            where PalliativeDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Encounter: &quot;Palliative Care Encounter&quot;]).isEncounterPerformed()) PalliativeEncounter
            where PalliativeEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Procedure: &quot;Palliative Care Intervention&quot;]).isInterventionPerformed()) PalliativeIntervention
            where PalliativeIntervention.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
        )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

    </tr>
    <tr>

      <td>

          <a name="supplementaldataelements-sde-sex"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
      case
        when Patient.sex() = '248153007' then &quot;Male (finding)&quot;
        when Patient.sex() = '248152002' then &quot;Female (finding)&quot;
        else null
      end</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

    </tr>
    <tr>

      <td>

          <a name="supplementaldataelements-sde-payer"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
      [USQualityCore.Coverage: type in &quot;Payer Type&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

    </tr>
    <tr>

      <td>

          <a name="supplementaldataelements-sde-ethnicity"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
      (Patient.ethnicity()) E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>

    </tr>
    <tr>

      <td>

          <a name="supplementaldataelements-sde-race"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
      (Patient.race()) R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-sde-sex"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
      SDE.&quot;SDE Sex&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-qualifying-blood-pressure-reading"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Qualifying Blood Pressure Reading&quot;:
      ( ( ( [USCore.BloodPressureProfile] ).isObservationBP ( ) ) BloodPressure
          without ( ( [Encounter: &quot;Encounter Inpatient&quot;]
              union [Encounter: &quot;Emergency Department Evaluation and Management Visit&quot;]
          ).isEncounterPerformed ( ) ) DisqualifyingEncounter
            such that BloodPressure.effective.latest ( ) during day of DisqualifyingEncounter.period
          where BloodPressure.effective.latest ( ) during day of &quot;Measurement Period&quot;
      )
        union ( ( ( [USCore.BloodPressureProfile] ).isObservationBP ( ) ) BloodPressure
            where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) )
              and BloodPressure.effective.latest ( ) during day of &quot;Measurement Period&quot;
        )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-blood-pressure-days"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Blood Pressure Days&quot;:
      &quot;Qualifying Blood Pressure Reading&quot; BPExam
        return date from BPExam.effective.latest ( )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-most-recent-blood-pressure-day"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Most Recent Blood Pressure Day&quot;:
      Last(&quot;Blood Pressure Days&quot; BPDays
          sort asc
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-lowest-systolic-reading-on-most-recent-blood-pressure-day"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Lowest Systolic Reading on Most Recent Blood Pressure Day&quot;:
      First(&quot;Qualifying Blood Pressure Reading&quot; BPReading
          where BPReading.effective.latest() same day as &quot;Most Recent Blood Pressure Day&quot;
          return singleton from(BPReading.component BPComponent
              where BPComponent.code ~ &quot;Systolic blood pressure&quot;
              return BPComponent.value as Quantity
          )
          sort asc
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-has-systolic-blood-pressure-less-than-140"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Systolic Blood Pressure Less Than 140&quot;:
      &quot;Lowest Systolic Reading on Most Recent Blood Pressure Day&quot; &lt; 140 'mm[Hg]'</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-lowest-diastolic-reading-on-most-recent-blood-pressure-day"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Lowest Diastolic Reading on Most Recent Blood Pressure Day&quot;:
      First(&quot;Qualifying Blood Pressure Reading&quot; BPReading
          where BPReading.effective.latest() same day as &quot;Most Recent Blood Pressure Day&quot;
          return singleton from(BPReading.component BPComponent
              where BPComponent.code ~ &quot;Diastolic blood pressure&quot;
              return BPComponent.value as Quantity
          )
          sort asc
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-has-diastolic-blood-pressure-less-than-90"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Diastolic Blood Pressure Less Than 90&quot;:
      &quot;Lowest Diastolic Reading on Most Recent Blood Pressure Day&quot; &lt; 90 'mm[Hg]'</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-numerator"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
      &quot;Has Systolic Blood Pressure Less Than 140&quot;
        and &quot;Has Diastolic Blood Pressure Less Than 90&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-essential-hypertension-diagnosis"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Essential Hypertension Diagnosis&quot;:
      ( ( [Condition: &quot;Essential Hypertension&quot;] ).verified ( ) ) Hypertension
        where Hypertension.prevalenceInterval ( ) overlaps Interval[start of &quot;Measurement Period&quot;, start of &quot;Measurement Period&quot; + 6 months )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-initial-population"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
      AgeInYearsAt(date from
        end of &quot;Measurement Period&quot;
      ) in Interval[18, 85]
        and exists &quot;Essential Hypertension Diagnosis&quot;
        and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-denominator"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
      &quot;Initial Population&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-sde-payer"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
      SDE.&quot;SDE Payer&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-sde-ethnicity"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
      SDE.&quot;SDE Ethnicity&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-pregnancy-or-renal-diagnosis"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Pregnancy or Renal Diagnosis&quot;:
      ( ( [Condition: &quot;Pregnancy&quot;]
          union [Condition: &quot;End Stage Renal Disease&quot;]
          union [Condition: &quot;Kidney Transplant Recipient&quot;]
          union [Condition: &quot;Chronic Kidney Disease, Stage 5&quot;]
      ).verified ( ) ) PregnancyESRDDiagnosis
        where PregnancyESRDDiagnosis.prevalenceInterval ( ) overlaps &quot;Measurement Period&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-end-stage-renal-disease-procedures"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;End Stage Renal Disease Procedures&quot;:
      ( ( [Procedure: &quot;Kidney Transplant&quot;]
          union [Procedure: &quot;Dialysis Services&quot;]
      ).isProcedurePerformed ( ) ) ESRDProcedure
        where ESRDProcedure.performed.toInterval ( ) ends on or before end of &quot;Measurement Period&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-end-stage-renal-disease-encounter"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;End Stage Renal Disease Encounter&quot;:
      ( ( [Encounter: &quot;ESRD Monthly Outpatient Services&quot;] ).isEncounterPerformed ( ) ) ESRDEncounter
        where ESRDEncounter.period starts on or before end of &quot;Measurement Period&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-denominator-exclusions"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
      Hospice.&quot;Has Hospice Services&quot;
        or exists ( &quot;Pregnancy or Renal Diagnosis&quot; )
        or exists ( &quot;End Stage Renal Disease Procedures&quot; )
        or exists ( &quot;End Stage Renal Disease Encounter&quot; )
        or AIFrailLTCF.&quot;Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-sde-race"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
      SDE.&quot;SDE Race&quot;</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CMS165FHIRControllingHighBP</td>

    </tr>
    <tr>

      <td>

          <a name="cms165fhircontrollinghighbp-getencounter"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function getEncounter(reference Reference):
      singleton from ( [Encounter] E
        where reference.references(E)
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-ext"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns the single extension (if present) on the given resource with the specified url.
    @comment: This function uses singleton from to ensure that a run-time exception is thrown if there
    is more than one extension on the given resource with the specified url.
    */
    define fluent function ext(domainResource DomainResource, url String):
      singleton from domainResource.exts(url)</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-exts"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns any extensions defined on the given resource with the specified url
    */
    define fluent function exts(domainResource DomainResource, url String):
      domainResource.extension E
        where E.url = url
        return E</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-latest"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Given an interval, returns the ending point if the interval has an ending boundary specified,
    otherwise, returns the starting point
    */
    define fluent function latest(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Age, FHIR.Range&gt;):
      (choice.toInterval()) period
        return
          if (period.hasEnd()) then end of period
          else start of period</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-tointerval"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
    @comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types
    to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
    representations for timing-valued elements in FHIR, allowing this function to be used across any resource.

    The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.
    The intent of this function is to provide a clear and concise mechanism to treat single
    elements that have multiple possible representations as intervals so that logic doesn't have to account
    for the variability. More complex calculations (such as medication request period or dispense period
    calculation) need specific guidance and consideration. That guidance may make use of this function, but
    the focus of this function is on single element calculations where the semantics are unambiguous.
    If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.
    If the input is a Period, the result is a DateTime Interval.
    If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.
    If the input is an instant, the result is a DateTime Interval beginning and ending on that instant.
    If the input is a string, an error is raised indicating a single interval cannot be computed from a string.
    If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,
    and ending immediately prior to when the patient was the given Age plus one year.
    If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given
    by the low end of the Range, and ending immediately prior to when the patient was the Age given by the
    high end of the Range plus one year.

    NOTE: Due to the
    complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used
    with a Timing or String.
    */
    define fluent function toInterval(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):
      case
        when choice is FHIR.dateTime then
          Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]
        when choice is FHIR.Period then
          FHIRHelpers.ToInterval(choice as FHIR.Period)
        when choice is FHIR.instant then
          Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]
        when choice is FHIR.Age then
          Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),
            FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)
        when choice is FHIR.Range then
          Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),
            FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)
        when choice is FHIR.Timing then
          Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')
        when choice is FHIR.string then
          Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
        else
          null as Interval&lt;DateTime&gt;
      end</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-hasend"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Given an interval, returns true if the interval has an ending boundary specified
    (i.e. the end of the interval is not null and not the maximum DateTime value)
    */
    define fluent function hasEnd(period Interval&lt;DateTime&gt;):
      not (
        end of period is null
          or end of period = maximum DateTime
      )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-references"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns true if the given reference is to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
      resource.id = Last(Split(reference.reference, '/'))</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-verified"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
    */
    define fluent function verified(conditions List&lt;FHIR.Condition&gt;):
      conditions C
        where C.verificationStatus is not null implies
          (C.verificationStatus ~ &quot;confirmed&quot;
            or C.verificationStatus ~ &quot;unconfirmed&quot;
            or C.verificationStatus ~ &quot;provisional&quot;
            or C.verificationStatus ~ &quot;differential&quot;
          )</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-prevalenceinterval"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns an interval representing the normalized prevalence period of a given Condition resource.
    @comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from
    onset to abatement as specified in the given Condition.
    */
    define fluent function prevalenceInterval(condition Condition):
    if condition.clinicalStatus ~ &quot;active&quot;
      or condition.clinicalStatus ~ &quot;recurrence&quot;
      or condition.clinicalStatus ~ &quot;relapse&quot; then
      Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
    else
      (end of condition.abatementInterval()) abatementDate
        return
    	  if abatementDate is null then
            Interval[start of condition.onset.toInterval(), abatementDate)
          else
            Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-abatementinterval"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns an interval representing the normalized Abatement of a given Condition resource.
    @comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result
    is an interval beginning and ending on that DateTime.
    If 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
    result is an interval from the date the patient turned that age to immediately before one year later.
    If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
    which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
    before one year later than the date the patient turned the ending age of the quantity interval.

