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

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

Active as of 2025-07-25

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<Measure xmlns="http://hl7.org/fhir">
  <id value="CMS122FHIRDiabetesAssessGT9Pct"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml" 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">Diabetes: Glycemic Status Assessment Greater Than 9%FHIR</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">CMS122FHIR</td>
</tr>



  
<tr>


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


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



  
<tr>


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


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



  
    
    
<tr>


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


<td class="content-container">122FHIR</td>
</tr>

  




  
    
    
<tr>


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


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

  















<tr>


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


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






<tr>


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


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






<tr>


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


<td class="content-container">Percentage of patients 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) &gt; 9.0% during the measurement period</td>
</tr>



<tr>


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


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


<tr>


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


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











<tr>


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


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


<tr>


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


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




<tr>
  
  
  
  

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


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

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    American Diabetes Association. (2022a). Statistics About Diabetes. Retrieved from https://diabetes.org/about-us/statistics/about-diabetes
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Centers for Disease Control and Prevention. (2022a). What is Diabetes? Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Centers for Disease Control and Prevention. (2022b). Diabetes Report Card 2021. US Dept of Health and Human Services. Retrieved from https://archive.cdc.gov/www_cdc_gov/diabetes/library/reports/reportcard.html
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


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







<tr>


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


<td class="content-container">If the glycemic status assessment (HbA1c or GMI) is in the medical record, the test can be used to determine numerator compliance. Glycemic status assessment (HbA1c or GMI) must be reported as a percentage (%). If multiple glycemic status assessments were recorded for a single date, use the lowest result. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS122v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</td>
</tr>



  
    
    <tr>


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


</tr>
  
  
  
  
<tr>


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


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



  
<tr>


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


<td class="content-container">[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#intermediate-outcome: 'Intermediate Outcome']</td>
</tr>




  
<tr>


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


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



  
<tr>


<th scope="row" class="row-header">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">Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period</p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms122fhirdiabetesassessgt9pct-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">Equals Initial Population</p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms122fhirdiabetesassessgt9pct-denominator">Denominator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: DenominatorExclusion_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one">Exclude patients who are in hospice care for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients receiving palliative care for any part of the measurement period.</p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms122fhirdiabetesassessgt9pct-denominator-exclusions">Denominator Exclusions</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: Numerator_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one">Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is &gt;9.0% or is missing, or was not performed during the measurement period</p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms122fhirdiabetesassessgt9pct-numerator">Numerator</a> 
          
        
      </td>
    </tr>
  

  


  
    
<tr>


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


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

  


  <tr>


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


</tr>


<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-ethnicity
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Ethnicity
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms122fhirdiabetesassessgt9pct-sde-ethnicity">SDE Ethnicity</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-payer
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Payer
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms122fhirdiabetesassessgt9pct-sde-payer">SDE Payer</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-race
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Race
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms122fhirdiabetesassessgt9pct-sde-race">SDE Race</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-sex
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Sex
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms122fhirdiabetesassessgt9pct-sde-sex">SDE Sex</a> 
      
    
  </td>
</tr>


<tr>


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


</tr>

<tr>


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


<td class="content-container">https://madie.cms.gov/Library/CMS122FHIRDiabetesAssessGT9Pct</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-cms122fhirdiabetesassessgt9pct-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 
    end of &quot;Measurement Period&quot;
  ) in Interval[18, 75]
    and exists &quot;Qualifying Encounters&quot;
    and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
        where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of &quot;Measurement Period&quot;
    )</code></pre>
  </td>

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            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms122fhirdiabetesassessgt9pct-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-cms122fhirdiabetesassessgt9pct-denominator-exclusions"> </a>
    
    
    Denominator Exclusion
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
  Hospice.&quot;Has Hospice Services&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;
    or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;</code></pre>
  </td>

</tr>

          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
      
    
  

  
    
      
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
            
              
            
            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms122fhirdiabetesassessgt9pct-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 Most Recent Glycemic Status Assessment Without Result&quot;
    or &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;
    or &quot;Has No Record Of Glycemic Status Assessment&quot;</code></pre>
  </td>

</tr>

          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
      
    
  

  
  

  
  


  <tr>


<th 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="hospice-has-hospice-services"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Hospice Services&quot;:
  exists ((([Encounter: &quot;Encounter Inpatient&quot;]).isEncounterPerformed()) InpatientEncounter
      where (InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
          or InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
      )
        and InpatientEncounter.period ends during day of &quot;Measurement Period&quot;
  )
    or exists ((([Encounter: &quot;Hospice Encounter&quot;]).isEncounterPerformed()) HospiceEncounter
        where HospiceEncounter.period overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ObservationScreeningAssessment: &quot;Hospice care [Minimum Data Set]&quot;]).isAssessmentPerformed()) HospiceAssessment
        where HospiceAssessment.value ~ &quot;Yes (qualifier value)&quot;
          and HospiceAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ServiceRequest: &quot;Hospice Care Ambulatory&quot;]).isInterventionOrder()) HospiceOrder
        where HospiceOrder.authoredOn during day of &quot;Measurement Period&quot;
    )
    or exists ((([Procedure: &quot;Hospice Care Ambulatory&quot;]).isInterventionPerformed()) HospicePerformed
        where HospicePerformed.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ConditionProblemsHealthConcerns: &quot;Hospice Diagnosis&quot;]
        union [ConditionEncounterDiagnosis: &quot;Hospice Diagnosis&quot;]).verified()) HospiceCareDiagnosis
        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
    )</code></pre>
  </td>

