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

: Sexually Transmitted Infection (STI) Testing for People with HIVFHIR - XML Representation

Active as of 2025-08-21

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<Measure xmlns="http://hl7.org/fhir">
  <id value="CMS1188FHIRHIVSTITesting"/>
  <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" class="col-12">
  <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">Sexually Transmitted Infection (STI) Testing for People with HIVFHIR</td>
</tr>



<tr>


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


<td class="content-container">1.0.000</td>
</tr>


  
<tr>


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


<td class="content-container">CMS1188FHIR</td>
</tr>



  
<tr>


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


<td class="content-container">urn:uuid:6f66ca77-1a2c-489c-b0d8-730da6e5a763</td>
</tr>



  
<tr>


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


<td class="content-container">urn:uuid:d64f90d4-91eb-4695-9b90-adc204023466</td>
</tr>



  
    
    
<tr>


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


<td class="content-container">1188FHIR</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">Health Resources &amp; Services Administration</td>
</tr>






<tr>


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


<td class="content-container">Health Resources &amp; Services Administration</td>
</tr>






<tr>


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


<td class="content-container"><p>Percentage of patients 13 years of age and older with a diagnosis of Human Immunodeficiency Virus (HIV) who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period</p></td>
</tr>



<tr>


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


<td class="content-container"><p>This measure was developed by the Health Resources &amp; Services Administration (HRSA) of the U.S. Department of Health &amp; Human Services (HHS). It is in the public domain.</p>
<p>Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.</p>
<p>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.</p>
<p>CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.</p>
<p>Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p></td>
</tr>


<tr>


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


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











<tr>


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


<td class="content-container"><p>The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2 percent, 5.9 percent, and 2.8 percent, respectively, from 2018 to 2019 (National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention [NCHHSTP], 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (Centers for Disease Control and Prevention [CDC], 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55 percent received a syphilis test in the past year, 23 percent received a gonorrhea test in the past year, and 24 percent received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).</p></td>
</tr>


<tr>


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


<td class="content-container"><p>&quot;Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners&quot; (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).</p>
<p>&quot;Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women&quot; (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).</p>
<p>&quot;The [United States Preventive Services Task Force (USPSTF)] recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service…. Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk&quot; (USPSTF, 2022, p. 1244-1246).</p>
<p>&quot;At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and [a nucleic acid amplification test] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure&quot; (Workowski et al., 2021, p. 26).</p></td>
</tr>




<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>Centers for Disease Control and Prevention, Health Resources and Services Administration, National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America, &amp; HIV Prevention in Clinical Care Working Group. (2004). Recommendations for incorporating human immunodeficiency virus (HIV) prevention into the medical care of persons living with HIV. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 38(1), 104-121. https://doi.org/10.1086/380131</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>Flagg, E. W., Weinstock, H. S., Frazier, E. L., Valverde, E. E., Heffelfinger, J. D., &amp; Skarbinski, J. (2015). Bacterial sexually transmitted infections among HIV-infected patients in the United States: Estimates from the Medical Monitoring Project. Sexually transmitted diseases, 42(4), 171-179. https://doi.org/10.1097/OLQ.0000000000000260. Erratum in: Sex Transm Dis. 2015 Jun;42(6):351-2. PMID: 25763669; PMCID: PMC6921480</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of STD Prevention. (2021). Sexually Transmitted Disease Surveillance 2019: National Overview – Sexually Transmitted Disease Surveillance, 2019. Retrieved from https://stacks.cdc.gov/view/cdc/105127</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>Panel on Opportunistic Infections in Adults and Adolescents with HIV. (2022, July). Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Recommendations from the Centers for Disease Controls and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Retrieved from https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/syphilis?view=full</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>Patel, P., Bush, T., Mayer, K., Milam, J., Richardson, J., Hammer, J., … SUN Study Investigators. (2012). Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care. Sexually Transmitted Diseases, 39(6), 470-474. https://doi.org/10.1097/OLQ.0b013e31824b3110</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>US Preventive Services Task Force, Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Chelmow, D., ... Wong, J. B. (2022). Screening for syphilis infection in nonpregnant adolescents and adults: US Preventive Services Task Force reaffirmation recommendation statement. JAMA, 328(12), 1243-1249. https://doi.org/10.1001/jama.2022.15322</p>
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    <p>Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., ... Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1</p>
    
