dQM QICore Content Implementation Guide
2025.0.0 - CI Build

dQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-qicore-2025/ and changes regularly. See the Directory of published versions

Library: CMS117FHIRChildImmunStatus

Official URL: https://madie.cms.gov/Library/CMS117FHIRChildImmunStatus Version: 1.0.000
Active as of 2025-07-25 Responsible: National Committee for Quality Assurance Computable Name: CMS117FHIRChildImmunStatus
Other Identifiers: https://madie.cms.gov/login#CMS117FHIRChildImmunStatus (use: official, )

CMS117FHIRChildImmunStatus

Metadata
Title CMS117FHIRChildImmunStatus
Version 1.0.000
Identifier CMS117FHIRChildImmunStatus
Steward (Publisher) National Committee for Quality Assurance
Description

CMS117FHIRChildImmunStatus
Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Parameter Name: Measurement Period
Use: In
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Patient
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: Qualifying Encounters
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Initial Population
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Date of Second Birthday
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: date
Parameter Name: First Two Years
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Has Severe Combined Immunodeficiency
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Immunodeficiency
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has HIV
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Lymphoreticular Cancer, Multiple Myeloma or Leukemia
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Has Intussusception
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Denominator Exclusions
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Vaccine Administration Interval - 42 Days up to 2 Years Old
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: DTaP Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Four DTaP Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: DTaP Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Polio Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Three Polio Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Polio Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Date of First Birthday
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: date
Parameter Name: Date of First Birthday to Date of Second Birthday
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: One MMR Vaccination
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: MMR Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Measles Indicators
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Mumps Indicators
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Rubella Indicators
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Hib 3 Dose Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Hib 4 Dose Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Hib 3 or 4 Dose Immunizations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Has Appropriate Number of Hib Immunizations
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Hib Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Hepatitis B Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Three Hepatitis B Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: NewBorn Vaccine Requirement
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Meets HepB Vaccination Requirement
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Hepatitis B Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: One Chicken Pox Vaccination
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Varicella Zoster Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Pneumococcal Conjugate Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Four Pneumococcal Conjugate Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Pneumococcal Conjugate Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: One Hepatitis A Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Hepatitis A Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Rotavirus 2 Dose Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Rotavirus 3 Dose Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Rotavirus 2 or 3 Dose Immunizations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Has Appropriate Number of Rotavirus Immunizations
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Rotavirus Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Vaccine Administration Interval - 180 Days up to 2 Years Old
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Period
Parameter Name: Influenza Immunizations or Procedures
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Two Influenza Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: LAIV Vaccinations
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: date
Parameter Name: Two Influenza Vaccinations Including One LAIV Vaccination
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: Influenza Numerator Inclusion Conditions
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: Numerator
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: boolean
Parameter Name: SDE Ethnicity
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Payer
Use: Out
Min Cardinality: 0
Max Cardinality: *
Type: Resource
Parameter Name: SDE Race
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Resource
Parameter Name: SDE Sex
Use: Out
Min Cardinality: 0
Max Cardinality: 1
Type: Coding
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Virtual Encounter
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Telephone Visits
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Severe Combined Immunodeficiency
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Severe Combined Immunodeficiency
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Disorders of the Immune System
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Disorders of the Immune System
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: HIV
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: HIV
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Malignant Neoplasm of Lymphatic and Hematopoietic Tissue
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Malignant Neoplasm of Lymphatic and Hematopoietic Tissue
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Intussusception
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Intussusception
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: DTaP Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: DTaP Vaccine Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Anaphylactic Reaction to DTaP Vaccine
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Anaphylactic Reaction to DTaP Vaccine
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Inactivated Polio Vaccine (IPV)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Inactivated Polio Vaccine (IPV) Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471321000124106 (Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471321000124106 (Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder))
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Measles, Mumps and Rubella (MMR) Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Measles, Mumps and Rubella (MMR) Vaccine Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471331000124109 (Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471331000124109 (Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Measles
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Mumps
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Mumps
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Rubella
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Rubella
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Hib Vaccine (3 dose schedule)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hib Vaccine (3 dose schedule) Administered
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Hib Vaccine (4 dose schedule)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hib Vaccine (4 dose schedule) Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 433621000124101 (Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 433621000124101 (Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder))
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Hepatitis B Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hepatitis B Vaccine Administered
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
Code(s): ICD-10 Procedure Codes: 3E0234Z (Introduction of Serum, Toxoid and Vaccine into Muscle, Percutaneous Approach)
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 428321000124101 (Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 428321000124101 (Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hepatitis B
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hepatitis B
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Varicella Zoster Vaccine (VZV)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Varicella Zoster Vaccine (VZV) Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Varicella Zoster
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Varicella Zoster
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471341000124104 (Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471341000124104 (Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder))
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Pneumococcal Conjugate Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Pneumococcal Conjugate Vaccine Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471141000124102 (Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471141000124102 (Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder))
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Hepatitis A Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Hepatitis A Vaccine Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hepatitis A
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Hepatitis A
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471311000124103 (Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471311000124103 (Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder))
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
Code(s): Vaccine Administered Code Set (CVX): 119 (rotavirus, live, monovalent vaccine)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Rotavirus Vaccine (2 dose schedule) Administered
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Rotavirus Vaccine (3 dose schedule)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Rotavirus Vaccine (3 dose schedule) Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 428331000124103 (Anaphylaxis caused by rotavirus vaccine (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 428331000124103 (Anaphylaxis caused by rotavirus vaccine (disorder))
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate.value
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Child Influenza Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Child Influenza Vaccine Administered
Data Requirement Type: Immunization
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-immunization
Must Support Elements: vaccineCode, occurrence
Code Filter(s):
Path: vaccineCode
ValueSet: Influenza Virus LAIV Vaccine
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code, performed
Code Filter(s):
Path: code
ValueSet: Influenza Virus LAIV Vaccine Administered
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471361000124100 (Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder))
Data Requirement Type: Condition
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): SNOMED CT: 471361000124100 (Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder))
Library Content
CQL Content 
library CMS117FHIRChildImmunStatus version '1.0.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers
include SupplementalDataElements version '5.1.000' called SDE
include Hospice version '6.18.000' called Hospice
include Status version '1.15.000' called Status
include QICoreCommon version '4.0.000' called QICoreCommon