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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="advancedillnessandfrailty-is-age-66-or-older-living-long-term-in-a-nursing-home"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="advancedillnessandfrailty-has-criteria-indicating-frailty"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="advancedillnessandfrailty-has-advanced-illness-in-year-before-or-during-measurement-period"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;:
exists ((([ConditionProblemsHealthConcerns: &quot;Advanced Illness&quot;]
union [ConditionEncounterDiagnosis: &quot;Advanced Illness&quot;]).verified()) AdvancedIllnessDiagnosis
where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of &quot;Measurement Period&quot; - 1 year, end of &quot;Measurement Period&quot;])</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="advancedillnessandfrailty-has-dementia-medications-in-year-before-or-during-measurement-period"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="advancedillnessandfrailty-is-age-66-or-older-with-advanced-illness-and-frailty"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="palliativecare-has-palliative-care-in-the-measurement-period"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Has Palliative Care in the Measurement Period&quot;:
  exists ((([ObservationScreeningAssessment: &quot;Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)&quot;]).isAssessmentPerformed()) PalliativeAssessment
      where PalliativeAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
  )
    or exists ((([ConditionProblemsHealthConcerns: &quot;Palliative Care Diagnosis&quot;]
    union [ConditionEncounterDiagnosis: &quot;Palliative Care Diagnosis&quot;]).verified()) PalliativeDiagnosis
        where PalliativeDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([Encounter: &quot;Palliative Care Encounter&quot;]).isEncounterPerformed()) PalliativeEncounter
        where PalliativeEncounter.period overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([Procedure: &quot;Palliative Care Intervention&quot;]).isInterventionPerformed()) PalliativeIntervention
        where PalliativeIntervention.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
    )</code></pre>
  </td>

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<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>

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<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>

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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-sde-sex"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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="cms122fhirdiabetesassessgt9pct-glycemic-status-assessment"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-most-recent-glycemic-status-date"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-lowest-glycemic-status-assessment-reading-on-most-recent-day"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-has-most-recent-glycemic-status-assessment-without-result"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-has-most-recent-elevated-glycemic-status-assessment"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-has-no-record-of-glycemic-status-assessment"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-numerator"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-qualifying-encounters"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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 
    end of &quot;Measurement Period&quot;
  ) in Interval[18, 75]
    and exists &quot;Qualifying Encounters&quot;
    and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
        where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of &quot;Measurement Period&quot;
    )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-denominator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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="cms122fhirdiabetesassessgt9pct-sde-payer"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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="cms122fhirdiabetesassessgt9pct-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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="cms122fhirdiabetesassessgt9pct-denominator-exclusions"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
  Hospice.&quot;Has Hospice Services&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;
    or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;</code></pre>
  </td>

</tr>



        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms122fhirdiabetesassessgt9pct-sde-race"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS122FHIRDiabetesAssessGT9Pct</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="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-toconcept"> </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 [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }</code></pre>
  </td>

</tr>



        


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

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<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="qicorecommon-tointerval"> </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: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end</code></pre>
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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="status-islaboratorytestperformed"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

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

</tr>



        



        



        


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

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

</tr>
<tr>

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

</tr>



        



        



        



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.

//Condition
//Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
define fluent function verified(conditions List&lt;Choice&lt;ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis&gt;&gt;):
  conditions C
    where C.verificationStatus is not null implies
      (C.verificationStatus ~ &quot;confirmed&quot;
        or C.verificationStatus ~ &quot;unconfirmed&quot;
        or C.verificationStatus ~ &quot;provisional&quot;
        or C.verificationStatus ~ &quot;differential&quot;
      )</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

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

</tr>



        


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

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

</tr>
<tr>

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

</tr>



        


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

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

</tr>
<tr>

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

</tr>



        



        


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

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

</tr>
<tr>

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

</tr>



        


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

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

</tr>
<tr>

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

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Medication, Active
define fluent function isMedicationActive(MedicationRequest List&lt;MedicationRequest&gt;):
  MedicationRequest M
    where M.status = 'active'
      and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}</code></pre>
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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cumulativemedicationduration-medicationrequestperiod"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function medicationRequestPeriod(Request &quot;MedicationRequest&quot;):
  Request R
    let
      dosage: singleton from R.dosageInstruction,
      doseAndRate: singleton from dosage.doseAndRate,
      timing: dosage.timing,
      frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
      period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
      doseRange: doseAndRate.dose,
      doseQuantity: doseAndRate.dose,
      dose: Coalesce(end of doseRange, doseQuantity),
      dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
      boundsPeriod: timing.repeat.bounds as Interval&lt;DateTime&gt;,
      daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
      quantity: R.dispenseRequest.quantity,
      refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
      startDate:
        Coalesce(
          date from start of boundsPeriod,
          date from R.authoredOn,
          date from start of R.dispenseRequest.validityPeriod
        ),
      totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
    return
      if startDate is not null and totalDaysSupplied is not null then
        Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
      else if startDate is not null and boundsPeriod.&quot;high&quot; is not null then
        Interval[startDate, date from end of boundsPeriod]
      else
        null</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

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

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

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
 Goal is to get to number of days
 Two broad approaches to the calculation:
  1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
  2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/

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

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

</tr>





  
  


  <tr>


<th 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 LOINC
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://loinc.org
    <br/>
    <em>Canonical URL</em>: <tt>http://loinc.org</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system CPT
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://www.ama-assn.org/go/cpt
    <br/>
    <em>Canonical URL</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system HCPCS
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
    <br/>
    <em>Canonical URL</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system ConditionVerificationStatusCodes
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: 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 HbA1c Laboratory Test
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Office Visit
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: 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 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 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 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 Nutrition Services
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1006</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Telephone Visits
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: 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 Diabetes
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Payer Type
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: 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">Value Set</th>


