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

: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up DocumentedFHIR - XML Representation

Active as of 2025-08-21

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<Measure xmlns="http://hl7.org/fhir">
  <id value="CMS22FHIRPCSBPScreeningFollowUp"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"/>
    <profile
             value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml" class="col-12">
  <table class="narrative-table">
    <tbody>
<tr>


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


</tr>

<tr>


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


<td class="content-container">Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up DocumentedFHIR</td>
</tr>



<tr>


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


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


  
<tr>


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


<td class="content-container">CMS22FHIR</td>
</tr>



  
<tr>


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


<td class="content-container">urn:uuid:1b17d846-cbe0-49fa-b503-518addf19fb0</td>
</tr>



  
<tr>


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


<td class="content-container">urn:uuid:54d53d09-d587-47b9-858f-2c6738fba7e7</td>
</tr>



  
    
    
<tr>


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


<td class="content-container">22FHIR</td>
</tr>

  




  
    
    
<tr>


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


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

  















<tr>


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


<td class="content-container">Centers for Medicare &amp; Medicaid Services (CMS)</td>
</tr>






<tr>


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


<td class="content-container">American Institutes for Research (AIR)</td>
</tr>






<tr>


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


<td class="content-container">Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive</td>
</tr>



<tr>


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


<td class="content-container"><p>This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare &amp; Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications.</p>
<p>Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications.</p>
<p>CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.</p></td>
</tr>


<tr>


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


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











<tr>


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


<td class="content-container"><p>Hypertension is a prevalent condition that affects approximately 66.9 million people in the United States. It is estimated that about 20-40% of the adult population has hypertension; the majority of people over age 65 have a hypertension diagnosis (Appleton et al., 2013 and Luehr et al., 2012). Winter (2013) noted that 1 in 3 American adults have hypertension and the lifetime risk of developing hypertension is 90%. The African American population or non-Hispanic Blacks, the elderly, diabetics and those with chronic kidney disease are at increased risk of stroke, myocardial infarction and renal disease. Non-Hispanic Blacks have the highest prevalence at 38.6% (Winter et al., 2013). Hypertension is a major risk factor for ischemic heart disease, left ventricular hypertrophy, renal failure, stroke and dementia (Luehr et al., 2012). Prevention of hypertension and the treatment of established hypertension are complementary approaches to reducing cardiovascular disease risk in the population, but prevention of hypertension provides the optimal means of reducing risk and avoiding harmful consequences. Periodic blood pressure (BP) screening can identify individuals who develop elevated BP over time. More frequent BP screening may be particularly important for individuals with elevated atherosclerotic cardiovascular disease (ASCVD) risk (Whelton et al., 2018).</p>
<p>Hypertension is the most common reason for adult office visits other than pregnancy. Garrison (2013) stated that in 2007, 42 million ambulatory visits were attributed to hypertension (Garrison &amp; Oberhelman, 2013). It also has the highest utilization of prescription drugs. Numerous resources and treatment options are available, yet only about 40-50% of the hypertensive patients have their blood pressure under control (&lt;140/90) (Appleton et al., 2013 and Luehr et al., 2012). In addition to medication non-compliance, poor outcomes are also attributed to poor adherence to lifestyle changes such as a low-sodium diet, weight loss, increased exercise and limiting alcohol intake. Many adults find it difficult to continue medications and lifestyle changes when they are asymptomatic. Symptoms of elevated blood pressure usually do not occur until secondary problems arise such as with vascular diseases (myocardial infarction, stroke, heart failure and renal insufficiency) (Luehr et al., 2012).</p>
<p>Appropriate follow-up after blood pressure measurement is a pivotal component in preventing the progression of hypertension and the development of heart disease. Detection of marginally or fully elevated blood pressure by a specialty clinician warrants referral to a provider familiar with the management of hypertension and prehypertension.</p>
<p>The American College of Cardiology/American Heart Association (ACC/AHA) 2017 Guidelines provide updated recommendations for ASCVD risk. For additional information please refer to the 2017 ACC/AHA guidelines: https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults.</p>
<p>Lifestyle modifications have demonstrated effectiveness in lowering blood pressure (U.S. Department of Health and Human Services, 2003). The synergistic effect of several lifestyle modifications results in greater benefits than a single modification alone. Baseline diagnostic/laboratory testing establishes if a co-existing underlying condition is the etiology of hypertension and evaluates if end organ damage from hypertension has already occurred. Landmark trials such as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have repeatedly proven the efficacy of pharmacologic therapy to control blood pressure and reduce the complications of hypertension. A review of 35 studies found that the pharmacist-led interventions involved medication counseling and patient education. Twenty-nine of the 35 studies showed statistically significant improvement in BP levels of the intervention groups at follow-up (Reeves et al., 2020). Follow-up intervals based on blood pressure control have been established by the 2017 ACC/AHA guideline and the United States Preventive Services Task Force (Whelton et al., 2018; USPSTF, 2021).</p></td>
</tr>


<tr>


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


<td class="content-container">The U.S. Preventive Services Task Force (USPSTF, 2021) recommends screening for high blood pressure in adults aged 18 years and older. This is a grade A recommendation.</td>
</tr>




<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Appleton, S. L., Neo, C., Hill, C. L., Douglas, K. A., &amp; Adams, R. J. (2013). Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample. Journal of Human Hypertension, 27, 453-462. https://doi.org/10.1038/jhh.2012.62
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Garrison, G. M. &amp; Oberhelman, S. (2013). Screening for hypertension annually compared with current practice. Annals of Family Medicine, 11 (2), 116-121. doi:10.1370/afm.1467
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Luehr, D., Woolley, T., Burke, R., Dohmen, F., Hayes, R., Johnson, M...., Schoenleber, M. (2012). Hypertension diagnosis and treatment; Institute for Clinical Systems Improvement health care guideline. Updated November, 2012
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Reeves, L., Robinson, K., McClelland, T., Adedoyin, C., Broeseker, A., and Adunlin, G. (2020). “Pharmacist Interventions in the Management of Blood Pressure Control and Adherence to Antihypertensive Medications: A Systematic Review of Randomized Controlled Trials.” Journal of Pharmacy Practice. Available at https://doi.org/10.1177/0897190020903573. Accessed October 5, 2020
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute &amp; National High Blood Pressure Education Program (2003). The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7). NIH Publication No. 03-5233
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    U.S. Preventive Services Task Force (USPSTF) (2021). Screening for hypertension in adults. US Preventive Services Task Force reaffirmation recommendation statement. Journal of the American Medical Association, 325(16): 1650-1656. doi:10.1001/jama.2021.4987
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Whelton, P.K., Carey, R.M., Aronow, W.S., Casey, D.E., Collins, K., Dennison Himmelfarb, C., Depalma, S.M., Gidding, S., Jamerson, K.A., Jones, D.W., MacLaughlin, E.J, Muntener, P., Ovbiaggele, B., Smith, S.C., Spencer, C.C., Stafford, R.S., Taler, S.J., Thomas, R.J., Williams, K. A., Williamson, J.D., Wright, J.T., (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), e13-e115. doi.org/10.1161/HYP.0000000000000065
    
    
    
    
    
  </td>
</tr>

<tr>
  
  
  
  

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


  
  
  <td class="content-container">
    
    
    
    Winter, K. H., Tuttle, L. A. &amp; Viera, A.J. (2013). Hypertension. Primary Care Clinics in Office Practice, 40, 179-194. doi:10.1016/j.pop.2012.11.008
    
    
    
    
    
  </td>
</tr>







<tr>


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


<td class="content-container"><p>This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 18 years and older during the measurement period. This measure should be reported for every visit. The measure requires that blood pressure measurements (i.e., diastolic and systolic) be obtained during each visit in order to determine the blood pressure reading used to evaluate if an intervention is needed.</p>
<p>Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures obtained during a patient visit, only the last, or most recent, pressure measurement will be used to evaluate the measure requirements.<br/><br/>
 The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current blood pressure reading as indicated, example: &quot;Patient referred to primary care provider for BP management.&quot;<br/><br/>
 Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth. <br/><br/>
 This FHIR-based measure has been derived from the QDM-based measure: CMS22v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>
</tr>



  
    
    <tr>


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


</tr>
  
  
    
<tr>


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


<td class="content-container"><p>Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive</p></td>
</tr>

  
  
  
<tr>


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


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



  
<tr>


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


<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>







  
<tr>


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


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





  
<tr>


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


<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>
</tr>


  
  
    <tr>
      
        

