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

: Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR - JSON Representation

Active as of 2025-08-22

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{
  "resourceType" : "Measure",
  "id" : "CMS135FHIRACEIorARBorARNIforHF",
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    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" class=\"col-12\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n<td class=\"content-container\">Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n<td class=\"content-container\">1.0.000</td>\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n<td class=\"content-container\">CMS135FHIR</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n<td class=\"content-container\">urn:uuid:86136d6c-dbe1-4b7f-89f3-406cb90f08d5</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n<td class=\"content-container\">urn:uuid:a0aa7f51-9882-4ceb-b4e5-bb94669b62ca</td>\n</tr>\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n<td class=\"content-container\">135FHIR</td>\n</tr>\n\n  \n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Consensus Based Entity Identifier</th>\n\n\n<td class=\"content-container\">0081e</td>\n</tr>\n\n  \n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n</tr>\n\n  \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n<td class=\"content-container\">American Heart Association</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n<td class=\"content-container\">American Heart Association</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n<td class=\"content-container\">American Medical Association (AMA)</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n<td class=\"content-container\"><p>Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) &lt;=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period</p></td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n<td class=\"content-container\"><p>Copyright 2025 American College of Cardiology and American Heart Association. All Rights Reserved.</p></td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n<td class=\"content-container\"><p>The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.</p>\n<p>The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.</p>\n<p>Commercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.</p>\n<p>ACC and AHA encourage use of the Measure by other health care professionals, where appropriate. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND.</p>\n<p>Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications.</p>\n<p>CPT(R) contained in the Measure specifications is copyright 2004-20234 American Medical Association. LOINC(R) is copyright 2004-20234 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-20234 International Health Terminology Standards Development Organisation. ICD-10 is copyright 20234 World Health Organization. All Rights Reserved.</p>\n<p>The American Medical Association’s and the PCPI(R) Foundation’s significant past efforts and contributions to the performance measure are gratefully acknowledged. Due to technical limitations, registered trademarks are indicated by (R) or [R].</p></td>\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n<td class=\"content-container\"><p>Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor–intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.</p></td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n<td class=\"content-container\"><p>In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF, the use of angiotension-converting enzyme inhibitors (ACEi) is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022). ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).</p>\n<p>Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)</p>\n<table style=\"width: 1020px\" class=\"rich-text-table\">\n <colgroup>\n  <col style=\"width: 203px\"/>\n  <col style=\"width: 209px\"/>\n  <col style=\"width: 205px\"/>\n  <col style=\"width: 403px\"/>\n </colgroup>\n <tbody>\n  <tr>\n   <th colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Drug</p></th>\n   <th colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>Initial Daily Dose(s)</p></th>\n   <th colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>Target Dose(s)</p></th>\n   <th colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>Mean Doses Achieved in Clinical Trials</p></th>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p><em> ACEi </em></p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p/></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Captopril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>6.25 mg 3 times</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>50 mg 3 times</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>122.7 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Enalapril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>2.5 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>10 to 20 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>16.6 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Fosinopril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>5 to 10 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>40 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>N/A</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Lisinopril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>2.5 to 5 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>20 to 40 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>32.5 to 35.0 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Perindopril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>2 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>8 to 16 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>N/A</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Quinapril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>5 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>20 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>N/A</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Ramipril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>1.25 to 2.5 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>10 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>N/A</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Trandolapril</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>1 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>4 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>N/A</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p><em> ARB</em></p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p/></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Candesartan</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>4 to 8 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>32 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>24 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Losartan</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>25 to 50 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>50 to 150 mg once</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>129 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Valsartan</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>20 to 40 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>160 mg twice</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>254 mg total daily</p></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p><em> ARNI</em></p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p/></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p/></td>\n  </tr>\n  <tr>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"203\"><p>Sacubitril-valsartan</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"209\"><p>49/51 mg twice (sacubitril/valsartan)</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"205\"><p>97/103 mg twice (sacubitril/valsartan)</p></td>\n   <td colspan=\"1\" rowspan=\"1\" colwidth=\"403\"><p>182/193 mg (sacubitril/valsartan) total daily</p><p>(therapy may be initiated at 24/26 mg twice)</p></td>\n  </tr>\n </tbody>\n</table></td>\n</tr>\n\n\n\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    <p>Heidenreich, P.A., Bozkurt, B, Aguilar, D., ... Allen, L. A. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. doi: 10.1161/CIR.0000000000001063</p>\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n\n\n\n\n\n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n<td class=\"content-container\">Moderate or Severe LVSD: <p>LVEF &lt;=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:</p>\n<ol>\n <li><p>that provides a numerical value of LVSD or</p></li>\n <li><p>that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.</p></li>\n</ol></td>\n</tr>\n\n\n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Definition</th>\n\n\n<td class=\"content-container\">Prescribed: <p>Denotes that a prescription has been given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR that the patient is already taking an ACE inhibitor or ARB or ARNI therapy as documented in their current medication list</p></td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n<td class=\"content-container\"><p>This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.</p>\n<p>The requirement of two or more visits is used to establish that the eligible clinician has an existing relationship with the patient.</p>\n<p>A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.</p>\n<p>In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of &quot;below 40%&quot; or &quot;ejection fraction between 35 and 40%&quot; will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as &quot;Moderate or Severe.&quot;</p>\n<p>Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.