define "Initial Population 1":
  exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Denominator 1":
  "Initial Population 1"

define "Denominator Exclusions":
  exists ( ( [ConditionProblemsHealthConcerns: "Breastfeeding"]
      union [ConditionProblemsHealthConcerns: "Rhabdomyolysis"]
      union [ConditionEncounterDiagnosis: "Breastfeeding"]
      union [ConditionEncounterDiagnosis: "Rhabdomyolysis"] ) ExclusionDiagnosis
      where ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ExclusionDiagnosis.isVerified ( )
  )

define "Numerator":
  exists "Statin Therapy Ordered during Measurement Period"
    or exists "Medication Active during the Measurement Period"

define "Denominator Exceptions":
  "Has Allergy to Statin"
    or Hospice."Has Hospice Services"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
    or "Has Hepatitis or Liver Disease Diagnosis"
    or "Has Statin Associated Muscle Symptoms"
    or "Has ESRD Diagnosis"
    or "Has Adverse Reaction to Statin"
    or "Has Medical Reason for Not Ordering Statin Therapy"

define "Initial Population 2":
  "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Denominator 2":
  "Initial Population 2"

define "Denominator Exclusions":
  exists ( ( [ConditionProblemsHealthConcerns: "Breastfeeding"]
      union [ConditionProblemsHealthConcerns: "Rhabdomyolysis"]
      union [ConditionEncounterDiagnosis: "Breastfeeding"]
      union [ConditionEncounterDiagnosis: "Rhabdomyolysis"] ) ExclusionDiagnosis
      where ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ExclusionDiagnosis.isVerified ( )
  )

define "Numerator":
  exists "Statin Therapy Ordered during Measurement Period"
    or exists "Medication Active during the Measurement Period"

define "Denominator Exceptions":
  "Has Allergy to Statin"
    or Hospice."Has Hospice Services"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
    or "Has Hepatitis or Liver Disease Diagnosis"
    or "Has Statin Associated Muscle Symptoms"
    or "Has ESRD Diagnosis"
    or "Has Adverse Reaction to Statin"
    or "Has Medical Reason for Not Ordering Statin Therapy"

define "Initial Population 3":
  "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Denominator 3":
  "Initial Population 3"

define "Denominator Exclusions":
  exists ( ( [ConditionProblemsHealthConcerns: "Breastfeeding"]
      union [ConditionProblemsHealthConcerns: "Rhabdomyolysis"]
      union [ConditionEncounterDiagnosis: "Breastfeeding"]
      union [ConditionEncounterDiagnosis: "Rhabdomyolysis"] ) ExclusionDiagnosis
      where ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ExclusionDiagnosis.isVerified ( )
  )

define "Numerator":
  exists "Statin Therapy Ordered during Measurement Period"
    or exists "Medication Active during the Measurement Period"

define "Denominator Exceptions":
  "Has Allergy to Statin"
    or Hospice."Has Hospice Services"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
    or "Has Hepatitis or Liver Disease Diagnosis"
    or "Has Statin Associated Muscle Symptoms"
    or "Has ESRD Diagnosis"
    or "Has Adverse Reaction to Statin"
    or "Has Medical Reason for Not Ordering Statin Therapy"

define "Initial Population 4":
  "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Denominator 4":
  "Initial Population 4"

define "Denominator Exclusions":
  exists ( ( [ConditionProblemsHealthConcerns: "Breastfeeding"]
      union [ConditionProblemsHealthConcerns: "Rhabdomyolysis"]
      union [ConditionEncounterDiagnosis: "Breastfeeding"]
      union [ConditionEncounterDiagnosis: "Rhabdomyolysis"] ) ExclusionDiagnosis
      where ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ExclusionDiagnosis.isVerified ( )
  )

define "Numerator":
  exists "Statin Therapy Ordered during Measurement Period"
    or exists "Medication Active during the Measurement Period"

define "Denominator Exceptions":
  "Has Allergy to Statin"
    or Hospice."Has Hospice Services"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
    or "Has Hepatitis or Liver Disease Diagnosis"
    or "Has Statin Associated Muscle Symptoms"
    or "Has ESRD Diagnosis"
    or "Has Adverse Reaction to Statin"
    or "Has Medical Reason for Not Ordering Statin Therapy"