    
    
    
    
  </td>
</tr>







<tr>


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


<td class="content-container"><p>This eCQM is a patient-based measure.</p>
<p>This FHIR-based measure has been derived from the QDM-based measure: CMS1188v3.</p>
<p>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)</p></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">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>







  
<tr>


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


<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>





  
<tr>


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


<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</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"><p>All patients 13 years of age and older at the start of the measurement period with an eligible encounter during the measurement period with a diagnosis of HIV before the end of the measurement period</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms1188fhirhivstitesting-initial-population">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"><p>Equals Initial Population</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms1188fhirhivstitesting-denominator">Denominator</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"><p>Patients who were tested for each of the following at least once during the measurement period: chlamydia, gonorrhea, and syphilis</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms1188fhirhivstitesting-numerator">Numerator</a> 
          
        
      </td>
    </tr>
  

  


  
    
<tr>


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


<td class="content-container"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></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>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Ethnicity
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms1188fhirhivstitesting-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>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Payer
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms1188fhirhivstitesting-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-sex
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Sex
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms1188fhirhivstitesting-sde-sex">SDE Sex</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-race
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Race
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms1188fhirhivstitesting-sde-race">SDE Race</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">https://madie.cms.gov/Library/CMS1188FHIRHIVSTITesting</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/>
  </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">
    
      
      <a name="primary-cms1188fhirhivstitesting-initial-population"> </a>
    
    
    Initial Population
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 13
    and &quot;Has Qualifying Encounter During Measurement Period&quot;
    and &quot;Has HIV Diagnosis Before End of Measurement Period&quot;</code></pre>
  </td>

</tr>

          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
      
    
  

  
    
      
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
            
              
            
            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms1188fhirhivstitesting-denominator"> </a>
    
    
    Denominator
    
  </th>
</tr>
<tr>

  <td>
    <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">
    
      
      <a name="primary-cms1188fhirhivstitesting-numerator"> </a>
    
    
    Numerator
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Has Chlamydia Testing&quot;
    and &quot;Has Gonorrhea Testing&quot;
    and &quot;Has Syphilis Testing&quot;</code></pre>
  </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">
    
      
      <a name="supplementaldataelements-sde-sex"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="supplementaldataelements-sde-payer"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  [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">
    
