dQM QICore Content Implementation Guide
2025.0.0 - CI Build
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
| Active as of 2025-08-20 |
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<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">Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR</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">CMS347FHIR</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Independent)</th>
<td class="content-container">urn:uuid:4d3066c5-88f7-48d2-8a93-9f946e1a41a6</td>
</tr>
<tr>
<th scope="row" class="row-header">GUID (Version Specific)</th>
<td class="content-container">urn:uuid:bcebaf84-db66-4cc4-ab1b-5c95eb02d300</td>
</tr>
<tr>
<th scope="row" class="row-header">CMS Identifier</th>
<td class="content-container">347FHIR</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 & 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"><p>Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period:</p>
<ul>
<li><p>All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR</p></li>
<li><p>Patients aged 20 to 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR</p></li>
<li><p>Patients aged 40-75 years with a diagnosis of diabetes; OR</p></li>
<li><p>Patients aged 40 to 75 with a 10-year ASCVD risk score of >= 20 percent.</p></li>
</ul></td>
</tr>
<tr>
<th scope="row" class="row-header">Copyright</th>
<td class="content-container">This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & 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.</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 "AS IS" 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>"Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 3 deaths in the United States in 2015. In 2015, stroke caused approximately 1 of every 19 deaths in the United States and the estimated annual costs for CVD and stroke were $329.7 billion, including $199.2 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $130.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group" (Benjamin et al., 2018). Data collected between 2011 and 2014 indicates that more than 94.6 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 28.5 million had levels 240 mg/dL or more (Benjamin et al., 2018). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015). In 2018, updated guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (Grundy et al., 2019). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The American College of Cardiology (ACC)/American Heart Association (AHA)/Multi-society (MS) Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of ASCVD in patients of all ages. The document concludes that the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C >= 190 mg/dL, with diabetes, or individuals with >= 20 percent risk of ASCVD as determined via use of an ASCVD risk estimator derived from the Pooled Cohort Equations (Grundy et al., 2019). One study surveying U.S. cardiology, primary care, and endocrinology practices found that 1 in 4 guideline-eligible patients were not on a statin and less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment (Navar et al., 2017). In a follow-up study authored by Nanna et al., the same clinics were divided into tertiles based on the percentage of patients with guideline-recommended statin use. The researchers found that patients in the high-tertile clinics were more likely to achieve target LDL-C levels than patients at the low- or mid-tertile clinics, and this held true when patients were stratified by primary and secondary prevention (Nanna et al., 2019a). Research also indicates that certain populations are far less likely to receive guideline-recommended statin therapy than others. A retrospective study of the National Health and Nutrition Examination Survey found that Black and Hispanic race or ethnicity, low income, lack of health insurance coverage, poor health care access, young age, and female gender are predictors of lower statin utilization (Gu et al., 2018). In particular, there is extensive evidence that women are far less likely than men to be prescribed guideline-recommended statin therapy (Nanna et al., 2019b), despite research showing that female patients with cardiovascular disease derive the same or greater benefit from statin therapy as male patients with cardiovascular disease (Puri et al., 2014). The Statin Safety Expert Panel that participated in a National Lipid Association (NLA) Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweigh any potential harm related to the drug (Jacobson, 2014).</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Clinical Recommendation Statement</th>
<td class="content-container"><p>This electronic clinical quality measure is intended to align with the 2018 ACC/AHA/MS Guideline on the Management of Blood Cholesterol (Grundy et al., 2019), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations. Recommendations for Management of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment: Secondary Prevention:</p>
<ol>
<li><p>In patients who are 75 years of age or younger with clinical ASCVD, high-intensity statin therapy should be initiated or continued with the aim of achieving a 50 percent or greater reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).</p></li>
<li><p>In patients with clinical ASCVD in whom high-intensity statin therapy is contraindicated or who experience statin-associated side effects, moderate-intensity statin therapy should be initiated or continued with the aim of achieving a 30 to 49 percent reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).</p></li>
<li><p>In patients older than 75 years of age with clinical ASCVD, it is reasonable to initiate moderate- or high-intensity statin therapy after evaluation of the potential for ASCVD risk reduction, adverse effects, and drug–drug interactions, as well as patient frailty and patient preferences (Class IIa Recommendation), (Grundy et al., 2019).</p></li>
</ol>
<p>Primary Prevention</p>
<ol>
<li><p>In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL or higher (>= 4.9 mmol/L), maximally tolerated statin therapy is recommended. (Class I Recommendation), (Grundy et al., 2019).</p></li>
<li><p>In adults 40 to 75 years of age with diabetes mellitus, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated (Class I Recommendation), (Grundy et al., 2019).</p></li>
<li><p>To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific Pooled Cohort Equations (PCE) to estimate 10-year ASCVD risk for asymptomatic adults 40 to 75 years of age. The higher the estimated risk, the more likely the patient is to benefit from statin treatment (Grundy et al., 2019).</p></li>
</ol>
<p>The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more of these CVD risk factors and an estimated 10-year CVD event risk of 7.5 percent to less than 10 percent has at least a small net benefit (USPSTF 2022).</p>
<p>Statin Safety and Statin-Associated Side Effects</p>
<p>A clinician–patient risk discussion is recommended before initiation of statin therapy to review net clinical benefit, weighing the potential for ASCVD risk reduction against the potential for statin-associated side effects, statin–drug interactions, and safety, while emphasizing that side effects can be addressed successfully (Class I Recommendation), (Grundy et al., 2019).</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