define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }

define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end

define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }

define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }

define "Has Hospice Services":
  exists ((([Encounter: "Encounter Inpatient"]).isEncounterPerformed()) InpatientEncounter
      where (InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
          or InpatientEncounter.hospitalization.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
      )
        and InpatientEncounter.period ends during day of "Measurement Period"
  )
    or exists ((([Encounter: "Hospice Encounter"]).isEncounterPerformed()) HospiceEncounter
        where HospiceEncounter.period overlaps day of "Measurement Period"
    )
    or exists ((([ObservationScreeningAssessment: "Hospice care [Minimum Data Set]"]).isAssessmentPerformed()) HospiceAssessment
        where HospiceAssessment.value ~ "Yes (qualifier value)"
          and HospiceAssessment.effective.toInterval() overlaps day of "Measurement Period"
    )
    or exists ((([ServiceRequest: "Hospice Care Ambulatory"]).isInterventionOrder()) HospiceOrder
        where HospiceOrder.authoredOn during day of "Measurement Period"
    )
    or exists ((([Procedure: "Hospice Care Ambulatory"]).isInterventionPerformed()) HospicePerformed
        where HospicePerformed.performed.toInterval() overlaps day of "Measurement Period"
    )
    or exists ((([ConditionProblemsHealthConcerns: "Hospice Diagnosis"]
        union [ConditionEncounterDiagnosis: "Hospice Diagnosis"]).verified()) HospiceCareDiagnosis
        where HospiceCareDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
    )

define "Has Palliative Care in the Measurement Period":
  exists ((([ObservationScreeningAssessment: "Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"]).isAssessmentPerformed()) PalliativeAssessment
      where PalliativeAssessment.effective.toInterval() overlaps day of "Measurement Period"
  )
    or exists ((([ConditionProblemsHealthConcerns: "Palliative Care Diagnosis"]
    union [ConditionEncounterDiagnosis: "Palliative Care Diagnosis"]).verified()) PalliativeDiagnosis
        where PalliativeDiagnosis.prevalenceInterval() overlaps day of "Measurement Period"
    )
    or exists ((([Encounter: "Palliative Care Encounter"]).isEncounterPerformed()) PalliativeEncounter
        where PalliativeEncounter.period overlaps day of "Measurement Period"
    )
    or exists ((([Procedure: "Palliative Care Intervention"]).isInterventionPerformed()) PalliativeIntervention
        where PalliativeIntervention.performed.toInterval() overlaps day of "Measurement Period"
    )

define "ASCVD Diagnosis or Procedure before End of Measurement Period":
  ( ( [ConditionProblemsHealthConcerns: "Myocardial Infarction"]
      union [ConditionProblemsHealthConcerns: "Subsequent non-ST elevation (NSTEMI) myocardial infarction"]
      union [ConditionProblemsHealthConcerns: "Cerebrovascular Disease Stroke or TIA"]
      union [ConditionProblemsHealthConcerns: "Atherosclerosis and Peripheral Arterial Disease"]
      union [ConditionProblemsHealthConcerns: "Ischemic Heart Disease or Other Related Diagnoses"]
      union [ConditionProblemsHealthConcerns: "Stable and Unstable Angina"] ) ASCVDDiagnosis
      where ASCVDDiagnosis.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"
        and ASCVDDiagnosis.isVerified ( )
  )
    union ( ( [Procedure: "PCI"]
        union [Procedure: "CABG Surgeries"]
        union [Procedure: "Carotid Intervention"]
        union [Procedure: "CABG or PCI Procedure"] ) ASCVDProcedure
        where ASCVDProcedure.performed.toInterval ( ) starts on or before day of end of "Measurement Period"
          and ASCVDProcedure.status = 'completed'
    )

define "Qualifying Encounter During Day of Measurement Period":
  ( [Encounter: "Annual Wellness Visit"]
    union [Encounter: "Office Visit"]
    union [Encounter: "Outpatient Consultation"]
    union [Encounter: "Outpatient Encounters for Preventive Care"]
    union [Encounter: "Preventive Care Services Established Office Visit, 18 and Up"]
    union [Encounter: "Preventive Care Services Individual Counseling"]
    union [Encounter: "Preventive Care Services Initial Office Visit, 18 and Up"]
    union [Encounter: "Preventive Care Services Other"]
    union [Encounter: "Telemedicine Services"] ) QualifyingEncounter
    where QualifyingEncounter.period during day of "Measurement Period"
      and QualifyingEncounter.status = 'finished'

define "Initial Population 1":
  exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Patients Aged 20 to 75 at Start of Measurement Period":
  AgeInYearsAt(date from start of "Measurement Period") in Interval[20, 75]

define "LDL Result Greater Than or Equal To 190":
  [LaboratoryResultObservation: "LDL Cholesterol"] LDL190
    where LDL190.value as Quantity >= 190 'mg/dL'
      and LDL190.effective.toInterval ( ) starts on or before day of end of "Measurement Period"
      and LDL190.status in { 'final', 'amended', 'corrected', 'appended' }

define "Hypercholesterolemia Diagnosis":
  ( [ConditionProblemsHealthConcerns: "Familial Hypercholesterolemia"] Hypercholesterolemia
      where Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"
        and Hypercholesterolemia.isVerified ( )
  )

define "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD":
  "Patients Aged 20 to 75 at Start of Measurement Period"
    and exists ( "LDL Result Greater Than or Equal To 190"
        union "Hypercholesterolemia Diagnosis"
    )
    and not exists ( "ASCVD Diagnosis or Procedure before End of Measurement Period" )

define "Initial Population 2":
  "Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"
    and exists "Qualifying Encounter During Day of Measurement Period"