codesystem "SNOMEDCT": 'http://snomed.info/sct'
codesystem "CPT": 'http://www.ama-assn.org/go/cpt'
codesystem "CVX": 'http://hl7.org/fhir/sid/cvx'
codesystem "ICD10": 'http://www.cms.gov/Medicare/Coding/ICD10'

valueset "Anaphylactic Reaction to DTaP Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.199.12.1031'
valueset "Disorders of the Immune System": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1001'
valueset "DTaP Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1214'
valueset "DTaP Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1022'
valueset "Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1164'
valueset "Hepatitis A": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024'
valueset "Hepatitis A Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1215'
valueset "Hepatitis A Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1041'
valueset "Hepatitis B": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1025'
valueset "Hepatitis B Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1216'
valueset "Hepatitis B Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1042'
valueset "Hib Vaccine (3 dose schedule)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1083'
valueset "Hib Vaccine (3 dose schedule) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1084'
valueset "Hib Vaccine (4 dose schedule)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1085'
valueset "Hib Vaccine (4 dose schedule) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1086'
valueset "HIV": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003'
valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'
valueset "Inactivated Polio Vaccine (IPV)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1219'
valueset "Inactivated Polio Vaccine (IPV) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1045'
valueset "Child Influenza Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1218'
valueset "Child Influenza Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1044'
valueset "Influenza Virus LAIV Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1087'
valueset "Influenza Virus LAIV Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1088'
valueset "Intussusception": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.199.12.1056'
valueset "Malignant Neoplasm of Lymphatic and Hematopoietic Tissue": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1009'
valueset "Measles": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1053'
valueset "Measles, Mumps and Rubella (MMR) Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1224'
valueset "Measles, Mumps and Rubella (MMR) Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1031'
valueset "Mumps": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1032'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Virtual Encounter": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1089'
valueset "Pneumococcal Conjugate Vaccine": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1221'
valueset "Pneumococcal Conjugate Vaccine Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1046'
valueset "Preventive Care Services, Initial Office Visit, 0 to 17": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022'
valueset "Preventive Care, Established Office Visit, 0 to 17": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024'
valueset "Rotavirus Vaccine (2 dose schedule) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1048'
valueset "Rotavirus Vaccine (3 dose schedule)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1223'
valueset "Rotavirus Vaccine (3 dose schedule) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1047'
valueset "Rubella": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1037'
valueset "Severe Combined Immunodeficiency": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1007'
valueset "Telephone Visits": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080'
valueset "Varicella Zoster": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1039'
valueset "Varicella Zoster Vaccine (VZV)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1170'
valueset "Varicella Zoster Vaccine (VZV) Administered": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1040'