<th scope="row" class="row-header">Initial Population</th>


      
      <td class="content-container">
        
        <em>ID</em>: InitialPopulation_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one"><p>All patient visits for patients aged 18 years and older at the beginning of the measurement period</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms22fhirpcsbpscreeningfollowup-initial-population">Initial Population</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: Denominator_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one"><p>Equals Initial Population</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms22fhirpcsbpscreeningfollowup-denominator">Denominator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: DenominatorExclusion_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one"><p>Patient has an active diagnosis of hypertension</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms22fhirpcsbpscreeningfollowup-denominator-exclusions">Denominator Exclusions</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: Numerator_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one"><p>Patient visits where patients were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated, if the blood pressure is elevated or hypertensive</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms22fhirpcsbpscreeningfollowup-numerator">Numerator</a> 
          
        
      </td>
    </tr>
  

  
    <tr>
      
        

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


      
      <td class="content-container">
        
        <em>ID</em>: DenominatorException_1
        <br/>
        
        
          <em>Description</em>:
          <p style="white-space: pre-line" class="tab-one"><p>Documentation of medical reason(s) for not screening for high blood pressure (e.g., patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status).</p>
<p>Documentation of patient reason(s) for not screening for blood pressure measurements or for not ordering an appropriate follow-up intervention if patient BP is elevated or hypertensive (e.g., patient refuses).</p></p>
        
        
          
            
            <em>Logic Definition</em>: <a href="#primary-cms22fhirpcsbpscreeningfollowup-denominator-exceptions">Denominator Exceptions</a> 
          
        
      </td>
    </tr>
  

  


  
    
<tr>


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


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

  


  <tr>


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


</tr>


<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-ethnicity
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Ethnicity
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms22fhirpcsbpscreeningfollowup-sde-ethnicity">SDE Ethnicity</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-payer
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Payer
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms22fhirpcsbpscreeningfollowup-sde-payer">SDE Payer</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-race
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Race
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms22fhirpcsbpscreeningfollowup-sde-race">SDE Race</a> 
      
    
  </td>
</tr>

<tr>
  

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


  <td class="content-container">
    
      <em>ID</em>: sde-sex
      
      <br/>
      
    
    
      
        
          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]
        
        <br/>
      
    
    
      <em>Description</em>: SDE Sex
    
    
      
        <br/>
        
        <em>Logic Definition</em>: <a href="#cms22fhirpcsbpscreeningfollowup-sde-sex">SDE Sex</a> 
      
    
  </td>
</tr>


<tr>


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


</tr>

<tr>


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


<td class="content-container">https://madie.cms.gov/Library/CMS22FHIRPCSBPScreeningFollowUp</td>
</tr>




<tr>
  <th scope="row" class="row-header">Contents</th>
  <td class="content-container">
    <em><a href="#population-criteria">Population Criteria</a></em>
    <br/>
    <em><a href="#definitions">Logic Definitions</a></em>
    <br/>
    <em><a href="#terminology">Terminology</a></em>
    <br/>
    <em><a href="#dependencies">Dependencies</a></em>
    <br/>
    <em><a href="#data-requirements">Data Requirements</a></em>
    <br/>
  </td>
</tr>


  <tr>


<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>


</tr>
  
  
  
  
    
    <tr>


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


</tr>
  
  
  
  
    
      
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
            
              
            
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  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms22fhirpcsbpscreeningfollowup-initial-population"> </a>
    
    
    Initial Population
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    where AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18</code></pre>
  </td>

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  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms22fhirpcsbpscreeningfollowup-denominator"> </a>
    
    
    Denominator
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
  &quot;Initial Population&quot;</code></pre>
  </td>

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            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms22fhirpcsbpscreeningfollowup-denominator-exclusions"> </a>
    
    
    Denominator Exclusion
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    with [ConditionProblemsHealthConcerns: &quot;Diagnosis of Hypertension&quot;] Hypertension
      such that Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period
        and Hypertension.isVerified ( )</code></pre>
  </td>

</tr>

          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
      
    
  

  
    
      
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
        
          
            
              
            
            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms22fhirpcsbpscreeningfollowup-numerator"> </a>
    
    
    Numerator
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Encounter with Normal Blood Pressure Reading&quot;
    union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions&quot; )
    union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions&quot; )</code></pre>
  </td>

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            <tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="primary-cms22fhirpcsbpscreeningfollowup-denominator-exceptions"> </a>
    
    
    Denominator Exception
    
  </th>
</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exceptions&quot;:
  &quot;Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement&quot;
    union &quot;Encounter with Order for Hypertension Follow Up Declined by Patient&quot;</code></pre>
  </td>

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  <tr>


<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>


</tr>
  
  
          
        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
  case
    when Patient.sex = '248153007' then &quot;Male (finding)&quot;
    when Patient.sex = '248152002' then &quot;Female (finding)&quot;
    else null
  end</code></pre>
  </td>

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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }</code></pre>
  </td>

</tr>



        



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }</code></pre>
  </td>

</tr>



        



        



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }</code></pre>
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<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="fhirhelpers-tostring"> </a>
    
    Logic Definition
  </th>

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }</code></pre>
  </td>

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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
if condition.clinicalStatus ~ &quot;active&quot;
  or condition.clinicalStatus ~ &quot;recurrence&quot;
  or condition.clinicalStatus ~ &quot;relapse&quot; then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]</code></pre>
  </td>

</tr>



        


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

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

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;</code></pre>
  </td>

</tr>



        