'Zhang, H., Plutzky, J., Shubina, M., & Turchin, A. (2016). Drivers of the Sex Disparity in Statin Therapy in Patients with Coronary Artery Disease: A Cohort Study. PloS one, 11(5), e0155228. doi:10.1371/journal.pone.0155228
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., …Munter, P. (2018). Heart disease and stroke statistics—2018 update: A report from the American Heart Association. Circulation, 137(12), e67-e492. doi.10.1161/CIR.0000000000000558
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Ference, B.A. (2015). Statins and the risk of developing new-onset Type 2 diabetes: Expert analysis. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2015/03/10/08/10/statins-and-the-risk-of-developing-new-onset-type-2-diabetes
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., …Yeboah, J. (2019) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Journal of the American College of Cardiology, 73 (24), e286-e343. doi.10.1016/j.jacc.2018.11.003
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Gu, A., Kamat, S., Argulian, E. (2018). Trends and disparities in statin use and low-density lipoprotein cholesterol levels among US patients with diabetes, 1999–2014. Diabetes Research and Clinical Practice, 139, 1-10. doi:10.1016/j.diabres.2018.02.019
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Jacobson, T. A. (2014). Executive summary: NLA Task Force on Statin Safety—2014 update. Journal of Clinical Lipidology, 8(3 Suppl.), S1-S4. doi:10.1016/jacl.2014.03.002
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Nanna, M. G., Navar, A. M., Wang, Y. T., Li, S., Virani, S. S., Li, Z., … Peterson, E. D. (2019a). Practice-Level Variation in Statin use and Low-Density Lipoprotein Cholesterol Control in the United States: Results from the Patient and Provider Assessment of Lipid Management (PALM) Registry. American Heart Journal, 214, 113–124. doi:10.1016/j.ahj.2019.05.009
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Nanna, M. G., Wang, T. Y., Xiang, Q., Goldberg, A. C., Robinson, J. G., Roger, V. L., … Navar, A. M. (2019b). Sex Differences in the use of Statins in Community Practice. Circulation. Cardiovascular Quality & Outcomes, 12(8), e005562. doi:10.1161/CIRCOUTCOMES.118.005562
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Navar, M., Wang, T. Y., Li, S.,Robinson, J. G., Goldberg, A. C., Virani, S., …Peterson, E. D. (2017). Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry. American Heart Journal, 193, 84-92. doi.10.1016/j.ahj.2017.08.005
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
Puri, R., Nissen, S. E., Shao, M., Ballantyne, C. M., Barter, P. J., Chapman, M. J., … Nicholls, S. J. (2014). Sex-related differences of coronary atherosclerosis regression following maximally intensive statin therapy: insights from SATURN. JACC. Cardiovascular imaging, 7(10), 1013–1022. doi:10.1016/j.jcmg.2014.04.019
</td>
</tr>
<tr>
<th scope="row" class="row-header">Citation</th>
<td class="content-container">
U.S. Preventive Services Task Force (USPSTF) (2022). Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. Journal of American Medical Association; 328(8):746-753. doi:10.1001/jama.2022.13044
</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Atherosclerotic Cardiovascular Disease (ASCVD) : <p>Clinical ASCVD includes:</p>
<ul>
<li><p>Acute coronary syndromes</p></li>
<li><p>History of myocardial infarction</p></li>
<li><p>Stable or unstable angina</p></li>
<li><p>Coronary or other arterial revascularization</p></li>
<li><p>Stroke or transient ischemic attack (TIA)</p></li>
<li><p>Peripheral arterial disease of atherosclerotic origin</p></li>
</ul></td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Lipoprotein Density Cholesterol (LDL-C) Result: A fasting or non-fasting LDL-C laboratory test performed and direct or calculated test result documented in the medical record. When both direct and calculated test results are available on the same day, the direct LDL-C test result should be used.</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Statin Medication Therapy List (NOTE: List does NOT include dosage): [Generic name] (Brand or trade name) and (-) Medication type, if applicable: [Atorvastatin] (Lipitor) - Statin [Fluvastatin] (Lescol XL or Lescol) - Statin [Lovastatin (Mevinolin)](Mevacor or Altoprev) - Statin [Pitavastatin] (Livalo or Zypitamag or Nikita) - Statin [Pravastatin Sodium] (Pravachol) - Statin [Rosuvastatin Calcium] (Crestor) - Statin [Simvastatin] (Zocor) - Statin [Amlodipine Besylate/Atorvastatin Calcium] (Caduet) – Fixed Dose Combination [Ezetimibe / Rosuvastatin] (Roszet) – Fixed Dose Combination [Ezetimibe/Simvastatin] (Vytorin) – Fixed Dose Combination</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Statin Therapy: Administration of one or more of a group of medications that are used to lower plasma lipoprotein levels in the treatment of hyperlipoproteinemia</td>
</tr>
<tr>
<th scope="row" class="row-header">Definition</th>
<td class="content-container">Statin-Associated Muscle Symptoms (SAMS): The 2018 ACC/AHA/MS Guideline (Grundy et al., 2019) includes the following SAMS: myalgias, myositis, myopathy, or statin-associated autoimmune myopathy. Patients who experience significant or repeated statin-associated muscle symptoms may prefer not to take or continue statin therapy and therefore may be removed from the denominator.</td>
</tr>
<tr>
<th scope="row" class="row-header">Guidance (Usage)</th>
<td class="content-container"><p>Initial Population Guidance: The initial population covers four distinct populations. Use the following process to prevent counting patients more than once. Initial Population 1: All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period.</p>
<ul>
<li><p>If YES, meets Initial Population 1 risk category.</p></li>
<li><p>If NO, screen for next risk category.</p></li>
</ul>
<p>Initial Population 2:</p>
<p>Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.</p>
<ul>
<li><p>If YES, meets Initial Population 2 risk category.</p></li>
<li><p>If NO, screen for next risk category.</p></li>
</ul>
<p>Initial Population 3:</p>
<p>Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period.</p>
<ul>
<li><p>If YES, meets Initial Population 3 risk category.</p></li>
<li><p>If NO, screen for next risk category.</p></li>
</ul>
<p>Initial Population 4:</p>
<p>Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of >= 20 percent during the measurement period.</p>
<ul>
<li><p>If YES, meets Initial Population 4 risk category.</p></li>
<li><p>If NO, patient does NOT meet Initial Population criteria and is NOT eligible for measure inclusion.</p></li>
</ul>
<p>Initial Population Guidance for Encounter:</p>
<p>In order for the patient to be included in the Initial Population, the patient must have ONE initial population-eligible visit, defined as follows: outpatient visit, initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit.</p>
<p>LDL-C Laboratory test result options:</p>
<p>The measure can be reported for all patients with a documented LDL-C level recorded as follows:</p>
<p>To meet Initial Population 1:</p>
<p>There is no LDL-C result required.</p>
<p>To meet Initial Population 2:</p>
<p>If a patient has ANY previous laboratory result of LDL-C >= 190 mg/dL, report the highest value >= 190 mg/dL.</p>
<p>To meet Initial Population 3:</p>
<p>There is no LDL-C result required.</p>