code "Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder)": '433621000124101' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder)'
code "Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder)": '428321000124101' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder)'
code "Anaphylaxis caused by rotavirus vaccine (disorder)": '428331000124103' from "SNOMEDCT" display 'Anaphylaxis caused by rotavirus vaccine (disorder)'
code "Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional": '99211' from "CPT" display 'Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional'
code "rotavirus, live, monovalent vaccine": '119' from "CVX" display 'rotavirus, live, monovalent vaccine'
code "Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder)": '471311000124103' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder)'
code "Introduction of Serum, Toxoid and Vaccine into Muscle, Percutaneous Approach": '3E0234Z' from "ICD10" display 'Introduction of Serum, Toxoid and Vaccine into Muscle, Percutaneous Approach'
code "Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder)": '471361000124100' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder)'
code "Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder)": '471331000124109' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder)'
code "Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder)": '471141000124102' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder)'
code "Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder)": '471321000124106' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder)'
code "Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder)": '471341000124104' from "SNOMEDCT" display 'Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder)'

parameter "Measurement Period" Interval<DateTime>
  default Interval[@2026-01-01T00:00:00.000Z, @2027-01-01T00:00:00.000Z)

context Patient

define "Initial Population":
  AgeInYearsAt(date from 
    end of "Measurement Period"
  ) = 2
    and exists ( "Qualifying Encounters" )

define "Qualifying Encounters":
  ( ( [Encounter: "Office Visit"]
      union [Encounter: "Home Healthcare Services"]
      union [Encounter: "Preventive Care, Established Office Visit, 0 to 17"]
      union [Encounter: "Preventive Care Services, Initial Office Visit, 0 to 17"]
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ "Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional"
          )
      )
      union [Encounter: "Virtual Encounter"]
      union [Encounter: "Telephone Visits"]
  ).isEncounterPerformed ( ) ) ValidEncounters
    where ValidEncounters.period during day of "Measurement Period"

define "Denominator":
  "Initial Population"

define "Denominator Exclusions":
  Hospice."Has Hospice Services"
    or "Has Severe Combined Immunodeficiency"
    or "Has Immunodeficiency"
    or "Has HIV"
    or "Has Lymphoreticular Cancer, Multiple Myeloma or Leukemia"
    or "Has Intussusception"

define "Has Severe Combined Immunodeficiency":
  exists ( ( ( [ConditionEncounterDiagnosis: "Severe Combined Immunodeficiency"]
        union [ConditionProblemsHealthConcerns: "Severe Combined Immunodeficiency"]
    ).verified ( ) ) SevereImmuneDisorder
      where date from start of SevereImmuneDisorder.prevalenceInterval ( ) during day of "First Two Years"
  )

define "Has Immunodeficiency":
  exists ( ( ( [ConditionEncounterDiagnosis: "Disorders of the Immune System"]
        union [ConditionProblemsHealthConcerns: "Disorders of the Immune System"]
    ).verified ( ) ) ImmuneDisorder
      where date from start of ImmuneDisorder.prevalenceInterval ( ) during day of "First Two Years"
  )

define "Has HIV":
  exists ( ( ( [ConditionEncounterDiagnosis: "HIV"]
        union [ConditionProblemsHealthConcerns: "HIV"]
    ).verified ( ) ) HIVDiagnosis
      where date from start of HIVDiagnosis.prevalenceInterval ( ) during day of "First Two Years"
  )

define "Has Lymphoreticular Cancer, Multiple Myeloma or Leukemia":
  exists ( ( ( [ConditionEncounterDiagnosis: "Malignant Neoplasm of Lymphatic and Hematopoietic Tissue"]
        union [ConditionProblemsHealthConcerns: "Malignant Neoplasm of Lymphatic and Hematopoietic Tissue"]
    ).verified ( ) ) LymphaticMalignantNeoplasm
      where date from start of LymphaticMalignantNeoplasm.prevalenceInterval ( ) during day of "First Two Years"
  )