        
        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-sde-sex"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-qualifying-encounter-during-measurement-period"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Qualifying Encounter during Measurement Period&quot;:
  [Encounter: &quot;Encounter to Screen for Blood Pressure&quot;] ValidEncounter
    where ValidEncounter.period ends during day of &quot;Measurement Period&quot;
      and ValidEncounter.status ~ 'finished'
      and ValidEncounter.class !~ &quot;virtual&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-normal-blood-pressure-reading"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Normal Blood Pressure Reading&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
        where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
          and BloodPressure.status in { 'final', 'amended', 'corrected' }
        sort by start of effective.toInterval()
    )
    where ( singleton from ( EncounterLastBP.component C
          where C.code ~ &quot;Systolic blood pressure&quot;
      )
    ).value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )
      and ( singleton from ( EncounterLastBP.component C
            where C.code ~ &quot;Diastolic blood pressure&quot;
        )
      ).value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-elevated-blood-pressure-reading-sbp-120-to-129-and-dbp-less-than-80"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
        where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
          and BloodPressure.status in { 'final', 'amended', 'corrected' }
        sort by start of effective.toInterval()
    )
    where ( ( singleton from ( EncounterLastBP.component C
            where C.code ~ &quot;Systolic blood pressure&quot;
        )
      ).value in Interval[120 'mm[Hg]', 129 'mm[Hg]']
        and ( singleton from ( EncounterLastBP.component C
              where C.code ~ &quot;Diastolic blood pressure&quot;
          )
        ).value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )
    )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-follow-up-with-rescreen-within-6-months"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Follow up with Rescreen Within 6 Months&quot;:
  [ServiceRequest: &quot;Follow Up Within 6 Months&quot;] FollowUp
    where FollowUp.intent ~ 'order'</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-nonpharmacological-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;NonPharmacological Interventions&quot;:
  ( [ServiceRequest: &quot;Lifestyle Recommendation&quot;]
    union [ServiceRequest: &quot;Weight Reduction Recommended&quot;]
    union [ServiceRequest: &quot;Dietary Recommendations&quot;]
    union [ServiceRequest: &quot;Recommendation to Increase Physical Activity&quot;]
    union [ServiceRequest: &quot;Referral or Counseling for Alcohol Consumption&quot;] ) NonPharmaInterventions
    where NonPharmaInterventions.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-referral-to-alternate-or-primary-healthcare-professional-for-hypertensive-reading"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot;:
  [ServiceRequest: &quot;Referral to Primary Care or Alternate Provider&quot;] Referral
    where Referral.reasonCode in &quot;Finding of Elevated Blood Pressure or Hypertension&quot;
      and Referral.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-elevated-blood-pressure-reading-sbp-120-to-129-and-dbp-less-than-80-and-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions&quot;:
  ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedEncounter
      with &quot;Follow up with Rescreen Within 6 Months&quot; Twoto6MonthRescreen
        such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period
      with &quot;NonPharmacological Interventions&quot; NonPharmInterventions
        such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period
  )
    union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedEncounter
        with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; Referral
          such that Referral.authoredOn during day of ElevatedEncounter.period
    )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-hypertensive-reading-within-year-prior"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Hypertensive Reading Within Year Prior&quot;:
  ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
      let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
          where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period
            and BloodPressure.status in { 'final', 'amended', 'corrected' }
          sort by start of effective.toInterval()
      )
      where ( ( singleton from ( EncounterLastBP.component C
              where C.code ~ &quot;Systolic blood pressure&quot;
          )
        ).value &gt; 0 'mm[Hg]'
          and ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Diastolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
          and ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value &gt;= 130 'mm[Hg]'
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value &gt;= 80 'mm[Hg]'
          )
      )
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-first-hypertensive-reading-sbp-greater-than-or-equal-to-130-or-dbp-greater-than-or-equal-to-80"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot;:
  ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
      let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
          where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
            and BloodPressure.status in { 'final', 'amended', 'corrected' }
          sort by start of effective.toInterval()
      )
      where ( ( ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Systolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
            and ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Diastolic blood pressure&quot;
              )
            ).value &gt; 0 'mm[Hg]'
        )
          and ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value &gt;= 130 'mm[Hg]'
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value &gt;= 80 'mm[Hg]'
          )
      )
  )
    except &quot;Encounter with Hypertensive Reading Within Year Prior&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-first-hypertensive-reading-interventions-or-referral-to-alternate-professional"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;First Hypertensive Reading Interventions or Referral to Alternate Professional&quot;:
  ( [ServiceRequest: &quot;Follow Up Within 4 Weeks&quot;] FourWeekRescreen
      with &quot;NonPharmacological Interventions&quot; NonPharmInterventionsHTN
        such that FourWeekRescreen.authoredOn during day of &quot;Measurement Period&quot;
          and NonPharmInterventionsHTN.authoredOn during day of &quot;Measurement Period&quot;
          and FourWeekRescreen.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
  )
    union ( &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-first-hypertensive-reading-sbp-greater-than-or-equal-to-130-or-dbp-greater-than-or-equal-to-80-and-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions&quot;:
  &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
    with &quot;First Hypertensive Reading Interventions or Referral to Alternate Professional&quot; FirstHTNIntervention
      such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.period</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-second-hypertensive-reading-sbp-130-to-139-or-dbp-80-to-89"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot;:
  ( ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
        let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
            where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
              and BloodPressure.status in { 'final', 'amended', 'corrected' }
            sort by start of effective.toInterval()
        )
        where ( ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value in Interval[130 'mm[Hg]', 139 'mm[Hg]']
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value in Interval[80 'mm[Hg]', 89 'mm[Hg]']
          )
            and not ( ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Systolic blood pressure&quot;
                )
              ).value &gt;= 140 'mm[Hg]'
                or ( singleton from ( EncounterLastBP.component C
                      where C.code ~ &quot;Diastolic blood pressure&quot;
                  )
                ).value &gt;= 90 'mm[Hg]'
            )
        )
    )
      intersect &quot;Encounter with Hypertensive Reading Within Year Prior&quot;
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-laboratory-test-or-ecg-for-hypertension"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Laboratory Test or ECG for Hypertension&quot;:
  ( [ServiceRequest: &quot;12 lead EKG panel&quot;]
    union [ServiceRequest: &quot;EKG study&quot;]
    union [ServiceRequest: &quot;Laboratory Tests for Hypertension&quot;] ) EKGLab
    where EKGLab.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-second-hypertensive-reading-sbp-130-to-139-or-dbp-80-to-89-and-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot;:
  &quot;Follow up with Rescreen Within 6 Months&quot; Rescreen2to6
    with &quot;Laboratory Test or ECG for Hypertension&quot; LabECGIntervention
      such that Rescreen2to6.authoredOn during day of &quot;Measurement Period&quot;
        and LabECGIntervention.authoredOn during day of &quot;Measurement Period&quot;
    with &quot;NonPharmacological Interventions&quot; NonPharmSecondIntervention
      such that NonPharmSecondIntervention.authoredOn during day of &quot;Measurement Period&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-second-hypertensive-reading-sbp-130-to-139-or-dbp-80-to-89-and-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot;:
  ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounterReading
      with &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot; EncounterInterventions
        such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period
  )
    union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounterReading
        with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; ReferralForHTN
          such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.period
    )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-second-hypertensive-reading-sbp-greater-than-or-equal-to-140-or-dbp-greater-than-or-equal-to-90"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot;:
  ( ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
        let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
            where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
              and BloodPressure.status in { 'final', 'amended', 'corrected' }
            sort by start of effective.toInterval()
        )
        where ( ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Systolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
            and ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Diastolic blood pressure&quot;
              )
            ).value &gt; 0 'mm[Hg]'
            and ( ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Systolic blood pressure&quot;
                )
              ).value &gt;= 140 'mm[Hg]'
                or ( singleton from ( EncounterLastBP.component C
                      where C.code ~ &quot;Diastolic blood pressure&quot;
                  )
                ).value &gt;= 90 'mm[Hg]'
            )
        )
    )
      intersect &quot;Encounter with Hypertensive Reading Within Year Prior&quot;
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-second-hypertensive-reading-sbp-greater-than-or-equal-to-140-or-dbp-greater-than-or-equal-to-90-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions&quot;:
  ( [ServiceRequest: &quot;Follow Up Within 4 Weeks&quot;] WeeksRescreen
      with &quot;Laboratory Test or ECG for Hypertension&quot; ECGLabTest
        such that WeeksRescreen.authoredOn during day of &quot;Measurement Period&quot;
          and ECGLabTest.authoredOn during day of &quot;Measurement Period&quot;
          and WeeksRescreen.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and ECGLabTest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
      with &quot;NonPharmacological Interventions&quot; HTNInterventions
        such that HTNInterventions.authoredOn during day of &quot;Measurement Period&quot;
      with [&quot;MedicationRequest&quot;: &quot;Pharmacologic Therapy for Hypertension&quot;] Medications
        such that Medications.authoredOn during day of &quot;Measurement Period&quot;
          and Medications.status in { 'active', 'completed' }
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-second-hypertensive-reading-sbp-greater-than-or-equal-to-140-or-dbp-greater-than-or-equal-to-90-and-interventions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions&quot;:
  ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTNEncounterReading140Over90
      with &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions&quot; SecondHTN140Over90Interventions
        such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period
  )
    union &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTNEncounterReading140Over90
      with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; ReferralToProfessional
        such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.period</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-numerator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Numerator&quot;:
  &quot;Encounter with Normal Blood Pressure Reading&quot;
    union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions&quot; )
    union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions&quot; )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-initial-population"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Initial Population&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    where AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-denominator"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator&quot;:
  &quot;Initial Population&quot;</code></pre>
  </td>

</tr>



        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-sde-payer"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;</code></pre>
  </td>

</tr>



        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-sde-ethnicity"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-denominator-exclusions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exclusions&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    with [ConditionProblemsHealthConcerns: &quot;Diagnosis of Hypertension&quot;] Hypertension
      such that Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period
        and Hypertension.isVerified ( )</code></pre>
  </td>