      
      <a name="supplementaldataelements-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="supplementaldataelements-sde-race"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="qicorecommon-latest"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (period.&quot;hasEnd&quot;()) then end of period
      else start of period</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-sde-sex"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-has-chlamydia-testing"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Chlamydia Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Chlamydia Screening&quot;] ChlamydiaTest
    where ChlamydiaTest.value is not null
      and ChlamydiaTest.status in { 'final', 'amended', 'corrected' }
      and ChlamydiaTest.effective.latest ( ) during day of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-has-gonorrhea-testing"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Gonorrhea Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Gonorrhea Screening&quot;] GonorrheaTest
    where GonorrheaTest.value is not null
      and GonorrheaTest.status in { 'final', 'amended', 'corrected' }
      and GonorrheaTest.effective.latest ( ) during day of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-has-syphilis-testing"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Syphilis Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Syphilis Tests&quot;] SyphilisTest
    where SyphilisTest.value is not null
      and SyphilisTest.status in { 'final', 'amended', 'corrected' }
      and SyphilisTest.effective.latest ( ) during day of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-numerator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Has Chlamydia Testing&quot;
    and &quot;Has Gonorrhea Testing&quot;
    and &quot;Has Syphilis Testing&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-has-qualifying-encounter-during-measurement-period"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Qualifying Encounter During Measurement Period&quot;:
  exists ( ( [&quot;Encounter&quot;: &quot;Office Visit&quot;]
      union [&quot;Encounter&quot;: &quot;Outpatient Consultation&quot;]
      union [&quot;Encounter&quot;: &quot;Annual Wellness Visit&quot;]
      union [&quot;Encounter&quot;: &quot;Face-to-Face Interaction&quot;]
      union [&quot;Encounter&quot;: &quot;Home Healthcare Services&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services, Initial Office Visit, 0 to 17&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care, Established Office Visit, 0 to 17&quot;]
      union [&quot;Encounter&quot;: &quot;Telephone Visits&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Other&quot;] ) QualifyingEncounter
      where QualifyingEncounter.period during day of &quot;Measurement Period&quot;
        and QualifyingEncounter.status = 'finished'
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-has-hiv-diagnosis-before-end-of-measurement-period"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has HIV Diagnosis Before End of Measurement Period&quot;:
  exists ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;HIV&quot;]
    union [&quot;ConditionEncounterDiagnosis&quot;: &quot;HIV&quot;] ) HIVDx
    where HIVDx.prevalenceInterval ( ) starts on or before day of end of &quot;Measurement Period&quot;
      and HIVDx.isVerified ( )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 13
    and &quot;Has Qualifying Encounter During Measurement Period&quot;
    and &quot;Has HIV Diagnosis Before End of Measurement Period&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms1188fhirhivstitesting-denominator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-sde-payer"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-sde-race"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="cms1188fhirhivstitesting-isverified"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS1188FHIRHIVSTITesting</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function isVerified(condition Choice&lt;QICore.ConditionProblemsHealthConcerns, QICore.ConditionEncounterDiagnosis&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;
  )</code></pre>
  </td>

</tr>



        




        
        



        



        



        



        



        



        



        



        



        



        



        



        



        



        



        



        


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

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="fhirhelpers-tointerval"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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">
    
      
      <a name="fhirhelpers-tocode"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <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 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>: http://snomed.info/sct
    <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 ConditionVerificationStatusCodes
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status
    <br/>
    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Chlamydia Screening
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Gonorrhea Screening
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Syphilis Tests
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.389
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.389</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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
    <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 Outpatient Consultation
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008</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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
    <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 Face-to-Face Interaction
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375</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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
    <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 Preventive Care Services Established Office Visit, 18 and Up
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
    <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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
    <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 Preventive Care Services, Initial Office Visit, 0 to 17
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Preventive Care, Established Office Visit, 0 to 17
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024</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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
    <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 Preventive Care Services Other
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set HIV
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003</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>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    <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">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>: Confirmed
        <br/>
      
      <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>Display</em>: Unconfirmed
        <br/>
      
      <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>Display</em>: Provisional
        <br/>
      
      <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>Display</em>: Differential
        <br/>
      
      <em>Code</em>: differential
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</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>: QICore model information
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</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>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</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>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library QICoreCommon
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
    <br/>        
  
   
   
    <em>Must Support Elements</em>: extension, url
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, value, status, status.value, effective
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, value, status, status.value, effective
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, value, status, status.value, effective
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.389
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003
    <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>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
    <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> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    <br/> 
  
  
  
   
  </td>
</tr>

  
  