define "Has Intussusception":
  exists ( ( ( [ConditionEncounterDiagnosis: "Intussusception"]
        union [ConditionProblemsHealthConcerns: "Intussusception"]
    ).verified ( ) ) IntussusceptionDisorder
      where date from start of IntussusceptionDisorder.prevalenceInterval ( ) during day of "First Two Years"
  )

define "Numerator":
  ( exists ( "Four DTaP Vaccinations" )
      or exists ( "DTaP Numerator Inclusion Conditions" )
  )
    and ( exists ( "Three Polio Vaccinations" )
        or exists ( "Polio Numerator Inclusion Conditions" )
    )
    and ( exists ( "One MMR Vaccination" )
        or exists ( "MMR Numerator Inclusion Conditions" )
        or ( exists ( "Measles Indicators" )
            and exists ( "Mumps Indicators" )
            and exists ( "Rubella Indicators" )
        )
    )
    and ( "Has Appropriate Number of Hib Immunizations"
        or exists ( "Hib Numerator Inclusion Conditions" )
    )
    and ( exists ( "Three Hepatitis B Vaccinations" )
        or ( exists ( "Meets HepB Vaccination Requirement" )
            or exists ( "Hepatitis B Numerator Inclusion Conditions" )
        )
    )
    and ( exists ( "One Chicken Pox Vaccination" )
        or exists ( "Varicella Zoster Numerator Inclusion Conditions" )
    )
    and ( exists ( "Four Pneumococcal Conjugate Vaccinations" )
        or exists ( "Pneumococcal Conjugate Numerator Inclusion Conditions" )
    )
    and ( exists ( "One Hepatitis A Vaccinations" )
        or exists ( "Hepatitis A Numerator Inclusion Conditions" )
    )
    and ( "Has Appropriate Number of Rotavirus Immunizations"
        or exists ( "Rotavirus Numerator Inclusion Conditions" )
    )
    and ( exists ( "Two Influenza Vaccinations" )
        or ( "Two Influenza Vaccinations Including One LAIV Vaccination" )
        or exists ( "Influenza Numerator Inclusion Conditions" )
    )

define "Vaccine Administration Interval - 180 Days up to 2 Years Old":
  Interval[date from Patient.birthDate + 180 days, "Date of Second Birthday"]

define "First Two Years":
  Interval[date from Patient.birthDate, "Date of Second Birthday"]

define "Vaccine Administration Interval - 42 Days up to 2 Years Old":
  Interval[date from Patient.birthDate + 42 days, "Date of Second Birthday"]

define "Date of Second Birthday":
  date from Patient.birthDate + 2 years

define "Date of First Birthday":
  date from Patient.birthDate + 1 year

define "Date of First Birthday to Date of Second Birthday":
  Interval["Date of First Birthday", "Date of Second Birthday"]

//DTaP


define "Four DTaP Vaccinations":
  from
    "DTaP Immunizations or Procedures" DTaPVaccination1,
    "DTaP Immunizations or Procedures" DTaPVaccination2,
    "DTaP Immunizations or Procedures" DTaPVaccination3,
    "DTaP Immunizations or Procedures" DTaPVaccination4
    where date from DTaPVaccination2.earliest ( ) 1 day or more after day of date from DTaPVaccination1.earliest ( )
      and date from DTaPVaccination3.earliest ( ) 1 day or more after day of DTaPVaccination2.earliest ( )
      and date from DTaPVaccination4.earliest ( ) 1 day or more after day of DTaPVaccination3.earliest ( )
    return all DTaPVaccination1

define "DTaP Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylactic Reaction to DTaP Vaccine"]
      union [ConditionProblemsHealthConcerns: "Anaphylactic Reaction to DTaP Vaccine"]
      union [ConditionEncounterDiagnosis: "Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine"]
      union [ConditionProblemsHealthConcerns: "Encephalitis Due to Diphtheria, Tetanus or Pertussis Vaccine"]
  ).verified ( ) ) DTaPConditions
    where date from start of DTaPConditions.prevalenceInterval ( ) during day of "First Two Years"

define "DTaP Immunizations or Procedures":
  ( ( ( [Immunization: "DTaP Vaccine"] ).isImmunizationAdministered ( ) ) DTaPVaccination
      where date from DTaPVaccination.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from DTaPVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "DTaP Vaccine Administered"] ).isProcedurePerformed ( ) ) DTaPProcedure
        where date from DTaPProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from DTaPProcedure.performed.earliest ( )
    )