    NOTE: Due to the complexity of determining an interval from a String, this function will throw
    a run-time exception if used with a Condition instance that has a String as the abatement value.
    */
    define fluent function abatementInterval(condition Condition):
      if condition.abatement is FHIR.dateTime then
        Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]
      else if condition.abatement is FHIR.Period then
        FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)
      else if condition.abatement is FHIR.string then
        Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
      else if condition.abatement is FHIR.Age then
        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),
          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)
      else if condition.abatement is FHIR.Range then
        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),
          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)
      else if condition.abatement is FHIR.boolean then
        Interval[end of condition.onset.toInterval(), condition.recordedDate)
      else
        null</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-ext"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns the single extension (if present) on the given element with the specified url.
    @comment: This function uses singleton from to ensure that a run-time exception is thrown if there
    is more than one extension on the given element with the specified url.
    */
    define fluent function ext(element Element, url String):
      singleton from element.exts(url)</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRCommon</td>

    </tr>
    <tr>

      <td>

          <a name="fhircommon-exts"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns any extensions defined on the given element with the specified url.
    */
    define fluent function exts(element Element, url String):
      element.extension E
        where E.url = url
        return E</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isobservationbp"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Observation Vital Signs
    define fluent function isObservationBP(Obs List&lt;BloodPressureProfile&gt;):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isencounterperformed"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Encounter, Performed
    //General usage unless required otherwise by measure intent (e.g., follow-up encounters)
    define fluent function isEncounterPerformed(Enc List&lt;FHIR.Encounter&gt;):
      Enc E
        where E.status = 'finished'</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isassessmentperformed"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Assessment, Performed
    define fluent function isAssessmentPerformed(Obs List&lt;ObservationScreeningAssessment&gt;):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isinterventionorder"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Intervention, Order
    define fluent function isInterventionOrder(ServiceRequest List&lt;FHIR.ServiceRequest&gt;):
      ServiceRequest S
        where S.status in { 'active', 'completed' }
          and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isinterventionperformed"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Intervention, Performed
    define fluent function isInterventionPerformed(Proc List&lt;FHIR.Procedure&gt;):
      Proc P
        where P.status ~ 'completed'</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isprocedureperformed"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Procedure, Performed
    define fluent function isProcedurePerformed(Proc List&lt;FHIR.Procedure&gt;):
      Proc P
        where P.status ~ 'completed'</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-isdeviceorderpersonalusedevices"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Device, Order - Personal Use Devices
    define fluent function isDeviceOrderPersonalUseDevices(DeviceRequest List&lt;FHIR.DeviceRequest&gt;):
      DeviceRequest D
        where D.status in { 'active', 'completed' }
          and D.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-issymptom"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Symptom
    define fluent function isSymptom(Obs List&lt;SimpleObservation&gt;):
      Obs O
        where O.status in { 'preliminary', 'final', 'amended', 'corrected' }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> Status</td>

    </tr>
    <tr>

      <td>

          <a name="status-ismedicationactive"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Medication, Active
    define fluent function isMedicationActive(MedicationRequest List&lt;FHIR.MedicationRequest&gt;):
      MedicationRequest M
        where M.status = 'active'
          and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>

    </tr>
    <tr>

      <td>

          <a name="cumulativemedicationduration-medicationrequestperiod"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    Calculates the Medication Period for a single MedicationRequest.
    MedicationRequest instances provided to this function are expected
    to conform to the [MMEMedicationRequest](http://build.fhir.org/ig/cqframework/opioid-mme-r4/StructureDefinition-mmemedicationrequest.html)
    profile, which expects:
    * 1 and only 1 dosageInstruction, multiple dosageInstruction elements will result in an error
    * 1 and only 1 doseAndRate, multiple doseAndRate elements will result in an error
    * 1 timing with 1 repeat, missing timing or repeat elements will result in a null
    * frequency, frequencyMax, defaulting to 1
    * period, periodUnit, defaulting to 1 'd'
    * timeOfDay
    * doseQuantity or doseRange, missing doseQuantity and doseRange will result in a null
    Note that MedicationRequest status is not considered by this calculation, as the
    list of MedicationRequest instances provided to this function should already have
    considered appropriate statuses, depending on the use case, typically `completed`.

    NOTE: Updated return to use &quot;date from end of boundsPeriod&quot; to ensure result is Interval&lt;Date&gt;
    */
    define fluent function medicationRequestPeriod(Request MedicationRequest):
      Request R
        let
          dosage: singleton from R.dosageInstruction,
          doseAndRate: singleton from dosage.doseAndRate,
          timing: dosage.timing,
          frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
          period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
          doseRange: doseAndRate.dose as FHIR.Range,
          doseQuantity: doseAndRate.dose as FHIR.SimpleQuantity,

          dose: Coalesce(end of doseRange, doseQuantity),
          dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
          boundsPeriod: timing.repeat.bounds as Period,
          // TODO: this isn't working as expected, convert results in null
          //daysSupply: (convert(R.dispenseRequest.expectedSupplyDuration) to days).value,
          daysSupply: (R.dispenseRequest.expectedSupplyDuration).value,
          quantity: R.dispenseRequest.quantity,
          refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
          startDate:
            Coalesce(
              date from start of boundsPeriod,
              date from R.authoredOn,
              date from start of R.dispenseRequest.validityPeriod
            ),
          totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
        return
          if startDate is not null and totalDaysSupplied is not null then
            Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
          else if startDate is not null and boundsPeriod.&quot;end&quot; is not null then
            Interval[startDate, date from end of boundsPeriod]
          else
            null</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>

    </tr>
    <tr>

      <td>

          <a name="cumulativemedicationduration-quantity"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/**********************************************************************/
    /* Functions in this region are copied from opioid-mme-r4             */
    /**********************************************************************/

    define function Quantity(value Decimal, unit String):
      if value is not null then
        System.Quantity { value: value, unit: unit }
      else
        null</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>

    </tr>
    <tr>

      <td>

          <a name="cumulativemedicationduration-todaily"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
     Goal is to get to number of days
     Two broad approaches to the calculation:
      1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
      2) Based on relevant period, determine a covered interval and calculate the length of that interval in days

    This topic covers several use cases and illustrates how to calculate Cumulative
    Medication Duration for each type of medication resource using the supply and
    frequency approach.
    */

    /*
      For the first approach, we need to get from frequency to a frequency/day
      So we define ToDaily
    */

    /*
      Calculates daily frequency given frequency within a period
    */
    define function ToDaily(frequency System.Integer, period System.Quantity):
      case period.unit
        when 'h' then frequency * (24.0 / period.value)
        when 'min' then frequency * (24.0 / period.value) * 60
        when 's' then frequency * (24.0 / period.value) * 60 * 60
        when 'd' then frequency * (24.0 / period.value) / 24
        when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
        when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hour' then frequency * (24.0 / period.value)
        when 'minute' then frequency * (24.0 / period.value) * 60
        when 'second' then frequency * (24.0 / period.value) * 60 * 60
        when 'day' then frequency * (24.0 / period.value) / 24
        when 'week' then frequency * (24.0 / period.value) / (24 * 7)
        when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hours' then frequency * (24.0 / period.value)
        when 'minutes' then frequency * (24.0 / period.value) * 60
        when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
        when 'days' then frequency * (24.0 / period.value) / 24
        when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
        when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' &amp; period.unit)
      end</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value string): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-toquantity"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity)
    value to a CQL Quantity
    @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity
    has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)
    an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.
    @seealso: ToCalendarUnit
    */
    define function ToQuantity(quantity FHIR.Quantity):
        case
            when quantity is null then null
            when quantity.value is null then null
            when quantity.comparator is not null then
                Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
            when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
                  or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
                System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
            else
                Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
        end</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tocalendarunit"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Converts a UCUM definite duration unit to a CQL calendar duration
    unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities)
    topic of the CQL specification.
    @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate
    */
    define function ToCalendarUnit(unit System.String):
        case unit
            when 'ms' then 'millisecond'
            when 's' then 'second'
            when 'min' then 'minute'
            when 'h' then 'hour'
            when 'd' then 'day'
            when 'wk' then 'week'
            when 'mo' then 'month'
            when 'a' then 'year'
            else unit
        end</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ObservationStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value EncounterStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-todatetime"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDateTime(value dateTime): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tointerval"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @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.&quot;start&quot; is null then
                Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
            else
                Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-todatetime"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDateTime(value instant): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-todate"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDate(value date): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-toconcept"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @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
            }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tocode"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @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
            }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ServiceRequestStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ServiceRequestIntent): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value ProcedureStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value DeviceRequestStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value RequestIntent): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value MedicationRequestStatus): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value MedicationRequestIntent): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-todecimal"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToDecimal(value decimal): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tostring"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value UnitsOfTime): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tointerval"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity
    */
    define function ToInterval(range FHIR.Range):
        if range is null then
            null
        else
            Interval[ToQuantity(range.low), ToQuantity(range.high)]</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> FHIRHelpers</td>

    </tr>
    <tr>

      <td>

          <a name="fhirhelpers-tointeger"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToInteger(value integer): value.value</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> USCoreCommon</td>

    </tr>
    <tr>

      <td>

          <a name="uscorecommon-sex"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
    @description: Returns the sex element as defined for the USCore patient profile
    */
    define fluent function sex(patient Patient):
      patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> USCoreCommon</td>

    </tr>
    <tr>

      <td>

          <a name="uscorecommon-ethnicity"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function ethnicity(patient Patient):
      (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E
        return {
          ombCategory: E.ext('ombCategory').value as FHIR.Coding,
          detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
          text: E.ext('text').value as FHIR.string
        }</code></pre>
      </td>

    </tr>

    <tr>
      <th scope="row" rowspan="2" class="row-header">
        Logic Definition
      </th>