<p>To meet Initial Population 4:</p>
<p>There is no LDL-C result required.</p>
<p>The 10-year ASCVD risk assessment options:</p>
<p>The 10-year ASCVD risk score is calculated using the Pooled Cohort Equations: 1) the 2013 ACC/AHA ASCVD Risk Estimator (maps to LOINC Code 79423-0) OR 2) the ACC Risk Estimator Plus (maps to LOINC Code 99055-6). If your EHR does not have either of these risk calculators, we recommend that you use the on-line versions. The 10-year ASCVD risk score (quantitative result, i.e., result.value, "%") must be documented in a structured field. The 10-year ASCVD risk assessment must be performed during the measurement period. Any documentation of a 10-year ASCVD risk score >=20 will qualify patient for the denominator population, even if risk score changes later in the measurement period.</p>
<p>Numerator instructions and guidance:</p>
<ul>
<li><p>Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.</p></li>
<li><p>ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).</p></li>
<li><p>Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.</p></li>
<li><p>Statin medication "samples" provided to patients can be documented as "current statin therapy" if documented in the medication list in health/medical record.</p></li>
<li><p>Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure unless they have an allowable denominator exception. Patients with an allowable denominator exception should be removed from the denominator of the measure and reported as a valid exception.</p></li>
<li><p>There is only one performance rate calculated for this measure: the weighted average of the four populations.</p></li>
<li><p>Adherence to statin therapy is not calculated in this measure.</p></li>
<li><p>It may not be appropriate to prescribe statin therapy for some patients (see exceptions and exclusions for the complete list).</p></li>
</ul>
<p>Intensity of statin therapy in primary and secondary prevention:</p>
<p>The expert panel of the 2018 ACC/AHA/MS Guidelines (Grundy et al., 2019) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.</p>
<p>Lifestyle modification coaching:</p>
<p>A healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.</p>
<p>Millimoles per liter (mmol/L) must be converted to milligrams per deciliter (mg/dL) for reporting this measure.</p>
<p>This eCQM is a patient-based measure.</p>
<p>This FHIR-based measure has been derived from the QDM-based measure CMS347v9. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" class="row-header">Summary</th>
<td class="content-container"><p>All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period and were taking a statin medication during the measure period</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container"><p>This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: InitialPopulation_1
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-initial-population-1">Initial Population 1</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-cms347fhirstatinpreventiontxcvd-denominator-1">Denominator 1</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"><ul>
<li><p>Patients who are breastfeeding at any time during the measurement period.</p></li>
<li><p>Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-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>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-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"><ul>
<li><p>Patients with statin-associated muscle symptoms or an allergy to statin medication.</p></li>
<li><p>Patients who are receiving palliative or hospice care.</p></li>
<li><p>Patients with active liver disease or hepatic disease or insufficiency.</p></li>
<li><p>Patients with end-stage renal disease (ESRD). Patients with documentation of a medical reason for not being prescribed statin therapy.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions">Denominator Exceptions</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_2)</th>
</tr>
<tr>
<th scope="row" class="row-header">Summary</th>
<td class="content-container"><p>Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia and were taking a statin medication during the measure period</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]</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_2
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-initial-population-2">Initial Population 2</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_2
<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-cms347fhirstatinpreventiontxcvd-denominator-2">Denominator 2</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_2
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients who are breastfeeding at any time during the measurement period.</p></li>
<li><p>Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions">Denominator Exclusions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_2
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exception</th>
<td class="content-container">
<em>ID</em>: DenominatorException_2
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients with statin-associated muscle symptoms or an allergy to statin medication.</p></li>
<li><p>Patients who are receiving palliative or hospice care.</p></li>
<li><p>Patients with active liver disease or hepatic disease or insufficiency.</p></li>
<li><p>Patients with end-stage renal disease (ESRD).</p></li>
<li><p>Patients with documentation of a medical reason for not being prescribed statin therapy.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions">Denominator Exceptions</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_3)</th>
</tr>
<tr>
<th scope="row" class="row-header">Summary</th>
<td class="content-container"><p>Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and were taking a statin medication during the measure period</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>
<tr>
<th scope="row" class="row-header">Rate Aggregation</th>
<td class="content-container">This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ [(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)]</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_3
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-initial-population-3">Initial Population 3</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_3
<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-cms347fhirstatinpreventiontxcvd-denominator-3">Denominator 3</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_3
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients who are breastfeeding at any time during the measurement period.</p></li>
<li><p>Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions">Denominator Exclusions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_3
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exception</th>
<td class="content-container">
<em>ID</em>: DenominatorException_3
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients with statin-associated muscle symptoms or an allergy to statin medication.</p></li>
<li><p>Patients who are receiving palliative or hospice care.</p></li>
<li><p>Patients with active liver disease or hepatic disease or insufficiency.</p></li>
<li><p>Patients with end-stage renal disease (ESRD).</p></li>