</tr>



        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-sde-race"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-medical-reason-for-not-obtaining-or-patient-declined-blood-pressure-measurement"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    with ( [ObservationCancelled: code ~ &quot;Blood pressure panel with all children optional&quot;]
      union [ObservationCancelled: code ~ &quot;Systolic blood pressure&quot;]
      union [ObservationCancelled: code ~ &quot;Diastolic blood pressure&quot;] ) NoBPScreen
      such that NoBPScreen.issued during day of QualifyingEncounter.period
        and ( NoBPScreen.notDoneReason in &quot;Patient Declined&quot;
            or NoBPScreen.notDoneReason in &quot;Medical Reason&quot;
        )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-nonpharmacological-intervention-not-ordered"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;NonPharmacological Intervention Not Ordered&quot;:
  ( [ServiceNotRequested: &quot;Lifestyle Recommendation&quot;]
    union [ServiceNotRequested: &quot;Weight Reduction Recommended&quot;]
    union [ServiceNotRequested: &quot;Dietary Recommendations&quot;]
    union [ServiceNotRequested: &quot;Recommendation to Increase Physical Activity&quot;]
    union [ServiceNotRequested: &quot;Referral or Counseling for Alcohol Consumption&quot;] ) NonPharmIntervention
    where NonPharmIntervention.status in { 'active', 'completed', 'on-hold' }
      and NonPharmIntervention.reasonRefused in &quot;Patient Declined&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-laboratory-test-or-ecg-for-hypertension-not-ordered"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;:
  ( [ServiceNotRequested: code = &quot;12 lead EKG panel&quot;]
    union [ServiceNotRequested: code = &quot;EKG study&quot;]
    union [ServiceNotRequested: &quot;Laboratory Tests for Hypertension&quot;] ) LabECGNotDone
    where LabECGNotDone.status in { 'active', 'completed', 'on-hold' }
      and LabECGNotDone.reasonRefused in &quot;Patient Declined&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-second-hypertensive-reading-sbp-130-to-139-or-dbp-80-to-89-interventions-declined"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined&quot;:
  ( ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
      union [ServiceNotRequested: &quot;Follow Up Within 6 Months&quot;] ) SecondHTNDeclinedReferralAndFollowUp
      where SecondHTNDeclinedReferralAndFollowUp.status in { 'active', 'completed', 'on-hold' }
        and SecondHTNDeclinedReferralAndFollowUp.reasonRefused in &quot;Patient Declined&quot;
  )
    union &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;
    union &quot;NonPharmacological Intervention Not Ordered&quot;</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-second-hypertensive-reading-sbp-greater-than-or-equal-to-140-or-dbp-greater-than-or-equal-to-90-interventions-declined"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined&quot;:
  ( ( ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
        union [ServiceNotRequested: &quot;Follow Up Within 4 Weeks&quot;] ) SecondHTN140Over90ReferralFollowUpNotDone
        where SecondHTN140Over90ReferralFollowUpNotDone.status in { 'active', 'completed', 'on-hold' }
          and SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in &quot;Patient Declined&quot;
    )
      union ( [MedicationNotRequested: &quot;Pharmacologic Therapy for Hypertension&quot;] MedicationRequestNotOrdered
          where MedicationRequestNotOrdered.status in { 'active', 'completed' }
      )
      union &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;
      union &quot;NonPharmacological Intervention Not Ordered&quot;
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-encounter-with-order-for-hypertension-follow-up-declined-by-patient"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Encounter with Order for Hypertension Follow Up Declined by Patient&quot;:
  ( ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedBPEncounter
        with ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
          union [ServiceNotRequested: &quot;Follow Up Within 6 Months&quot;] ) ElevatedBPDeclinedInterventions
          such that ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period
            and ElevatedBPDeclinedInterventions.status in { 'active', 'completed', 'on-hold' }
            and ElevatedBPDeclinedInterventions.reasonRefused in &quot;Patient Declined&quot;
    )
      union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedBPEncounter
          with &quot;NonPharmacological Intervention Not Ordered&quot; NotOrdered
            such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period
      )
      union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
          with ( [ServiceNotRequested: &quot;Follow Up Within 4 Weeks&quot;]
            union [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;] ) FirstHTNDeclinedInterventions
            such that FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period
              and FirstHTNDeclinedInterventions.status in { 'active', 'completed', 'on-hold' }
              and FirstHTNDeclinedInterventions.reasonRefused in &quot;Patient Declined&quot;
      )
      union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
          with &quot;NonPharmacological Intervention Not Ordered&quot; NoNonPharm
            such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period
      )
      union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounter
          with &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined&quot; SecondHTNDeclinedInterventions
            such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period
      )
      union ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTN140Over90Encounter
          with &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined&quot; SecondHTN140Over90DeclinedInterventions
            such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period
      )
  )</code></pre>
  </td>

</tr>



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-denominator-exceptions"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define &quot;Denominator Exceptions&quot;:
  &quot;Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement&quot;
    union &quot;Encounter with Order for Hypertension Follow Up Declined by Patient&quot;</code></pre>
  </td>

</tr>



        



        



        



        



        



        



        


<tr>
  <th scope="row" rowspan="2" class="row-header">
    
      
      <a name="cms22fhirpcsbpscreeningfollowup-isverified"> </a>
    
    Logic Definition
  </th>

  <td class="content-container"><em>Library Name:</em> CMS22FHIRPCSBPScreeningFollowUp</td>

</tr>
<tr>

  <td>
    <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/


define fluent function isVerified(condition Choice&lt;QICore.ConditionProblemsHealthConcerns, QICore.ConditionEncounterDiagnosis&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;
  )</code></pre>
  </td>

</tr>





  
  


  <tr>


<th colspan="2" scope="row" class="row-header"><a name="terminology"> </a>Terminology</th>


</tr>
  
  
  

 

 

 

 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system SNOMEDCT
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://snomed.info/sct
    <br/>
    <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system ActCode
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/v3-ActCode
    <br/>
    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system LOINC
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://loinc.org
    <br/>
    <em>Canonical URL</em>: <tt>http://loinc.org</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system ConditionClinicalStatusCodes
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-clinical
    <br/>
    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
    
  </td>
</tr>
 


<tr>
  
  
  

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


  
  <td class="content-container">
    
    <em>Description</em>: Code system ConditionVerificationStatusCodes
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status
    <br/>
    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Encounter to Screen for Blood Pressure
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Follow Up Within 6 Months
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Lifestyle Recommendation
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Weight Reduction Recommended
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Dietary Recommendations
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Recommendation to Increase Physical Activity
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Referral or Counseling for Alcohol Consumption
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Referral to Primary Care or Alternate Provider
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Finding of Elevated Blood Pressure or Hypertension
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Follow Up Within 4 Weeks
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Laboratory Tests for Hypertension
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Pharmacologic Therapy for Hypertension
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Payer Type
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Diagnosis of Hypertension
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Patient Declined
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582</tt>
    
  </td>
</tr>
 


<tr>
  
  

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


  
  
  <td class="content-container">
    
    <em>Description</em>: Value set Medical Reason
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007
    <br/>
    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007</tt>
    
  </td>
</tr>
 


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

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

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: virtual
        <br/>
      
      <em>Code</em>: VR
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/v3-ActCode</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Systolic blood pressure
        <br/>
      
      <em>Code</em>: 8480-6
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Diastolic blood pressure
        <br/>
      
      <em>Code</em>: 8462-4
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: EKG 12 channel panel
        <br/>
      
      <em>Code</em>: 34534-8
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: EKG study
        <br/>
      
      <em>Code</em>: 11524-6
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Active
        <br/>
      
      <em>Code</em>: active
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Recurrence
        <br/>
      
      <em>Code</em>: recurrence
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Relapse
        <br/>
      
      <em>Code</em>: relapse
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Confirmed
        <br/>
      
      <em>Code</em>: confirmed
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Unconfirmed
        <br/>
      
      <em>Code</em>: unconfirmed
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Provisional
        <br/>
      
      <em>Code</em>: provisional
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Differential
        <br/>
      
      <em>Code</em>: differential
      <br/>
      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>
    </td>
  </tr>

  <tr>
    <th scope="row" class="row-header">Direct Reference Code</th>
    <td class="content-container">
      
        <em>Display</em>: Blood pressure panel with all children optional
        <br/>
      
      <em>Code</em>: 85354-9
      <br/>
      <em>System</em>: <tt>http://loinc.org</tt>
    </td>
  </tr>

  
  


  <tr>


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


</tr>
  
  
  


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: QICore model information
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
    <br/>
    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library SDE
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library FHIRHelpers
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>
    
  </td>
</tr>
 


<tr>
  

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


  <td class="content-container">
    
    <em>Description</em>: Library QICoreCommon
    
    <br/>
    
    
    
    
    
    
    <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
    <br/>
    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>
    
  </td>
</tr>
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


  
  


  <tr>


<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>


</tr>
  
  
  
<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Patient
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
    <br/>        
  
   
   
    <em>Must Support Elements</em>: extension, url, birthDate, birthDate.value
    <br/>
   
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Encounter
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period, status, status.value, class
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920
    <br/> 
  
  
  
   
  </td>
</tr>

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

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#34534-8: 'EKG 12 channel panel'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#11524-6: 'EKG study'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, authoredOn, authoredOn.value, intent, intent.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, reasonCode, intent, intent.value, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: MedicationRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest
    <br/>        
  
   
   
    <em>Must Support Elements</em>: medication, authoredOn, authoredOn.value, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: medication</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
    <br/> 
  
  
  
   
  </td>
</tr>

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

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

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Coverage
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
    <br/>        
  
   
   
    <em>Must Support Elements</em>: type, period
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: type</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Condition
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, issued, issued.value, extension
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#85354-9: 'Blood pressure panel with all children optional'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, issued, issued.value, extension
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#8480-6: 'Systolic blood pressure'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: Observation
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, issued, issued.value, extension
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#8462-4: 'Diastolic blood pressure'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#34534-8: 'EKG 12 channel panel'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
  
    <span class="tab-one"><em>Code(s)</em>: 
    
      
      http://loinc.org#11524-6: 'EKG study'
      
    
    </span>
    <br/>
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: ServiceRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: code, status, status.value, extension, authoredOn, authoredOn.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: code</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580
    <br/> 
  
  
  
   
  </td>
</tr>

<tr>
  <th scope="row" class="row-header">Data Requirement</th>
  <td class="content-container">
    <em>Type</em>: MedicationRequest
    <br/>
  
    <em>Profile(s)</em>: 
  
    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested
    <br/>        
  
   
   