//Polio


define "Polio Immunizations or Procedures":
  ( ( ( [Immunization: "Inactivated Polio Vaccine (IPV)"] ).isImmunizationAdministered ( ) ) PolioVaccination
      where date from PolioVaccination.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from PolioVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Inactivated Polio Vaccine (IPV) Administered"] ).isProcedurePerformed ( ) ) PolioProcedure
        where date from PolioProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from PolioProcedure.performed.earliest ( )
    )

define "Three Polio Vaccinations":
  from
    "Polio Immunizations or Procedures" PolioVaccination1,
    "Polio Immunizations or Procedures" PolioVaccination2,
    "Polio Immunizations or Procedures" PolioVaccination3
    where date from PolioVaccination2.earliest ( ) 1 day or more after date from PolioVaccination1.earliest ( )
      and date from PolioVaccination3.earliest ( ) 1 day or more after date from PolioVaccination2.earliest ( )
    return date from PolioVaccination1.earliest ( )

define "Polio Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing human poliovirus antigen (disorder)"]
  ).verified ( ) ) PolioConditions
    where date from start of PolioConditions.prevalenceInterval ( ) during day of "First Two Years"

//MMR


define "One MMR Vaccination":
  ( ( ( [Immunization: "Measles, Mumps and Rubella (MMR) Vaccine"] ).isImmunizationAdministered ( ) ) MMRVaccination
      where date from MMRVaccination.occurrence.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
      return date from MMRVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Measles, Mumps and Rubella (MMR) Vaccine Administered"] ).isProcedurePerformed ( ) ) MMRProcedure
        where date from MMRProcedure.performed.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
        return date from MMRProcedure.performed.earliest ( )
    )

define "Measles Indicators":
  ( ( [ConditionEncounterDiagnosis: "Measles"]
      union [ConditionEncounterDiagnosis: "Measles"]
  ).verified ( ) ) MeaslesDiagnosis
    where date from start of MeaslesDiagnosis.prevalenceInterval ( ) during day of "First Two Years"

define "Mumps Indicators":
  ( ( [ConditionEncounterDiagnosis: "Mumps"]
      union [ConditionProblemsHealthConcerns: "Mumps"]
  ).verified ( ) ) MumpsDiagnosis
    where date from start of MumpsDiagnosis.prevalenceInterval ( ) during day of "First Two Years"

define "Rubella Indicators":
  ( ( [ConditionEncounterDiagnosis: "Rubella"]
      union [ConditionProblemsHealthConcerns: "Rubella"]
  ).verified ( ) ) RubellaDiagnosis
    where date from start of RubellaDiagnosis.prevalenceInterval ( ) during day of "First Two Years"

define "MMR Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing Measles morbillivirus and Mumps orthorubulavirus and Rubella virus antigens (disorder)"]
  ).verified ( ) ) MMRConditions
    where date from start of MMRConditions.prevalenceInterval ( ) during day of "First Two Years"

//HiB


define "Has Appropriate Number of Hib Immunizations":
  exists ( "Hib 3 or 4 Dose Immunizations" HibImmunization //4 dose test
      
      let HasFourDose: Count("Hib 4 Dose Immunizations or Procedures") > 0
      where ( HasFourDose //if pt had at least one 4 dose code
          
          and Count(distinct("Hib 3 or 4 Dose Immunizations" HibVaccinations
                return date from HibVaccinations.earliest()
            )
          ) >= 4 //pt must have 4 regimens (e.g., 3,3,4,4 or 4,3,4,4)
      
      )
        or ( HasFourDose is false //if pt did not have at least one 4 dose code
            
            and Count(distinct("Hib 3 or 4 Dose Immunizations" HibVaccinations
                  return date from HibVaccinations.earliest()
              )
            ) >= 3 //pt must have 3 regimens of 3 dose codes
        