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Encounter Inpatient
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Hospice Encounter
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Hospice Care Ambulatory
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Hospice Diagnosis
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Frailty Device
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Frailty Diagnosis
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Frailty Encounter
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Frailty Symptom
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Advanced Illness
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Dementia Medications
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Palliative Care Diagnosis
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Palliative Care Encounter
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Palliative Care Intervention
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</tt>
    
  </td>
</tr>
 


  
  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Male (finding)
        <br/>
      
      <em>Code</em>: 248153007
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Female (finding)
        <br/>
      
      <em>Code</em>: 248152002
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Glucose management indicator
        <br/>
      
      <em>Code</em>: 97506-0
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes
        <br/>
      
      <em>Code</em>: 97802
      <br/>
      <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes
        <br/>
      
      <em>Code</em>: 97803
      <br/>
      <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes
        <br/>
      
      <em>Code</em>: 97804
      <br/>
      <em>System</em>: <tt>http://www.ama-assn.org/go/cpt</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes
        <br/>
      
      <em>Code</em>: G0270
      <br/>
      <em>System</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes
        <br/>
      
      <em>Code</em>: G0271
      <br/>
      <em>System</em>: <tt>http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>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 scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Discharge to home for hospice care (procedure)
        <br/>
      
      <em>Code</em>: 428361000124107
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Discharge to healthcare facility for hospice care (procedure)
        <br/>
      
      <em>Code</em>: 428371000124100
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Hospice care [Minimum Data Set]
        <br/>
      
      <em>Code</em>: 45755-6
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Yes (qualifier value)
        <br/>
      
      <em>Code</em>: 373066001
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Housing status
        <br/>
      
      <em>Code</em>: 71802-3
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Lives in nursing home (finding)
        <br/>
      
      <em>Code</em>: 160734000
      <br/>
      <em>System</em>: <tt>http://snomed.info/sct</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Medical equipment used
        <br/>
      
      <em>Code</em>: 98181-1
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
        <br/>
      
      <em>Code</em>: 71007-9
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  
  


  <tr>


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


</tr>
  
  
  


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: 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 Status
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/Status|1.15.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Status|1.15.000</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 scope="row" class="row-header">Dependency</th>


  <td class="content-container">
    
    <em>Description</em>: Library Hospice
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/Hospice|6.18.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Hospice|6.18.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library AIFrailLTCF
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.27.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.27.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library CMD
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library PalliativeCare
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/PalliativeCare|1.18.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/PalliativeCare|1.18.000</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, birthDate, birthDate.value
    <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, status, status.value, effective, value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013
    <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, status, status.value, effective, value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#97506-0: 'Glucose management indicator'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
    <br/>        
  
   
   
    <em>Must Support Elements</em>: value, status, status.value, effective
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, status, status.value, 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/2.16.840.1.113883.3.464.1003.101.12.1001
    <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, status, status.value, 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/2.16.840.1.113883.3.526.3.1240
    <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, status, status.value, 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/2.16.840.1.113883.3.464.1003.101.12.1025
    <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, status, status.value, 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/2.16.840.1.113883.3.464.1003.101.12.1023
    <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, status, status.value, 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/2.16.840.1.113883.3.464.1003.101.12.1016
    <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, status, status.value, 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/2.16.840.1.113883.3.464.1003.1006
    <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, status, status.value, period
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, status, status.value, 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/2.16.840.1.113883.3.464.1003.101.12.1080
    <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, hospitalization, hospitalization.dischargeDisposition, 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/2.16.840.1.113883.3.666.5.307
    <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/2.16.840.1.113883.3.464.1003.1003
    <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/2.16.840.1.113883.3.464.1003.101.12.1088
    <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/2.16.840.1.113883.3.464.1003.101.12.1090
    <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/2.16.840.1.113883.3.464.1003.103.12.1001
    <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/2.16.840.1.113883.3.464.1003.1165
    <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/2.16.840.1.113883.3.464.1003.113.12.1074
    <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/2.16.840.1.113883.3.464.1003.110.12.1082
    <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/2.16.840.1.113883.3.464.1003.1167
    <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 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-screening-assessment
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, value, effective, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#45755-6: 'Hospice care [Minimum Data Set]'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, effective, status, status.value, value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#71802-3: 'Housing status'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, value, effective, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#98181-1: 'Medical equipment used'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, effective, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#71007-9: 'Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Procedure
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, performed, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
    <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/2.16.840.1.113883.3.464.1003.1165
    <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/2.16.840.1.113883.3.464.1003.113.12.1074
    <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/2.16.840.1.113883.3.464.1003.110.12.1082
    <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/2.16.840.1.113883.3.464.1003.1167
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: DeviceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300
    <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-simple-observation
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, effective, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: MedicationRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: medication, status, status.value, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: medication</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: MedicationRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: medication.reference.value, status, status.value, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, authoredOn, authoredOn.value, dispenseRequest.validityPeriod
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Medication
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
    <br/>        
  
   
   