    <em>Must Support Elements</em>: medication, status, status.value
    <br/>
   
  
    <em>Code Filter(s)</em>: 
    <br/>
  
  
    <span class="tab-one"><em>Path</em>: medication</span>
    <br/>
  
  
  
    <span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577
    <br/> 
  
  
  
   
  </td>
</tr>

  
  

<tr>
  <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>
</tr>

    </tbody>
  </table>
</div>
  </text>
  <contained>
    <Library>
      <id value="effective-data-requirements"/>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="248153007"/>
          <display value="Male (finding)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://snomed.info/sct"/>
          <code value="248152002"/>
          <display value="Female (finding)"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="VR"/>
          <display value="virtual"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="8480-6"/>
          <display value="Systolic blood pressure"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="8462-4"/>
          <display value="Diastolic blood pressure"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="34534-8"/>
          <display value="EKG 12 channel panel"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="11524-6"/>
          <display value="EKG study"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
          <code value="active"/>
          <display value="Active"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
          <code value="recurrence"/>
          <display value="Recurrence"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
          <code value="relapse"/>
          <display value="Relapse"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="confirmed"/>
          <display value="Confirmed"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="unconfirmed"/>
          <display value="Unconfirmed"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="provisional"/>
          <display value="Provisional"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
          <code value="differential"/>
          <display value="Differential"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
        <valueCoding>
          <system value="http://loinc.org"/>
          <code value="85354-9"/>
          <display value="Blood pressure panel with all children optional"/>
        </valueCoding>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  case
    when Patient.sex = '248153007' then &quot;Male (finding)&quot;
    when Patient.sex = '248152002' then &quot;Female (finding)&quot;
    else null
  end"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="0"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Sex"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="1"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Qualifying Encounter during Measurement Period"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Qualifying Encounter during Measurement Period&quot;:
  [Encounter: &quot;Encounter to Screen for Blood Pressure&quot;] ValidEncounter
    where ValidEncounter.period ends during day of &quot;Measurement Period&quot;
      and ValidEncounter.status ~ 'finished'
      and ValidEncounter.class !~ &quot;virtual&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="2"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Encounter with Normal Blood Pressure Reading"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Normal Blood Pressure Reading&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
        where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
          and BloodPressure.status in { 'final', 'amended', 'corrected' }
        sort by start of effective.toInterval()
    )
    where ( singleton from ( EncounterLastBP.component C
          where C.code ~ &quot;Systolic blood pressure&quot;
      )
    ).value in Interval[1 'mm[Hg]', 120 'mm[Hg]' )
      and ( singleton from ( EncounterLastBP.component C
            where C.code ~ &quot;Diastolic blood pressure&quot;
        )
      ).value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="3"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
        where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
          and BloodPressure.status in { 'final', 'amended', 'corrected' }
        sort by start of effective.toInterval()
    )
    where ( ( singleton from ( EncounterLastBP.component C
            where C.code ~ &quot;Systolic blood pressure&quot;
        )
      ).value in Interval[120 'mm[Hg]', 129 'mm[Hg]']
        and ( singleton from ( EncounterLastBP.component C
              where C.code ~ &quot;Diastolic blood pressure&quot;
          )
        ).value in Interval[1 'mm[Hg]', 80 'mm[Hg]' )
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="4"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Follow up with Rescreen Within 6 Months"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Follow up with Rescreen Within 6 Months&quot;:
  [ServiceRequest: &quot;Follow Up Within 6 Months&quot;] FollowUp
    where FollowUp.intent ~ 'order'"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="5"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="NonPharmacological Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;NonPharmacological Interventions&quot;:
  ( [ServiceRequest: &quot;Lifestyle Recommendation&quot;]
    union [ServiceRequest: &quot;Weight Reduction Recommended&quot;]
    union [ServiceRequest: &quot;Dietary Recommendations&quot;]
    union [ServiceRequest: &quot;Recommendation to Increase Physical Activity&quot;]
    union [ServiceRequest: &quot;Referral or Counseling for Alcohol Consumption&quot;] ) NonPharmaInterventions
    where NonPharmaInterventions.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="6"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot;:
  [ServiceRequest: &quot;Referral to Primary Care or Alternate Provider&quot;] Referral
    where Referral.reasonCode in &quot;Finding of Elevated Blood Pressure or Hypertension&quot;
      and Referral.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="7"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions&quot;:
  ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedEncounter
      with &quot;Follow up with Rescreen Within 6 Months&quot; Twoto6MonthRescreen
        such that Twoto6MonthRescreen.authoredOn during day of ElevatedEncounter.period
      with &quot;NonPharmacological Interventions&quot; NonPharmInterventions
        such that NonPharmInterventions.authoredOn during day of ElevatedEncounter.period
  )
    union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedEncounter
        with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; Referral
          such that Referral.authoredOn during day of ElevatedEncounter.period
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="8"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Hypertensive Reading Within Year Prior"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Hypertensive Reading Within Year Prior&quot;:
  ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
      let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
          where BloodPressure.effective.toInterval() ends 1 year or less before or on start of QualifyingEncounter.period
            and BloodPressure.status in { 'final', 'amended', 'corrected' }
          sort by start of effective.toInterval()
      )
      where ( ( singleton from ( EncounterLastBP.component C
              where C.code ~ &quot;Systolic blood pressure&quot;
          )
        ).value &gt; 0 'mm[Hg]'
          and ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Diastolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
          and ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value &gt;= 130 'mm[Hg]'
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value &gt;= 80 'mm[Hg]'
          )
      )
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="9"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot;:
  ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
      let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
          where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
            and BloodPressure.status in { 'final', 'amended', 'corrected' }
          sort by start of effective.toInterval()
      )
      where ( ( ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Systolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
            and ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Diastolic blood pressure&quot;
              )
            ).value &gt; 0 'mm[Hg]'
        )
          and ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value &gt;= 130 'mm[Hg]'
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value &gt;= 80 'mm[Hg]'
          )
      )
  )
    except &quot;Encounter with Hypertensive Reading Within Year Prior&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="10"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="First Hypertensive Reading Interventions or Referral to Alternate Professional"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;First Hypertensive Reading Interventions or Referral to Alternate Professional&quot;:
  ( [ServiceRequest: &quot;Follow Up Within 4 Weeks&quot;] FourWeekRescreen
      with &quot;NonPharmacological Interventions&quot; NonPharmInterventionsHTN
        such that FourWeekRescreen.authoredOn during day of &quot;Measurement Period&quot;
          and NonPharmInterventionsHTN.authoredOn during day of &quot;Measurement Period&quot;
          and FourWeekRescreen.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
  )
    union ( &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="11"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions&quot;:
  &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
    with &quot;First Hypertensive Reading Interventions or Referral to Alternate Professional&quot; FirstHTNIntervention
      such that FirstHTNIntervention.authoredOn during day of FirstHTNEncounter.period"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="12"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot;:
  ( ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
        let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
            where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
              and BloodPressure.status in { 'final', 'amended', 'corrected' }
            sort by start of effective.toInterval()
        )
        where ( ( ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Systolic blood pressure&quot;
              )
            ).value in Interval[130 'mm[Hg]', 139 'mm[Hg]']
              or ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Diastolic blood pressure&quot;
                )
              ).value in Interval[80 'mm[Hg]', 89 'mm[Hg]']
          )
            and not ( ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Systolic blood pressure&quot;
                )
              ).value &gt;= 140 'mm[Hg]'
                or ( singleton from ( EncounterLastBP.component C
                      where C.code ~ &quot;Diastolic blood pressure&quot;
                  )
                ).value &gt;= 90 'mm[Hg]'
            )
        )
    )
      intersect &quot;Encounter with Hypertensive Reading Within Year Prior&quot;
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="13"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Laboratory Test or ECG for Hypertension"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Laboratory Test or ECG for Hypertension&quot;:
  ( [ServiceRequest: &quot;12 lead EKG panel&quot;]
    union [ServiceRequest: &quot;EKG study&quot;]
    union [ServiceRequest: &quot;Laboratory Tests for Hypertension&quot;] ) EKGLab
    where EKGLab.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="14"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot;:
  &quot;Follow up with Rescreen Within 6 Months&quot; Rescreen2to6
    with &quot;Laboratory Test or ECG for Hypertension&quot; LabECGIntervention
      such that Rescreen2to6.authoredOn during day of &quot;Measurement Period&quot;
        and LabECGIntervention.authoredOn during day of &quot;Measurement Period&quot;
    with &quot;NonPharmacological Interventions&quot; NonPharmSecondIntervention
      such that NonPharmSecondIntervention.authoredOn during day of &quot;Measurement Period&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="15"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot;:
  ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounterReading
      with &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot; EncounterInterventions
        such that EncounterInterventions.authoredOn during day of SecondHTNEncounterReading.period
  )
    union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounterReading
        with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; ReferralForHTN
          such that ReferralForHTN.authoredOn during day of SecondHTNEncounterReading.period
    )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="16"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot;:
  ( ( &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
        let EncounterLastBP: Last([USCoreBloodPressureProfile] BloodPressure
            where BloodPressure.effective.toInterval() ends during day of QualifyingEncounter.period
              and BloodPressure.status in { 'final', 'amended', 'corrected' }