<li><p>Patients with documentation of a medical reason for not being prescribed statin therapy.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions">Denominator Exceptions</a>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_4)</th>
</tr>
<tr>
<th scope="row" class="row-header">Summary</th>
<td class="content-container"><p>Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of >= 20 percent and were taking a statin medication during the measure period</p></td>
</tr>
<tr>
<th scope="row" class="row-header">Basis</th>
<td class="content-container">boolean</td>
</tr>
<tr>
<th scope="row" class="row-header">Scoring</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>
</tr>
<tr>
<th scope="row" class="row-header">Type</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>
</tr>
<tr>
<th scope="row" class="row-header">Improvement Notation</th>
<td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>
</tr>
<tr>
<th scope="row" class="row-header">Initial Population</th>
<td class="content-container">
<em>ID</em>: InitialPopulation_4
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of >= 20 percent during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-initial-population-4">Initial Population 4</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator</th>
<td class="content-container">
<em>ID</em>: Denominator_4
<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-cms347fhirstatinpreventiontxcvd-denominator-4">Denominator 4</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exclusion</th>
<td class="content-container">
<em>ID</em>: DenominatorExclusion_4
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients who are breastfeeding at any time during the measurement period.</p></li>
<li><p>Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions">Denominator Exclusions</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Numerator</th>
<td class="content-container">
<em>ID</em>: Numerator_4
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><p>Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period</p></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-numerator">Numerator</a>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Denominator Exception</th>
<td class="content-container">
<em>ID</em>: DenominatorException_4
<br/>
<em>Description</em>:
<p style="white-space: pre-line" class="tab-one"><ul>
<li><p>Patients with statin-associated muscle symptoms or an allergy to statin medication.</p></li>
<li><p>Patients who are receiving palliative or hospice care.</p></li>
<li><p>Patients with active liver disease or hepatic disease or insufficiency. Patients with end-stage renal disease (ESRD).</p></li>
<li><p>Patients with documentation of a medical reason for not being prescribed statin therapy.</p></li>
</ul></p>
<em>Logic Definition</em>: <a href="#primary-cms347fhirstatinpreventiontxcvd-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="#cms347fhirstatinpreventiontxcvd-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="#cms347fhirstatinpreventiontxcvd-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="#cms347fhirstatinpreventiontxcvd-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="#cms347fhirstatinpreventiontxcvd-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/CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<th scope="row" class="row-header">Contents</th>
<td class="content-container">
<em><a href="#population-criteria">Population Criteria</a></em>
<br/>
<em><a href="#definitions">Logic Definitions</a></em>
<br/>
<em><a href="#terminology">Terminology</a></em>
<br/>
<em><a href="#dependencies">Dependencies</a></em>
<br/>
<em><a href="#data-requirements">Data Requirements</a></em>
<br/>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="population-criteria"> </a>Population Criteria</th>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-initial-population-1"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population 1":
exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
and exists "Qualifying Encounter During Day of Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-1"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 1":
"Initial Population 1"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions"> </a>
Denominator Exception
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_2)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-initial-population-2"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-2"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 2":
"Initial Population 2"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions"> </a>
Denominator Exception
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_3)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-initial-population-3"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-3"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 3":
"Initial Population 3"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions"> </a>
Denominator Exception
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_4)</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-initial-population-4"> </a>
Initial Population
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-4"> </a>
Denominator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 4":
"Initial Population 4"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exclusions"> </a>
Denominator Exclusion
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-numerator"> </a>
Numerator
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="primary-cms347fhirstatinpreventiontxcvd-denominator-exceptions"> </a>
Denominator Exception
</th>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="definitions"> </a>Logic Definitions</th>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-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 "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="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 "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="supplementaldataelements-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> SupplementalDataElements</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
[Coverage: type in "Payer Type"] 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 "SDE Ethnicity":
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="hospice-has-hospice-services"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Hospice</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="palliativecare-has-palliative-care-in-the-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> PalliativeCare</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-ascvd-diagnosis-or-procedure-before-end-of-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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'
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-qualifying-encounter-during-day-of-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-initial-population-1"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population 1":
exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
and exists "Qualifying Encounter During Day of Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-patients-aged-20-to-75-at-start-of-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Patients Aged 20 to 75 at Start of Measurement Period":