        )
  )

define "Hib Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing only Haemophilus influenzae type b antigen (disorder)"]
  ).verified ( ) ) HibReaction
    where date from start of HibReaction.prevalenceInterval ( ) during day of "First Two Years"

define "Hib 3 Dose Immunizations or Procedures":
  ( ( ( [Immunization: "Hib Vaccine (3 dose schedule)"] ).isImmunizationAdministered ( ) ) ThreeDoseHibVaccine
      where date from ThreeDoseHibVaccine.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from ThreeDoseHibVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Hib Vaccine (3 dose schedule) Administered"] ).isProcedurePerformed ( ) ) ThreeDoseHibProcedure
        where date from ThreeDoseHibProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from ThreeDoseHibProcedure.performed.earliest ( )
    )

define "Hib 3 or 4 Dose Immunizations":
  "Hib 3 Dose Immunizations or Procedures"
    union "Hib 4 Dose Immunizations or Procedures"

define "Hib 4 Dose Immunizations or Procedures":
  ( ( ( [Immunization: "Hib Vaccine (4 dose schedule)"] ).isImmunizationAdministered ( ) ) HibVaccine
      where date from HibVaccine.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from HibVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Hib Vaccine (4 dose schedule) Administered"] ).isProcedurePerformed ( ) ) HibProcedure
        where date from HibProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from HibProcedure.performed.earliest ( )
    )

//HepB


define "Hepatitis B Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing Hepatitis B virus antigen (disorder)"]
      union [ConditionEncounterDiagnosis: "Hepatitis B"]
      union [ConditionProblemsHealthConcerns: "Hepatitis B"]
  ).verified ( ) ) HepBConditions
    where date from start of HepBConditions.prevalenceInterval ( ) during day of "First Two Years"

define "Three Hepatitis B Vaccinations":
  from
    "Hepatitis B Immunizations or Procedures" HepatitisBVaccination1,
    "Hepatitis B Immunizations or Procedures" HepatitisBVaccination2,
    "Hepatitis B Immunizations or Procedures" HepatitisBVaccination3
    where date from HepatitisBVaccination2.earliest ( ) 1 day or more after date from HepatitisBVaccination1.earliest ( )
      and date from HepatitisBVaccination3.earliest ( ) 1 day or more after date from HepatitisBVaccination2.earliest ( )
    return date from HepatitisBVaccination1.earliest ( )

define "Hepatitis B Immunizations or Procedures":
  ( ( ( [Immunization: "Hepatitis B Vaccine"] ).isImmunizationAdministered ( ) ) HepatitisBVaccination
      where date from HepatitisBVaccination.occurrence.earliest ( ) during day of "First Two Years"
      return date from HepatitisBVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Hepatitis B Vaccine Administered"] ).isProcedurePerformed ( ) ) HepatitisBProcedure
        where date from HepatitisBProcedure.performed.earliest ( ) during day of "First Two Years"
        return date from HepatitisBProcedure.performed.earliest ( )
    )

define "Meets HepB Vaccination Requirement":
  from
    "Hepatitis B Immunizations or Procedures" HepatitisBVaccination1,
    "Hepatitis B Immunizations or Procedures" HepatitisBVaccination2,
    "NewBorn Vaccine Requirement" NewBornVaccine3
    where date from HepatitisBVaccination2.earliest ( ) 1 day or more after date from HepatitisBVaccination1.earliest ( )
      and date from HepatitisBVaccination1.earliest ( ) 1 day or more after date from NewBornVaccine3.earliest ( )
      and date from HepatitisBVaccination2.earliest ( ) 1 day or more after date from NewBornVaccine3.earliest ( )
    return date from HepatitisBVaccination1.earliest ( )

define "NewBorn Vaccine Requirement":
  ( ( [Procedure: "Introduction of Serum, Toxoid and Vaccine into Muscle, Percutaneous Approach"] ).isProcedurePerformed ( ) ) NewBornVaccine
    where date from NewBornVaccine.performed.earliest ( ) during day of Interval[date from Patient.birthDate, date from Patient.birthDate + 7 days]
    return date from NewBornVaccine.performed.earliest ( )