<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 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://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="confirmed"/>
          <display 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"/>
          <display 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"/>
          <display 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"/>
          <display value="Differential"/>
        </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="CMS1188FHIRHIVSTITesting"/>
        </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="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="Has Chlamydia Testing"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Chlamydia Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Chlamydia Screening&quot;] ChlamydiaTest
    where ChlamydiaTest.value is not null
      and ChlamydiaTest.status in { 'final', 'amended', 'corrected' }
      and ChlamydiaTest.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="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="Has Gonorrhea Testing"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Gonorrhea Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Gonorrhea Screening&quot;] GonorrheaTest
    where GonorrheaTest.value is not null
      and GonorrheaTest.status in { 'final', 'amended', 'corrected' }
      and GonorrheaTest.effective.latest ( ) during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="Has Syphilis Testing"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Syphilis Testing&quot;:
  exists [&quot;LaboratoryResultObservation&quot;: &quot;Syphilis Tests&quot;] SyphilisTest
    where SyphilisTest.value is not null
      and SyphilisTest.status in { 'final', 'amended', 'corrected' }
      and SyphilisTest.effective.latest ( ) during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
  &quot;Has Chlamydia Testing&quot;
    and &quot;Has Gonorrhea Testing&quot;
    and &quot;Has Syphilis Testing&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has Qualifying Encounter During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Qualifying Encounter During Measurement Period&quot;:
  exists ( ( [&quot;Encounter&quot;: &quot;Office Visit&quot;]
      union [&quot;Encounter&quot;: &quot;Outpatient Consultation&quot;]
      union [&quot;Encounter&quot;: &quot;Annual Wellness Visit&quot;]
      union [&quot;Encounter&quot;: &quot;Face-to-Face Interaction&quot;]
      union [&quot;Encounter&quot;: &quot;Home Healthcare Services&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services, Initial Office Visit, 0 to 17&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care, Established Office Visit, 0 to 17&quot;]
      union [&quot;Encounter&quot;: &quot;Telephone Visits&quot;]
      union [&quot;Encounter&quot;: &quot;Preventive Care Services Other&quot;] ) QualifyingEncounter
      where QualifyingEncounter.period during day of &quot;Measurement Period&quot;
        and QualifyingEncounter.status = 'finished'
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has HIV Diagnosis Before End of Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has HIV Diagnosis Before End of Measurement Period&quot;:
  exists ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;HIV&quot;]
    union [&quot;ConditionEncounterDiagnosis&quot;: &quot;HIV&quot;] ) HIVDx
    where HIVDx.prevalenceInterval ( ) starts on or before day of end of &quot;Measurement Period&quot;
      and HIVDx.isVerified ( )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 13
    and &quot;Has Qualifying Encounter During Measurement Period&quot;
    and &quot;Has HIV Diagnosis Before End of Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </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="9"/>
        </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;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </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="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 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="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </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="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 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="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </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="15"/>
        </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="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="QICoreCommon"/>
        </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;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (period.&quot;hasEnd&quot;()) then end of period
      else start of period"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="QICoreCommon"/>
        </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="18"/>
        </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="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS1188FHIRHIVSTITesting"/>
        </extension>
        <extension url="name">
          <valueString value="isVerified"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define fluent function isVerified(condition Choice&lt;QICore.ConditionProblemsHealthConcerns, QICore.ConditionEncounterDiagnosis&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="20"/>
        </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="21"/>
        </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="QICore model information"/>
        <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library SDE"/>
        <resource
                  value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library QICoreCommon"/>
        <resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
      </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 ConditionVerificationStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Chlamydia Screening"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Gonorrhea Screening"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Syphilis Tests"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.389"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Office Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Outpatient Consultation"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Annual Wellness Visit"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Face-to-Face Interaction"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Home Healthcare Services"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services Established Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services Initial Office Visit, 18 and Up"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care Services, Initial Office Visit, 0 to 17"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Preventive Care, Established Office Visit, 0 to 17"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Telephone Visits"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Preventive Care Services Other"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set HIV"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer Type"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="boolean"/>
      </parameter>
      <parameter>
        <name value="SDE Sex"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="SDE Payer"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Ethnicity"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Race"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
        <mustSupport value="extension"/>
        <mustSupport value="url"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1052"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1258.1"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.389"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.375"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1080"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
        <mustSupport value="code"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
        <mustSupport value="code"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.120.12.1003"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Coverage"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
        </codeFilter>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
    <extension url="guidance">
      <valueString
                   value="&lt;p&gt;For every patient evaluated by this measure also identify payer, race, ethnicity and sex&lt;/p&gt;"/>
    </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">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url value="https://madie.cms.gov/Measure/CMS1188FHIRHIVSTITesting"/>
  <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="CMS1188FHIR"/>
  </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:6f66ca77-1a2c-489c-b0d8-730da6e5a763"/>
  </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:d64f90d4-91eb-4695-9b90-adc204023466"/>
  </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="1188FHIR"/>
    <assigner>
      <display value="CMS"/>
    </assigner>
  </identifier>
  <version value="1.0.000"/>
  <name value="CMS1188FHIRHIVSTITesting"/>
  <title
         value="Sexually Transmitted Infection (STI) Testing for People with HIVFHIR
"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2025-08-21T14:16:24+00:00"/>
  <publisher value="Health Resources &amp;amp; Services Administration"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value=" https://www.hrsa.gov/"/>
    </telecom>
  </contact>
  <description
               value="Percentage of patients 13 years of age and older with a diagnosis of Human Immunodeficiency Virus (HIV) who had tests for syphilis, gonorrhea, and chlamydia performed within the measurement period
"/>
  <usage
         value="This eCQM is a patient-based measure.