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

define "Has Diabetes Diagnosis":
  exists ( [ConditionProblemsHealthConcerns: "Diabetes"] DiabetesDiagnosis
      where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and DiabetesDiagnosis.isVerified ( )
  )

define "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia":
  AgeInYearsAt(date from start of "Measurement Period") in Interval[40, 75]
    and "Has Diabetes Diagnosis"
    and ( not exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
        and not exists "LDL Result Greater Than or Equal To 190"
        and not exists "Hypercholesterolemia Diagnosis"
    )

define "Initial Population 3":
  "Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "Ten Year CVD Risk is High":
  exists ( ( [ObservationScreeningAssessment: "Cardiovascular disease 10Y risk [Likelihood]"]
      union [ObservationScreeningAssessment: "Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"] ) AtRiskCVD
      where AtRiskCVD.value as Quantity >= 20 '%'
        and AtRiskCVD.effective.toInterval ( ) during day of "Measurement Period"
        and AtRiskCVD.status in { 'final', 'amended', 'corrected' }
  )

define "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes":
  AgeInYearsAt(date from start of "Measurement Period") in Interval[40, 75]
    and "Ten Year CVD Risk is High"
    and not ( exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
        or exists "Hypercholesterolemia Diagnosis"
        or exists "LDL Result Greater Than or Equal To 190"
        or "Has Diabetes Diagnosis"
    )

define "Initial Population 4":
  "Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"
    and exists "Qualifying Encounter During Day of Measurement Period"

define "SDE Sex":
  SDE."SDE Sex"

define "Denominator 3":
  "Initial Population 3"

define "Statin Therapy Ordered during Measurement Period":
  ( [MedicationRequest: "Low Intensity Statin Therapy"]
    union [MedicationRequest: "Moderate Intensity Statin Therapy"]
    union [MedicationRequest: "High Intensity Statin Therapy"] ) StatinRequest
    where StatinRequest.authoredOn during day of "Measurement Period"
      and StatinRequest.status in { 'active', 'completed' }
      and StatinRequest.intent in { 'order', 'original-order', 'reflex-order', 'filter-order', 'instance-order' }

define "Medication Active during the Measurement Period":
  ( [MedicationRequest: "Low Intensity Statin Therapy"]
    union [MedicationRequest: "Moderate Intensity Statin Therapy"]
    union [MedicationRequest: "High Intensity Statin Therapy"] ) ActiveStatin
    where ActiveStatin.medicationRequestPeriod ( ) overlaps day of "Measurement Period"
      and ActiveStatin.status in { 'active', 'completed' }

define "Numerator":
  exists "Statin Therapy Ordered during Measurement Period"
    or exists "Medication Active during the Measurement Period"

define "Denominator 2":
  "Initial Population 2"

define "Denominator 4":
  "Initial Population 4"

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

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

define "Denominator Exclusions":
  exists ( ( [ConditionProblemsHealthConcerns: "Breastfeeding"]
      union [ConditionProblemsHealthConcerns: "Rhabdomyolysis"]
      union [ConditionEncounterDiagnosis: "Breastfeeding"]
      union [ConditionEncounterDiagnosis: "Rhabdomyolysis"] ) ExclusionDiagnosis
      where ExclusionDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ExclusionDiagnosis.isVerified ( )
  )

define "Denominator 1":
  "Initial Population 1"

define "Has Allergy to Statin":
  exists ( [AllergyIntolerance: "Statin Allergen"] StatinAllergy
      where StatinAllergy.onset.toInterval ( ) overlaps day of "Measurement Period"
        and StatinAllergy.clinicalStatus ~ QICoreCommon."allergy-active"
  )

define "Has Hepatitis or Liver Disease Diagnosis":
  exists ( ( [ConditionProblemsHealthConcerns: "Hepatitis A"]
      union [ConditionProblemsHealthConcerns: "Hepatitis B"]
      union [ConditionProblemsHealthConcerns: "Liver Disease"] ) HepatitisLiverDisease
      where HepatitisLiverDisease.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and HepatitisLiverDisease.isVerified ( )
  )