</p>\n<p>This FHIR-based measure has been derived from the QDM-based measure CMS135v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>\n</tr>\n\n\n\n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n<td class=\"content-container\">boolean</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>\n</tr>\n\n\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>\n</tr>\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>\n</tr>\n\n\n  \n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: InitialPopulation_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms135fhiraceiorarborarniforhf-initial-population\">Initial Population</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Denominator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Equals Initial Population with a current or prior LVEF &lt;= 40%</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms135fhiraceiorarborarniforhf-denominator\">Denominator</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exclusion</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorExclusion_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms135fhiraceiorarborarniforhf-denominator-exclusions\">Denominator Exclusions</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Numerator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms135fhiraceiorarborarniforhf-numerator\">Numerator</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exception</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorException_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><ul>\n <li><p>Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).</p></li>\n <li><p>Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).</p></li>\n</ul></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms135fhiraceiorarborarniforhf-denominator-exceptions\">Denominator Exceptions</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n\n\n  \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Guidance</th>\n\n\n<td class=\"content-container\"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></td>\n</tr>\n\n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-ethnicity\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Ethnicity\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms135fhiraceiorarborarniforhf-sde-ethnicity\">SDE Ethnicity</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-payer\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Payer\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms135fhiraceiorarborarniforhf-sde-payer\">SDE Payer</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-race\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Race\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms135fhiraceiorarborarniforhf-sde-race\">SDE Race</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-sex\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Sex\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms135fhiraceiorarborarniforhf-sde-sex\">SDE Sex</a> \n      \n    \n  </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n<td class=\"content-container\">https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF</td>\n</tr>\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Contents</th>\n  <td class=\"content-container\">\n    <em><a href=\"#population-criteria\">Population Criteria</a></em>\n    <br/>\n    <em><a href=\"#definitions\">Logic Definitions</a></em>\n    <br/>\n    <em><a href=\"#terminology\">Terminology</a></em>\n    <br/>\n    <em><a href=\"#dependencies\">Dependencies</a></em>\n    <br/>\n    <em><a href=\"#data-requirements\">Data Requirements</a></em>\n    <br/>\n  </td>\n</tr>\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n  \n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms135fhiraceiorarborarniforhf-initial-population\"> </a>\n    \n    \n    Initial Population\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AHA.&quot;Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms135fhiraceiorarborarniforhf-denominator\"> </a>\n    \n    \n    Denominator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;\n    and exists AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms135fhiraceiorarborarniforhf-denominator-exclusions\"> </a>\n    \n    \n    Denominator Exclusion\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  AHA.&quot;Has Heart Transplant&quot;\n    or AHA.&quot;Has Heart Transplant Complications&quot;\n    or AHA.&quot;Has Left Ventricular Assist Device&quot;\n    or AHA.&quot;Has Left Ventricular Assist Device Complications&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms135fhiraceiorarborarniforhf-numerator\"> </a>\n    \n    \n    Numerator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  &quot;Has ACEI or ARB or ARNI Ordered&quot;\n    or &quot;Is Currently Taking ACEI or ARB or ARNI&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms135fhiraceiorarborarniforhf-denominator-exceptions\"> </a>\n    \n    \n    Denominator Exception\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  &quot;Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI&quot;\n    or &quot;Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient&quot;\n    or &quot;Has Diagnosis of Allergy or Intolerance to ACEI or ARB&quot;\n    or &quot;Has Diagnosis of Pregnancy&quot;\n    or &quot;Has Diagnosis of Renal Failure Due to ACEI&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n  \n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n  \n  \n          \n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-sex\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n    when Patient.sex = '248153007' then &quot;Male (finding)&quot;\n    when Patient.sex = '248152002' then &quot;Female (finding)&quot;\n    else null\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-payer\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  [Coverage: type in &quot;Payer Type&quot;] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  Patient.ethnicity E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-race\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  Patient.race R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-sde-sex\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-acei-or-arb-or-arni-ordered\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has ACEI or ARB or ARNI Ordered&quot;:\n  exists ( [MedicationRequest: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] ACEIOrARBOrARNIOrdered\n      where ACEIOrARBOrARNIOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-is-currently-taking-acei-or-arb-or-arni\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Is Currently Taking ACEI or ARB or ARNI&quot;:\n  exists ( [MedicationRequest: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] ActiveACEIOrARBOrARNI\n      where ActiveACEIOrARBOrARNI.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-numerator\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  &quot;Has ACEI or ARB or ARNI Ordered&quot;\n    or &quot;Is Currently Taking ACEI or ARB or ARNI&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-initial-population\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  AHA.&quot;Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-denominator\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Initial Population&quot;\n    and exists AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-sde-payer\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-sde-ethnicity\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-denominator-exclusions\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  AHA.&quot;Has Heart Transplant&quot;\n    or AHA.&quot;Has Heart Transplant Complications&quot;\n    or AHA.&quot;Has Left Ventricular Assist Device&quot;\n    or AHA.&quot;Has Left Ventricular Assist Device Complications&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-sde-race\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-medical-or-patient-reason-for-not-ordering-acei-or-arb-or-arni\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI&quot;:\n  exists ( [MedicationNotRequested: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] NoACEIOrARBOrARNIOrdered\n      where NoACEIOrARBOrARNIOrdered.isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter ( )\n        and ( NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Medical Reason&quot;\n            or NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Patient Reason&quot;\n            or NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Patient Reason for ACE Inhibitor or ARB Decline&quot;\n        )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-allergy-or-intolerance-to-acei-or-arb-or-arni-ingredient\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient&quot;:\n  exists ( ( [AllergyIntolerance: &quot;ACE Inhibitor or ARB or ARNI Ingredient&quot;]\n      union [AllergyIntolerance: &quot;Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)&quot;]\n      union [AllergyIntolerance: &quot;Substance with angiotensin II receptor antagonist mechanism of action (substance)&quot;]\n      union [AllergyIntolerance: &quot;Substance with neprilysin inhibitor mechanism of action (substance)&quot;] ) ACEIOrARBOrARNIAllergyIntolerance\n      where ACEIOrARBOrARNIAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-diagnosis-of-allergy-or-intolerance-to-acei-or-arb\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Diagnosis of Allergy or Intolerance to ACEI or ARB&quot;:\n  exists ( ( ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Allergy to ACE Inhibitor or ARB&quot;]\n        union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Allergy to ACE Inhibitor or ARB&quot;]\n    )\n      union ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Intolerance to ACE Inhibitor or ARB&quot;] )\n      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Intolerance to ACE Inhibitor or ARB&quot;] ) ACEIOrARBAllergyOrIntoleranceDiagnosis\n      where ACEIOrARBAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-diagnosis-of-pregnancy\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Diagnosis of Pregnancy&quot;:\n  exists ( ( [ConditionProblemsHealthConcerns: &quot;Pregnancy&quot;]\n      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Pregnancy&quot;] ) PregnancyDiagnosis\n      with AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n        such that PregnancyDiagnosis.prevalenceInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period\n          and PregnancyDiagnosis.isVerified ( )\n  )\n    or exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation\n        with AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n          