      <td class="content-container"><em>Library Name:</em> USCoreCommon</td>

    </tr>
    <tr>

      <td>

          <a name="uscorecommon-race"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function race(patient Patient):
      (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E
        return {
          ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,
          detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
          text: E.ext('text').value as FHIR.string
        }</code></pre>
      </td>

    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Code System</th>

      <td class="content-container">

        <em>Description</em>: Code system SNOMEDCT

        <br/>

        <em>Resource</em>: <a href="http://hl7.org/fhir/R4/codesystem-snomedct.html">SNOMED CT (all versions)</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Code System</th>

      <td class="content-container">

        <em>Description</em>: Code system LOINC

        <br/>

        <em>Resource</em>: <a href="http://terminology.hl7.org/6.5.0/CodeSystem-v3-loinc.html">Logical Observation Identifiers, Names and Codes (LOINC)</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://loinc.org</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Code System</th>

      <td class="content-container">

        <em>Description</em>: Code system ConditionVerificationStatusCodes

        <br/>

        <em>Resource</em>: <a href="http://terminology.hl7.org/7.1.0/CodeSystem-condition-ver-status.html">ConditionVerificationStatus</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Code System</th>

      <td class="content-container">

        <em>Description</em>: Code system ConditionClinicalStatusCodes

        <br/>

        <em>Resource</em>: <a href="http://terminology.hl7.org/7.1.0/CodeSystem-condition-clinical.html">Condition Clinical Status Codes</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Encounter Inpatient

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Emergency Department Evaluation and Management Visit

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1010/expansion">Emergency Department Evaluation and Management Visit</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Essential Hypertension

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.104.12.1011/expansion">Essential Hypertension</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.104.12.1011</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Office Visit

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Annual Wellness Visit

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Preventive Care Services Established Office Visit, 18 and Up

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services Established Office Visit, 18 and Up</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Preventive Care Services Initial Office Visit, 18 and Up

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services Initial Office Visit, 18 and Up</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Home Healthcare Services

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Virtual Encounter

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">Virtual Encounter</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Telephone Visits

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Payer Type

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Hospice Encounter

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">Hospice Encounter</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Hospice Care Ambulatory

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Hospice Diagnosis

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">Hospice Diagnosis</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Pregnancy

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion">Pregnancy</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set End Stage Renal Disease

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.353/expansion">End Stage Renal Disease</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Kidney Transplant Recipient

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1029/expansion">Kidney Transplant Recipient</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1029</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Chronic Kidney Disease, Stage 5

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1002/expansion">Chronic Kidney Disease, Stage 5</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1002</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Kidney Transplant

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1012/expansion">Kidney Transplant</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1012</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Dialysis Services

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1013/expansion">Dialysis Services</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1013</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set ESRD Monthly Outpatient Services

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1014/expansion">ESRD Monthly Outpatient Services</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1014</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Frailty Device

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1300/expansion">Frailty Device</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Frailty Diagnosis

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1074/expansion">Frailty Diagnosis</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Frailty Encounter

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1088/expansion">Frailty Encounter</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Frailty Symptom

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1075/expansion">Frailty Symptom</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Advanced Illness

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion">Advanced Illness</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Dementia Medications

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.196.12.1510/expansion">Dementia Medications</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Palliative Care Diagnosis

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion">Palliative Care Diagnosis</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Palliative Care Encounter

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion">Palliative Care Encounter</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Value Set</th>

      <td class="content-container">

        <em>Description</em>: Value set Palliative Care Intervention

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion">Palliative Care Intervention</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</tt>

      </td>
    </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Male (finding)
            <br/>

          <em>Code</em>: 248153007
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Female (finding)
            <br/>

          <em>Code</em>: 248152002
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Systolic blood pressure
            <br/>

          <em>Code</em>: 8480-6
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Diastolic blood pressure
            <br/>

          <em>Code</em>: 8462-4
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: confirmed
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: unconfirmed
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: provisional
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: differential
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: active
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: recurrence
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

          <em>Code</em>: relapse
          <br/>
          <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Discharge to home for hospice care (procedure)
            <br/>

          <em>Code</em>: 428361000124107
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Discharge to healthcare facility for hospice care (procedure)
            <br/>

          <em>Code</em>: 428371000124100
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Yes (qualifier value)
            <br/>

          <em>Code</em>: 373066001
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Hospice care [Minimum Data Set]
            <br/>

          <em>Code</em>: 45755-6
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Medical equipment used
            <br/>

          <em>Code</em>: 98181-1
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Housing status
            <br/>

          <em>Code</em>: 71802-3
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Lives in nursing home (finding)
            <br/>

          <em>Code</em>: 160734000
          <br/>
          <em>System</em>: <tt>http://snomed.info/sct</tt>
        </td>
      </tr>

      <tr>
        <th scope="row" class="row-header">Direct Reference Code</th>
        <td class="content-container">

            <em>Display</em>: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
            <br/>

          <em>Code</em>: 71007-9
          <br/>
          <em>System</em>: <tt>http://loinc.org</tt>
        </td>
      </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>

    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: USQualityCore model information

        <br/>

        <em>Resource</em>: <code>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</code>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: USCore model information

        <br/>

        <em>Resource</em>: <a href="https://build.fhir.org/ig/HL7/us-cql-ig/Library-USCore-ModelInfo.html">http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: FHIR model information

        <br/>

        <em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library SDE

        <br/>

        <em>Resource</em>: <a href="Library-SupplementalDataElements.html">SupplementalDataElementsversion: null6.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|6.1.000</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library FHIRHelpers

        <br/>

        <em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library USCommon

        <br/>

        <em>Resource</em>: <a href="https://build.fhir.org/ig/HL7/us-cql-ig/Library-USCoreCommon.html">http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library FHIRCommon

        <br/>

        <em>Resource</em>: <a href="http://hl7.org/fhir/uv/cql/STU2/Library-FHIRCommon.html">http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library Status

        <br/>

        <em>Resource</em>: <a href="Library-Status.html">Statusversion: null2.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Status|2.1.000</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library AdultOutpatientEncounters

        <br/>

        <em>Resource</em>: <a href="Library-AdultOutpatientEncounters.html">AdultOutpatientEncountersversion: null5.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/AdultOutpatientEncounters|5.1.000</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library Hospice

        <br/>

        <em>Resource</em>: <a href="Library-Hospice.html">Hospiceversion: null7.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Hospice|7.1.000</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library AIFrailLTCF

        <br/>

        <em>Resource</em>: <a href="Library-AdvancedIllnessandFrailty.html">AdvancedIllnessandFrailtyversion: null2.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/AdvancedIllnessandFrailty|2.1.000</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library CMD

        <br/>

        <em>Resource</em>: <a href="https://build.fhir.org/ig/HL7/us-cql-ig/Library-CumulativeMedicationDuration.html">http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot</tt>

      </td>
    </tr>

    <tr>

    <th scope="row" class="row-header">Dependency</th>

      <td class="content-container">

        <em>Description</em>: Library PalliativeCare

        <br/>

        <em>Resource</em>: <a href="Library-PalliativeCare.html">PalliativeCareversion: null2.1.000)</a>
        <br/>
        <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/PalliativeCare|2.1.000</tt>

      </td>
    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>

    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Patient
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient</code>
        <br/>

        <em>Must Support Elements</em>: ombCategory, detailed, text
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Patient
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/patient.html">Patient</a>
        <br/>

        <em>Must Support Elements</em>: birthDate
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Resource
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/resource.html">Resource</a>
        <br/>

        <em>Must Support Elements</em>: id
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
        <br/>

        <em>Must Support Elements</em>: status, period
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
        <br/>

        <em>Must Support Elements</em>: type, status, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
        <br/>

        <em>Must Support Elements</em>: type, status, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1010/expansion">Emergency Department Evaluation and Management Visit</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/encounter.html">Encounter</a>
        <br/>

        <em>Must Support Elements</em>: type, period, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1014/expansion">ESRD Monthly Outpatient Services</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-blood-pressure.html">US Core Blood Pressure Profile</a>
        <br/>

        <em>Must Support Elements</em>: effective, status, component, encounter, encounter.class, encounter.class.code
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: abatement, verificationStatus, onset, recordedDate, clinicalStatus
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.104.12.1011/expansion">Essential Hypertension</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1165/expansion">Hospice Diagnosis</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion">Pregnancy</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.353/expansion">End Stage Renal Disease</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1029/expansion">Kidney Transplant Recipient</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1002/expansion">Chronic Kidney Disease, Stage 5</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1074/expansion">Frailty Diagnosis</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1082/expansion">Advanced Illness</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Condition
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/condition.html">Condition</a>
        <br/>

        <em>Must Support Elements</em>: code, verificationStatus
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1167/expansion">Palliative Care Diagnosis</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion">Office Visit</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion">Annual Wellness Visit</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion">Preventive Care Services Established Office Visit, 18 and Up</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion">Preventive Care Services Initial Office Visit, 18 and Up</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion">Home Healthcare Services</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1089/expansion">Virtual Encounter</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, hospitalization, hospitalization.dischargeDisposition, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion">Encounter Inpatient</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1003/expansion">Hospice Encounter</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1088/expansion">Frailty Encounter</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Encounter
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-encounter</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1090/expansion">Palliative Care Encounter</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Coverage
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage</code>
        <br/>

        <em>Must Support Elements</em>: type, period
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: type</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion">Payer Type</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>
        <br/>

        <em>Must Support Elements</em>: code, value, effective, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>Code(s)</em>:

          <a href="https://loinc.org/45755-6">LOINC: 45755-6</a> (Hospice care [Minimum Data Set])

        </span>
        <br/>

        <span class="tab-one"><em>Path</em>: value</span>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>
        <br/>

        <em>Must Support Elements</em>: code, value, effective, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>Code(s)</em>:

          <a href="https://loinc.org/98181-1">LOINC: 98181-1</a> (Medical equipment used)

        </span>
        <br/>

        <span class="tab-one"><em>Path</em>: value</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1300/expansion">Frailty Device</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>
        <br/>

        <em>Must Support Elements</em>: code, effective, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>Code(s)</em>:

          <a href="https://loinc.org/71802-3">LOINC: 71802-3</a> (Housing status)

        </span>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>
        <br/>

        <em>Must Support Elements</em>: code, effective, value, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>Code(s)</em>:

          <a href="https://loinc.org/71802-3">LOINC: 71802-3</a> (Housing status)

        </span>
        <br/>

        <span class="tab-one"><em>Path</em>: value</span>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-observation-screening-assessment</code>
        <br/>

        <em>Must Support Elements</em>: code, effective, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>Code(s)</em>:

          <a href="https://loinc.org/71007-9">LOINC: 71007-9</a> (Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal))

        </span>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: ServiceRequest
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-servicerequest</code>
        <br/>

        <em>Must Support Elements</em>: code, authoredOn
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Procedure
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure</code>
        <br/>

        <em>Must Support Elements</em>: code, performed
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1584/expansion">Hospice Care Ambulatory</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Procedure
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-procedure</code>
        <br/>

        <em>Must Support Elements</em>: code, performed
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1135/expansion">Palliative Care Intervention</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Procedure
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
        <br/>

        <em>Must Support Elements</em>: code, status, performed
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1012/expansion">Kidney Transplant</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Procedure
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/procedure.html">Procedure</a>
        <br/>

        <em>Must Support Elements</em>: code, status, performed
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1013/expansion">Dialysis Services</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: DeviceRequest
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-devicerequest</code>
        <br/>

        <em>Must Support Elements</em>: code, authoredOn
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.118.12.1300/expansion">Frailty Device</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Observation
        <br/>

        <em>Profile(s)</em>:

        <code>http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation</code>
        <br/>

        <em>Must Support Elements</em>: code, effective, status
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.113.12.1075/expansion">Frailty Symptom</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: Medication
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/medication.html">Medication</a>
        <br/>

        <em>Must Support Elements</em>: id, code
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: code</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.196.12.1510/expansion">Dementia Medications</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: MedicationRequest
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/medicationrequest.html">MedicationRequest</a>
        <br/>

        <em>Must Support Elements</em>: medication.reference, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, dispenseRequest.validityPeriod
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: MedicationRequest
        <br/>

        <em>Profile(s)</em>:

        <a href="http://hl7.org/fhir/R4/medicationrequest.html">MedicationRequest</a>
        <br/>

        <em>Must Support Elements</em>: medication, status, intent, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.expectedSupplyDuration.value, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, authoredOn, dispenseRequest.validityPeriod
        <br/>

        <em>Code Filter(s)</em>:
        <br/>

        <span class="tab-one"><em>Path</em>: medication</span>
        <br/>

        <span class="tab-one"><em>ValueSet</em>:</span> <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.196.12.1510/expansion">Dementia Medications</a>
        <br/>

      </td>
    </tr>

      <tr>

    <th colspan="2" scope="row" class="row-header"><a name="parameters"> </a>Parameters</th>

    </tr>

      <tr>

    <th scope="row" class="row-header"/>

      <td class="content-container">
        <table>
          <thead>
            <tr>
              <td><em>Name</em></td>
              <td><em>Use</em></td>
              <td><em>Card.</em></td>
              <td><em>Type</em></td>
              <td><em>Documentation</em></td>
            </tr>
          </thead>
          <tbody>

            <tr>
              <td>Measurement Period</td>
              <td>In</td>
              <td>0..1</td>
              <td>Period</td>
              <td/>
            </tr>

            <tr>
              <td>ErrorLevel</td>
              <td>In</td>
              <td>0..1</td>
              <td>string</td>
              <td/>
            </tr>

            <tr>
              <td>SDE Sex</td>
              <td>Out</td>
              <td>0..1</td>
              <td>Coding</td>
              <td/>
            </tr>

            <tr>
              <td>Numerator</td>
              <td>Out</td>
              <td>0..1</td>
              <td>boolean</td>
              <td/>
            </tr>

            <tr>
              <td>Denominator</td>
              <td>Out</td>
              <td>0..1</td>
              <td>boolean</td>
              <td/>
            </tr>

            <tr>
              <td>SDE Payer</td>
              <td>Out</td>
              <td>0..*</td>
              <td>Resource</td>
              <td/>
            </tr>

            <tr>
              <td>Initial Population</td>
              <td>Out</td>
              <td>0..1</td>
              <td>boolean</td>
              <td/>
            </tr>

            <tr>
              <td>SDE Ethnicity</td>
              <td>Out</td>
              <td>0..1</td>
              <td>Resource</td>
              <td/>
            </tr>

            <tr>
              <td>Denominator Exclusions</td>
              <td>Out</td>
              <td>0..1</td>
              <td>boolean</td>
              <td/>
            </tr>

            <tr>
              <td>SDE Race</td>
              <td>Out</td>
              <td>0..1</td>
              <td>Resource</td>
              <td/>
            </tr>

          </tbody>
        </table>
      </td>
    </tr>

    <tr>
      <th colspan="2" scope="row" class="row-header">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>
    </tr>