            sort by start of effective.toInterval()
        )
        where ( ( singleton from ( EncounterLastBP.component C
                where C.code ~ &quot;Systolic blood pressure&quot;
            )
          ).value &gt; 0 'mm[Hg]'
            and ( singleton from ( EncounterLastBP.component C
                  where C.code ~ &quot;Diastolic blood pressure&quot;
              )
            ).value &gt; 0 'mm[Hg]'
            and ( ( singleton from ( EncounterLastBP.component C
                    where C.code ~ &quot;Systolic blood pressure&quot;
                )
              ).value &gt;= 140 'mm[Hg]'
                or ( singleton from ( EncounterLastBP.component C
                      where C.code ~ &quot;Diastolic blood pressure&quot;
                  )
                ).value &gt;= 90 'mm[Hg]'
            )
        )
    )
      intersect &quot;Encounter with Hypertensive Reading Within Year Prior&quot;
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="17"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions&quot;:
  ( [ServiceRequest: &quot;Follow Up Within 4 Weeks&quot;] WeeksRescreen
      with &quot;Laboratory Test or ECG for Hypertension&quot; ECGLabTest
        such that WeeksRescreen.authoredOn during day of &quot;Measurement Period&quot;
          and ECGLabTest.authoredOn during day of &quot;Measurement Period&quot;
          and WeeksRescreen.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and ECGLabTest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
      with &quot;NonPharmacological Interventions&quot; HTNInterventions
        such that HTNInterventions.authoredOn during day of &quot;Measurement Period&quot;
      with [&quot;MedicationRequest&quot;: &quot;Pharmacologic Therapy for Hypertension&quot;] Medications
        such that Medications.authoredOn during day of &quot;Measurement Period&quot;
          and Medications.status in { 'active', 'completed' }
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="18"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions&quot;:
  ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTNEncounterReading140Over90
      with &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions&quot; SecondHTN140Over90Interventions
        such that SecondHTN140Over90Interventions.authoredOn during day of SecondHTNEncounterReading140Over90.period
  )
    union &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTNEncounterReading140Over90
      with &quot;Referral to Alternate or Primary Healthcare Professional for Hypertensive Reading&quot; ReferralToProfessional
        such that ReferralToProfessional.authoredOn during day of SecondHTNEncounterReading140Over90.period"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="19"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Numerator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Numerator&quot;:
  &quot;Encounter with Normal Blood Pressure Reading&quot;
    union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80 and Interventions&quot; )
    union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 and Interventions&quot; )
    union ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 and Interventions&quot; )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="20"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Initial Population"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Initial Population&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    where AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="21"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator&quot;:
  &quot;Initial Population&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="22"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="23"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Payer"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="24"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="25"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Ethnicity"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="26"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator Exclusions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator Exclusions&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    with [ConditionProblemsHealthConcerns: &quot;Diagnosis of Hypertension&quot;] Hypertension
      such that Hypertension.prevalenceInterval ( ) starts before or on day of QualifyingEncounter.period
        and Hypertension.isVerified ( )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="27"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="SupplementalDataElements"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="28"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="SDE Race"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="29"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement&quot;:
  &quot;Qualifying Encounter during Measurement Period&quot; QualifyingEncounter
    with ( [ObservationCancelled: code ~ &quot;Blood pressure panel with all children optional&quot;]
      union [ObservationCancelled: code ~ &quot;Systolic blood pressure&quot;]
      union [ObservationCancelled: code ~ &quot;Diastolic blood pressure&quot;] ) NoBPScreen
      such that NoBPScreen.issued during day of QualifyingEncounter.period
        and ( NoBPScreen.notDoneReason in &quot;Patient Declined&quot;
            or NoBPScreen.notDoneReason in &quot;Medical Reason&quot;
        )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="30"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="NonPharmacological Intervention Not Ordered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;NonPharmacological Intervention Not Ordered&quot;:
  ( [ServiceNotRequested: &quot;Lifestyle Recommendation&quot;]
    union [ServiceNotRequested: &quot;Weight Reduction Recommended&quot;]
    union [ServiceNotRequested: &quot;Dietary Recommendations&quot;]
    union [ServiceNotRequested: &quot;Recommendation to Increase Physical Activity&quot;]
    union [ServiceNotRequested: &quot;Referral or Counseling for Alcohol Consumption&quot;] ) NonPharmIntervention
    where NonPharmIntervention.status in { 'active', 'completed', 'on-hold' }
      and NonPharmIntervention.reasonRefused in &quot;Patient Declined&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="31"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Laboratory Test or ECG for Hypertension Not Ordered"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;:
  ( [ServiceNotRequested: code = &quot;12 lead EKG panel&quot;]
    union [ServiceNotRequested: code = &quot;EKG study&quot;]
    union [ServiceNotRequested: &quot;Laboratory Tests for Hypertension&quot;] ) LabECGNotDone
    where LabECGNotDone.status in { 'active', 'completed', 'on-hold' }
      and LabECGNotDone.reasonRefused in &quot;Patient Declined&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="32"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined&quot;:
  ( ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
      union [ServiceNotRequested: &quot;Follow Up Within 6 Months&quot;] ) SecondHTNDeclinedReferralAndFollowUp
      where SecondHTNDeclinedReferralAndFollowUp.status in { 'active', 'completed', 'on-hold' }
        and SecondHTNDeclinedReferralAndFollowUp.reasonRefused in &quot;Patient Declined&quot;
  )
    union &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;
    union &quot;NonPharmacological Intervention Not Ordered&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="33"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined&quot;:
  ( ( ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
        union [ServiceNotRequested: &quot;Follow Up Within 4 Weeks&quot;] ) SecondHTN140Over90ReferralFollowUpNotDone
        where SecondHTN140Over90ReferralFollowUpNotDone.status in { 'active', 'completed', 'on-hold' }
          and SecondHTN140Over90ReferralFollowUpNotDone.reasonRefused in &quot;Patient Declined&quot;
    )
      union ( [MedicationNotRequested: &quot;Pharmacologic Therapy for Hypertension&quot;] MedicationRequestNotOrdered
          where MedicationRequestNotOrdered.status in { 'active', 'completed' }
      )
      union &quot;Laboratory Test or ECG for Hypertension Not Ordered&quot;
      union &quot;NonPharmacological Intervention Not Ordered&quot;
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="34"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString
                       value="Encounter with Order for Hypertension Follow Up Declined by Patient"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Encounter with Order for Hypertension Follow Up Declined by Patient&quot;:
  ( ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedBPEncounter
        with ( [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;]
          union [ServiceNotRequested: &quot;Follow Up Within 6 Months&quot;] ) ElevatedBPDeclinedInterventions
          such that ElevatedBPDeclinedInterventions.authoredOn during day of ElevatedBPEncounter.period
            and ElevatedBPDeclinedInterventions.status in { 'active', 'completed', 'on-hold' }
            and ElevatedBPDeclinedInterventions.reasonRefused in &quot;Patient Declined&quot;
    )
      union ( &quot;Encounter with Elevated Blood Pressure Reading SBP 120 to 129 AND DBP less than 80&quot; ElevatedBPEncounter
          with &quot;NonPharmacological Intervention Not Ordered&quot; NotOrdered
            such that NotOrdered.authoredOn during day of ElevatedBPEncounter.period
      )
      union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
          with ( [ServiceNotRequested: &quot;Follow Up Within 4 Weeks&quot;]
            union [ServiceNotRequested: &quot;Referral to Primary Care or Alternate Provider&quot;] ) FirstHTNDeclinedInterventions
            such that FirstHTNDeclinedInterventions.authoredOn during day of FirstHTNEncounter.period
              and FirstHTNDeclinedInterventions.status in { 'active', 'completed', 'on-hold' }
              and FirstHTNDeclinedInterventions.reasonRefused in &quot;Patient Declined&quot;
      )
      union ( &quot;Encounter with First Hypertensive Reading SBP Greater than or Equal to 130 OR DBP Greater than or Equal to 80&quot; FirstHTNEncounter
          with &quot;NonPharmacological Intervention Not Ordered&quot; NoNonPharm
            such that NoNonPharm.authoredOn during day of FirstHTNEncounter.period
      )
      union ( &quot;Encounter with Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89&quot; SecondHTNEncounter
          with &quot;Second Hypertensive Reading SBP 130 to 139 OR DBP 80 to 89 Interventions Declined&quot; SecondHTNDeclinedInterventions
            such that SecondHTNDeclinedInterventions.authoredOn during day of SecondHTNEncounter.period
      )
      union ( &quot;Encounter with Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90&quot; SecondHTN140Over90Encounter
          with &quot;Second Hypertensive Reading SBP Greater than or Equal to 140 OR DBP Greater than or Equal to 90 Interventions Declined&quot; SecondHTN140Over90DeclinedInterventions
            such that SecondHTN140Over90DeclinedInterventions.authoredOn during day of SecondHTN140Over90Encounter.period
      )
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="35"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="Denominator Exceptions"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define &quot;Denominator Exceptions&quot;:
  &quot;Encounter with Medical Reason for Not Obtaining or Patient Declined Blood Pressure Measurement&quot;
    union &quot;Encounter with Order for Hypertension Follow Up Declined by Patient&quot;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="36"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToString"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="define function ToString(value uri): value.value"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="37"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="38"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToConcept"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="39"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="FHIRHelpers"/>
        </extension>
        <extension url="name">
          <valueString value="ToCode"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="40"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="QICoreCommon"/>
        </extension>
        <extension url="name">
          <valueString value="prevalenceInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
if condition.clinicalStatus ~ &quot;active&quot;
  or condition.clinicalStatus ~ &quot;recurrence&quot;
  or condition.clinicalStatus ~ &quot;relapse&quot; then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="41"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="QICoreCommon"/>
        </extension>
        <extension url="name">
          <valueString value="abatementInterval"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="42"/>
        </extension>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
        <extension url="libraryName">
          <valueString value="CMS22FHIRPCSBPScreeningFollowUp"/>
        </extension>
        <extension url="name">
          <valueString value="isVerified"/>
        </extension>
        <extension url="statement">
          <valueString
                       value="/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/