This FHIR-based measure has been derived from the QDM-based measure: CMS1188v3.

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 measure was developed by the Health Resources \&amp; Services Administration (HRSA) of the U.S. Department of Health \&amp; Human Services (HHS). It is in the public domain.

Citation of HRSA as the source of the original measure is appreciated. Any modified versions may not be represented as approved, endorsed, or authorized by HRSA or HHS. 42 U.S.C. Section 1320b-10. Users of modified versions should clearly explain how they deviate from HRSA's original measure.

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.

CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\[R\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.

Due to technical limitations, registered trademarks are indicated by (R) or \[R\] and unregistered trademarks are indicated by (TM) or \[TM\].
"/>
  <effectivePeriod>
    <start value="2026-01-01"/>
    <end value="2026-12-31"/>
  </effectivePeriod>
  <author>
    <name value="Health Resources &amp;amp; Services Administration"/>
    <telecom>
      <system value="url"/>
      <value value=" https://www.hrsa.gov/"/>
    </telecom>
  </author>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Centers for Disease Control and Prevention, Health Resources and Services Administration, National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America, \&amp; HIV Prevention in Clinical Care Working Group. (2004). Recommendations for incorporating human immunodeficiency virus (HIV) prevention into the medical care of persons living with HIV. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 38(1), 104-121. https://doi.org/10.1086/380131
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Flagg, E. W., Weinstock, H. S., Frazier, E. L., Valverde, E. E., Heffelfinger, J. D., \&amp; Skarbinski, J. (2015). Bacterial sexually transmitted infections among HIV-infected patients in the United States: Estimates from the Medical Monitoring Project. Sexually transmitted diseases, 42(4), 171-179. https://doi.org/10.1097/OLQ.0000000000000260. Erratum in: Sex Transm Dis. 2015 Jun;42(6):351-2. PMID: 25763669; PMCID: PMC6921480
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of STD Prevention. (2021). Sexually Transmitted Disease Surveillance 2019: National Overview -- Sexually Transmitted Disease Surveillance, 2019. Retrieved from https://stacks.cdc.gov/view/cdc/105127
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Panel on Opportunistic Infections in Adults and Adolescents with HIV. (2022, July). Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: Recommendations from the Centers for Disease Controls and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Retrieved from https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/syphilis?view=full
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Patel, P., Bush, T., Mayer, K., Milam, J., Richardson, J., Hammer, J., ... SUN Study Investigators. (2012). Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care. Sexually Transmitted Diseases, 39(6), 470-474. https://doi.org/10.1097/OLQ.0b013e31824b3110
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="US Preventive Services Task Force, Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Chelmow, D., ... Wong, J. B. (2022). Screening for syphilis infection in nonpregnant adolescents and adults: US Preventive Services Task Force reaffirmation recommendation statement. JAMA, 328(12), 1243-1249. https://doi.org/10.1001/jama.2022.15322
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., ... Bolan, G. A. (2021). Sexually transmitted infections treatment guidelines, 2021. MMWR. Recommendations and Reports, 70(4), 1-187. https://doi.org/10.15585/mmwr.rr7004a1
"/>
  </relatedArtifact>
  <library value="https://madie.cms.gov/Library/CMS1188FHIRHIVSTITesting"/>
  <disclaimer
              value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.

