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

## : Diabetes: Glycemic Status Assessment Greater Than 9%FHIR - XML Representation

Active as of 2026-01-16

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    <Measure xmlns="http://hl7.org/fhir">
      <id value="CMS122FHIRDiabetesAssessGT9Pct"/>
      <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">Diabetes: Glycemic Status Assessment Greater Than 9%FHIR</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">CMS122FHIR</td>

    </tr>

    <tr>

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

    <td class="content-container">urn:uuid:f04ee808-8ece-4936-8b26-fafa462e1594</td>

    </tr>

    <tr>

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

    <td class="content-container">urn:uuid:2ea22cb2-9bcc-4ca6-b2f2-68fc964365ad</td>

    </tr>

    <tr>

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

    <td class="content-container">122FHIR</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 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) &gt; 9.0% 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>Diabetes is the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2022a). In 2019, diabetes affected more than 37 million Americans (11.3% of the U.S. population) and killed more than 87,000 people (American Diabetes Association [ADA], 2022a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2022a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, amputation of feet or legs, and premature death (CDC, 2022b). In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (ADA, 2018). Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2022b).</p>
    </div></td>

    </tr>

    <tr>

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

    <td class="content-container"><div><p>American Diabetes Association (2023): - Assess glycemic status (A1C or other glycemic measurement such as time in range or glucose management indicator) at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). (Level of evidence: E) - An A1C goal for many nonpregnant adults of &lt;7% (53 mmol/mol) without significant hypoglycemia is appropriate. (Level of evidence: A) - On the basis of health care professional judgement and patient preference, achievement of lower A1C levels than the goal of 7% may be acceptable and even beneficial if it can be achieved safely without significant hypoglycemia or other adverse effects of treatment. (Level of evidence: B) - Less stringent A1C goals (such as &lt;8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits. Health care professionals should consider deintensification of therapy if appropriate to reduce the risk of hypoglycemia in patients with inappropriate stringent A1C targets. (Level of evidence: B) - Standardized, single-page glucose reports from continuous glucose monitoring (CGM) devices with visual cues, such as the ambulatory glucose profile, should be considered as a standard summary for all CGM devices. Level of evidence: E</p>
    </div></td>

    </tr>

    <tr>

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

      <td class="content-container">

        <div><p>American Diabetes Association. (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care, 41, 917-928. Retrieved from http://care.diabetesjournals.org/content/early/2018/03/20/dci18-0007</p>
    </div>

      </td>
    </tr>

    <tr>

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

      <td class="content-container">

        <div><p>American Diabetes Association. (2022a). Statistics About Diabetes. Retrieved from https://diabetes.org/about-us/statistics/about-diabetes</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. (2022a). What is Diabetes? Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.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. (2022b). Diabetes Report Card 2021. US Dept of Health and Human Services. Retrieved from https://archive.cdc.gov/www_cdc_gov/diabetes/library/reports/reportcard.html</p>
    </div>

      </td>
    </tr>

    <tr>

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

      <td class="content-container">

        <div><p>ElSayed, N.A., Aleppo, G., Ardoda, V.R., Bannuru, R.B., Brown, F.M., Bruemmer, D.,…Staton, R.C., American Diabetes Association (ADA). (2022). 6. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care 2023,46(Supplement_1):S97–S110. https://doi.org/10.2337/dc23-S006</p>
    </div>

      </td>
    </tr>

    <tr>

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

    <td class="content-container">If the glycemic status assessment (HbA1c or GMI) is in the medical record, the test can be used to determine numerator compliance. Glycemic status assessment (HbA1c or GMI) must be reported as a percentage (%). If multiple glycemic status assessments were recorded for a single date, use the lowest result. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS122v14. 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 18-75 years of age by the end of the measurement period, with diabetes with a visit during 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. 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 66 and older 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 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 glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is &amp;gt;9.0% or is missing, or was not performed 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-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="#cms122fhirdiabetesassessgt9pct-sde-ethnicity">SDE Ethnicity</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="#cms122fhirdiabetesassessgt9pct-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-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="#cms122fhirdiabetesassessgt9pct-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-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="#cms122fhirdiabetesassessgt9pct-sde-sex">SDE Sex</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-CMS122FHIRDiabetesAssessGT9Pct.html">CMS122FHIRDiabetesAssessGT9Pct</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, 75]
        and exists &quot;Qualifying Encounters&quot;
        and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
            where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of &quot;Measurement Period&quot;
        )</code></pre>