AgeInYearsAt(date from start of "Measurement Period") in Interval[20, 75]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-ldl-result-greater-than-or-equal-to-190"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-hypercholesterolemia-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Hypercholesterolemia Diagnosis":
( [ConditionProblemsHealthConcerns: "Familial Hypercholesterolemia"] Hypercholesterolemia
where Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"
and Hypercholesterolemia.isVerified ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-patients-aged-20-to-75-with-ldl-cholesterol-result-greater-than-or-equal-to-190-or-hypercholesterolemia-without-ascvd"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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" )</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-initial-population-2"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-sde-race"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
SDE."SDE Race"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-diabetes-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Diabetes Diagnosis":
exists ( [ConditionProblemsHealthConcerns: "Diabetes"] DiabetesDiagnosis
where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
and DiabetesDiagnosis.isVerified ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-patients-aged-40-to-75-years-with-diabetes-without-ascvd-or-ldl-greater-than-190-or-hypercholesterolemia"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-initial-population-3"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-ten-year-cvd-risk-is-high"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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' }
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-patients-age-40-to-75-years-and-have-a-10-year-cvd-risk-of-high-without-ascvd-and-high-ldl-and-diabetes"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-initial-population-4"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-sde-sex"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
SDE."SDE Sex"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-3"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 3":
"Initial Population 3"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-statin-therapy-ordered-during-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-medication-active-during-the-measurement-period"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-numerator"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-2"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 2":
"Initial Population 2"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-4"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 4":
"Initial Population 4"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-sde-payer"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
SDE."SDE Payer"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-sde-ethnicity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
SDE."SDE Ethnicity"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-exclusions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-1"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator 1":
"Initial Population 1"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-allergy-to-statin"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-hepatitis-or-liver-disease-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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 ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-statin-associated-muscle-symptoms"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Statin Associated Muscle Symptoms":
exists ( [ConditionProblemsHealthConcerns: "Statin Associated Muscle Symptoms"] StatinMuscleSymptom
where StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of "Measurement Period"
and StatinMuscleSymptom.isVerified ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-esrd-diagnosis"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has ESRD Diagnosis":
exists ( [ConditionProblemsHealthConcerns: "End Stage Renal Disease"] ESRD
where ESRD.prevalenceInterval ( ) overlaps day of "Measurement Period"
and ESRD.isVerified ( )
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-adverse-reaction-to-statin"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Adverse Reaction to Statin":
exists ( [AdverseEvent: "Statin Allergen"] StatinReaction
where Coalesce(StatinReaction.date, StatinReaction.recordedDate) during day of "Measurement Period"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-has-medical-reason-for-not-ordering-statin-therapy"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"
)</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-denominator-exceptions"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cms347fhirstatinpreventiontxcvd-isverified"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CMS347FHIRStatinPreventionTxCVD</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">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"
)</code></pre>
</td>
</tr>
<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<"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]</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<"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></code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="qicorecommon-tointerval"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> QICoreCommon</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cumulativemedicationduration-medicationrequestperiod"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define fluent function medicationRequestPeriod(Request "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</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cumulativemedicationduration-quantity"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4 */
/**********************************************************************/
define function Quantity(value Decimal, unit String):
if value is not null then
System.Quantity { value: value, unit: unit }
else
null</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="cumulativemedicationduration-todaily"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> CumulativeMedicationDuration</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
Goal is to get to number of days
Two broad approaches to the calculation:
1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/
/*
For the first approach, we need to get from frequency to a frequency/day
So we define ToDaily
*/
/*
Calculates daily frequency given frequency within a period
*/
define function ToDaily(frequency System.Integer, period System.Quantity):
case period.unit
when 'h' then frequency * (24.0 / period.value)
when 'min' then frequency * (24.0 / period.value) * 60
when 's' then frequency * (24.0 / period.value) * 60 * 60
when 'd' then frequency * (24.0 / period.value) / 24
when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hour' then frequency * (24.0 / period.value)
when 'minute' then frequency * (24.0 / period.value) * 60
when 'second' then frequency * (24.0 / period.value) * 60 * 60
when 'day' then frequency * (24.0 / period.value) / 24
when 'week' then frequency * (24.0 / period.value) / (24 * 7)
when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hours' then frequency * (24.0 / period.value)
when 'minutes' then frequency * (24.0 / period.value) * 60
when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
when 'days' then frequency * (24.0 / period.value) / 24