such that PregnantObservation.effective.toInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period\n            and ( PregnantObservation.value in &quot;Pregnancy&quot;\n                and PregnantObservation.status in { 'final', 'amended', 'corrected' }\n            )\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-has-diagnosis-of-renal-failure-due-to-acei\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Diagnosis of Renal Failure Due to ACEI&quot;:\n  exists ( ( [ConditionProblemsHealthConcerns: &quot;Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)&quot;]\n      union [ConditionEncounterDiagnosis: &quot;Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)&quot;] ) RenalFailureDueToACEI\n      where RenalFailureDueToACEI.overlapsHeartFailureOutpatientEncounter ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms135fhiraceiorarborarniforhf-denominator-exceptions\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  &quot;Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI&quot;\n    or &quot;Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient&quot;\n    or &quot;Has Diagnosis of Allergy or Intolerance to ACEI or ARB&quot;\n    or &quot;Has Diagnosis of Pregnancy&quot;\n    or &quot;Has Diagnosis of Renal Failure Due to ACEI&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-prevalenceinterval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):\nif condition.clinicalStatus ~ &quot;active&quot;\n  or condition.clinicalStatus ~ &quot;recurrence&quot;\n  or condition.clinicalStatus ~ &quot;relapse&quot; then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n    (end of condition.abatementInterval()) abatementDate\n    return if abatementDate is null then\n      Interval[start of condition.onset.toInterval(), abatementDate)\n    else\n      Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-abatementinterval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns an interval representing the normalized abatement of a given Condition.\n@comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n*/\ndefine fluent function abatementInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):\n\tif condition.abatement is DateTime then\n\t  Interval[condition.abatement as DateTime, condition.abatement as DateTime]\n\telse if condition.abatement is Quantity then\n\t\tInterval[Patient.birthDate + (condition.abatement as Quantity),\n\t\t\tPatient.birthDate + (condition.abatement as Quantity) + 1 year)\n\telse if condition.abatement is Interval&lt;Quantity&gt; then\n\t  Interval[Patient.birthDate + (condition.abatement.low as Quantity),\n\t\t  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)\n\telse if condition.abatement is Interval&lt;DateTime&gt; then\n\t  Interval[condition.abatement.low, condition.abatement.high)\n\telse null as Interval&lt;DateTime&gt;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-references\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n  resource.id = Last(Split(reference.reference, '/'))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-tointerval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval&lt;DateTime&gt; then\n  \t\tchoice as Interval&lt;DateTime&gt;\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval&lt;Quantity&gt; then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;\n\t\telse\n\t\t\tnull as Interval&lt;DateTime&gt;\n\tend</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.&quot;start&quot; is null then\n            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]\n        else\n            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tocode\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-toconcept\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-outpatient-encounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Outpatient Encounter&quot;:\n  ( [Encounter: &quot;Care Services in Long Term Residential Facility&quot;]\n      union [Encounter: &quot;Home Healthcare Services&quot;]\n      union [Encounter: &quot;Nursing Facility Visit&quot;]\n      union [Encounter: &quot;Office Visit&quot;]\n      union [Encounter: &quot;Outpatient Consultation&quot;]\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-heart-failure-outpatient-encounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns certain finished encounter types that overlap a Heart Failure condition and are during the measurement period: \n                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)\n                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)\n                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)\n                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)\n                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)\n*/\ndefine &quot;Heart Failure Outpatient Encounter&quot;:\n  &quot;Outpatient Encounter&quot; QualifyingEncounter\n    with ( [ConditionProblemsHealthConcerns: &quot;Heart Failure&quot;]\n      union [ConditionEncounterDiagnosis: &quot;Heart Failure&quot;] ) HeartFailure\n      such that HeartFailure.prevalenceInterval ( ) overlaps day of QualifyingEncounter.period\n        and HeartFailure.isVerified ( )\n    where QualifyingEncounter.period during day of &quot;Measurement Period&quot;\n      and QualifyingEncounter.isEncounterFinished ( )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-moderate-or-severe-lvsd-findings\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns a union  of the following:\n                * Observations where the final, amended or correction ejection fraction result is &lt;= 40\n                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active\n*/\ndefine &quot;Moderate or Severe LVSD Findings&quot;:\n  ( [ObservationClinicalResult: &quot;Ejection Fraction&quot;] EjectionFraction\n      where EjectionFraction.value as Quantity &lt;= 40 '%'\n        and EjectionFraction.status in { 'final', 'amended', 'corrected' }\n  )\n    union ( ( ( [ConditionProblemsHealthConcerns: &quot;Moderate or Severe LVSD&quot;]\n          union [ConditionEncounterDiagnosis: &quot;Moderate or Severe LVSD&quot;]\n      )\n        union ( ( [ConditionProblemsHealthConcerns: &quot;Left ventricular systolic dysfunction (disorder)&quot;]\n            union [ConditionEncounterDiagnosis: &quot;Left ventricular systolic dysfunction (disorder)&quot;] ) LVSDDiagnosis\n            where LVSDDiagnosis.severity in &quot;Moderate or Severe&quot;\n        ) ) ModerateOrSevereLVSD\n        where ModerateOrSevereLVSD.isVerified ( )\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-heart-failure-outpatient-encounter-with-history-of-moderate-or-severe-lvsd\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns heart failure outpatient encounters that start before the end of a moderate or severe LVSD finding\n*/\ndefine &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot;:\n  &quot;Heart Failure Outpatient Encounter&quot; HFOutpatientEncounter\n    with &quot;Moderate or Severe LVSD Findings&quot; LVSDFindings\n      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of HFOutpatientEncounter.period</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-outpatient-encounter-or-patient-provider-interaction\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Outpatient Encounter or Patient Provider Interaction&quot;:\n  &quot;Outpatient Encounter&quot;\n    union [Encounter: &quot;Patient Provider Interaction&quot;]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-qualifying-outpatient-encounter-during-measurement-period\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns certain finished encounter types that occurred during the measurement period: \n                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)\n                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)\n                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)\n                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)\n                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)\n                * patient provider interactions (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012) \n*/\ndefine &quot;Qualifying Outpatient Encounter During Measurement Period&quot;:\n  &quot;Outpatient Encounter or Patient Provider Interaction&quot; ValidEncounter\n    where ValidEncounter.period during day of &quot;Measurement Period&quot;\n      and ValidEncounter.isEncounterFinished ( )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-is-adult-with-two-qualifying-outpatient-encounters-and-one-heart-failure-outpatient-encounter-during-the-measurement-period\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the patient meets the following criteria:\n                * 18 years of age or older,\n                * Has two Qualifying Outpatient Encounters During Measurement Period\n                * Has a Heart Failure Outpatient Encounter\n*/\ndefine &quot;Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period&quot;:\n  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18\n    and exists ( &quot;Qualifying Outpatient Encounter During Measurement Period&quot; Encounter1\n        with &quot;Qualifying Outpatient Encounter During Measurement Period&quot; Encounter2\n          such that Encounter2.id !~ Encounter1.id\n    )\n    and exists &quot;Heart Failure Outpatient Encounter&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-has-heart-transplant\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns completed heart tansplant procedures that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine &quot;Has Heart Transplant&quot;:\n  exists ( [Procedure: &quot;Heart Transplant&quot;] HeartTransplant\n      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n        such that HeartTransplant.