define "Has Statin Associated Muscle Symptoms":
  exists ( [ConditionProblemsHealthConcerns: "Statin Associated Muscle Symptoms"] StatinMuscleSymptom
      where StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and StatinMuscleSymptom.isVerified ( )
  )

define "Has ESRD Diagnosis":
  exists ( [ConditionProblemsHealthConcerns: "End Stage Renal Disease"] ESRD
      where ESRD.prevalenceInterval ( ) overlaps day of "Measurement Period"
        and ESRD.isVerified ( )
  )

define "Has Adverse Reaction to Statin":
  exists ( [AdverseEvent: "Statin Allergen"] StatinReaction
      where Coalesce(StatinReaction.date, StatinReaction.recordedDate) during day of "Measurement Period"
  )

define "Has Medical Reason for Not Ordering Statin Therapy":
  exists ( ( [MedicationNotRequested: "Low Intensity Statin Therapy"]
      union [MedicationNotRequested: "Moderate Intensity Statin Therapy"]
      union [MedicationNotRequested: "High Intensity Statin Therapy"] ) NoStatinTherapyOrdered
      with "Qualifying Encounter During Day of Measurement Period" QualifyingEncounter
        such that NoStatinTherapyOrdered.authoredOn during day of QualifyingEncounter.period
          and NoStatinTherapyOrdered.status in { 'active', 'completed' }
          and NoStatinTherapyOrdered.reasonCode in "Medical Reason"
  )

define "Denominator Exceptions":
  "Has Allergy to Statin"
    or Hospice."Has Hospice Services"
    or PalliativeCare."Has Palliative Care in the Measurement Period"
    or "Has Hepatitis or Liver Disease Diagnosis"
    or "Has Statin Associated Muscle Symptoms"
    or "Has ESRD Diagnosis"
    or "Has Adverse Reaction to Statin"
    or "Has Medical Reason for Not Ordering Statin Therapy"

define fluent function isVerified(condition Choice<ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns>):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon."confirmed"
      or condition.verificationStatus ~ QICoreCommon."unconfirmed"
      or condition.verificationStatus ~ QICoreCommon."provisional"
      or condition.verificationStatus ~ QICoreCommon."differential"
  )

/*
@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<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" 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]

/*
@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<"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns">):
	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<Quantity> then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval<DateTime> then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval<DateTime>

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

define fluent function medicationRequestPeriod(Request "MedicationRequest"):
  Request R
    let
      dosage: singleton from R.dosageInstruction,
      doseAndRate: singleton from dosage.doseAndRate,
      timing: dosage.timing,
      frequency: Coalesce(timing.repeat.frequencyMax, timing.repeat.frequency),
      period: Quantity(timing.repeat.period, timing.repeat.periodUnit),
      doseRange: doseAndRate.dose,
      doseQuantity: doseAndRate.dose,
      dose: Coalesce(end of doseRange, doseQuantity),
      dosesPerDay: Coalesce(ToDaily(frequency, period), Count(timing.repeat.timeOfDay), 1.0),
      boundsPeriod: timing.repeat.bounds as Interval<DateTime>,
      daysSupply: (convert R.dispenseRequest.expectedSupplyDuration to days).value,
      quantity: R.dispenseRequest.quantity,
      refills: Coalesce(R.dispenseRequest.numberOfRepeatsAllowed, 0),
      startDate:
        Coalesce(
          date from start of boundsPeriod,
          date from R.authoredOn,
          date from start of R.dispenseRequest.validityPeriod
        ),
      totalDaysSupplied: Coalesce(daysSupply, quantity.value / (dose.value * dosesPerDay)) * (1 + refills)
    return
      if startDate is not null and totalDaysSupplied is not null then
        Interval[startDate, startDate + Quantity(totalDaysSupplied - 1, 'day') ]
      else if startDate is not null and boundsPeriod."high" is not null then
        Interval[startDate, date from end of boundsPeriod]
      else
        null

/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4             */
/**********************************************************************/

define function Quantity(value Decimal, unit String):
  if value is not null then
    System.Quantity { value: value, unit: unit }
  else
    null

/*
 Goal is to get to number of days
 Two broad approaches to the calculation:
  1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
  2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/

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

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

//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
  Enc E
    where E.status = 'finished'

//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):
  Obs O
    where O.status in { 'final', 'amended', 'corrected' }

//Intervention, Order
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
  ServiceRequest S
    where S.status in { 'active', 'completed' }
      and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}

//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
  Proc P
    where P.status ~ 'completed'

//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.

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

/*
@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."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]

define function ToString(value uri): value.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
        }

/*
@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
        }