          <a href="#cms122fhirdiabetesassessgt9pct-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="#cms122fhirdiabetesassessgt9pct-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 AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;
        or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;</code></pre>

          <a href="#cms122fhirdiabetesassessgt9pct-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 Most Recent Glycemic Status Assessment Without Result&quot;
        or &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;
        or &quot;Has No Record Of Glycemic Status Assessment&quot;</code></pre>

          <a href="#cms122fhirdiabetesassessgt9pct-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> 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-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> 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-or-older-with-advanced-illness-and-frailty"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;:
       AgeInYearsAt(date from end of &quot;Measurement Period&quot;) &gt;= 66
        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;
        )</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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-glycemic-status-assessment"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Glycemic Status Assessment&quot;:
      ( ( [LaboratoryResultObservation: &quot;HbA1c Laboratory Test&quot;]
          union [LaboratoryResultObservation: &quot;Glucose management indicator&quot;]
      ).isLaboratoryTestPerformed ( ) ) GlycemicStatus
        where GlycemicStatus.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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-most-recent-glycemic-status-date"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Most Recent Glycemic Status Date&quot;:
      Last((&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
          return date from QualifyingGlycemicStatus.effective.latest()) QualifyingGlycemicStatus
          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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-lowest-glycemic-status-assessment-reading-on-most-recent-day"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;:
      First(&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
          where QualifyingGlycemicStatus.effective.latest() same day as &quot;Most Recent Glycemic Status Date&quot;
          return {
            QualifyingGlycemicStatusValue: QualifyingGlycemicStatus.value as Quantity,
            QualifyingGlycemicStatus: QualifyingGlycemicStatus
          }
          sort by QualifyingGlycemicStatusValue
      ).QualifyingGlycemicStatus</code></pre>
      </td>

    </tr>

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

      <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-has-most-recent-glycemic-status-assessment-without-result"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;:
      &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot; is not null
        and &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value is 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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-has-most-recent-elevated-glycemic-status-assessment"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;:
      &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value &gt; 9 '%'</code></pre>
      </td>

    </tr>

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

      <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-has-no-record-of-glycemic-status-assessment"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has No Record Of Glycemic Status Assessment&quot;:
      not exists &quot;Glycemic Status Assessment&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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-numerator"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
      &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;
        or &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;
        or &quot;Has No Record Of Glycemic Status Assessment&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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-qualifying-encounters"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Qualifying Encounters&quot;:
      ( ( [Encounter: &quot;Office Visit&quot;]
          union [Encounter: &quot;Annual Wellness Visit&quot;]
          union [Encounter: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
          union [Encounter: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
          union [Encounter: &quot;Home Healthcare Services&quot;]
          union [Encounter: &quot;Nutrition Services&quot;]
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes&quot;
              )
          )
          union [Encounter: &quot;Telephone Visits&quot;]
      ).isEncounterPerformed ( ) ) ValidEncounters
        where ValidEncounters.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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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, 75]
        and exists &quot;Qualifying Encounters&quot;
        and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
            where DiabetesDiagnosis.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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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 AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&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> CMS122FHIRDiabetesAssessGT9Pct</td>

    </tr>
    <tr>

      <td>

          <a name="cms122fhirdiabetesassessgt9pct-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> 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-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-islaboratorytestperformed"> </a>

        <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Laboratory Test, Performed
    define fluent function isLaboratoryTestPerformed(Obs List&lt;LaboratoryResultObservation&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-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-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-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-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 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-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 CPT

        <br/>

        <em>Resource</em>: <a href="http://terminology.hl7.org/6.5.0/CodeSystem-CPT.html">Current Procedural Terminology (CPT®)</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://www.ama-assn.org/go/cpt</tt>