    <em>Must Support Elements</em>: id.value, code
    <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://loinc.org"/>
          <code value="97506-0"/>
          <display value="Glucose management indicator"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://www.ama-assn.org/go/cpt"/>
          <code value="97802"/>
          <display
                   value="Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://www.ama-assn.org/go/cpt"/>
          <code value="97803"/>
          <display
                   value="Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://www.ama-assn.org/go/cpt"/>
          <code value="97804"/>
          <display
                   value="Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
          <code value="G0270"/>
          <display
                   value="Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
          <code value="G0271"/>
          <display
                   value="Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="confirmed"/>
          <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-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="428361000124107"/>
          <display value="Discharge to home for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="428371000124100"/>
          <display
                   value="Discharge to healthcare facility for hospice care (procedure)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="45755-6"/>
          <display value="Hospice care [Minimum Data Set]"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="373066001"/>
          <display value="Yes (qualifier value)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="71802-3"/>
          <display value="Housing status"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="160734000"/>
          <display value="Lives in nursing home (finding)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="98181-1"/>
          <display value="Medical equipment used"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="71007-9"/>
          <display
                   value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  case
    when Patient.sex = '248153007' then &quot;Male (finding)&quot;
    when Patient.sex = '248152002' then &quot;Female (finding)&quot;
    else null
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Glycemic Status Assessment"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Glycemic Status Assessment&quot;:
  ( ( [LaboratoryResultObservation: &quot;HbA1c Laboratory Test&quot;]
      union [LaboratoryResultObservation: &quot;Glucose management indicator&quot;]
  ).isLaboratoryTestPerformed ( ) ) GlycemicStatus
    where GlycemicStatus.effective.latest ( ) during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Most Recent Glycemic Status Date"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Most Recent Glycemic Status Date&quot;:
  Last((&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
      return date from QualifyingGlycemicStatus.effective.latest()) QualifyingGlycemicStatus
      sort asc
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Lowest Glycemic Status Assessment Reading on Most Recent Day"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;:
  First(&quot;Glycemic Status Assessment&quot; QualifyingGlycemicStatus
      where QualifyingGlycemicStatus.effective.latest() same day as &quot;Most Recent Glycemic Status Date&quot;
      return {
        QualifyingGlycemicStatusValue: QualifyingGlycemicStatus.value as Quantity,
        QualifyingGlycemicStatus: QualifyingGlycemicStatus
      }
      sort by QualifyingGlycemicStatusValue
  ).QualifyingGlycemicStatus"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has Most Recent Glycemic Status Assessment Without Result"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;:
  &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot; is not null
    and &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value is null"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has Most Recent Elevated Glycemic Status Assessment"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;:
  &quot;Lowest Glycemic Status Assessment Reading on Most Recent Day&quot;.value &gt; 9 '%'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Has No Record Of Glycemic Status Assessment"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has No Record Of Glycemic Status Assessment&quot;:
  not exists &quot;Glycemic Status Assessment&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
  &quot;Has Most Recent Glycemic Status Assessment Without Result&quot;
    or &quot;Has Most Recent Elevated Glycemic Status Assessment&quot;
    or &quot;Has No Record Of Glycemic Status Assessment&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Qualifying Encounters"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Qualifying Encounters&quot;:
  ( ( [Encounter: &quot;Office Visit&quot;]
      union [Encounter: &quot;Annual Wellness Visit&quot;]
      union [Encounter: &quot;Preventive Care Services Established Office Visit, 18 and Up&quot;]
      union [Encounter: &quot;Preventive Care Services Initial Office Visit, 18 and Up&quot;]
      union [Encounter: &quot;Home Healthcare Services&quot;]
      union [Encounter: &quot;Nutrition Services&quot;]
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ &quot;Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
          )
      )
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ &quot;Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes&quot;
          )
      )
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ &quot;Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes&quot;
          )
      )
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ &quot;Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes&quot;
          )
      )
      union ( [Encounter] E
          where exists ( ( E.type ) T
              where T ~ &quot;Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes&quot;
          )
      )
      union [Encounter: &quot;Telephone Visits&quot;]
  ).isEncounterPerformed ( ) ) ValidEncounters
    where ValidEncounters.period during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
  AgeInYearsAt(date from 
    end of &quot;Measurement Period&quot;
  ) in Interval[18, 75]
    and exists &quot;Qualifying Encounters&quot;
    and exists ( ( ( [ConditionEncounterDiagnosis: &quot;Diabetes&quot;] ).verified ( ) ) DiabetesDiagnosis
        where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of &quot;Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator&quot;:
  &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Hospice"/>
        </extension>
        <extension url="name">
          <valueString value="Has Hospice Services"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Hospice Services&quot;:
  exists ((([Encounter: &quot;Encounter Inpatient&quot;]).isEncounterPerformed()) InpatientEncounter
      where (InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;
          or InpatientEncounter.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;
      )
        and InpatientEncounter.period ends during day of &quot;Measurement Period&quot;
  )
    or exists ((([Encounter: &quot;Hospice Encounter&quot;]).isEncounterPerformed()) HospiceEncounter
        where HospiceEncounter.period overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ObservationScreeningAssessment: &quot;Hospice care [Minimum Data Set]&quot;]).isAssessmentPerformed()) HospiceAssessment
        where HospiceAssessment.value ~ &quot;Yes (qualifier value)&quot;