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where HeartTransplant.status = 'completed'\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-has-heart-transplant-complications\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if patient has confirmed heart transplant complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD \n*/\ndefine &quot;Has Heart Transplant Complications&quot;:\n  exists ( ( [ConditionEncounterDiagnosis: &quot;Heart Transplant Complications&quot;]\n      union [ConditionProblemsHealthConcerns: &quot;Heart Transplant Complications&quot;] ) HeartTransplantComplications\n      let diagnosisStart: Coalesce(start of HeartTransplantComplications.prevalenceInterval(), HeartTransplantComplications.recordedDate)\n      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where HeartTransplantComplications.isVerified ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-has-left-ventricular-assist-device\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if patient has a completed LVAD placement that starts before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine &quot;Has Left Ventricular Assist Device&quot;:\n  exists ( [Procedure: &quot;Left Ventricular Assist Device Placement&quot;] LVADPlacement\n      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n        such that LVADPlacement.performed.toInterval ( ) starts before day of end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where LVADPlacement.status = 'completed'\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-has-left-ventricular-assist-device-complications\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if patient has active LVAD complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine &quot;Has Left Ventricular Assist Device Complications&quot;:\n  exists ( ( [ConditionEncounterDiagnosis: &quot;Left Ventricular Assist Device Complications&quot;]\n      union [ConditionProblemsHealthConcerns: &quot;Left Ventricular Assist Device Complications&quot;] ) LVADComplications\n      let diagnosisStart: Coalesce(start of LVADComplications.prevalenceInterval(), LVADComplications.recordedDate)\n      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where LVADComplications.isVerified ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-isorderedduringheartfailureoutpatientencounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given MedicationRequest is ordered during the heart failure outpatient encounter with history of moderate or severe LVSD at any point\n*/\ndefine fluent function isOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):\n  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'active', 'completed' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n        )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-isverified\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given Condition has a verification status of &quot;confirmed&quot;, &quot;unconfirmed&quot;, &quot;provisional&quot;, or &quot;differential&quot;\n*/\ndefine fluent function isVerified(condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):\n  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;\n      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;\n      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;\n      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-isencounterfinished\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given Encounter is finished\n*/\ndefine fluent function isEncounterFinished(Encounter Encounter):\n  Encounter.status = 'finished'</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-overlapsafterheartfailureoutpatientencounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@overloaded\n@description: Returns true if the given MedicationRequest overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function overlapsAfterHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):\n  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n      where First((collapse(MedicationRequest.dosageInstruction.timing.repeat.bounds DoseTime\n            return TimingBoundToInterval(MedicationRequest.authoredOn, DoseTime)\n        )) DrugPeriods\n          sort by start of $this\n      ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'active', 'completed' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n        )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-timingboundtointerval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function TimingBoundToInterval(startDate System.DateTime, choice Choice&lt;Quantity, Interval&lt;Quantity&gt;, Interval&lt;DateTime&gt;&gt;):\n  case\n    when choice is Interval&lt;DateTime&gt; then\n        choice as Interval&lt;DateTime&gt;\n    when choice is Interval&lt;Quantity&gt; then\n        Interval[startDate + (choice.low as Quantity), startDate + (choice.high as Quantity)]\n    when choice is Quantity then\n        Interval[startDate, startDate + (choice as Quantity))\n    else\n\t\tnull as Interval&lt;DateTime&gt;\n\tend</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-ismedicationnotrequestedorderedduringheartfailureoutpatientencounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given MedicationNotRequested overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationNotRequested):\n  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'completed', 'active' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n        )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-overlapsafterheartfailureoutpatientencounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@overloaded\n@description: Returns true if the given AllergyIntolerance overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function overlapsAfterHeartFailureOutpatientEncounter(AllergyIntolerance AllergyIntolerance):\n  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n      where Interval[start of AllergyIntolerance.onset.toInterval ( ), AllergyIntolerance.lastOccurrence]overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and AllergyIntolerance.isVerified ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-isverified\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential\n*/\ndefine fluent function isVerified(AllergyIntolerance AllergyIntolerance):\n  AllergyIntolerance.verificationStatus is not null implies ( AllergyIntolerance.verificationStatus ~ QICoreCommon.&quot;allergy-confirmed&quot;\n      or AllergyIntolerance.verificationStatus ~ QICoreCommon.&quot;allergy-unconfirmed&quot;\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"ahaoverall-overlapsafterheartfailureoutpatientencounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AHAOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@overloaded\n@description: Returns true if the given Condition overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function overlapsAfterHeartFailureOutpatientEncounter(Condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):\n  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter\n      where Condition.prevalenceInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and Condition.isVerified ( )\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n  \n  \n  \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system SNOMEDCT\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://snomed.info/sct\n    <br/>\n    <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system ConditionVerificationStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system ConditionClinicalStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-clinical\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system TaskCodeSystem\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://hl7.org/fhir/CodeSystem/task-code\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system AllergyIntoleranceVerificationStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set ACE Inhibitor or ARB or ARNI\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Care Services in Long Term Residential Facility\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Home Healthcare Services\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Nursing Facility Visit\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Office Visit\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Outpatient Consultation\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Heart Failure\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Ejection Fraction\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Moderate or Severe LVSD\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Moderate or Severe\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Patient Provider Interaction\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Payer Type\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Heart Transplant\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Heart Transplant Complications\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Left Ventricular Assist Device Placement\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Left Ventricular Assist Device Complications\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Medical Reason\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Patient Reason\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Patient Reason for ACE Inhibitor or ARB Decline\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set ACE Inhibitor or ARB or ARNI Ingredient\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Allergy to ACE Inhibitor or ARB\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Intolerance to ACE Inhibitor or ARB\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Pregnancy\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378</tt>\n    \n  </td>\n</tr>\n \n\n\n  \n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Male (finding)\n        <br/>\n      \n      <em>Code</em>: 248153007\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Female (finding)\n        <br/>\n      \n      <em>Code</em>: 248152002\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Confirmed\n        <br/>\n      \n      <em>Code</em>: confirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Unconfirmed\n        <br/>\n      \n      <em>Code</em>: unconfirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Provisional\n        <br/>\n      \n      <em>Code</em>: provisional\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Differential\n        <br/>\n      \n      <em>Code</em>: differential\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Left ventricular systolic dysfunction (disorder)\n        <br/>\n      \n      <em>Code</em>: 134401001\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Active\n        <br/>\n      \n      <em>Code</em>: active\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Recurrence\n        <br/>\n      \n      <em>Code</em>: recurrence\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Relapse\n        <br/>\n      \n      <em>Code</em>: relapse\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Fulfill\n        <br/>\n      \n      <em>Code</em>: fulfill\n      <br/>\n      <em>System</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)\n        <br/>\n      \n      <em>Code</em>: 372733002\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Substance with angiotensin II receptor antagonist mechanism of action (substance)\n        <br/>\n      \n      <em>Code</em>: 372913009\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Substance with neprilysin inhibitor mechanism of action (substance)\n        <br/>\n      \n      <em>Code</em>: 786886009\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Confirmed\n        <br/>\n      \n      <em>Code</em>: confirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Unconfirmed\n        <br/>\n      \n      <em>Code</em>: unconfirmed\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)\n        <br/>\n      \n      <em>Code</em>: 422593004\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n  \n  \n  \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: QICore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library SDE\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRHelpers\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library AHA\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/AHAOverall|4.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/AHAOverall|4.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library QICoreCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>\n    \n  </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n  \n  \n  \n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: extension, birthDate, birthDate.value, url\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <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\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <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\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: status, period, id, id.value, status.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, id, id.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-clinical-result\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, value, status, status.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Resource\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/StructureDefinition/Resource\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: id, id.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: authoredOn, timing, repeat, bounds, authoredOn.value, status, status.value, intent, intent.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, timing, repeat, bounds\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Task\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: focus, code\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Coverage\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, performed, status, status.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, performed, status, status.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: authoredOn, authoredOn.value, status, status.value, intent, intent.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, reasonCode\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: AllergyIntolerance\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: verificationStatus, onset, lastOccurrence, lastOccurrence.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: AllergyIntolerance\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: AllergyIntolerance\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#372733002: 'Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: AllergyIntolerance\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#372913009: 'Substance with angiotensin II receptor antagonist mechanism of action (substance)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: AllergyIntolerance\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      http://snomed.info/sct#786886009: 'Substance with neprilysin inhibitor mechanism of action (substance)'\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: effective, effective.value, value, status, status.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n  \n  \n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248153007",
            "display" : "Male (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248152002",
            "display" : "Female (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "confirmed",
            "display" : "Confirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "unconfirmed",
            "display" : "Unconfirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "provisional",
            "display" : "Provisional"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "differential",
            "display" : "Differential"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "134401001",
            "display" : "Left ventricular systolic dysfunction (disorder)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
            "code" : "active",
            "display" : "Active"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
            "code" : "recurrence",
            "display" : "Recurrence"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical",
            "code" : "relapse",
            "display" : "Relapse"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://hl7.org/fhir/CodeSystem/task-code",
            "code" : "fulfill",
            "display" : "Fulfill"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "372733002",
            "display" : "Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "372913009",
            "display" : "Substance with angiotensin II receptor antagonist mechanism of action (substance)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "786886009",
            "display" : "Substance with neprilysin inhibitor mechanism of action (substance)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
            "code" : "confirmed",
            "display" : "Confirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/allergyintolerance-verification",
            "code" : "unconfirmed",
            "display" : "Unconfirmed"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "422593004",
            "display" : "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.sex = '248153007' then \"Male (finding)\"\n    when Patient.sex = '248152002' then \"Female (finding)\"\n    else null\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  SDE.\"SDE Sex\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Outpatient Encounter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Outpatient Encounter\":\n  ( [Encounter: \"Care Services in Long Term Residential Facility\"]\n      union [Encounter: \"Home Healthcare Services\"]\n      union [Encounter: \"Nursing Facility Visit\"]\n      union [Encounter: \"Office Visit\"]\n      union [Encounter: \"Outpatient Consultation\"]\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Heart Failure Outpatient Encounter"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns certain finished encounter types that overlap a Heart Failure condition and are during the measurement period: \n                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)\n                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)\n                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)\n                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)\n                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)\n*/\ndefine \"Heart Failure Outpatient Encounter\":\n  \"Outpatient Encounter\" QualifyingEncounter\n    with ( [ConditionProblemsHealthConcerns: \"Heart Failure\"]\n      union [ConditionEncounterDiagnosis: \"Heart Failure\"] ) HeartFailure\n      such that HeartFailure.prevalenceInterval ( ) overlaps day of QualifyingEncounter.period\n        and HeartFailure.isVerified ( )\n    where QualifyingEncounter.period during day of \"Measurement Period\"\n      and QualifyingEncounter.isEncounterFinished ( )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Moderate or Severe LVSD Findings"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns a union  of the following:\n                * Observations where the final, amended or correction ejection fraction result is <= 40\n                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active\n*/\ndefine \"Moderate or Severe LVSD Findings\":\n  ( [ObservationClinicalResult: \"Ejection Fraction\"] EjectionFraction\n      where EjectionFraction.value as Quantity <= 40 '%'\n        and EjectionFraction.status in { 'final', 'amended', 'corrected' }\n  )\n    union ( ( ( [ConditionProblemsHealthConcerns: \"Moderate or Severe LVSD\"]\n          union [ConditionEncounterDiagnosis: \"Moderate or Severe LVSD\"]\n      )\n        union ( ( [ConditionProblemsHealthConcerns: \"Left ventricular systolic dysfunction (disorder)\"]\n            union [ConditionEncounterDiagnosis: \"Left ventricular systolic dysfunction (disorder)\"] ) LVSDDiagnosis\n            where LVSDDiagnosis.severity in \"Moderate or Severe\"\n        ) ) ModerateOrSevereLVSD\n        where ModerateOrSevereLVSD.isVerified ( )\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns heart failure outpatient encounters that start before the end of a moderate or severe LVSD finding\n*/\ndefine \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\":\n  \"Heart Failure Outpatient Encounter\" HFOutpatientEncounter\n    with \"Moderate or Severe LVSD Findings\" LVSDFindings\n      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of HFOutpatientEncounter.period"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has ACEI or ARB or ARNI Ordered"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has ACEI or ARB or ARNI Ordered\":\n  exists ( [MedicationRequest: medication in \"ACE Inhibitor or ARB or ARNI\"] ACEIOrARBOrARNIOrdered\n      where ACEIOrARBOrARNIOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Is Currently Taking ACEI or ARB or ARNI"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Is Currently Taking ACEI or ARB or ARNI\":\n  exists ( [MedicationRequest: medication in \"ACE Inhibitor or ARB or ARNI\"] ActiveACEIOrARBOrARNI\n      where ActiveACEIOrARBOrARNI.