when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
end</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="status-isencounterperformed"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Status</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status = 'finished'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="status-isassessmentperformed"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Status</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="status-isinterventionorder"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Status</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Intervention, Order
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="status-isinterventionperformed"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Status</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="status-verified"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> Status</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.
//Condition
//Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
define fluent function verified(conditions List<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"
)</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."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tostring"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-tocode"> </a>
Logic Definition
</th>
<td class="content-container"><em>Library Name:</em> FHIRHelpers</td>
</tr>
<tr>
<td>
<pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}</code></pre>
</td>
</tr>
<tr>
<th scope="row" rowspan="2" class="row-header">
<a name="fhirhelpers-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 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 ICD10CM
<br/>
<em>Resource</em>: http://hl7.org/fhir/sid/icd-10-cm
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</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">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 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 AllergyIntoleranceClinicalStatusCodes
<br/>
<em>Resource</em>: http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical
<br/>
<em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Myocardial Infarction
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.101
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.101</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Cerebrovascular Disease Stroke or TIA
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Atherosclerosis and Peripheral Arterial Disease
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Ischemic Heart Disease or Other Related Diagnoses
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Stable and Unstable Angina
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set PCI
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set CABG Surgeries
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Carotid Intervention
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set CABG or PCI Procedure
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Annual Wellness Visit
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Office Visit
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Outpatient Consultation
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Outpatient Encounters for Preventive Care
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services Established Office Visit, 18 and Up
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services Individual Counseling
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services Initial Office Visit, 18 and Up
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Preventive Care Services Other
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Telemedicine Services
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.276
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.276</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set LDL Cholesterol
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Familial Hypercholesterolemia
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.100
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.100</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Diabetes
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Low Intensity Statin Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Moderate Intensity Statin Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set High Intensity Statin Therapy
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572</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 Breastfeeding
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Rhabdomyolysis
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Statin Allergen
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Encounter Inpatient
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospice Encounter
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospice Care Ambulatory
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hospice Diagnosis
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Palliative Care Diagnosis
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Palliative Care Encounter
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Palliative Care Intervention
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hepatitis A
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Hepatitis B
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.269
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.269</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Liver Disease
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set Statin Associated Muscle Symptoms
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Value Set</th>
<td class="content-container">
<em>Description</em>: Value set End Stage Renal Disease
<br/>
<em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353
<br/>
<em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353</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>: Subsequent non-ST elevation (NSTEMI) myocardial infarction
<br/>
<em>Code</em>: I22.2
<br/>
<em>System</em>: <tt>http://hl7.org/fhir/sid/icd-10-cm</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>: Cardiovascular disease 10Y risk [Likelihood]
<br/>
<em>Code</em>: 99055-6
<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>: Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013
<br/>
<em>Code</em>: 79423-0
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: 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>: Active
<br/>
<em>Code</em>: active
<br/>
<em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Discharge to home for hospice care (procedure)
<br/>
<em>Code</em>: 428361000124107
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Discharge to healthcare facility for hospice care (procedure)
<br/>
<em>Code</em>: 428371000124100
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Hospice care [Minimum Data Set]
<br/>
<em>Code</em>: 45755-6
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Yes (qualifier value)
<br/>
<em>Code</em>: 373066001
<br/>
<em>System</em>: <tt>http://snomed.info/sct</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Direct Reference Code</th>
<td class="content-container">
<em>Display</em>: Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)
<br/>
<em>Code</em>: 71007-9
<br/>