          and HospiceAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ServiceRequest: &quot;Hospice Care Ambulatory&quot;]).isInterventionOrder()) HospiceOrder
        where HospiceOrder.authoredOn during day of &quot;Measurement Period&quot;
    )
    or exists ((([Procedure: &quot;Hospice Care Ambulatory&quot;]).isInterventionPerformed()) HospicePerformed
        where HospicePerformed.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([ConditionProblemsHealthConcerns: &quot;Hospice Diagnosis&quot;]
        union [ConditionEncounterDiagnosis: &quot;Hospice Diagnosis&quot;]).verified()) HospiceCareDiagnosis
        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdvancedIllnessandFrailty"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Is Age 66 or Older Living Long Term in a Nursing Home"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;:
  AgeInYearsAt(date from 
     end of &quot;Measurement Period&quot;
  )&gt;= 66
    and ( ( Last( (([ObservationScreeningAssessment: &quot;Housing status&quot;]).isAssessmentPerformed()) HousingStatus    
          where HousingStatus.effective.toInterval() ends on or before 
          day of end of &quot;Measurement Period&quot;
          sort by 
          end of effective.toInterval() asc
      )) LastHousingStatus
        where LastHousingStatus.value ~ &quot;Lives in nursing home (finding)&quot;
    ) is not null"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdvancedIllnessandFrailty"/>
        </extension>
        <extension url="name">
          <valueString value="Has Criteria Indicating Frailty"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Criteria Indicating Frailty&quot;:
  exists ( (([DeviceRequest: &quot;Frailty Device&quot;]).isDeviceOrderPersonalUseDevices()) FrailtyDeviceOrder
      where FrailtyDeviceOrder.authoredOn.toInterval() during day of &quot;Measurement Period&quot;
  )
    or exists ( (([ObservationScreeningAssessment: &quot;Medical equipment used&quot;]).isAssessmentPerformed()) EquipmentUsed
        where EquipmentUsed.value as Concept in &quot;Frailty Device&quot; 
        and EquipmentUsed.effective.toInterval() ends during day of &quot;Measurement Period&quot;
    )
    or exists ( (([ConditionProblemsHealthConcerns: &quot;Frailty Diagnosis&quot;]
    union [ConditionEncounterDiagnosis: &quot;Frailty Diagnosis&quot;]).verified()) FrailtyDiagnosis
        where FrailtyDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ( (([Encounter: &quot;Frailty Encounter&quot;]).isEncounterPerformed()) FrailtyEncounter
        where FrailtyEncounter.period overlaps day of &quot;Measurement Period&quot;
    )
    or exists ( (([SimpleObservation: &quot;Frailty Symptom&quot;]).isSymptom()) FrailtySymptom
        where FrailtySymptom.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdvancedIllnessandFrailty"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has Advanced Illness in Year Before or During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;:
exists ((([ConditionProblemsHealthConcerns: &quot;Advanced Illness&quot;]
union [ConditionEncounterDiagnosis: &quot;Advanced Illness&quot;]).verified()) AdvancedIllnessDiagnosis
where AdvancedIllnessDiagnosis.prevalenceInterval() starts during day of Interval[start of &quot;Measurement Period&quot; - 1 year, end of &quot;Measurement Period&quot;])"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdvancedIllnessandFrailty"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Has Dementia Medications in Year Before or During Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;:
  exists (( ([MedicationRequest: &quot;Dementia Medications&quot;]).isMedicationActive()) DementiaMedication
      where DementiaMedication.medicationRequestPeriod() overlaps day of Interval[start of &quot;Measurement Period&quot; - 1 year, 
        end of &quot;Measurement Period&quot;]
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="20"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="AdvancedIllnessandFrailty"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Is Age 66 or Older with Advanced Illness and Frailty"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;:
   AgeInYearsAt(date from end of &quot;Measurement Period&quot;)&gt;= 66
    and &quot;Has Criteria Indicating Frailty&quot;
    and ( &quot;Has Advanced Illness in Year Before or During Measurement Period&quot;
        or &quot;Has Dementia Medications in Year Before or During Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="21"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="PalliativeCare"/>
        </extension>
        <extension url="name">
          <valueString value="Has Palliative Care in the Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Has Palliative Care in the Measurement Period&quot;:
  exists ((([ObservationScreeningAssessment: &quot;Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)&quot;]).isAssessmentPerformed()) PalliativeAssessment
      where PalliativeAssessment.effective.toInterval() overlaps day of &quot;Measurement Period&quot;
  )
    or exists ((([ConditionProblemsHealthConcerns: &quot;Palliative Care Diagnosis&quot;]
    union [ConditionEncounterDiagnosis: &quot;Palliative Care Diagnosis&quot;]).verified()) PalliativeDiagnosis
        where PalliativeDiagnosis.prevalenceInterval() overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([Encounter: &quot;Palliative Care Encounter&quot;]).isEncounterPerformed()) PalliativeEncounter
        where PalliativeEncounter.period overlaps day of &quot;Measurement Period&quot;
    )
    or exists ((([Procedure: &quot;Palliative Care Intervention&quot;]).isInterventionPerformed()) PalliativeIntervention
        where PalliativeIntervention.performed.toInterval() overlaps day of &quot;Measurement Period&quot;
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="22"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator Exclusions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator Exclusions&quot;:
  Hospice.&quot;Has Hospice Services&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older Living Long Term in a Nursing Home&quot;
    or AIFrailLTCF.&quot;Is Age 66 or Older with Advanced Illness and Frailty&quot;
    or PalliativeCare.&quot;Has Palliative Care in the Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="23"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="24"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS122FHIRDiabetesAssessGT9Pct"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="25"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value uri): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="26"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isLaboratoryTestPerformed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Laboratory Test, Performed
define fluent function isLaboratoryTestPerformed(Obs List&lt;LaboratoryResultObservation&gt;):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="27"/>
        </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="28"/>
        </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="29"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isEncounterPerformed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List&lt;Encounter&gt;):
  Enc E
    where E.status = 'finished'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="30"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToConcept"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="31"/>
        </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="32"/>
        </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="33"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="verified"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.