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Numerator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator\":\n  \"Has ACEI or ARB or ARNI Ordered\"\n    or \"Is Currently Taking ACEI or ARB or ARNI\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Outpatient Encounter or Patient Provider Interaction"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Outpatient Encounter or Patient Provider Interaction\":\n  \"Outpatient Encounter\"\n    union [Encounter: \"Patient Provider Interaction\"]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Qualifying Outpatient Encounter During Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns certain finished encounter types that occurred during the measurement period: \n                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)\n                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)\n                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)\n                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)\n                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)\n                * patient provider interactions (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012) \n*/\ndefine \"Qualifying Outpatient Encounter During Measurement Period\":\n  \"Outpatient Encounter or Patient Provider Interaction\" ValidEncounter\n    where ValidEncounter.period during day of \"Measurement Period\"\n      and ValidEncounter.isEncounterFinished ( )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the patient meets the following criteria:\n                * 18 years of age or older,\n                * Has two Qualifying Outpatient Encounters During Measurement Period\n                * Has a Heart Failure Outpatient Encounter\n*/\ndefine \"Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period\":\n  AgeInYearsAt(date from start of \"Measurement Period\") >= 18\n    and exists ( \"Qualifying Outpatient Encounter During Measurement Period\" Encounter1\n        with \"Qualifying Outpatient Encounter During Measurement Period\" Encounter2\n          such that Encounter2.id !~ Encounter1.id\n    )\n    and exists \"Heart Failure Outpatient Encounter\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 11
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\":\n  AHA.\"Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 12
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Denominator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator\":\n  \"Initial Population\"\n    and exists AHA.\"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 13
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  [Coverage: type in \"Payer Type\"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 14
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 15
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  Patient.ethnicity E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 16
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 17
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Has Heart Transplant"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns completed heart tansplant procedures that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine \"Has Heart Transplant\":\n  exists ( [Procedure: \"Heart Transplant\"] HeartTransplant\n      with \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n        such that HeartTransplant.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where HeartTransplant.status = 'completed'\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 18
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Has Heart Transplant Complications"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if patient has confirmed heart transplant complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD \n*/\ndefine \"Has Heart Transplant Complications\":\n  exists ( ( [ConditionEncounterDiagnosis: \"Heart Transplant Complications\"]\n      union [ConditionProblemsHealthConcerns: \"Heart Transplant Complications\"] ) HeartTransplantComplications\n      let diagnosisStart: Coalesce(start of HeartTransplantComplications.prevalenceInterval(), HeartTransplantComplications.recordedDate)\n      with \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where HeartTransplantComplications.isVerified ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 19
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Has Left Ventricular Assist Device"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if patient has a completed LVAD placement that starts before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine \"Has Left Ventricular Assist Device\":\n  exists ( [Procedure: \"Left Ventricular Assist Device Placement\"] LVADPlacement\n      with \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n        such that LVADPlacement.performed.toInterval ( ) starts before day of end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where LVADPlacement.status = 'completed'\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 20
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "Has Left Ventricular Assist Device Complications"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if patient has active LVAD complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine \"Has Left Ventricular Assist Device Complications\":\n  exists ( ( [ConditionEncounterDiagnosis: \"Left Ventricular Assist Device Complications\"]\n      union [ConditionProblemsHealthConcerns: \"Left Ventricular Assist Device Complications\"] ) LVADComplications\n      let diagnosisStart: Coalesce(start of LVADComplications.prevalenceInterval(), LVADComplications.recordedDate)\n      with \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period\n      where LVADComplications.isVerified ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 21
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exclusions"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exclusions\":\n  AHA.\"Has Heart Transplant\"\n    or AHA.\"Has Heart Transplant Complications\"\n    or AHA.\"Has Left Ventricular Assist Device\"\n    or AHA.\"Has Left Ventricular Assist Device Complications\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 22
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  Patient.race R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 23
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 24
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI\":\n  exists ( [MedicationNotRequested: medication in \"ACE Inhibitor or ARB or ARNI\"] NoACEIOrARBOrARNIOrdered\n      where NoACEIOrARBOrARNIOrdered.isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter ( )\n        and ( NoACEIOrARBOrARNIOrdered.reasonCode in \"Medical Reason\"\n            or NoACEIOrARBOrARNIOrdered.reasonCode in \"Patient Reason\"\n            or NoACEIOrARBOrARNIOrdered.reasonCode in \"Patient Reason for ACE Inhibitor or ARB Decline\"\n        )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 25
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient\":\n  exists ( ( [AllergyIntolerance: \"ACE Inhibitor or ARB or ARNI Ingredient\"]\n      union [AllergyIntolerance: \"Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)\"]\n      union [AllergyIntolerance: \"Substance with angiotensin II receptor antagonist mechanism of action (substance)\"]\n      union [AllergyIntolerance: \"Substance with neprilysin inhibitor mechanism of action (substance)\"] ) ACEIOrARBOrARNIAllergyIntolerance\n      where ACEIOrARBOrARNIAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 26
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has Diagnosis of Allergy or Intolerance to ACEI or ARB"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Diagnosis of Allergy or Intolerance to ACEI or ARB\":\n  exists ( ( ( [\"ConditionProblemsHealthConcerns\": \"Allergy to ACE Inhibitor or ARB\"]\n        union [\"ConditionEncounterDiagnosis\": \"Allergy to ACE Inhibitor or ARB\"]\n    )\n      union ( [\"ConditionProblemsHealthConcerns\": \"Intolerance to ACE Inhibitor or ARB\"] )\n      union [\"ConditionEncounterDiagnosis\": \"Intolerance to ACE Inhibitor or ARB\"] ) ACEIOrARBAllergyOrIntoleranceDiagnosis\n      where ACEIOrARBAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 27
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has Diagnosis of Pregnancy"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Diagnosis of Pregnancy\":\n  exists ( ( [ConditionProblemsHealthConcerns: \"Pregnancy\"]\n      union [\"ConditionEncounterDiagnosis\": \"Pregnancy\"] ) PregnancyDiagnosis\n      with AHA.\"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n        such that PregnancyDiagnosis.prevalenceInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period\n          and PregnancyDiagnosis.isVerified ( )\n  )\n    or exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation\n        with AHA.\"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n          such that PregnantObservation.effective.toInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period\n            and ( PregnantObservation.value in \"Pregnancy\"\n                and PregnantObservation.status in { 'final', 'amended', 'corrected' }\n            )\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 28
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Has Diagnosis of Renal Failure Due to ACEI"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Has Diagnosis of Renal Failure Due to ACEI\":\n  exists ( ( [ConditionProblemsHealthConcerns: \"Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)\"]\n      union [ConditionEncounterDiagnosis: \"Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)\"] ) RenalFailureDueToACEI\n      where RenalFailureDueToACEI.overlapsHeartFailureOutpatientEncounter ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 29