      </td>
    </tr>

    <tr>

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

      <td class="content-container">

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

        <br/>

        <em>Resource</em>: <a href="http://terminology.hl7.org/6.5.0/CodeSystem-hcpcs-Level-II.html">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</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 HbA1c Laboratory Test

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1013/expansion">HbA1c Laboratory Test</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013</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 Nutrition Services

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.1006/expansion">Nutrition Services</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006</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 Diabetes

        <br/>

        <em>Resource</em>: <a href="https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.103.12.1001/expansion">Diabetes</a>
        <br/>
        <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001</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 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 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 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>: Glucose management indicator
            <br/>

          <em>Code</em>: 97506-0
          <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 nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
            <br/>

          <em>Code</em>: 97802
          <br/>
          <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
        </td>
      </tr>

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

            <em>Display</em>: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
            <br/>

          <em>Code</em>: 97803
          <br/>
          <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
        </td>
      </tr>

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

            <em>Display</em>: Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
            <br/>

          <em>Code</em>: 97804
          <br/>
          <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
        </td>
      </tr>

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

            <em>Display</em>: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
            <br/>

          <em>Code</em>: G0270
          <br/>
          <em>System</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</tt>
        </td>
      </tr>

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

            <em>Display</em>: Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
            <br/>

          <em>Code</em>: G0271
          <br/>
          <em>System</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</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>: 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>: 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>: 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>: 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>: 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 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>: Observation
        <br/>

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

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

        <em>Must Support Elements</em>: code, status, effective, value
        <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/2.16.840.1.113883.3.464.1003.198.12.1013/expansion">HbA1c Laboratory Test</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-lab</code>
        <br/>

        <em>Must Support Elements</em>: code, status, effective, value
        <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/97506-0">LOINC: 97506-0</a> (Glucose management indicator)

        </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-lab</code>
        <br/>

        <em>Must Support Elements</em>: value, status, effective
        <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/>

      </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/2.16.840.1.113883.3.464.1003.101.12.1001/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>:

        <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/2.16.840.1.113883.3.526.3.1240/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>:

        <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/2.16.840.1.113883.3.464.1003.101.12.1025/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>:

        <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/2.16.840.1.113883.3.464.1003.101.12.1023/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>:

        <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/2.16.840.1.113883.3.464.1003.101.12.1016/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>:

        <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/2.16.840.1.113883.3.464.1003.1006/expansion">Nutrition 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>:

        <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/2.16.840.1.113883.3.464.1003.101.12.1080/expansion">Telephone Visits</a>
        <br/>

      </td>
    </tr>

    <tr>
      <th scope="row" class="row-header">Data Requirement</th>
      <td class="content-container">
        <em>Type</em>: 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/2.16.840.1.113883.3.464.1003.1165/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/2.16.840.1.113883.3.464.1003.113.12.1074/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>: Condition
        <br/>