        </tbody>
      </table>
    </div>
      </text>
      <contained>
        <Library>
          <id value="effective-data-requirements"/>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="248153007"/>
              <display value="Male (finding)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="248152002"/>
              <display value="Female (finding)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="8480-6"/>
              <display value="Systolic blood pressure"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="8462-4"/>
              <display value="Diastolic blood pressure"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
              <code value="confirmed"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
              <code value="unconfirmed"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
              <code value="provisional"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
              <code value="differential"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
              <code value="active"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
              <code value="recurrence"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
              <code value="relapse"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="428361000124107"/>
              <display value="Discharge to home for hospice care (procedure)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="428371000124100"/>
              <display
                       value="Discharge to healthcare facility for hospice care (procedure)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="373066001"/>
              <display value="Yes (qualifier value)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="45755-6"/>
              <display value="Hospice care [Minimum Data Set]"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="98181-1"/>
              <display value="Medical equipment used"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="71802-3"/>
              <display value="Housing status"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://snomed.info/sct"/>
              <code value="160734000"/>
              <display value="Lives in nursing home (finding)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://loinc.org"/>
              <code value="71007-9"/>
              <display
                       value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="SupplementalDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Sex"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Sex&quot;:
      case
        when Patient.sex() = '248153007' then &quot;Male (finding)&quot;
        when Patient.sex() = '248152002' then &quot;Female (finding)&quot;
        else null
      end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="0"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Sex"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Sex&quot;:
      SDE.&quot;SDE Sex&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="1"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Qualifying Blood Pressure Reading"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Qualifying Blood Pressure Reading&quot;:
      ( ( ( [USCore.BloodPressureProfile] ).isObservationBP ( ) ) BloodPressure
          without ( ( [Encounter: &quot;Encounter Inpatient&quot;]
              union [Encounter: &quot;Emergency Department Evaluation and Management Visit&quot;]
          ).isEncounterPerformed ( ) ) DisqualifyingEncounter
            such that BloodPressure.effective.latest ( ) during day of DisqualifyingEncounter.period
          where BloodPressure.effective.latest ( ) during day of &quot;Measurement Period&quot;
      )
        union ( ( ( [USCore.BloodPressureProfile] ).isObservationBP ( ) ) BloodPressure
            where ( not ( ( BloodPressure.encounter.getEncounter ( ) ).class.code in { 'EMER', 'IMP', 'ACUTE', 'NONAC', 'PRENC', 'SS' } ) )
              and BloodPressure.effective.latest ( ) during day of &quot;Measurement Period&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="2"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Blood Pressure Days"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Blood Pressure Days&quot;:
      &quot;Qualifying Blood Pressure Reading&quot; BPExam
        return date from BPExam.effective.latest ( )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="3"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Most Recent Blood Pressure Day"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Most Recent Blood Pressure Day&quot;:
      Last(&quot;Blood Pressure Days&quot; BPDays
          sort asc
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="4"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Lowest Systolic Reading on Most Recent Blood Pressure Day"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Lowest Systolic Reading on Most Recent Blood Pressure Day&quot;:
      First(&quot;Qualifying Blood Pressure Reading&quot; BPReading
          where BPReading.effective.latest() same day as &quot;Most Recent Blood Pressure Day&quot;
          return singleton from(BPReading.component BPComponent
              where BPComponent.code ~ &quot;Systolic blood pressure&quot;
              return BPComponent.value as Quantity
          )
          sort asc
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="5"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Has Systolic Blood Pressure Less Than 140"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Systolic Blood Pressure Less Than 140&quot;:
      &quot;Lowest Systolic Reading on Most Recent Blood Pressure Day&quot; &lt; 140 'mm[Hg]'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="6"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Lowest Diastolic Reading on Most Recent Blood Pressure Day"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Lowest Diastolic Reading on Most Recent Blood Pressure Day&quot;:
      First(&quot;Qualifying Blood Pressure Reading&quot; BPReading
          where BPReading.effective.latest() same day as &quot;Most Recent Blood Pressure Day&quot;
          return singleton from(BPReading.component BPComponent
              where BPComponent.code ~ &quot;Diastolic blood pressure&quot;
              return BPComponent.value as Quantity
          )
          sort asc
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="7"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Has Diastolic Blood Pressure Less Than 90"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Diastolic Blood Pressure Less Than 90&quot;:
      &quot;Lowest Diastolic Reading on Most Recent Blood Pressure Day&quot; &lt; 90 'mm[Hg]'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="8"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Numerator"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Numerator&quot;:
      &quot;Has Systolic Blood Pressure Less Than 140&quot;
        and &quot;Has Diastolic Blood Pressure Less Than 90&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="9"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Essential Hypertension Diagnosis"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Essential Hypertension Diagnosis&quot;:
      ( ( [Condition: &quot;Essential Hypertension&quot;] ).verified ( ) ) Hypertension
        where Hypertension.prevalenceInterval ( ) overlaps Interval[start of &quot;Measurement Period&quot;, start of &quot;Measurement Period&quot; + 6 months )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="10"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdultOutpatientEncounters"/>
            </extension>
            <extension url="name">
              <valueString value="Qualifying Encounters"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="// NOTE: The USQualityCore encounter here is not introducing any constraints, and so could be expressed directly using US Core
    define &quot;Qualifying Encounters&quot;:
      ( (
        [USQualityCore.Encounter: &quot;Office Visit&quot;]
          union [USQualityCore.Encounter: &quot;Annual Wellness Visit&quot;]
          union [USQualityCore.Encounter: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
          union [USQualityCore.Encounter: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
          union [USQualityCore.Encounter: &quot;Home Healthcare Services&quot;]
          union [USQualityCore.Encounter: &quot;Virtual Encounter&quot;]
          union [USQualityCore.Encounter: &quot;Telephone Visits&quot;]
        ).isEncounterPerformed()
      ) ValidEncounter
        where ValidEncounter.period during day of &quot;Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="11"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Initial Population"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Initial Population&quot;:
      AgeInYearsAt(date from
        end of &quot;Measurement Period&quot;
      ) in Interval[18, 85]
        and exists &quot;Essential Hypertension Diagnosis&quot;
        and exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="12"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Denominator"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Denominator&quot;:
      &quot;Initial Population&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="13"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="SupplementalDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Payer"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Payer&quot;:
      [USQualityCore.Coverage: type in &quot;Payer Type&quot;] Payer
        return {
          code: Payer.type,
          period: Payer.period
        }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="14"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Payer"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Payer&quot;:
      SDE.&quot;SDE Payer&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="15"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="SupplementalDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Ethnicity"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Ethnicity&quot;:
      (Patient.ethnicity()) E
        return Tuple {
          codes: { E.ombCategory } union E.detailed,
          display: E.text
        }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="16"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Ethnicity"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Ethnicity&quot;:
      SDE.&quot;SDE Ethnicity&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="17"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Hospice"/>
            </extension>
            <extension url="name">
              <valueString value="Has Hospice Services"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Hospice Services&quot;:
      exists ((([USQualityCore.Encounter: &quot;Encounter Inpatient&quot;]).isEncounterPerformed()) InpatientEncounter
          where (InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
              or InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
          )
            and InpatientEncounter.period ends during day of &quot;Measurement Period&quot;
      )
        or exists ((([USQualityCore.Encounter: &quot;Hospice Encounter&quot;]).isEncounterPerformed()) HospiceEncounter
            where HospiceEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)
        or exists ((([USQualityCore.ObservationScreeningAssessment: code ~ &quot;Hospice care [Minimum Data Set]&quot;]).isAssessmentPerformed()) HospiceAssessment
            where HospiceAssessment.value ~ &quot;Yes (qualifier value)&quot;
              and HospiceAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.ServiceRequest: &quot;Hospice Care Ambulatory&quot;]).isInterventionOrder()) HospiceOrder
            where HospiceOrder.authoredOn during day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Procedure: &quot;Hospice Care Ambulatory&quot;]).isInterventionPerformed()) HospicePerformed
            where HospicePerformed.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
        )
        // TODO: Consider whether to keep this as the union of Problems and EncounterDiagnosis
        or exists ((([FHIR.Condition: &quot;Hospice Diagnosis&quot;]).verified()) HospiceCareDiagnosis
            where HospiceCareDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="18"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Pregnancy or Renal Diagnosis"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Pregnancy or Renal Diagnosis&quot;:
      ( ( [Condition: &quot;Pregnancy&quot;]
          union [Condition: &quot;End Stage Renal Disease&quot;]
          union [Condition: &quot;Kidney Transplant Recipient&quot;]
          union [Condition: &quot;Chronic Kidney Disease, Stage 5&quot;]
      ).verified ( ) ) PregnancyESRDDiagnosis
        where PregnancyESRDDiagnosis.prevalenceInterval ( ) overlaps &quot;Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="19"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="End Stage Renal Disease Procedures"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;End Stage Renal Disease Procedures&quot;:
      ( ( [Procedure: &quot;Kidney Transplant&quot;]
          union [Procedure: &quot;Dialysis Services&quot;]
      ).isProcedurePerformed ( ) ) ESRDProcedure
        where ESRDProcedure.performed.toInterval ( ) ends on or before end of &quot;Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="20"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="End Stage Renal Disease Encounter"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;End Stage Renal Disease Encounter&quot;:
      ( ( [Encounter: &quot;ESRD Monthly Outpatient Services&quot;] ).isEncounterPerformed ( ) ) ESRDEncounter
        where ESRDEncounter.period starts on or before end of &quot;Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="21"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdvancedIllnessandFrailty"/>
            </extension>
            <extension url="name">
              <valueString value="Has Criteria Indicating Frailty"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Criteria Indicating Frailty&quot;:
      exists ( (([USQualityCore.DeviceRequest: &quot;Frailty Device&quot;]).isDeviceOrderPersonalUseDevices()) FrailtyDeviceOrder
          where FrailtyDeviceOrder.authoredOn.toInterval() during day of &quot;Measurement Period&quot;
      )
        or exists ( (([ObservationScreeningAssessment: &quot;Medical equipment used&quot;]).isAssessmentPerformed()) EquipmentUsed
            where EquipmentUsed.value as CodeableConcept in &quot;Frailty Device&quot;
            and EquipmentUsed.effective.toInterval() ends during day of &quot;Measurement Period&quot;
        )
        // TODO: Consider whether to keep this as the union of problems and encounter diagnoses
        or exists ( (([FHIR.Condition: &quot;Frailty Diagnosis&quot;]).verified()) FrailtyDiagnosis
            where FrailtyDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ( (([USQualityCore.Encounter: &quot;Frailty Encounter&quot;]).isEncounterPerformed()) FrailtyEncounter
            where FrailtyEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        or exists ( (([USQualityCore.SimpleObservation: &quot;Frailty Symptom&quot;]).isSymptom()) FrailtySymptom
            where FrailtySymptom.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="22"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdvancedIllnessandFrailty"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Has Advanced Illness in Year Before or During Measurement Period"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;:
    // TODO: Consider whether to keep this as the union of problems and encounter diagnoses
    exists ((([Condition: &quot;Advanced Illness&quot;]).verified()) AdvancedIllnessDiagnosis
    where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of &quot;Measurement Period&quot; - 1 year, end of &quot;Measurement Period&quot;])"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="23"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdvancedIllnessandFrailty"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Has Dementia Medications in Year Before or During Measurement Period"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;:
      exists (( ([FHIR.MedicationRequest: &quot;Dementia Medications&quot;]).isMedicationActive()) DementiaMedication
          where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of &quot;Measurement Period&quot; - 1 year,
            end of &quot;Measurement Period&quot;]
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="24"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdvancedIllnessandFrailty"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty&quot;:
      ( AgeInYearsAt(date from end of &quot;Measurement Period&quot;) in Interval[66, 80]
          and &quot;Has Criteria Indicating Frailty&quot;
          and ( &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;
              or &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;
          )
      )
        or ( AgeInYearsAt(date from end of &quot;Measurement Period&quot;)&gt;= 81
            and &quot;Has Criteria Indicating Frailty&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="25"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="AdvancedIllnessandFrailty"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Is Age 66 or Older Living Long Term in a Nursing Home"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;:
      AgeInYearsAt(date from end of &quot;Measurement Period&quot;) &gt;= 66
        and ( ( Last( (([ObservationScreeningAssessment: &quot;Housing status&quot;]).isAssessmentPerformed()) HousingStatus
              where HousingStatus.effective.toInterval() ends on or before
              day of end of &quot;Measurement Period&quot;
              sort by
              end of effective.toInterval() asc
          )) LastHousingStatus
            where LastHousingStatus.value ~ &quot;Lives in nursing home (finding)&quot;
        ) is not null"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="26"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="PalliativeCare"/>
            </extension>
            <extension url="name">
              <valueString value="Has Palliative Care in the Measurement Period"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Palliative Care in the Measurement Period&quot;:
      // TODO: Shouldn't need to specify a code path here (see https://jira.hl7.org/browse/FHIR-53941)
      exists ((([USQualityCore.ObservationScreeningAssessment: code ~ &quot;Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)&quot;]).isAssessmentPerformed()) PalliativeAssessment
          where PalliativeAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
      )
        // TODO: Consider whether to keep this as the union of the problems and encounter diagnosis list? Anything enforced by the profiles that is expected but isn't stated here?
        or exists ((([FHIR.Condition: &quot;Palliative Care Diagnosis&quot;]).verified()) PalliativeDiagnosis
            where PalliativeDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Encounter: &quot;Palliative Care Encounter&quot;]).isEncounterPerformed()) PalliativeEncounter
            where PalliativeEncounter.period overlaps day of &quot;Measurement Period&quot;
        )
        or exists ((([USQualityCore.Procedure: &quot;Palliative Care Intervention&quot;]).isInterventionPerformed()) PalliativeIntervention
            where PalliativeIntervention.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="27"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="Denominator Exclusions"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Denominator Exclusions&quot;:
      Hospice.&quot;Has Hospice Services&quot;
        or exists ( &quot;Pregnancy or Renal Diagnosis&quot; )
        or exists ( &quot;End Stage Renal Disease Procedures&quot; )
        or exists ( &quot;End Stage Renal Disease Encounter&quot; )
        or AIFrailLTCF.&quot;Is Age 66 to 80 with Advanced Illness and Frailty or Is Age 81 or Older with Frailty&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="28"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="SupplementalDataElements"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Race"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Race&quot;:
      (Patient.race()) R
        return Tuple {
          codes: R.ombCategory union R.detailed,
          display: R.text
        }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="29"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="SDE Race"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;SDE Race&quot;:
      SDE.&quot;SDE Race&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="30"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value string): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="31"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="USCoreCommon"/>
            </extension>
            <extension url="name">
              <valueString value="sex"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns the sex element as defined for the USCore patient profile
    */
    define fluent function sex(patient Patient):
      patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-sex').value as FHIR.code"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="32"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="ext"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns the single extension (if present) on the given resource with the specified url.
    @comment: This function uses singleton from to ensure that a run-time exception is thrown if there
    is more than one extension on the given resource with the specified url.
    */
    define fluent function ext(domainResource DomainResource, url String):
      singleton from domainResource.exts(url)"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="33"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="exts"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns any extensions defined on the given resource with the specified url
    */
    define fluent function exts(domainResource DomainResource, url String):
      domainResource.extension E
        where E.url = url
        return E"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="34"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value uri): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="35"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToQuantity"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity)
    value to a CQL Quantity
    @comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity
    has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)
    an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.
    @seealso: ToCalendarUnit
    */
    define function ToQuantity(quantity FHIR.Quantity):
        case
            when quantity is null then null
            when quantity.value is null then null
            when quantity.comparator is not null then
                Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
            when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
                  or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
                System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
            else
                Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
        end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="36"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToCalendarUnit"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Converts a UCUM definite duration unit to a CQL calendar duration
    unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities)
    topic of the CQL specification.
    @comment: Note that for durations above days (or weeks), the conversion is understood to be approximate
    */
    define function ToCalendarUnit(unit System.String):
        case unit
            when 'ms' then 'millisecond'
            when 's' then 'second'
            when 'min' then 'minute'
            when 'h' then 'hour'
            when 'd' then 'day'
            when 'wk' then 'week'
            when 'mo' then 'month'
            when 'a' then 'year'
            else unit
        end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="37"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isObservationBP"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Observation Vital Signs
    define fluent function isObservationBP(Obs List&lt;BloodPressureProfile&gt;):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="38"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value ObservationStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="39"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isEncounterPerformed"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Encounter, Performed
    //General usage unless required otherwise by measure intent (e.g., follow-up encounters)
    define fluent function isEncounterPerformed(Enc List&lt;FHIR.Encounter&gt;):
      Enc E
        where E.status = 'finished'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="40"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value EncounterStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="41"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="latest"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Given an interval, returns the ending point if the interval has an ending boundary specified,
    otherwise, returns the starting point
    */
    define fluent function latest(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Age, FHIR.Range&gt;):
      (choice.toInterval()) period
        return
          if (period.hasEnd()) then end of period
          else start of period"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="42"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="toInterval"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
    @comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types
    to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
    representations for timing-valued elements in FHIR, allowing this function to be used across any resource.