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS135FHIRACEIorARBorARNIforHF"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exceptions"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exceptions\":\n  \"Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI\"\n    or \"Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient\"\n    or \"Has Diagnosis of Allergy or Intolerance to ACEI or ARB\"\n    or \"Has Diagnosis of Pregnancy\"\n    or \"Has Diagnosis of Renal Failure Due to ACEI\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 30
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value uri): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 31
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "isOrderedDuringHeartFailureOutpatientEncounter"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given MedicationRequest is ordered during the heart failure outpatient encounter with history of moderate or severe LVSD at any point\n*/\ndefine fluent function isOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):\n  exists ( \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'active', 'completed' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [\"TaskRejected\"] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.\"Fulfill\"\n        )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 32
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 33
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "isVerified"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given Condition has a verification status of \"confirmed\", \"unconfirmed\", \"provisional\", or \"differential\"\n*/\ndefine fluent function isVerified(condition Choice<ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns>):\n  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.\"confirmed\"\n      or condition.verificationStatus ~ QICoreCommon.\"unconfirmed\"\n      or condition.verificationStatus ~ QICoreCommon.\"provisional\"\n      or condition.verificationStatus ~ QICoreCommon.\"differential\"\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 34
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "isEncounterFinished"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given Encounter is finished\n*/\ndefine fluent function isEncounterFinished(Encounter Encounter):\n  Encounter.status = 'finished'"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 35
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "prevalenceInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns an interval representing the normalized prevalence period of a given Condition.\n@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from\nonset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting \ninterval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.\n*/\ndefine fluent function prevalenceInterval(condition Choice<\"ConditionEncounterDiagnosis\", \"ConditionProblemsHealthConcerns\">):\nif condition.clinicalStatus ~ \"active\"\n  or condition.clinicalStatus ~ \"recurrence\"\n  or condition.clinicalStatus ~ \"relapse\" then\n  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]\nelse\n    (end of condition.abatementInterval()) abatementDate\n    return if abatementDate is null then\n      Interval[start of condition.onset.toInterval(), abatementDate)\n    else\n      Interval[start of condition.onset.toInterval(), abatementDate]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 36
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "abatementInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns an interval representing the normalized abatement of a given Condition.\n@comment: If the abatement element of the Condition is represented as a DateTime, the result\nis an interval beginning and ending on that DateTime.\nIf the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The\nresult is an interval from the date the patient turned that age to immediately before one year later.\nIf the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during\nwhich the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately\nbefore one year later than the date the patient turned the ending age of the quantity interval.\n*/\ndefine fluent function abatementInterval(condition Choice<\"ConditionEncounterDiagnosis\", \"ConditionProblemsHealthConcerns\">):\n\tif condition.abatement is DateTime then\n\t  Interval[condition.abatement as DateTime, condition.abatement as DateTime]\n\telse if condition.abatement is Quantity then\n\t\tInterval[Patient.birthDate + (condition.abatement as Quantity),\n\t\t\tPatient.birthDate + (condition.abatement as Quantity) + 1 year)\n\telse if condition.abatement is Interval<Quantity> then\n\t  Interval[Patient.birthDate + (condition.abatement.low as Quantity),\n\t\t  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)\n\telse if condition.abatement is Interval<DateTime> then\n\t  Interval[condition.abatement.low, condition.abatement.high)\n\telse null as Interval<DateTime>"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 37
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "references"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n  resource.id = Last(Split(reference.reference, '/'))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 38
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "overlapsAfterHeartFailureOutpatientEncounter"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@overloaded\n@description: Returns true if the given MedicationRequest overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function overlapsAfterHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):\n  exists ( \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n      where First((collapse(MedicationRequest.dosageInstruction.timing.repeat.bounds DoseTime\n            return TimingBoundToInterval(MedicationRequest.authoredOn, DoseTime)\n        )) DrugPeriods\n          sort by start of $this\n      ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'active', 'completed' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [\"TaskRejected\"] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.\"Fulfill\"\n        )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 39
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "TimingBoundToInterval"
            },
            {
              "url" : "statement",
              "valueString" : "define function TimingBoundToInterval(startDate System.DateTime, choice Choice<Quantity, Interval<Quantity>, Interval<DateTime>>):\n  case\n    when choice is Interval<DateTime> then\n        choice as Interval<DateTime>\n    when choice is Interval<Quantity> then\n        Interval[startDate + (choice.low as Quantity), startDate + (choice.high as Quantity)]\n    when choice is Quantity then\n        Interval[startDate, startDate + (choice as Quantity))\n    else\n\t\tnull as Interval<DateTime>\n\tend"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 40
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToCode"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 41
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "toInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf 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\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n  \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 42
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given MedicationNotRequested overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationNotRequested):\n  exists ( \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and MedicationRequest.status in { 'completed', 'active' }\n        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and not exists ( [\"TaskRejected\"] TaskReject\n            where TaskReject.focus.references ( MedicationRequest )\n              and TaskReject.code ~ QICoreCommon.\"Fulfill\"\n        )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 43
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToConcept"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 44
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "AHAOverall"
            },
            {
              "url" : "name",
              "valueString" : "overlapsAfterHeartFailureOutpatientEncounter"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@overloaded\n@description: Returns true if the given AllergyIntolerance overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD\n*/\ndefine fluent function overlapsAfterHeartFailureOutpatientEncounter(AllergyIntolerance AllergyIntolerance):\n  exists ( \"Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD\" ModerateOrSevereLVSDHFOutpatientEncounter\n      where Interval[start of AllergyIntolerance.onset.toInterval ( ), AllergyIntolerance.lastOccurrence]overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period\n        and AllergyIntolerance.isVerified ( )\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 45
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
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                }
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                }
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  ],
  "extension" : [
    {
      "id" : "supplementalDataGuidance",
      "extension" : [
        {
          "url" : "guidance",
          "valueString" : "<p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>"
        },
        {
          "url" : "usage",
          "valueCodeableConcept" : {
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    },
    {
      "extension" : [
        {
          "url" : "term",
          "valueString" : "Moderate or Severe LVSD"
        },
        {
          "url" : "definition",
          "valueMarkdown" : "LVEF \\<=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:\n\n1. that provides a numerical value of LVSD or\n\n2. that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.\n\n"
        }
      ],
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    {
      "extension" : [