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

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

        <em>Must Support Elements</em>: 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/2.16.840.1.113883.3.464.1003.103.12.1001/expansion">Diabetes</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>: 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>: 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, 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, 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/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>: 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="97506-0"/>
              <display value="Glucose management indicator"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="97802"/>
              <display
                       value="Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="97803"/>
              <display
                       value="Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system value="http://www.ama-assn.org/go/cpt"/>
              <code value="97804"/>
              <display
                       value="Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
              <code value="G0270"/>
              <display
                       value="Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes"/>
            </valueCoding>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
              <system
                      value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
              <code value="G0271"/>
              <display
                       value="Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes"/>
            </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://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://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="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="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="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="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString value="Glycemic Status Assessment"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Glycemic Status Assessment&quot;:
      ( ( [LaboratoryResultObservation: &quot;HbA1c Laboratory Test&quot;]
          union [LaboratoryResultObservation: &quot;Glucose management indicator&quot;]
      ).isLaboratoryTestPerformed ( ) ) GlycemicStatus
        where GlycemicStatus.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="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString value="Most Recent Glycemic Status Date"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Most Recent Glycemic Status Date&quot;:
      Last((&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
          return date from QualifyingGlycemicStatus.effective.latest()) QualifyingGlycemicStatus
          sort asc
      )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="3"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Lowest Glycemic Status Assessment Reading on Most Recent Day"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;:
      First(&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
          where QualifyingGlycemicStatus.effective.latest() same day as &quot;Most Recent Glycemic Status Date&quot;
          return {
            QualifyingGlycemicStatusValue: QualifyingGlycemicStatus.value as Quantity,
            QualifyingGlycemicStatus: QualifyingGlycemicStatus
          }
          sort by QualifyingGlycemicStatusValue
      ).QualifyingGlycemicStatus"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="4"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Has Most Recent Glycemic Status Assessment Without Result"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;:
      &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot; is not null
        and &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value is null"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="5"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString
                           value="Has Most Recent Elevated Glycemic Status Assessment"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;:
      &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value &gt; 9 '%'"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="6"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString value="Has No Record Of Glycemic Status Assessment"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Has No Record Of Glycemic Status Assessment&quot;:
      not exists &quot;Glycemic Status Assessment&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="7"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString value="Numerator"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Numerator&quot;:
      &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;
        or &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;
        or &quot;Has No Record Of Glycemic Status Assessment&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="8"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </extension>
            <extension url="name">
              <valueString value="Qualifying Encounters"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Qualifying Encounters&quot;:
      ( ( [Encounter: &quot;Office Visit&quot;]
          union [Encounter: &quot;Annual Wellness Visit&quot;]
          union [Encounter: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
          union [Encounter: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
          union [Encounter: &quot;Home Healthcare Services&quot;]
          union [Encounter: &quot;Nutrition Services&quot;]
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes&quot;
              )
          )
          union ( [Encounter] E
              where exists ( ( E.type ) T
                  where T ~ &quot;Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes&quot;
              )
          )
          union [Encounter: &quot;Telephone Visits&quot;]
      ).isEncounterPerformed ( ) ) ValidEncounters
        where ValidEncounters.period during day of &quot;Measurement Period&quot;"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="9"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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, 75]
        and exists &quot;Qualifying Encounters&quot;
        and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
            where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of &quot;Measurement Period&quot;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="10"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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="11"/>
            </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="12"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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="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 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="14"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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="15"/>
            </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="16"/>
            </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="17"/>
            </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="18"/>
            </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="19"/>
            </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="20"/>
            </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 with Advanced Illness and Frailty"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="define &quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;:
       AgeInYearsAt(date from end of &quot;Measurement Period&quot;) &gt;= 66
        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;
        )"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="21"/>
            </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="22"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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 AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