    The input can be provided as a dateTime, Period, Timing, instant, string, Age, or Range.
    The intent of this function is to provide a clear and concise mechanism to treat single
    elements that have multiple possible representations as intervals so that logic doesn't have to account
    for the variability. More complex calculations (such as medication request period or dispense period
    calculation) need specific guidance and consideration. That guidance may make use of this function, but
    the focus of this function is on single element calculations where the semantics are unambiguous.
    If the input is a dateTime, the result a DateTime Interval beginning and ending on that dateTime.
    If the input is a Period, the result is a DateTime Interval.
    If the input is a Timing, an error is raised indicating a single interval cannot be computed from a Timing.
    If the input is an instant, the result is a DateTime Interval beginning and ending on that instant.
    If the input is a string, an error is raised indicating a single interval cannot be computed from a string.
    If the input is an Age, the result is a DateTime Interval beginning when the patient was the given Age,
    and ending immediately prior to when the patient was the given Age plus one year.
    If the input is a Range, the result is a DateTime Interval beginning when the patient was the Age given
    by the low end of the Range, and ending immediately prior to when the patient was the Age given by the
    high end of the Range plus one year.

    NOTE: Due to the
    complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used
    with a Timing or String.
    */
    define fluent function toInterval(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):
      case
        when choice is FHIR.dateTime then
          Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]
        when choice is FHIR.Period then
          FHIRHelpers.ToInterval(choice as FHIR.Period)
        when choice is FHIR.instant then
          Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]
        when choice is FHIR.Age then
          Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),
            FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)
        when choice is FHIR.Range then
          Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),
            FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)
        when choice is FHIR.Timing then
          Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported')
        when choice is FHIR.string then
          Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
        else
          null as Interval&lt;DateTime&gt;
      end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="43"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToDateTime"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToDateTime(value dateTime): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="44"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToInterval"/>
            </extension>
            <extension url="statement">
              <valueString
                           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.&quot;start&quot; is null then
                Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
            else
                Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="45"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToDateTime"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToDateTime(value instant): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="46"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToDate"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToDate(value date): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="47"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="hasEnd"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Given an interval, returns true if the interval has an ending boundary specified
    (i.e. the end of the interval is not null and not the maximum DateTime value)
    */
    define fluent function hasEnd(period Interval&lt;DateTime&gt;):
      not (
        end of period is null
          or end of period = maximum DateTime
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="48"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS165FHIRControllingHighBP"/>
            </extension>
            <extension url="name">
              <valueString value="getEncounter"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define fluent function getEncounter(reference Reference):
      singleton from ( [Encounter] E
        where reference.references(E)
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="49"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="references"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns true if the given reference is to the given resource
    @comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
    NOTE: This function assumes resources from the same source server.
    */
    define fluent function references(reference FHIR.Reference, resource FHIR.Resource):
      resource.id = Last(Split(reference.reference, '/'))"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="50"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToConcept"/>
            </extension>
            <extension url="statement">
              <valueString
                           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
            }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="51"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToCode"/>
            </extension>
            <extension url="statement">
              <valueString
                           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
            }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="52"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="verified"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
    */
    define fluent function verified(conditions List&lt;FHIR.Condition&gt;):
      conditions C
        where C.verificationStatus is not null implies
          (C.verificationStatus ~ &quot;confirmed&quot;
            or C.verificationStatus ~ &quot;unconfirmed&quot;
            or C.verificationStatus ~ &quot;provisional&quot;
            or C.verificationStatus ~ &quot;differential&quot;
          )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="53"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="prevalenceInterval"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns an interval representing the normalized prevalence period of a given Condition resource.
    @comment: Uses the toInterval and toAbatementInterval functions to determine the widest potential interval from
    onset to abatement as specified in the given Condition.
    */
    define fluent function prevalenceInterval(condition Condition):
    if condition.clinicalStatus ~ &quot;active&quot;
      or condition.clinicalStatus ~ &quot;recurrence&quot;
      or condition.clinicalStatus ~ &quot;relapse&quot; then
      Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
    else
      (end of condition.abatementInterval()) abatementDate
        return
    	  if abatementDate is null then
            Interval[start of condition.onset.toInterval(), abatementDate)
          else
            Interval[start of condition.onset.toInterval(), abatementDate]"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="54"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="abatementInterval"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns an interval representing the normalized Abatement of a given Condition resource.
    @comment: @comment: If the abatement element of the Condition is represented as a DateTime, the result
    is an interval beginning and ending on that DateTime.
    If 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
    result is an interval from the date the patient turned that age to immediately before one year later.
    If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
    which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
    before one year later than the date the patient turned the ending age of the quantity interval.

    NOTE: Due to the complexity of determining an interval from a String, this function will throw
    a run-time exception if used with a Condition instance that has a String as the abatement value.
    */
    define fluent function abatementInterval(condition Condition):
      if condition.abatement is FHIR.dateTime then
        Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)]
      else if condition.abatement is FHIR.Period then
        FHIRHelpers.ToInterval(condition.abatement as FHIR.Period)
      else if condition.abatement is FHIR.string then
        Message(null as Interval&lt;DateTime&gt;, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a String value is not supported')
      else if condition.abatement is FHIR.Age then
        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age),
          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year)
      else if condition.abatement is FHIR.Range then
        Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low),
          FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year)
      else if condition.abatement is FHIR.boolean then
        Interval[end of condition.onset.toInterval(), condition.recordedDate)
      else
        null"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="55"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="USCoreCommon"/>
            </extension>
            <extension url="name">
              <valueString value="ethnicity"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define fluent function ethnicity(patient Patient):
      (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity')) E
        return {
          ombCategory: E.ext('ombCategory').value as FHIR.Coding,
          detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
          text: E.ext('text').value as FHIR.string
        }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="56"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="ext"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns the single extension (if present) on the given element with the specified url.
    @comment: This function uses singleton from to ensure that a run-time exception is thrown if there
    is more than one extension on the given element with the specified url.
    */
    define fluent function ext(element Element, url String):
      singleton from element.exts(url)"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="57"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRCommon"/>
            </extension>
            <extension url="name">
              <valueString value="exts"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Returns any extensions defined on the given element with the specified url.
    */
    define fluent function exts(element Element, url String):
      element.extension E
        where E.url = url
        return E"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="58"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isAssessmentPerformed"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Assessment, Performed
    define fluent function isAssessmentPerformed(Obs List&lt;ObservationScreeningAssessment&gt;):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="59"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isInterventionOrder"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Intervention, Order
    define fluent function isInterventionOrder(ServiceRequest List&lt;FHIR.ServiceRequest&gt;):
      ServiceRequest S
        where S.status in { 'active', 'completed' }
          and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="60"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value ServiceRequestStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="61"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value ServiceRequestIntent): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="62"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isInterventionPerformed"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Intervention, Performed
    define fluent function isInterventionPerformed(Proc List&lt;FHIR.Procedure&gt;):
      Proc P
        where P.status ~ 'completed'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="63"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value ProcedureStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="64"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isProcedurePerformed"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Procedure, Performed
    define fluent function isProcedurePerformed(Proc List&lt;FHIR.Procedure&gt;):
      Proc P
        where P.status ~ 'completed'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="65"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isDeviceOrderPersonalUseDevices"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Device, Order - Personal Use Devices
    define fluent function isDeviceOrderPersonalUseDevices(DeviceRequest List&lt;FHIR.DeviceRequest&gt;):
      DeviceRequest D
        where D.status in { 'active', 'completed' }
          and D.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="66"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value DeviceRequestStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="67"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value RequestIntent): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="68"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isSymptom"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Symptom
    define fluent function isSymptom(Obs List&lt;SimpleObservation&gt;):
      Obs O
        where O.status in { 'preliminary', 'final', 'amended', 'corrected' }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="69"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isMedicationActive"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Medication, Active
    define fluent function isMedicationActive(MedicationRequest List&lt;FHIR.MedicationRequest&gt;):
      MedicationRequest M
        where M.status = 'active'
          and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="70"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value MedicationRequestStatus): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="71"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value MedicationRequestIntent): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="72"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CumulativeMedicationDuration"/>
            </extension>
            <extension url="name">
              <valueString value="medicationRequestPeriod"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    Calculates the Medication Period for a single MedicationRequest.
    MedicationRequest instances provided to this function are expected
    to conform to the [MMEMedicationRequest](http://build.fhir.org/ig/cqframework/opioid-mme-r4/StructureDefinition-mmemedicationrequest.html)
    profile, which expects:
    * 1 and only 1 dosageInstruction, multiple dosageInstruction elements will result in an error
    * 1 and only 1 doseAndRate, multiple doseAndRate elements will result in an error
    * 1 timing with 1 repeat, missing timing or repeat elements will result in a null
    * frequency, frequencyMax, defaulting to 1
    * period, periodUnit, defaulting to 1 'd'
    * timeOfDay
    * doseQuantity or doseRange, missing doseQuantity and doseRange will result in a null
    Note that MedicationRequest status is not considered by this calculation, as the
    list of MedicationRequest instances provided to this function should already have
    considered appropriate statuses, depending on the use case, typically `completed`.