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          "valueString" : "Prescribed"
        },
        {
          "url" : "definition",
          "valueMarkdown" : "Denotes that a prescription has been given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR that the patient is already taking an ACE inhibitor or ARB or ARNI therapy as documented in their current medication list\n"
        }
      ],
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      "valueReference" : {
        "reference" : "#effective-data-requirements"
      }
    }
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  "url" : "https://madie.cms.gov/Measure/CMS135FHIRACEIorARBorARNIforHF",
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            "display" : "Endorser"
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      "system" : "https://madie.cms.gov/measure/cbeId",
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            "code" : "publisher",
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  "version" : "1.0.000",
  "name" : "CMS135FHIRACEIorARBorARNIforHF",
  "title" : "Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR\n",
  "status" : "active",
  "experimental" : false,
  "date" : "2025-08-22T19:19:00+00:00",
  "publisher" : "American Heart Association",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.heart.org/"
        }
      ]
    }
  ],
  "description" : "Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) \\<=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period\n",
  "usage" : "This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.\n\nThe requirement of two or more visits is used to establish that the eligible clinician has an existing relationship with the patient.\n\nA range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.\n\nIn order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of \"below 40%\" or \"ejection fraction between 35 and 40%\" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as \"Moderate or Severe.\"\n\nEligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.\n\nThis FHIR-based measure has been derived from the QDM-based measure CMS135v14. 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).\n",
  "copyright" : "Copyright 2025 American College of Cardiology and American Heart Association. All Rights Reserved.\n",
  "effectivePeriod" : {
    "start" : "2026-01-01",
    "end" : "2026-12-31"
  },
  "author" : [
    {
      "name" : "American Heart Association",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.heart.org/"
        }
      ]
    },
    {
      "name" : "American Medical Association (AMA)",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.ama-assn.org/"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "citation",
      "citation" : "Heidenreich, P.A., Bozkurt, B, Aguilar, D., ... Allen, L. A. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. doi: 10.1161/CIR.0000000000001063\n"
    }
  ],
  "library" : [
    🔗 "https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF"
  ],
  "disclaimer" : "The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.\n\nThe Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.\n\nCommercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.\n\nACC and AHA encourage use of the Measure by other health care professionals, where appropriate. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n\nLimited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT\\[R\\]) or other coding contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-20234 American Medical Association. LOINC(R) is copyright 2004-20234 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\\[R\\]) copyright 2004-20234 International Health Terminology Standards Development Organisation. ICD-10 is copyright 20234 World Health Organization. All Rights Reserved.\n\nThe American Medical Association's and the PCPI(R) Foundation's significant past efforts and contributions to the performance measure are gratefully acknowledged. Due to technical limitations, registered trademarks are indicated by (R) or \\[R\\].\n",
  "rationale" : "Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor--intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.\n",
  "clinicalRecommendationStatement" : "In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF, the use of angiotension-converting enzyme inhibitors (ACEi) is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022). ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).\n\nDrugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)\n\n|         Drug         |         Initial Daily Dose(s)         |             Target Dose(s)             |                           Mean Doses Achieved in Clinical Trials                           |\n|----------------------|---------------------------------------|----------------------------------------|--------------------------------------------------------------------------------------------|\n| *ACEi*               | <br />                                | <br />                                 | <br />                                                                                     |\n| Captopril            | 6.25 mg 3 times                       | 50 mg 3 times                          | 122.7 mg total daily                                                                       |\n| Enalapril            | 2.5 mg twice                          | 10 to 20 mg twice                      | 16.6 mg total daily                                                                        |\n| Fosinopril           | 5 to 10 mg once                       | 40 mg once                             | N/A                                                                                        |\n| Lisinopril           | 2.5 to 5 mg once                      | 20 to 40 mg once                       | 32.5 to 35.0 mg total daily                                                                |\n| Perindopril          | 2 mg once                             | 8 to 16 mg once                        | N/A                                                                                        |\n| Quinapril            | 5 mg twice                            | 20 mg twice                            | N/A                                                                                        |\n| Ramipril             | 1.25 to 2.5 mg once                   | 10 mg once                             | N/A                                                                                        |\n| Trandolapril         | 1 mg once                             | 4 mg once                              | N/A                                                                                        |\n| *ARB*                | <br />                                | <br />                                 | <br />                                                                                     |\n| Candesartan          | 4 to 8 mg once                        | 32 mg once                             | 24 mg total daily                                                                          |\n| Losartan             | 25 to 50 mg once                      | 50 to 150 mg once                      | 129 mg total daily                                                                         |\n| Valsartan            | 20 to 40 mg twice                     | 160 mg twice                           | 254 mg total daily                                                                         |\n| *ARNI*               | <br />                                | <br />                                 | <br />                                                                                     |\n| Sacubitril-valsartan | 49/51 mg twice (sacubitril/valsartan) | 97/103 mg twice (sacubitril/valsartan) | 182/193 mg (sacubitril/valsartan) total daily (therapy may be initiated at 24/26 mg twice) |\n\n",
  "group" : [
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                "code" : "proportion",
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                "code" : "increase",
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      ],
      "population" : [
        {
          "id" : "InitialPopulation_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "description" : "All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "Denominator_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
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          },
          "description" : "Equals Initial Population with a current or prior LVEF \\<= 40%\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        },
        {
          "id" : "DenominatorExclusion_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exclusion",
                "display" : "Denominator Exclusion"
              }
            ]
          },
          "description" : "Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exclusions"
          }
        },
        {
          "id" : "Numerator_1",
          "code" : {
            "coding" : [
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                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "description" : "Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        },
        {
          "id" : "DenominatorException_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exception",
                "display" : "Denominator Exception"
              }
            ]
          },
          "description" : "* Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).\n\n* Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).\n\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exceptions"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Ethnicity\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-payer",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Payer\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-race",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Race\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-sex",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Sex\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}