define fluent function isVerified(condition Choice&lt;QICore.ConditionProblemsHealthConcerns, QICore.ConditionEncounterDiagnosis&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;
  )"/>
        </extension>
        <extension url="displaySequence">
          <valueInteger value="43"/>
        </extension>
      </extension>
      <name value="EffectiveDataRequirements"/>
      <status value="active"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/library-type"/>
          <code value="module-definition"/>
        </coding>
      </type>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="QICore model information"/>
        <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library SDE"/>
        <resource
                  value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library FHIRHelpers"/>
        <resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Library QICoreCommon"/>
        <resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system SNOMEDCT"/>
        <resource value="http://snomed.info/sct"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ActCode"/>
        <resource value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system LOINC"/>
        <resource value="http://loinc.org"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionClinicalStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-clinical"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Code system ConditionVerificationStatusCodes"/>
        <resource
                  value="http://terminology.hl7.org/CodeSystem/condition-ver-status"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Encounter to Screen for Blood Pressure"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Follow Up Within 6 Months"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Lifestyle Recommendation"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Weight Reduction Recommended"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Dietary Recommendations"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Recommendation to Increase Physical Activity"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Referral or Counseling for Alcohol Consumption"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Referral to Primary Care or Alternate Provider"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display
                 value="Value set Finding of Elevated Blood Pressure or Hypertension"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.514"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Follow Up Within 4 Weeks"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Laboratory Tests for Hypertension"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Pharmacologic Therapy for Hypertension"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Payer Type"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Diagnosis of Hypertension"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Patient Declined"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1582"/>
      </relatedArtifact>
      <relatedArtifact>
        <type value="depends-on"/>
        <display value="Value set Medical Reason"/>
        <resource
                  value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"/>
      </relatedArtifact>
      <parameter>
        <name value="Measurement Period"/>
        <use value="in"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Period"/>
      </parameter>
      <parameter>
        <name value="Numerator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Initial Population"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator Exclusions"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="Denominator Exceptions"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Sex"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Coding"/>
      </parameter>
      <parameter>
        <name value="SDE Payer"/>
        <use value="out"/>
        <min value="0"/>
        <max value="*"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Ethnicity"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <parameter>
        <name value="SDE Race"/>
        <use value="out"/>
        <min value="0"/>
        <max value="1"/>
        <type value="Resource"/>
      </parameter>
      <dataRequirement>
        <type value="Patient"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
        <mustSupport value="extension"/>
        <mustSupport value="url"/>
        <mustSupport value="birthDate"/>
        <mustSupport value="birthDate.value"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Encounter"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="class"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1920"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-blood-pressure"/>
        <mustSupport value="effective"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="component"/>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1518"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1583"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="34534-8"/>
            <display value="EKG 12 channel panel"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="11524-6"/>
            <display value="EKG study"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1482"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.125"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1578"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest"/>
        <mustSupport value="code"/>
        <mustSupport value="reasonCode"/>
        <mustSupport value="intent"/>
        <mustSupport value="intent.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1580"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="MedicationRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
        <mustSupport value="medication"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <codeFilter>
          <path value="medication"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.1577"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="MedicationRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"/>
        <mustSupport value="medication.reference.value"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Medication"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"/>
        <mustSupport value="id.value"/>
        <mustSupport value="code"/>
      </dataRequirement>
      <dataRequirement>
        <type value="Coverage"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"/>
        <mustSupport value="type"/>
        <mustSupport value="period"/>
        <codeFilter>
          <path value="type"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Condition"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
        <mustSupport value="code"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.263"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled"/>
        <mustSupport value="code"/>
        <mustSupport value="issued"/>
        <mustSupport value="issued.value"/>
        <mustSupport value="extension"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="85354-9"/>
            <display value="Blood pressure panel with all children optional"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled"/>
        <mustSupport value="code"/>
        <mustSupport value="issued"/>
        <mustSupport value="issued.value"/>
        <mustSupport value="extension"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="8480-6"/>
            <display value="Systolic blood pressure"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="Observation"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observationcancelled"/>
        <mustSupport value="code"/>
        <mustSupport value="issued"/>
        <mustSupport value="issued.value"/>
        <mustSupport value="extension"/>
        <codeFilter>
          <path value="code"/>
          <code>
            <system value="http://loinc.org"/>
            <code value="8462-4"/>
            <display value="Diastolic blood pressure"/>
          </code>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="extension"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="extension"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1581"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="extension"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="extension"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1510"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
        <mustSupport value="code"/>
        <mustSupport value="status"/>
        <mustSupport value="status.value"/>
        <mustSupport value="extension"/>
        <mustSupport value="authoredOn"/>
        <mustSupport value="authoredOn.value"/>
        <codeFilter>
          <path value="code"/>
          <valueSet
                    value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.1515"/>
        </codeFilter>
      </dataRequirement>
      <dataRequirement>
        <type value="ServiceRequest"/>
        <profile
                 value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicenotrequested"/>
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             url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
    <extension url="guidance">
      <valueString
                   value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
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             url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
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      <reference value="#effective-data-requirements"/>
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  <url value="https://madie.cms.gov/Measure/CMS22FHIRPCSBPScreeningFollowUp"/>
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  <version value="1.0.000"/>
  <name value="CMS22FHIRPCSBPScreeningFollowUp"/>
  <title
         value="Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up DocumentedFHIR
"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2025-08-21T13:25:42+00:00"/>
  <publisher value="Centers for Medicare &amp;amp; Medicaid Services (CMS)"/>
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  <description
               value="Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive
"/>
  <usage
         value="This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 18 years and older during the measurement period. This measure should be reported for every visit. The measure requires that blood pressure measurements (i.e., diastolic and systolic) be obtained during each visit in order to determine the blood pressure reading used to evaluate if an intervention is needed.

Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures obtained during a patient visit, only the last, or most recent, pressure measurement will be used to evaluate the measure requirements.  


The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current blood pressure reading as indicated, example: &quot;Patient referred to primary care provider for BP management.&quot;  


Telehealth encounters are not eligible for this measure because the measure requires a clinical action that cannot be conducted via telehealth.   


This FHIR-based measure has been derived from the QDM-based measure: CMS22v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/index.html) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
"/>
  <copyright
             value="This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare \&amp; Medicaid Services (CMS). CMS contracted (Contract # 75FCMC18D0027/ Task Order #: 75FCMC24F0144) with the American Institutes for Research (AIR) to develop this electronic measure. AIR is not responsible for any use of the Measure. AIR makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and AIR has no liability to anyone who relies on such measures or specifications.