//VZV


define "One Chicken Pox Vaccination":
  ( ( ( [Immunization: "Varicella Zoster Vaccine (VZV)"] ).isImmunizationAdministered ( ) ) ChickenPoxVaccination
      where date from ChickenPoxVaccination.occurrence.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
      return date from ChickenPoxVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Varicella Zoster Vaccine (VZV) Administered"] ).isProcedurePerformed ( ) ) ChickenPoxProcedure
        where date from ChickenPoxProcedure.performed.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
        return date from ChickenPoxProcedure.performed.earliest ( )
    )

define "Varicella Zoster Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Varicella Zoster"]
      union [ConditionProblemsHealthConcerns: "Varicella Zoster"]
      union [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine containing Human alphaherpesvirus 3 antigen (disorder)"]
  ).verified ( ) ) VaricellaZoster
    where date from start of VaricellaZoster.prevalenceInterval ( ) during day of "First Two Years"

//PCV


define "Four Pneumococcal Conjugate Vaccinations":
  from
    "Pneumococcal Conjugate Immunizations or Procedures" PneumococcalVaccination1,
    "Pneumococcal Conjugate Immunizations or Procedures" PneumococcalVaccination2,
    "Pneumococcal Conjugate Immunizations or Procedures" PneumococcalVaccination3,
    "Pneumococcal Conjugate Immunizations or Procedures" PneumococcalVaccination4
    where date from PneumococcalVaccination2.earliest ( ) 1 day or more after date from PneumococcalVaccination1.earliest ( )
      and date from PneumococcalVaccination3.earliest ( ) 1 day or more after date from PneumococcalVaccination2.earliest ( )
      and date from PneumococcalVaccination4.earliest ( ) 1 day or more after date from PneumococcalVaccination3.earliest ( )
    return date from PneumococcalVaccination1.earliest ( )

define "Pneumococcal Conjugate Immunizations or Procedures":
  ( ( ( [Immunization: "Pneumococcal Conjugate Vaccine"] ).isImmunizationAdministered ( ) ) PneumococcalVaccination
      where date from PneumococcalVaccination.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from PneumococcalVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Pneumococcal Conjugate Vaccine Administered"] ).isProcedurePerformed ( ) ) PneumococcalProcedure
        where date from PneumococcalProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from PneumococcalProcedure.performed.earliest ( )
    )

define "Pneumococcal Conjugate Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing Streptococcus pneumoniae antigen (disorder)"]
  ).verified ( ) ) PneumococcalReaction
    where date from start of PneumococcalReaction.prevalenceInterval ( ) during day of "First Two Years"

//HepA


define "One Hepatitis A Vaccinations":
  ( ( ( [Immunization: "Hepatitis A Vaccine"] ).isImmunizationAdministered ( ) ) HepatitisAVaccination
      where date from HepatitisAVaccination.occurrence.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
      return date from HepatitisAVaccination.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Hepatitis A Vaccine Administered"] ).isProcedurePerformed ( ) ) HepatitisAProcedure
        where date from HepatitisAProcedure.performed.earliest ( ) during "Date of First Birthday to Date of Second Birthday"
        return date from HepatitisAProcedure.performed.earliest ( )
    )

define "Hepatitis A Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Hepatitis A"]
      union [ConditionProblemsHealthConcerns: "Hepatitis A"]
      union [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing Hepatitis A virus antigen (disorder)"]
  ).verified ( ) ) HepatitisADiagnosis
    where date from start of HepatitisADiagnosis.prevalenceInterval ( ) during day of "First Two Years"

//RV


define "Has Appropriate Number of Rotavirus Immunizations":
  exists ( "Rotavirus 2 or 3 Dose Immunizations" RotavirusImmunization
      let HasThreeDose: Count("Rotavirus 3 Dose Immunizations or Procedures") > 0
      where ( HasThreeDose
          and Count(distinct("Rotavirus 2 or 3 Dose Immunizations" RotavirusVaccinations
                return date from RotavirusVaccinations.earliest()
            )
          ) >= 3
      )
        or ( HasThreeDose is false
            and Count(distinct("Rotavirus 2 or 3 Dose Immunizations" RotavirusVaccinations
                  return date from RotavirusVaccinations.earliest()
              )
            ) >= 2
        )
  )