        or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;
        or PalliativeCare.&quot;Has Palliative Care in the 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="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="24"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
            </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="25"/>
            </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="26"/>
            </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="27"/>
            </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="28"/>
            </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="29"/>
            </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="30"/>
            </extension>
          </extension>
          <extension
                     url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
              <valueString value="Status"/>
            </extension>
            <extension url="name">
              <valueString value="isLaboratoryTestPerformed"/>
            </extension>
            <extension url="statement">
              <valueString
                           value="//Laboratory Test, Performed
    define fluent function isLaboratoryTestPerformed(Obs List&lt;LaboratoryResultObservation&gt;):
      Obs O
        where O.status in { 'final', 'amended', 'corrected' }"/>
            </extension>
            <extension url="displaySequence">
              <valueInteger value="31"/>
            </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="32"/>
            </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="33"/>
            </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="34"/>
            </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="35"/>
            </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="36"/>
            </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="37"/>
            </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="38"/>
            </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="39"/>
            </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="40"/>
            </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="41"/>
            </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="42"/>
            </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="43"/>
            </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="44"/>
            </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="45"/>
            </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="46"/>
            </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="47"/>
            </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="48"/>
            </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="49"/>
            </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="50"/>
            </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="51"/>
            </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="52"/>
            </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="53"/>
            </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="54"/>
            </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="55"/>
            </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="56"/>
            </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="57"/>
            </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="58"/>
            </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="59"/>
            </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="60"/>
            </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="61"/>
            </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="62"/>
            </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="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 MedicationRequestIntent): 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="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="65"/>
            </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="66"/>
            </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="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 UnitsOfTime): 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="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="69"/>
            </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="70"/>
            </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="71"/>
            </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="72"/>
            </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 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 CPT"/>
            <resource value="http://www.ama-assn.org/go/cpt"/>
          </relatedArtifact>
          <relatedArtifact>
            <type value="depends-on"/>
            <display value="Code system HCPCS"/>
            <resource
                      value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
          </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"/>
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            </codeFilter>
          </dataRequirement>
          <dataRequirement>
            <type value="Observation"/>
            <profile
                     value="http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-simple-observation"/>
            <mustSupport value="code"/>
            <mustSupport value="effective"/>
            <mustSupport value="status"/>
            <codeFilter>
              <path value="code"/>
              <valueSet
                        value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075"/>
            </codeFilter>
          </dataRequirement>
          <dataRequirement>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/cqf-relatedRequirement">
              <extension url="targetId">
                <valueString value="730"/>
              </extension>
              <extension url="targetProperty">
                <valueString value="medication"/>
              </extension>
            </extension>
            <type value="Medication"/>
            <profile value="http://hl7.org/fhir/StructureDefinition/Medication"/>
            <mustSupport value="id"/>
            <mustSupport value="code"/>
            <codeFilter>
              <path value="code"/>
              <valueSet
                        value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
            </codeFilter>
          </dataRequirement>
          <dataRequirement id="730">
            <type value="MedicationRequest"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
            <mustSupport value="medication.reference"/>
            <mustSupport value="status"/>
            <mustSupport value="intent"/>
            <mustSupport value="dosageInstruction"/>
            <mustSupport value="dispenseRequest"/>
            <mustSupport value="dispenseRequest.expectedSupplyDuration"/>
            <mustSupport value="dispenseRequest.expectedSupplyDuration.value"/>
            <mustSupport value="dispenseRequest.quantity"/>
            <mustSupport value="dispenseRequest.numberOfRepeatsAllowed"/>
            <mustSupport value="authoredOn"/>
            <mustSupport value="dispenseRequest.validityPeriod"/>
          </dataRequirement>
          <dataRequirement>
            <type value="MedicationRequest"/>
            <profile
                     value="http://hl7.org/fhir/StructureDefinition/MedicationRequest"/>
            <mustSupport value="medication"/>
            <mustSupport value="status"/>
            <mustSupport value="intent"/>
            <mustSupport value="dosageInstruction"/>
            <mustSupport value="dispenseRequest"/>
            <mustSupport value="dispenseRequest.expectedSupplyDuration"/>
            <mustSupport value="dispenseRequest.expectedSupplyDuration.value"/>