//Condition
//Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
define fluent function verified(conditions List&lt;Choice&lt;ConditionProblemsHealthConcerns, ConditionEncounterDiagnosis&gt;&gt;):
  conditions C
    where C.verificationStatus is not null implies
      (C.verificationStatus ~ &quot;confirmed&quot;
        or C.verificationStatus ~ &quot;unconfirmed&quot;
        or C.verificationStatus ~ &quot;provisional&quot;
        or C.verificationStatus ~ &quot;differential&quot;
      )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="34"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isAssessmentPerformed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List&lt;ObservationScreeningAssessment&gt;):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="35"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isInterventionOrder"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Intervention, Order
define fluent function isInterventionOrder(ServiceRequest List&lt;ServiceRequest&gt;):
  ServiceRequest S
    where S.status in { 'active', 'completed' }
      and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="36"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isInterventionPerformed"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Intervention, Performed
define fluent function isInterventionPerformed(Proc List&lt;Procedure&gt;):
  Proc P
    where P.status ~ 'completed'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="37"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="QICoreCommon"/>
        </extension>
        <extension url="name">
          <valueString value="toInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="38"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isDeviceOrderPersonalUseDevices"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Device, Order - Personal Use Devices
define fluent function isDeviceOrderPersonalUseDevices(DeviceRequest List&lt;DeviceRequest&gt;):
  DeviceRequest D
    where D.status in { 'active', 'completed' }
      and D.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="39"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isSymptom"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Symptom
define fluent function isSymptom(Obs List&lt;SimpleObservation&gt;):
  Obs O
    where O.status in { 'preliminary', 'final', 'amended', 'corrected' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="40"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="Status"/>
        </extension>
        <extension url="name">
          <valueString value="isMedicationActive"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="//Medication, Active
define fluent function isMedicationActive(MedicationRequest List&lt;MedicationRequest&gt;):
  MedicationRequest M
    where M.status = 'active'
      and M.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="41"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CumulativeMedicationDuration"/>
        </extension>
        <extension url="name">
          <valueString value="medicationRequestPeriod"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define fluent function medicationRequestPeriod(Request &quot;MedicationRequest&quot;):
  Request R
    let
      dosage: singleton from R.dosageInstruction,
      doseAndRate: singleton from dosage.doseAndRate,
      timing: dosage.timing,
      frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
      period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
      doseRange: doseAndRate.dose,
      doseQuantity: doseAndRate.dose,
      dose: Coalesce(end of doseRange, doseQuantity),
      dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
      boundsPeriod: timing.repeat.bounds as Interval&lt;DateTime&gt;,
      daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
      quantity: R.dispenseRequest.quantity,
      refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
      startDate:
        Coalesce(
          date from start of boundsPeriod,
          date from R.authoredOn,
          date from start of R.dispenseRequest.validityPeriod
        ),
      totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
    return
      if startDate is not null and totalDaysSupplied is not null then
        Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
      else if startDate is not null and boundsPeriod.&quot;high&quot; is not null then
        Interval[startDate, date from end of boundsPeriod]
      else
        null"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="42"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CumulativeMedicationDuration"/>
        </extension>
        <extension url="name">
          <valueString value="Quantity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4             */
/**********************************************************************/