define "Rotavirus 2 Dose Immunizations or Procedures":
  ( ( ( [Immunization: "rotavirus, live, monovalent vaccine"] ).isImmunizationAdministered ( ) ) TwoDoseRotavirusVaccine
      where date from TwoDoseRotavirusVaccine.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from TwoDoseRotavirusVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Rotavirus Vaccine (2 dose schedule) Administered"] ).isProcedurePerformed ( ) ) TwoDoseRotavirusProcedure
        where date from TwoDoseRotavirusProcedure.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from TwoDoseRotavirusProcedure.performed.earliest ( )
    )

define "Rotavirus 2 or 3 Dose Immunizations":
  "Rotavirus 2 Dose Immunizations or Procedures"
    union "Rotavirus 3 Dose Immunizations or Procedures"

define "Rotavirus Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by rotavirus vaccine (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by rotavirus vaccine (disorder)"]
  ).verified ( ) ) RotavirusConditions
    where date from start of RotavirusConditions.prevalenceInterval ( ) during day of "First Two Years"

define "Rotavirus 3 Dose Immunizations or Procedures":
  ( ( ( [Immunization: "Rotavirus Vaccine (3 dose schedule)"] ).isImmunizationAdministered ( ) ) ThreeDoseRotavirusVaccine
      where date from ThreeDoseRotavirusVaccine.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
      return date from ThreeDoseRotavirusVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Rotavirus Vaccine (3 dose schedule) Administered"] ).isProcedurePerformed ( ) ) ThreeDoseRotavirusAdministered
        where date from ThreeDoseRotavirusAdministered.performed.earliest ( ) during day of "Vaccine Administration Interval - 42 Days up to 2 Years Old"
        return date from ThreeDoseRotavirusAdministered.performed.earliest ( )
    )

//Flu


define "Influenza Immunizations or Procedures":
  ( ( ( [Immunization: "Child Influenza Vaccine"] ).isImmunizationAdministered ( ) ) InfluenzaVaccine
      where date from InfluenzaVaccine.occurrence.earliest ( ) during day of "Vaccine Administration Interval - 180 Days up to 2 Years Old"
      return date from InfluenzaVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Child Influenza Vaccine Administered"] ).isProcedurePerformed ( ) ) InfluenzaAdministration
        where date from InfluenzaAdministration.performed.earliest ( ) during day of "Vaccine Administration Interval - 180 Days up to 2 Years Old"
        return date from InfluenzaAdministration.performed.earliest ( )
    )

define "Two Influenza Vaccinations":
  from
    "Influenza Immunizations or Procedures" FluVaccination1,
    "Influenza Immunizations or Procedures" FluVaccination2
    where date from FluVaccination2.earliest ( ) 1 day or more after date from FluVaccination1.earliest ( )
    return date from FluVaccination1.earliest ( )

define "Influenza Numerator Inclusion Conditions":
  ( ( [ConditionEncounterDiagnosis: "Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder)"]
      union [ConditionProblemsHealthConcerns: "Anaphylaxis caused by vaccine product containing Influenza virus antigen (disorder)"]
  ).verified ( ) ) InfluenzaConditions
    where date from start of InfluenzaConditions.prevalenceInterval ( ) during day of "First Two Years"

define "Two Influenza Vaccinations Including One LAIV Vaccination":
  exists "LAIV Vaccinations"
    and exists "Influenza Immunizations or Procedures"

define "LAIV Vaccinations":
  ( ( ( [Immunization: "Influenza Virus LAIV Vaccine"] ).isImmunizationAdministered ( ) ) LAIVVaccine
      where date from LAIVVaccine.occurrence.earliest ( ) during day of Interval["Date of Second Birthday", "Date of Second Birthday"]
      return date from LAIVVaccine.occurrence.earliest ( )
  )
    union ( ( ( [Procedure: "Influenza Virus LAIV Vaccine Administered"] ).isProcedurePerformed ( ) ) InfluenzaAdministration
        where date from InfluenzaAdministration.performed.earliest ( ) during day of Interval["Date of Second Birthday", "Date of Second Birthday"]
        return date from InfluenzaAdministration.performed.earliest ( )
    )

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

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

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

define "SDE Sex":
  SDE."SDE Sex"
ELM XML Content 
Encoded data
ELM JSON Content 
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Generated using version 0.5.0 of the sample-content-ig Liquid templates