    NOTE: Updated return to use &quot;date from end of boundsPeriod&quot; to ensure result is Interval&lt;Date&gt;
    */
    define fluent function medicationRequestPeriod(Request MedicationRequest):
      Request R
        let
          dosage: singleton from R.dosageInstruction,
          doseAndRate: singleton from dosage.doseAndRate,
          timing: dosage.timing,
          frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
          period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
          doseRange: doseAndRate.dose as FHIR.Range,
          doseQuantity: doseAndRate.dose as FHIR.SimpleQuantity,

          dose: Coalesce(end of doseRange, doseQuantity),
          dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
          boundsPeriod: timing.repeat.bounds as Period,
          // TODO: this isn't working as expected, convert results in null
          //daysSupply: (convert(R.dispenseRequest.expectedSupplyDuration) to days).value,
          daysSupply: (R.dispenseRequest.expectedSupplyDuration).value,
          quantity: R.dispenseRequest.quantity,
          refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
          startDate:
            Coalesce(
              date from start of boundsPeriod,
              date from R.authoredOn,
              date from start of R.dispenseRequest.validityPeriod
            ),
          totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
        return
          if startDate is not null and totalDaysSupplied is not null then
            Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
          else if startDate is not null and boundsPeriod.&quot;end&quot; is not null then
            Interval[startDate, date from end of boundsPeriod]
          else
            null"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="73"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CumulativeMedicationDuration"/>
            </extension>
            <extension url="name">
              <valueString value="Quantity"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/**********************************************************************/
    /* Functions in this region are copied from opioid-mme-r4             */
    /**********************************************************************/

    define function Quantity(value Decimal, unit String):
      if value is not null then
        System.Quantity { value: value, unit: unit }
      else
        null"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="74"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToDecimal"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToDecimal(value decimal): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="75"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToString"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToString(value UnitsOfTime): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="76"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToInterval"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
    @description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity
    */
    define function ToInterval(range FHIR.Range):
        if range is null then
            null
        else
            Interval[ToQuantity(range.low), ToQuantity(range.high)]"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="77"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CumulativeMedicationDuration"/>
            </extension>
            <extension url="name">
              <valueString value="ToDaily"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="/*
     Goal is to get to number of days
     Two broad approaches to the calculation:
      1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
      2) Based on relevant period, determine a covered interval and calculate the length of that interval in days

    This topic covers several use cases and illustrates how to calculate Cumulative
    Medication Duration for each type of medication resource using the supply and
    frequency approach.
    */

    /*
      For the first approach, we need to get from frequency to a frequency/day
      So we define ToDaily
    */