THE MEASURES 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="The rates of syphilis, gonorrhea, and chlamydia cases per 100,000 in the United States have steadily risen over the last decade and increased 11.2 percent, 5.9 percent, and 2.8 percent, respectively, from 2018 to 2019 (National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention \[NCHHSTP\], 2021). People with HIV are at an increased risk of bacterial sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis (Centers for Disease Control and Prevention \[CDC\], 2004). However, early detection and treatment of bacterial STIs in people with HIV can lead to a reduction in HIV transmission (CDC, 2004). Despite guidelines for at least annual screening among sexually active persons with HIV, only an estimated 55 percent received a syphilis test in the past year, 23 percent received a gonorrhea test in the past year, and 24 percent received a chlamydia test in the past year based on a nationally-representative survey of adults with HIV receiving medical care in the United States (Flagg et al., 2015). This measure will help providers focus their attention and quality improvement efforts towards testing and treating sexually transmitted infections in patients with HIV, thus reducing the complications to long-term syphilis infection and reducing STI incidence (Patel et al., 2012).
"/>
  <clinicalRecommendationStatement
                                   value="&quot;Routine serologic screening for syphilis is recommended at least annually for all persons with HIV infection who are sexually active, with more frequent screening (i.e., every 3-6 months) for those who have multiple or anonymous partners&quot; (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).

&quot;Patients undergoing screening or treatment for syphilis also should be evaluated for other sexually transmitted diseases such as chlamydia and gonorrhea at anatomic sites of exposure in men and for chlamydia, gonorrhea, and trichomonas in women&quot; (Panel on Opportunistic Infections in Adults and Adolescents with HIV, 2022, p. Y-3).

&quot;The \[United States Preventive Services Task Force (USPSTF)\] recommends screening for syphilis in persons who are at increased risk for infection. When deciding which persons to screen for syphilis, clinicians should consider the prevalence of infection in the communities they serve, as well as other sociodemographic and behavioral factors that may be associated with increased risk of syphilis infection. For example, prevalence of syphilis is higher in men, men who have sex with men, persons with HIV infection, young adults, and persons with a history of incarceration, sex work, or military service.... Optimal screening frequency for persons who are at increased risk for syphilis infection is not well established. Men who have sex with men or persons with HIV infection may benefit from screening at least annually or more frequently (e.g., every 3 to 6 months) if they continue to be at high risk&quot; (USPSTF, 2022, p. 1244-1246).

&quot;At the initial HIV care visit, providers should screen all sexually active persons for syphilis, gonorrhea, and chlamydia, and perform screening for these infections at least annually during the course of HIV care. Specific testing includes syphilis serology and \[a nucleic acid amplification test\] NAAT for N. gonorrhoeae and C. trachomatis at the anatomic site of exposure&quot; (Workowski et al., 2021, p. 26).
"/>
  <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="process"/>
          <display value="Process"/>
        </coding>
      </valueCodeableConcept>
    </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="All patients 13 years of age and older at the start of the measurement period with an eligible encounter during the measurement period with a diagnosis of HIV before the end of the measurement period
"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="Denominator_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <description value="Equals Initial Population
"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population id="Numerator_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <description
                   value="Patients who were tested for each of the following at least once during the measurement period: chlamydia, gonorrhea, and syphilis
"/>
      <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-sex">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Sex
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-race">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Race
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
</Measure>