<em>System</em>: <tt>http://loinc.org</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="dependencies"> </a>Dependencies</th>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: QICore model information
<br/>
<em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo
<br/>
<em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library QICoreCommon
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library 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 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 CMD
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library Hospice
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/Hospice|6.18.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Hospice|6.18.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library Status
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/Status|1.15.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/Status|1.15.000</tt>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Dependency</th>
<td class="content-container">
<em>Description</em>: Library PalliativeCare
<br/>
<em>Resource</em>: https://madie.cms.gov/Library/PalliativeCare|1.18.000
<br/>
<em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/PalliativeCare|1.18.000</tt>
</td>
</tr>
<tr>
<th colspan="2" scope="row" class="row-header"><a name="data-requirements"> </a>Data Requirements</th>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Patient
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
<br/>
<em>Must Support Elements</em>: birthDate, birthDate.value, url, extension
<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/2.16.840.1.113762.1.4.1108.101
<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>Code(s)</em>:
http://hl7.org/fhir/sid/icd-10-cm#I22.2: 'Subsequent non-ST elevation (NSTEMI) myocardial infarction'
</span>
<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/2.16.840.1.113762.1.4.1047.44
<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/2.16.840.1.113762.1.4.1047.21
<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/2.16.840.1.113762.1.4.1047.46
<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/2.16.840.1.113762.1.4.1047.47
<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/2.16.840.1.113762.1.4.1047.100
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-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/2.16.840.1.113762.1.4.1047.73
<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/2.16.840.1.113762.1.4.1047.102
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024
<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/2.16.840.1.113883.3.67.1.101.1.269
<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/2.16.840.1.113762.1.4.1047.42
<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/2.16.840.1.113762.1.4.1108.85
<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/2.16.840.1.113883.3.526.3.353
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Procedure
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
<br/>
<em>Must Support Elements</em>: code, performed, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.276
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, hospitalization, hospitalization.dischargeDisposition, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Encounter
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
<br/>
<em>Must Support Elements</em>: type, period, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: type</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-lab
<br/>
<em>Must Support Elements</em>: code, value, effective, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, value, effective, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#99055-6: 'Cardiovascular disease 10Y risk [Likelihood]'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, value, effective, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#79423-0: 'Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, value, effective, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#45755-6: 'Hospice care [Minimum Data Set]'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Observation
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-screening-assessment
<br/>
<em>Must Support Elements</em>: code, effective, value, status, status.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>Code(s)</em>:
http://loinc.org#71007-9: 'Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)'
</span>
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: 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, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574
<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, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575
<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, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: medication</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572
<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, intent, intent.value, dosageInstruction, dispenseRequest, dispenseRequest.expectedSupplyDuration, dispenseRequest.quantity, dispenseRequest.numberOfRepeatsAllowed, dispenseRequest.numberOfRepeatsAllowed.value, dispenseRequest.validityPeriod
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Medication
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication
<br/>
<em>Must Support Elements</em>: id.value, code
<br/>
</td>
</tr>
<tr>
<th 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-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: Condition
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis
<br/>
<em>Must Support Elements</em>: code
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: AllergyIntolerance
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance
<br/>
<em>Must Support Elements</em>: code, onset, clinicalStatus
<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/2.16.840.1.113762.1.4.1110.42
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: ServiceRequest
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
<br/>
<em>Must Support Elements</em>: code, authoredOn, authoredOn.value, status, status.value, intent, intent.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: code</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584
<br/>
</td>
</tr>
<tr>
<th scope="row" class="row-header">Data Requirement</th>
<td class="content-container">
<em>Type</em>: AdverseEvent
<br/>
<em>Profile(s)</em>:
http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent
<br/>
<em>Must Support Elements</em>: event, date, date.value, recordedDate, recordedDate.value
<br/>
<em>Code Filter(s)</em>:
<br/>
<span class="tab-one"><em>Path</em>: event</span>
<br/>
<span class="tab-one"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42
<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, authoredOn, authoredOn.value, status, status.value, reasonCode
<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/2.16.840.1.113883.3.526.3.1574
<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, authoredOn, authoredOn.value, status, status.value, reasonCode
<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/2.16.840.1.113883.3.526.3.1575
<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, authoredOn, authoredOn.value, status, status.value, reasonCode
<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/2.16.840.1.113883.3.526.3.1572
<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://hl7.org/fhir/sid/icd-10-cm"/>