define function Quantity(value Decimal, unit String):
  if value is not null then
    System.Quantity { value: value, unit: unit }
  else
    null"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="43"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CumulativeMedicationDuration"/>
        </extension>
        <extension url="name">
          <valueString value="ToDaily"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
 Goal is to get to number of days
 Two broad approaches to the calculation:
  1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
  2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/

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

/*
  Calculates daily frequency given frequency within a period
*/
define function ToDaily(frequency System.Integer, period System.Quantity):
  case period.unit
    when 'h' then frequency * (24.0 / period.value)
    when 'min' then frequency * (24.0 / period.value) * 60
    when 's' then frequency * (24.0 / period.value) * 60 * 60
    when 'd' then frequency * (24.0 / period.value) / 24
    when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
    when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
    when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
    when 'hour' then frequency * (24.0 / period.value)
    when 'minute' then frequency * (24.0 / period.value) * 60
    when 'second' then frequency * (24.0 / period.value) * 60 * 60
    when 'day' then frequency * (24.0 / period.value) / 24
    when 'week' then frequency * (24.0 / period.value) / (24 * 7)
    when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
    when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
    when 'hours' then frequency * (24.0 / period.value)
    when 'minutes' then frequency * (24.0 / period.value) * 60
    when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
    when 'days' then frequency * (24.0 / period.value) / 24
    when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
    when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
    when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
    else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' &amp; period.unit)
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="44"/>
        </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 Status"/>
        <resource value="https://madie.cms.gov/Library/Status|1.15.000"/>
      </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="Library Hospice"/>
        <resource value="https://madie.cms.gov/Library/Hospice|6.18.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library AIFrailLTCF"/>
        <resource
                  value="https://madie.cms.gov/Library/AdvancedIllnessandFrailty|1.27.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library CMD"/>
        <resource
                  value="https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library PalliativeCare"/>
        <resource
                  value="https://madie.cms.gov/Library/PalliativeCare|1.18.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system SNOMEDCT"/>
        <resource value="http://snomed.info/sct"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system LOINC"/>
        <resource value="http://loinc.org"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system CPT"/>
        <resource value="http://www.ama-assn.org/go/cpt"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system HCPCS"/>
        <resource
                  value="http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionVerificationStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set HbA1c Laboratory Test"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1013"/>
      </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 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
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        <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
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      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Home Healthcare Services"/>
        <resource
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      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Nutrition Services"/>
        <resource
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      </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 Diabetes"/>
        <resource
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      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer Type"/>
        <resource
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      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Encounter Inpatient"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice Encounter"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice Care Ambulatory"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Hospice Diagnosis"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Frailty Device"/>
        <resource
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      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Frailty Diagnosis"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1074"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Frailty Encounter"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1088"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Frailty Symptom"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Advanced Illness"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1082"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Dementia Medications"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Palliative Care Diagnosis"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Palliative Care Encounter"/>
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      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Palliative Care Intervention"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="ErrorLevel"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="string"/>
      </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="Denominator Exclusions"/>
        <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"/>
        <mustSupport value="birthDate"/>
        <mustSupport value="birthDate.value"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
        <mustSupport value="value"/>
        <codeFilter>
          <path value="code"/>
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        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
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        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
        <mustSupport value="value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="97506-0"/>
            <display value="Glucose management indicator"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab"/>
        <mustSupport value="value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="effective"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
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        <mustSupport value="type"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="period"/>
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        <mustSupport value="status"/>
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      <dataRequirement>
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        <mustSupport value="type"/>
        <mustSupport value="status"/>
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        <mustSupport value="type"/>
        <mustSupport value="status"/>
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        <mustSupport value="type"/>
        <mustSupport value="status"/>
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        <type value="Encounter"/>
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        <mustSupport value="type"/>
        <mustSupport value="hospitalization"/>
        <mustSupport value="hospitalization.dischargeDisposition"/>
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        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
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          <path value="type"/>
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        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
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      <dataRequirement>
        <type value="Encounter"/>
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        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="type"/>
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      <dataRequirement>
        <type value="Condition"/>
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        <mustSupport value="code"/>
        <codeFilter>
          <path value="code"/>
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        <type value="Condition"/>
        <profile
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        <mustSupport value="code"/>
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        <mustSupport value="code"/>
        <codeFilter>
          <path value="code"/>
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        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Coverage"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
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          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
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      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="45755-6"/>
            <display value="Hospice care [Minimum Data Set]"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
        <mustSupport value="code"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="71802-3"/>
            <display value="Housing status"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
        <mustSupport value="code"/>
        <mustSupport value="value"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="98181-1"/>
            <display value="Medical equipment used"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment"/>
        <mustSupport value="code"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="71007-9"/>
            <display
                     value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="status"/>
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        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
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      <dataRequirement>
        <type value="Procedure"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Procedure"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"/>
        <mustSupport value="code"/>
        <mustSupport value="performed"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"/>
        </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/2.16.840.1.113883.3.464.1003.1165"/>
        </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/2.16.840.1.113883.3.464.1003.113.12.1074"/>
        </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/2.16.840.1.113883.3.464.1003.110.12.1082"/>
        </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/2.16.840.1.113883.3.464.1003.1167"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="DeviceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.118.12.1300"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation"/>
        <mustSupport value="code"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.113.12.1075"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="MedicationRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
        <mustSupport value="medication"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="dosageInstruction"/>
        <mustSupport value="dispenseRequest"/>
        <mustSupport value="dispenseRequest.expectedSupplyDuration"/>
        <mustSupport value="dispenseRequest.quantity"/>
        <mustSupport value="dispenseRequest.numberOfRepeatsAllowed"/>
        <mustSupport value="dispenseRequest.numberOfRepeatsAllowed.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="dispenseRequest.validityPeriod"/>
        <codeFilter>
          <path value="medication"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.196.12.1510"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="MedicationRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
        <mustSupport value="medication.reference.value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="dosageInstruction"/>
        <mustSupport value="dispenseRequest"/>
        <mustSupport value="dispenseRequest.expectedSupplyDuration"/>