            <mustSupport value="dispenseRequest.quantity"/>
            <mustSupport value="dispenseRequest.numberOfRepeatsAllowed"/>
            <mustSupport value="authoredOn"/>
            <mustSupport value="dispenseRequest.validityPeriod"/>
            <codeFilter>
              <path value="medication"/>
              <valueSet
                        value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
            </codeFilter>
          </dataRequirement>
        </Library>
      </contained>
      <extension
                 url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
        <extension url="guidance">
          <valueString
                       value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
        </extension>
        <extension url="usage">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
              <code value="supplemental-data"/>
              <display value="Supplemental Data"/>
            </coding>
            <text value="Supplemental Data Guidance"/>
          </valueCodeableConcept>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
        <valueCanonical value="#effective-data-requirements"/>
      </extension>
      <url value="https://madie.cms.gov/Measure/CMS122FHIRDiabetesAssessGT9Pct"/>
      <identifier>
        <use value="usual"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
            <code value="short-name"/>
            <display value="Short Name"/>
          </coding>
        </type>
        <system value="https://madie.cms.gov/measure/shortName"/>
        <value value="CMS122FHIR"/>
      </identifier>
      <identifier>
        <use value="official"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
            <code value="version-independent"/>
            <display value="Version Independent"/>
          </coding>
        </type>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:uuid:f04ee808-8ece-4936-8b26-fafa462e1594"/>
      </identifier>
      <identifier>
        <use value="official"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
            <code value="version-specific"/>
            <display value="Version Specific"/>
          </coding>
        </type>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:uuid:2ea22cb2-9bcc-4ca6-b2f2-68fc964365ad"/>
      </identifier>
      <identifier>
        <use value="official"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
            <code value="publisher"/>
            <display value="Publisher"/>
          </coding>
        </type>
        <system value="https://madie.cms.gov/measure/cmsId"/>
        <value value="122FHIR"/>
        <assigner>
          <display value="CMS"/>
        </assigner>
      </identifier>
      <version value="1.1.000"/>
      <name value="CMS122FHIRDiabetesAssessGT9Pct"/>
      <title value="Diabetes: Glycemic Status Assessment Greater Than 9%FHIR"/>
      <status value="active"/>
      <experimental value="false"/>
      <date value="2026-01-16T18:18:12+00:00"/>
      <publisher value="National Committee for Quality Assurance"/>
      <contact>
        <telecom>
          <system value="url"/>
          <value value="https://www.ncqa.org/"/>
        </telecom>
      </contact>
      <description
                   value="Percentage of patients 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) &amp;gt; 9.0% during the measurement period"/>
      <usage
             value="If the glycemic status assessment (HbA1c or GMI) is in the medical record, the test can be used to determine numerator compliance. Glycemic status assessment (HbA1c or GMI) must be reported as a percentage (%). If multiple glycemic status assessments were recorded for a single date, use the lowest result. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS122v14. 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. (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care, 41, 917-928. Retrieved from http://care.diabetesjournals.org/content/early/2018/03/20/dci18-0007"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="American Diabetes Association. (2022a). Statistics About Diabetes. Retrieved from https://diabetes.org/about-us/statistics/about-diabetes"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Centers for Disease Control and Prevention. (2022a). What is Diabetes? Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="Centers for Disease Control and Prevention. (2022b). Diabetes Report Card 2021. US Dept of Health and Human Services. Retrieved from https://archive.cdc.gov/www_cdc_gov/diabetes/library/reports/reportcard.html"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="citation"/>
        <citation
                  value="ElSayed, N.A., Aleppo, G., Ardoda, V.R., Bannuru, R.B., Brown, F.M., Bruemmer, D.,…Staton, R.C., American Diabetes Association (ADA). (2022). 6. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care 2023,46(Supplement_1):S97–S110. https://doi.org/10.2337/dc23-S006"/>
      </relatedArtifact>
      <library
               value="https://madie.cms.gov/Library/CMS122FHIRDiabetesAssessGT9Pct"/>
      <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="Diabetes is the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2022a). In 2019, diabetes affected more than 37 million Americans (11.3% of the U.S. population) and killed more than 87,000 people (American Diabetes Association [ADA], 2022a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2022a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, amputation of feet or legs, and premature death (CDC, 2022b). In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (ADA, 2018). Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2022b)."/>
      <clinicalRecommendationStatement
                                       value="American Diabetes Association (2023): - Assess glycemic status (A1C or other glycemic measurement such as time in range or glucose management indicator) at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). (Level of evidence: E) - An A1C goal for many nonpregnant adults of &amp;lt;7% (53 mmol/mol) without significant hypoglycemia is appropriate. (Level of evidence: A) - On the basis of health care professional judgement and patient preference, achievement of lower A1C levels than the goal of 7% may be acceptable and even beneficial if it can be achieved safely without significant hypoglycemia or other adverse effects of treatment. (Level of evidence: B) - Less stringent A1C goals (such as &amp;lt;8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits. Health care professionals should consider deintensification of therapy if appropriate to reduce the risk of hypoglycemia in patients with inappropriate stringent A1C targets. (Level of evidence: B) - Standardized, single-page glucose reports from continuous glucose monitoring (CGM) devices with visual cues, such as the ambulatory glucose profile, should be considered as a standard summary for all CGM devices. Level of evidence: E"/>
      <group id="Group_1">
        <extension
                   url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
          <valueCodeableConcept>
            <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 18-75 years of age by the end of the measurement period, with diabetes with a visit during 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. 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 66 and older 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 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 glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is &amp;gt;9.0% or is missing, or was not performed during the measurement period"/>
          <criteria>
            <language value="text/cql-identifier"/>
            <expression value="Numerator"/>
          </criteria>
        </population>
      </group>
      <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>
      <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-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-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>
    </Measure>