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. AIR disclaims all liability for use or accuracy of any third-party codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2024 American Medical Association. LOINC(R) is copyright 2004-2024 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\[R\]) copyright 2004-2024 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2024 World Health Organization. All Rights Reserved.
"/>
  <effectivePeriod>
    <start value="2026-01-01"/>
    <end value="2026-12-31"/>
  </effectivePeriod>
  <author>
    <name value="American Institutes for Research (AIR)"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.air.org"/>
    </telecom>
  </author>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Appleton, S. L., Neo, C., Hill, C. L., Douglas, K. A., \&amp; Adams, R. J. (2013). Untreated hypertension: prevalence and patient factors and beliefs associated with under-treatment in a population sample. Journal of Human Hypertension, 27, 453-462. https://doi.org/10.1038/jhh.2012.62
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Garrison, G. M. \&amp; Oberhelman, S. (2013). Screening for hypertension annually compared with current practice. Annals of Family Medicine, 11 (2), 116-121. doi:10.1370/afm.1467
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Luehr, D., Woolley, T., Burke, R., Dohmen, F., Hayes, R., Johnson, M...., Schoenleber, M. (2012). Hypertension diagnosis and treatment; Institute for Clinical Systems Improvement health care guideline. Updated November, 2012
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Reeves, L., Robinson, K., McClelland, T., Adedoyin, C., Broeseker, A., and Adunlin, G. (2020). &quot;Pharmacist Interventions in the Management of Blood Pressure Control and Adherence to Antihypertensive Medications: A Systematic Review of Randomized Controlled Trials.&quot; Journal of Pharmacy Practice. Available at https://doi.org/10.1177/0897190020903573. Accessed October 5, 2020
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute \&amp; National High Blood Pressure Education Program (2003). The Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7). NIH Publication No. 03-5233
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="U.S. Preventive Services Task Force (USPSTF) (2021). Screening for hypertension in adults. US Preventive Services Task Force reaffirmation recommendation statement. Journal of the American Medical Association, 325(16): 1650-1656. doi:10.1001/jama.2021.4987
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Whelton, P.K., Carey, R.M., Aronow, W.S., Casey, D.E., Collins, K., Dennison Himmelfarb, C., Depalma, S.M., Gidding, S., Jamerson, K.A., Jones, D.W., MacLaughlin, E.J, Muntener, P., Ovbiaggele, B., Smith, S.C., Spencer, C.C., Stafford, R.S., Taler, S.J., Thomas, R.J., Williams, K. A., Williamson, J.D., Wright, J.T., (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), e13-e115. doi.org/10.1161/HYP.0000000000000065
"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation"/>
    <citation
              value="Winter, K. H., Tuttle, L. A. \&amp; Viera, A.J. (2013). Hypertension. Primary Care Clinics in Office Practice, 40, 179-194. doi:10.1016/j.pop.2012.11.008
"/>
  </relatedArtifact>
  <library
           value="https://madie.cms.gov/Library/CMS22FHIRPCSBPScreeningFollowUp"/>
  <disclaimer
              value="These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or \[R\] and unregistered trademarks are indicated by (TM) or \[TM\].
"/>
  <rationale
             value="Hypertension is a prevalent condition that affects approximately 66.9 million people in the United States. It is estimated that about 20-40% of the adult population has hypertension; the majority of people over age 65 have a hypertension diagnosis (Appleton et al., 2013 and Luehr et al., 2012). Winter (2013) noted that 1 in 3 American adults have hypertension and the lifetime risk of developing hypertension is 90%. The African American population or non-Hispanic Blacks, the elderly, diabetics and those with chronic kidney disease are at increased risk of stroke, myocardial infarction and renal disease. Non-Hispanic Blacks have the highest prevalence at 38.6% (Winter et al., 2013). Hypertension is a major risk factor for ischemic heart disease, left ventricular hypertrophy, renal failure, stroke and dementia (Luehr et al., 2012). Prevention of hypertension and the treatment of established hypertension are complementary approaches to reducing cardiovascular disease risk in the population, but prevention of hypertension provides the optimal means of reducing risk and avoiding harmful consequences. Periodic blood pressure (BP) screening can identify individuals who develop elevated BP over time. More frequent BP screening may be particularly important for individuals with elevated atherosclerotic cardiovascular disease (ASCVD) risk (Whelton et al., 2018).

Hypertension is the most common reason for adult office visits other than pregnancy. Garrison (2013) stated that in 2007, 42 million ambulatory visits were attributed to hypertension (Garrison \&amp; Oberhelman, 2013). It also has the highest utilization of prescription drugs. Numerous resources and treatment options are available, yet only about 40-50% of the hypertensive patients have their blood pressure under control (\&lt;140/90) (Appleton et al., 2013 and Luehr et al., 2012). In addition to medication non-compliance, poor outcomes are also attributed to poor adherence to lifestyle changes such as a low-sodium diet, weight loss, increased exercise and limiting alcohol intake. Many adults find it difficult to continue medications and lifestyle changes when they are asymptomatic. Symptoms of elevated blood pressure usually do not occur until secondary problems arise such as with vascular diseases (myocardial infarction, stroke, heart failure and renal insufficiency) (Luehr et al., 2012).

Appropriate follow-up after blood pressure measurement is a pivotal component in preventing the progression of hypertension and the development of heart disease. Detection of marginally or fully elevated blood pressure by a specialty clinician warrants referral to a provider familiar with the management of hypertension and prehypertension.

The American College of Cardiology/American Heart Association (ACC/AHA) 2017 Guidelines provide updated recommendations for ASCVD risk. For additional information please refer to the 2017 ACC/AHA guidelines: https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2017/11/09/11/41/2017-guideline-for-high-blood-pressure-in-adults.

Lifestyle modifications have demonstrated effectiveness in lowering blood pressure (U.S. Department of Health and Human Services, 2003). The synergistic effect of several lifestyle modifications results in greater benefits than a single modification alone. Baseline diagnostic/laboratory testing establishes if a co-existing underlying condition is the etiology of hypertension and evaluates if end organ damage from hypertension has already occurred. Landmark trials such as the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) have repeatedly proven the efficacy of pharmacologic therapy to control blood pressure and reduce the complications of hypertension. A review of 35 studies found that the pharmacist-led interventions involved medication counseling and patient education. Twenty-nine of the 35 studies showed statistically significant improvement in BP levels of the intervention groups at follow-up (Reeves et al., 2020). Follow-up intervals based on blood pressure control have been established by the 2017 ACC/AHA guideline and the United States Preventive Services Task Force (Whelton et al., 2018; USPSTF, 2021).
"/>
  <clinicalRecommendationStatement
                                   value="The U.S. Preventive Services Task Force (USPSTF, 2021) recommends screening for high blood pressure in adults aged 18 years and older. This is a grade A recommendation.
"/>
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          <display value="Increased score indicates improvement"/>
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    <description
                 value="Percentage of patient visits for patients aged 18 years and older seen during the measurement period who were screened for high blood pressure AND a recommended follow-up plan is documented, as indicated, if blood pressure is elevated or hypertensive
"/>
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"/>
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    <population id="Denominator_1">
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        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exclusion"/>
          <display value="Denominator Exclusion"/>
        </coding>
      </code>
      <description value="Patient has an active diagnosis of hypertension
"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exclusions"/>
      </criteria>
    </population>
    <population id="Numerator_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="numerator"/>
          <display value="Numerator"/>
        </coding>
      </code>
      <description
                   value="Patient visits where patients were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated, if the blood pressure is elevated or hypertensive
"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Numerator"/>
      </criteria>
    </population>
    <population id="DenominatorException_1">
      <code>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/measure-population"/>
          <code value="denominator-exception"/>
          <display value="Denominator Exception"/>
        </coding>
      </code>
      <description
                   value="Documentation of medical reason(s) for not screening for high blood pressure (e.g., patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status).

Documentation of patient reason(s) for not screening for blood pressure measurements or for not ordering an appropriate follow-up intervention if patient BP is elevated or hypertensive (e.g., patient refuses).
"/>
      <criteria>
        <language value="text/cql-identifier"/>
        <expression value="Denominator Exceptions"/>
      </criteria>
    </population>
  </group>
  <supplementalData id="sde-ethnicity">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Ethnicity
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Ethnicity"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-payer">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Payer
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Payer"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-race">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Race
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Race"/>
    </criteria>
  </supplementalData>
  <supplementalData id="sde-sex">
    <usage>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
        <code value="supplemental-data"/>
      </coding>
    </usage>
    <description value="SDE Sex
"/>
    <criteria>
      <language value="text/cql-identifier"/>
      <expression value="SDE Sex"/>
    </criteria>
  </supplementalData>
</Measure>