        <mustSupport value="dispenseRequest.quantity"/>
        <mustSupport value="dispenseRequest.numberOfRepeatsAllowed"/>
        <mustSupport value="dispenseRequest.numberOfRepeatsAllowed.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="dispenseRequest.validityPeriod"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Medication"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"/>
        <mustSupport value="id.value"/>
        <mustSupport value="code"/>
      </dataRequirement>
    </Library>
  </contained>
  <extension
             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
    <extension url="guidance">
      <valueString
                   value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
    </extension>
    <extension url="usage">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
          <code value="supplemental-data"/>
          <display value="Supplemental Data"/>
        </coding>
        <text value="Supplemental Data Guidance"/>
      </valueCodeableConcept>
    </extension>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
    <valueReference>
      <reference value="#effective-data-requirements"/>
    </valueReference>
  </extension>
  <url value="https://madie.cms.gov/Measure/CMS122FHIRDiabetesAssessGT9Pct"/>
  <identifier>
    <use value="usual"/>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
        <code value="short-name"/>
        <display value="Short Name"/>
      </coding>
    </type>
    <system value="https://madie.cms.gov/measure/shortName"/>
    <value value="CMS122FHIR"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
        <code value="version-independent"/>
        <display value="Version Independent"/>
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    </type>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:f04ee808-8ece-4936-8b26-fafa462e1594"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <type>
      <coding>
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                value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
        <code value="version-specific"/>
        <display value="Version Specific"/>
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    </type>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:2ea22cb2-9bcc-4ca6-b2f2-68fc964365ad"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
        <code value="publisher"/>
        <display value="Publisher"/>
      </coding>
    </type>
    <system value="https://madie.cms.gov/measure/cmsId"/>
    <value value="122FHIR"/>
    <assigner>
      <display value="CMS"/>
    </assigner>
  </identifier>
  <version value="1.0.000"/>
  <name value="CMS122FHIRDiabetesAssessGT9Pct"/>
  <title value="Diabetes: Glycemic Status Assessment Greater Than 9%FHIR"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2025-07-25T20:45:50+00:00"/>
  <publisher value="National Committee for Quality Assurance"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="https://www.ncqa.org/"/>
    </telecom>
  </contact>
  <description
               value="Percentage of patients 18-75 years of age with diabetes who had a glycemic status assessment (hemoglobin A1c [HbA1c] or glucose management indicator [GMI]) &amp;gt; 9.0% during the measurement period"/>
  <usage
         value="If the glycemic status assessment (HbA1c or GMI) is in the medical record, the test can be used to determine numerator compliance. Glycemic status assessment (HbA1c or GMI) must be reported as a percentage (%). If multiple glycemic status assessments were recorded for a single date, use the lowest result. This eCQM is a patient-based measure. This FHIR-based measure has been derived from the QDM-based measure: CMS122v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html)."/>
  <copyright
             value="This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties or endorsements about the quality of any product, test or protocol identified as numerator compliant or otherwise identified as meeting the requirements of the measure or specification. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure may be used for internal, noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. All other uses, including a commercial use (including but not limited to vendors using or embedding the measures and specifications into any product or service to calculate measure results for customers for any purpose), must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2025 National Committee for Quality Assurance. All Rights Reserved. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2025. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. Some measure specifications contain coding from LOINC(R) (https://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2025 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at https://loinc.org/kb/license/. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 copyright 2025 World Health Organization. All Rights Reserved. Some measures use RxNorm, a standardized nomenclature and coding for clinical drugs and drug delivery devices, which is made publicly available courtesy of the U.S. National Library of Medicine (NLM), National Institutes of Health, Department of Health and Human Services. NLM is not responsible for the measures and does not endorse or recommend this or any other product. “HL7” is the registered trademark of Health Level Seven International."/>
  <effectivePeriod>
    <start value="2026-01-01"/>
    <end value="2026-12-31"/>
  </effectivePeriod>
  <author>
    <name value="National Committee for Quality Assurance"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.ncqa.org/"/>
    </telecom>
  </author>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="American Diabetes Association. (2018). Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care, 41, 917-928. Retrieved from http://care.diabetesjournals.org/content/early/2018/03/20/dci18-0007"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="American Diabetes Association. (2022a). Statistics About Diabetes. Retrieved from https://diabetes.org/about-us/statistics/about-diabetes"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Centers for Disease Control and Prevention. (2022a). What is Diabetes? Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Centers for Disease Control and Prevention. (2022b). Diabetes Report Card 2021. US Dept of Health and Human Services. Retrieved from https://archive.cdc.gov/www_cdc_gov/diabetes/library/reports/reportcard.html"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="ElSayed, N.A., Aleppo, G., Ardoda, V.R., Bannuru, R.B., Brown, F.M., Bruemmer, D.,…Staton, R.C., American Diabetes Association (ADA). (2022). 6. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care 2023,46(Supplement_1):S97–S110. https://doi.org/10.2337/dc23-S006"/>
  </relatedArtifact>
  <library
           value="https://madie.cms.gov/Library/CMS122FHIRDiabetesAssessGT9Pct"/>
  <disclaimer
              value="The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]."/>
  <rationale
             value="Diabetes is the seventh leading cause of death in the United States (Centers for Disease Control and Prevention [CDC], 2022a). In 2019, diabetes affected more than 37 million Americans (11.3% of the U.S. population) and killed more than 87,000 people (American Diabetes Association [ADA], 2022a). Diabetes is a long-lasting disease marked by high blood glucose levels, resulting from the body's inability to produce or use insulin properly (CDC, 2022a). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney damage, amputation of feet or legs, and premature death (CDC, 2022b). In 2017, diabetes cost the U.S. an estimated $327 billion: $237 billion in direct medical costs and $90 billion in reduced productivity. This is a 34% increase from the estimated $245 billion spent on diabetes in 2012 (ADA, 2018). Controlling A1c blood levels helps reduce the risk of microvascular complications (eye, kidney and nerve diseases) (ADA, 2022b)."/>
  <clinicalRecommendationStatement
                                   value="American Diabetes Association (2023): - Assess glycemic status (A1C or other glycemic measurement such as time in range or glucose management indicator) at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control). (Level of evidence: E) - An A1C goal for many nonpregnant adults of &amp;lt;7% (53 mmol/mol) without significant hypoglycemia is appropriate. (Level of evidence: A) - On the basis of health care professional judgement and patient preference, achievement of lower A1C levels than the goal of 7% may be acceptable and even beneficial if it can be achieved safely without significant hypoglycemia or other adverse effects of treatment. (Level of evidence: B) - Less stringent A1C goals (such as &amp;lt;8% [64 mmol/mol]) may be appropriate for patients with limited life expectancy or where the harms of treatment are greater than the benefits. Health care professionals should consider deintensification of therapy if appropriate to reduce the risk of hypoglycemia in patients with inappropriate stringent A1C targets. (Level of evidence: B) - Standardized, single-page glucose reports from continuous glucose monitoring (CGM) devices with visual cues, such as the ambulatory glucose profile, should be considered as a standard summary for all CGM devices. Level of evidence: E"/>
  <group id="Group_1">
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
          <code value="proportion"/>
          <display value="Proportion"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
      <valueCode value="boolean"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
      <valueCodeableConcept>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
          <code value="intermediate-outcome"/>
          <display value="Intermediate Outcome"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
      <valueCode value="None"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
          <code value="increase"/>
          <display value="Increased score indicates improvement"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <population id="InitialPopulation_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="initial-population"/>
          <display value="Initial Population"/>
        </coding>
      </code>
      <description
                   value="Patients 18-75 years of age by the end of the measurement period, with diabetes with a visit during the measurement period"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Initial Population"/>
      </criteria>
    </population>
    <population id="Denominator_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator"/>
          <display value="Denominator"/>
        </coding>
      </code>
      <description value="Equals Initial Population"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator"/>
      </criteria>
    </population>
    <population id="DenominatorExclusion_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exclusion"/>
          <display value="Denominator Exclusion"/>
        </coding>
      </code>
      <description
                   value="Exclude patients who are in hospice care for any part of the measurement period. Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period. Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria: - Advanced illness diagnosis during the measurement period or the year prior - OR taking dementia medications during the measurement period or the year prior Exclude patients receiving palliative care for any part of the measurement period."/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exclusions"/>
      </criteria>
    </population>
    <population id="Numerator_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <description
                   value="Patients whose most recent glycemic status assessment (HbA1c or GMI) (performed during the measurement period) is &amp;gt;9.0% or is missing, or was not performed during the measurement period"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
  </group>
  <supplementalData id="sde-ethnicity">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Ethnicity"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-payer">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Payer"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-race">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Race"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-sex">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Sex"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>