    /*
      Calculates daily frequency given frequency within a period
    */
    define function ToDaily(frequency System.Integer, period System.Quantity):
      case period.unit
        when 'h' then frequency * (24.0 / period.value)
        when 'min' then frequency * (24.0 / period.value) * 60
        when 's' then frequency * (24.0 / period.value) * 60 * 60
        when 'd' then frequency * (24.0 / period.value) / 24
        when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
        when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hour' then frequency * (24.0 / period.value)
        when 'minute' then frequency * (24.0 / period.value) * 60
        when 'second' then frequency * (24.0 / period.value) * 60 * 60
        when 'day' then frequency * (24.0 / period.value) / 24
        when 'week' then frequency * (24.0 / period.value) / (24 * 7)
        when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        when 'hours' then frequency * (24.0 / period.value)
        when 'minutes' then frequency * (24.0 / period.value) * 60
        when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
        when 'days' then frequency * (24.0 / period.value) / 24
        when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
        when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
        when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
        else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' &amp; period.unit)
      end"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="78"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="FHIRHelpers"/>
            </extension>
            <extension url="name">
              <valueString value="ToInteger"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define function ToInteger(value integer): value.value"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="79"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="USCoreCommon"/>
            </extension>
            <extension url="name">
              <valueString value="race"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define fluent function race(patient Patient):
      (patient.ext('http://hl7.org/fhir/us/core/StructureDefinition/us-core-race')) E
        return {
          ombCategory: (E.exts('ombCategory')) o return o.value as FHIR.Coding,
          detailed: (E.exts('detailed')) d return d.value as FHIR.Coding,
          text: E.ext('text').value as FHIR.string
        }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="80"/>
            </extension>
          </extension>
          <name value="EffectiveDataRequirements"/>
          <status value="active"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
              <code value="module-definition"/>
            </coding>
          </type>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="USQualityCore model information"/>
            <resource
                      value="https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="USCore model information"/>
            <resource
                      value="http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="FHIR model information"/>
            <resource
                      value="http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library SDE"/>
            <resource
                      value="https://madie.cms.gov/Library/SupplementalDataElements|6.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library FHIRHelpers"/>
            <resource
                      value="http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library USCommon"/>
            <resource
                      value="http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library FHIRCommon"/>
            <resource
                      value="http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library Status"/>
            <resource value="https://madie.cms.gov/Library/Status|2.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library AdultOutpatientEncounters"/>
            <resource
                      value="https://madie.cms.gov/Library/AdultOutpatientEncounters|5.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library Hospice"/>
            <resource value="https://madie.cms.gov/Library/Hospice|7.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library AIFrailLTCF"/>
            <resource
                      value="https://madie.cms.gov/Library/AdvancedIllnessandFrailty|2.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library CMD"/>
            <resource
                      value="http://hl7.org/fhir/us/cql/Library/CumulativeMedicationDuration|2.0.0-ballot"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Library PalliativeCare"/>
            <resource
                      value="https://madie.cms.gov/Library/PalliativeCare|2.1.000"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Code system SNOMEDCT"/>
            <resource value="http://snomed.info/sct"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Code system LOINC"/>
            <resource value="http://loinc.org"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Code system ConditionVerificationStatusCodes"/>
            <resource
                      value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Code system ConditionClinicalStatusCodes"/>
            <resource
                      value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Value set Encounter Inpatient"/>
            <resource
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display
                     value="Value set Emergency Department Evaluation and Management Visit"/>
            <resource
                      value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1010"/>
          </relatedArtifact>
          <relatedArtifact>
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                     value="http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation"/>
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                       url="http://hl7.org/fhir/StructureDefinition/cqf-relatedRequirement">
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            <mustSupport value="dispenseRequest.expectedSupplyDuration.value"/>
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                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
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          <valueString
                       value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
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                      value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
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                 url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
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      <url value="https://madie.cms.gov/Measure/CMS165FHIRControllingHighBP"/>
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        <value value="165FHIR"/>
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      <version value="1.1.000"/>
      <name value="CMS165FHIRControllingHighBP"/>
      <title value="Controlling High Blood PressureFHIR"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2026-01-16T18:18:13+00:00"/>
      <publisher value="National Committee for Quality Assurance"/>
      <contact>
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          <value value="https://www.ncqa.org/"/>
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      <description
                   value="Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (&amp;lt;140/90 mmHg) during the measurement period"/>
      <usage
             value="In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Do not include BP readings taken during an acute inpatient stay or an emergency department (ED) visit. If no blood pressure is recorded during the measurement period, the patient's blood pressure is assumed &quot;not controlled&quot;. If there are multiple blood pressure readings on the same day, use the lowest systolic and the lowest diastolic reading as the most recent blood pressure reading. Ranges and thresholds do not meet criteria for this measure. A distinct numeric result for both the systolic and diastolic BP reading is required for numerator compliance. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS165v14. 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)."/>
      <copyright
                 value="This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International."/>
      <effectivePeriod>
        <start value="2026-01-01"/>
        <end value="2026-12-31"/>
      </effectivePeriod>
      <author>
        <name value="National Committee for Quality Assurance"/>
        <telecom>
          <system value="url"/>
          <value value="https://www.ncqa.org/"/>
        </telecom>
      </author>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="American Diabetes Association. (2022). 10. Cardiovascular disease and risk management: Standards of medical care in diabetes—2022. Diabetes Care 2022, 44(Suppl. 1), S144-S175. https://doi.org/10.2337/dc22-S010"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Centers for Disease Control and Prevention, National Center for Health Statistics. (2022). About Multiple Cause of Death, 1999–2020. CDC WONDER Online Database website. Atlanta, GA: Centers for Disease Control and Prevention. Available from http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm#Mortality_Multiple"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Centers for Disease Control and Prevention. (2021). Team-based care for high blood pressure. Retrieved from https://www.cdc.gov/policy/polaris/healthtopics/highbloodpressure/tbctool.html"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Centers for Disease Control and Prevention. (2023). Facts about hypertension. Retrieved from https://www.cdc.gov/bloodpressure/facts.htm"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Coles, S., Fisher, L., Lin, K. W., Lyon, C., Vosooney, A. A., &amp;amp; Bird, M. D. (2022). Blood Pressure Targets in Adults With Hypertension: A Clinical Practice Guideline From the AAFP. American family physician, 106(6). Retrieved from https://www.aafp.org/pubs/afp/issues/2022/1200/practice-guidelines-aafp-hypertension-full-guideline.html"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="James, P.A., Oparil, S., Carter, B.L., et al. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. doi: 10.1001/jama.2013.284427"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Kirkland, E. B., Heincelman, M., Bishu, K. G., Schumann, S. O., Schreiner, A., Axon, R. N.,...Moran, W. P. (2018). Trends in Healthcare Expenditures Among US Adults With Hypertension: National Estimates, 2003–2014. Journal of the American Heart Association, 7(11), e008731. https://doi.org/10.1161/JAHA.118.008731"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Moran, A. E., Odden, M. C., Thanataveerat, A., et al. (2015). Cost-effectiveness of hypertension therapy according to 2014 guidelines. [published correction appears in N Engl J. Med. 2015;372:1677]. New England Journal of Medicine. 2015;372, 447-455. doi: 10.1056/NEJMsa1406751. [published correction appears on page 1677]"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Patel, S. A., Winkel, M., Ali, M. K., et al. (2015). Cardiovascular mortality associated with 5 leading risk factors: National and state preventable fractions estimated from survey data. Annals of Internal Medicine, 163(4), 245-253. doi: 10.7326/M14-1753"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Qaseem, A., Wilt, T. J., Rich, R., et al. (2017). Pharmacologic treatment of hypertension in adults aged 60 years or older to higher versus lower blood pressure targets: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Annals of Internal Medicine, 166(6), 430-437. Retrieved from https://annals.org/aim/fullarticle/2598413/pharmacologic-treatment-hypertension-adults-aged-60-years-older-higher-versus"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="SPRINT Research Group, Wright, J. T., Jr., Williamson, J. D., et al. (2015). A randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine, 373(22), 2103–2116."/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S.,...Kissela, B. M. (2022). Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation, 145(8), e153–e639. https://doi.org/10.1161/CIR.0000000000001052"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="U.S. Preventive Services Task Force. Screening for hypertension in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. JAMA, 325(16), 1650. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Virani, S.S., Alonso, A., Aparicio, H.J., et al.; on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2021). Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation. 2021;143:e254–e743. doi: 10.1161/CIR.0000000000000950"/>
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      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Whelton, P. K., Carey, R. M., Aronow, W. S., et al. (2017). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. Hypertension. 71(6). https://doi.org/10.1161/HYP.0000000000000065"/>
      </relatedArtifact>
      <library value="https://madie.cms.gov/Library/CMS165FHIRControllingHighBP"/>
      <disclaimer
                  value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
      <rationale
                 value="High blood pressure (HBP), also known as hypertension, is when the pressure in blood vessels is higher than normal (Centers for Disease Control and Prevention [CDC], 2023). The causes of hypertension are multiple and multifaceted and can be based on genetic predisposition, environmental risk factors, being overweight and obese, sodium intake, potassium intake, physical activity, and alcohol use. High blood pressure is common; according to the American Heart Association, between 2013-2016, approximately 121.5 million US adults &amp;gt;= 20 years of age had HBP and the prevalence of hypertension among US adults 65 and older was 77.0 percent (Virani et al., 2021). In an analysis of adults with hypertension in National Health and Nutrition Examination Survey (NHANES), the estimated age-adjusted proportion with controlled blood pressure (BP) increased from 31.8 percent in 1999 to 53.8 percent in 2014. However, that proportion declined to 43.7 percent in 2017 to 2018 (Tsao et al., 2022). HBP increases risks of heart disease and stroke which are two of the leading causes of death in the US (CDC, 2023). A person who has HBP is four times more likely to die from a stroke and three times more likely to die from heart disease (CDC, 2021). The National Center for Health Statistics reported that in 2020 there were over 670,000 deaths with HBP as a primary or contributing cause (CDC, 2022). Between 2009 and 2019 the number of deaths due to HBP rose by 65.3 percent (Tsao et al., 2022). Managing and treating HBP would reduce cardiovascular disease mortality for males and females by 30.4 percent and 38.0 percent, respectively (Patel et al., 2015). Age-adjusted death rates attributable to HBP in 2019 were more than twice as high in non-Hispanic Black males (56.7 percent) when compared to rates for non-Hispanic White males (25.7 percent) (Tsao et al., 2022). HBP costs the U.S. approximately 131 billion dollars each year, averaged over 12 years from 2003 to 2014 (Kirkland et al., 2018). A study on cost-effectiveness on treating hypertension found that controlling HBP in patients with cardiovascular disease and systolic blood pressures (SBP) of &amp;gt;= 160 mmHg could be effective and cost-saving (Moran et al., 2015). Many studies have shown that controlling high blood pressure reduces cardiovascular events and mortality. The Systolic Blood Pressure Intervention Trial (SPRINT) investigated the impact of obtaining a SBP goal of &amp;lt;120 mmHg compared to a SBP goal of &amp;lt;140 mmHg among patients 50 and older with established cardiovascular disease and found that the patients with the former goal had reduced cardiovascular events and mortality (SPRINT Research Group et al., 2015). Controlling HBP will significantly reduce the risks of cardiovascular disease mortality and lead to better health outcomes like reduction of heart attacks, stroke, and kidney disease (James et al., 2014). Thus, the relationship between the measure (control of hypertension) and the long-term clinical outcomes listed is well established."/>
      <clinicalRecommendationStatement
                                       value="U.S. Preventive Services Task Force (USPSTF) (2021): - The USPSTF recommends screening for hypertension in adults 18 years or older with office blood pressure measurement (OBPM). The USPSTF recommends obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation before starting treatment. This is a grade A recommendation. American College of Cardiology/American Heart Association (2017): - For adults with confirmed hypertension and known cardiovascular disease (CVD) or 10-year atherosclerotic cardiovascular disease (ASCVD) event risk of 10 percent or higher, a blood pressure target of less than 130/80 mmHg is recommended (Level of evidence: B-R (for systolic blood pressures), Level of evidence: C-EO (for diastolic blood pressure)) - For adults with confirmed hypertension, without additional markers of increased CVD risk, a blood pressure target of less than 130/80 mmHg may be reasonable (Note: clinical trial evidence is strongest for a target blood pressure of 140/90 mmHg in this population. However, observational studies suggest that these individuals often have a high lifetime risk and would benefit from blood pressure control earlier in life) (Level of evidence: B-NR (for systolic blood pressure), Level of evidence: C-EO (for diastolic blood pressure)). American Academy of Family Physicians (2022): - Treat adults who have hypertension to a standard blood pressure target (less than 140/90 mm Hg) to reduce the risk of all-cause and cardiovascular mortality (strong recommendation; high-quality evidence). Treating to a lower blood pressure target (less than 135/85 mm Hg) does not provide additional benefit at preventing mortality; however, a lower blood pressure target could be considered based on patient preferences and values. (Grade: strong recommendation, Quality of evidence: high) - Consider treating adults who have hypertension to a lower blood pressure target (less than 135/85 mm Hg) to reduce risk of myocardial infarction (weak recommendation; moderate-quality evidence). Although treatment to a standard blood pressure target (less than 140/90 mm Hg) reduced the risk of myocardial infarction, there was a small additional benefit observed with a lower blood pressure target. There was no observed additional benefit in preventing stroke with the lower blood pressure target. (Grade: weak recommendation, Quality of evidence: low) American Diabetes Association (2022): - For individuals with diabetes and hypertension at higher cardiovascular risk (existing atherosclerotic cardiovascular disease or 10-year atherosclerotic cardiovascular disease risk &amp;gt;=15 percent), a blood pressure target of &amp;lt;130/80 mmHg may be appropriate, if it can be safely attained (Level of evidence: B) - For individuals with diabetes and hypertension at lower risk for cardiovascular disease (10-year atherosclerotic cardiovascular disease risk &amp;lt;15 percent), treat to a blood pressure target of &amp;lt;140/90 mmHg (Level of evidence: A)"/>
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                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
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            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
              <code value="proportion"/>
              <display value="Proportion"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
          <valueCode value="boolean"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
          <valueCodeableConcept>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
              <code value="intermediate-outcome"/>
              <display value="Intermediate Outcome"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
          <valueCode value="None"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
              <code value="increase"/>
              <display value="Increased score indicates improvement"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <population id="InitialPopulation_1">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="initial-population"/>
              <display value="Initial Population"/>
            </coding>
          </code>
          <description
                       value="Patients 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period"/>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Initial Population"/>
          </criteria>
        </population>
        <population id="Denominator_1">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="denominator"/>
              <display value="Denominator"/>
            </coding>
          </code>
          <description value="Equals Initial Population"/>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Denominator"/>
          </criteria>
        </population>
        <population id="DenominatorExclusion_1">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="denominator-exclusion"/>
              <display value="Denominator Exclusion"/>
            </coding>
          </code>
          <description
                       value="Exclude patients who are in hospice care for any part of the measurement period. Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period. Also exclude patients with a diagnosis of pregnancy during the measurement period. Exclude patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients receiving palliative care for any part of the measurement period."/>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Denominator Exclusions"/>
          </criteria>
        </population>
        <population id="Numerator_1">
          <code>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-population"/>
              <code value="numerator"/>
              <display value="Numerator"/>
            </coding>
          </code>
          <description
                       value="Patients whose most recent blood pressure is adequately controlled (systolic blood pressure &amp;lt; 140 mmHg and diastolic blood pressure &amp;lt; 90 mmHg) during the measurement period"/>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Numerator"/>
          </criteria>
        </population>
      </group>
      <supplementalData id="sde-sex">
        <usage>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
            <code value="supplemental-data"/>
          </coding>
        </usage>
        <description value="SDE Sex"/>
        <criteria>
          <language value="text/cql-identifier"/>
          <expression value="SDE Sex"/>
        </criteria>
      </supplementalData>
      <supplementalData id="sde-race">
        <usage>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
            <code value="supplemental-data"/>
          </coding>
        </usage>
        <description value="SDE Race"/>
        <criteria>
          <language value="text/cql-identifier"/>
          <expression value="SDE Race"/>
        </criteria>
      </supplementalData>
      <supplementalData id="sde-payer">
        <usage>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
            <code value="supplemental-data"/>
          </coding>
        </usage>
        <description value="SDE Payer"/>
        <criteria>
          <language value="text/cql-identifier"/>
          <expression value="SDE Payer"/>
        </criteria>
      </supplementalData>
      <supplementalData id="sde-ethnicity">
        <usage>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
            <code value="supplemental-data"/>
          </coding>
        </usage>
        <description value="SDE Ethnicity"/>
        <criteria>
          <language value="text/cql-identifier"/>
          <expression value="SDE Ethnicity"/>
        </criteria>
      </supplementalData>
    </Measure>