<code value="I22.2"/>
<display
value="Subsequent non-ST elevation (NSTEMI) myocardial infarction"/>
</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="99055-6"/>
<display value="Cardiovascular disease 10Y risk [Likelihood]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="79423-0"/>
<display
value="Cardiovascular disease 10Y risk [Likelihood] ACC-AHA Pooled Cohort by Goff 2013"/>
</valueCoding>
</extension>
<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/allergyintolerance-clinical"/>
<code value="active"/>
<display value="Active"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428361000124107"/>
<display value="Discharge to home for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="428371000124100"/>
<display
value="Discharge to healthcare facility for hospice care (procedure)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://snomed.info/sct"/>
<code value="373066001"/>
<display value="Yes (qualifier value)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
<valueCoding>
<system value="http://loinc.org"/>
<code value="71007-9"/>
<display
value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
</valueCoding>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="ASCVD Diagnosis or Procedure before End of Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="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'
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Qualifying Encounter During Day of Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="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'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Initial Population 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Initial Population 1":
exists "ASCVD Diagnosis or Procedure before End of Measurement Period"
and exists "Qualifying Encounter During Day of Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Patients Aged 20 to 75 at Start of Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Patients Aged 20 to 75 at Start of Measurement Period":
AgeInYearsAt(date from start of "Measurement Period") in Interval[20, 75]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="LDL Result Greater Than or Equal To 190"/>
</extension>
<extension url="statement">
<valueString
value="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' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Hypercholesterolemia Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Hypercholesterolemia Diagnosis":
( [ConditionProblemsHealthConcerns: "Familial Hypercholesterolemia"] Hypercholesterolemia
where Hypercholesterolemia.prevalenceInterval ( ) starts on or before day of end of "Measurement Period"
and Hypercholesterolemia.isVerified ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Patients Aged 20 to 75 with LDL Cholesterol Result Greater than or Equal to 190 or Hypercholesterolemia without ASCVD"/>
</extension>
<extension url="statement">
<valueString
value="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" )"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Initial Population 2"/>
</extension>
<extension url="statement">
<valueString
value="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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</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 "SDE Race":
Patient.race R
return Tuple {
codes: R.ombCategory union R.detailed,
display: R.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="SDE Race"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Race":
SDE."SDE Race""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has Diabetes Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Diabetes Diagnosis":
exists ( [ConditionProblemsHealthConcerns: "Diabetes"] DiabetesDiagnosis
where DiabetesDiagnosis.prevalenceInterval ( ) overlaps day of "Measurement Period"
and DiabetesDiagnosis.isVerified ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Patients Aged 40 to 75 Years with Diabetes without ASCVD or LDL Greater than 190 or Hypercholesterolemia"/>
</extension>
<extension url="statement">
<valueString
value="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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Initial Population 3"/>
</extension>
<extension url="statement">
<valueString
value="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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Ten Year CVD Risk is High"/>
</extension>
<extension url="statement">
<valueString
value="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' }
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Patients Age 40 to 75 Years and have a 10 Year CVD Risk of High without ASCVD and High LDL and Diabetes"/>
</extension>
<extension url="statement">
<valueString
value="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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Initial Population 4"/>
</extension>
<extension url="statement">
<valueString
value="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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</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 "SDE Sex":
case
when Patient.sex = '248153007' then "Male (finding)"
when Patient.sex = '248152002' then "Female (finding)"
else null
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="SDE Sex"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Sex":
SDE."SDE Sex""/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator 3"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator 3":
"Initial Population 3""/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Statin Therapy Ordered during Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="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' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Medication Active during the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="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' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Numerator"/>
</extension>
<extension url="statement">
<valueString
value="define "Numerator":
exists "Statin Therapy Ordered during Measurement Period"
or exists "Medication Active during the Measurement Period""/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator 2"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator 2":
"Initial Population 2""/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator 4"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator 4":
"Initial Population 4""/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="SupplementalDataElements"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
[Coverage: type in "Payer Type"] Payer
return {
code: Payer.type,
period: Payer.period
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="24"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="SDE Payer"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Payer":
SDE."SDE Payer""/>
</extension>
<extension url="displaySequence">
<valueInteger value="25"/>
</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 "SDE Ethnicity":
Patient.ethnicity E
return Tuple {
codes: { E.ombCategory } union E.detailed,
display: E.text
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="26"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="SDE Ethnicity"/>
</extension>
<extension url="statement">
<valueString
value="define "SDE Ethnicity":
SDE."SDE Ethnicity""/>
</extension>
<extension url="displaySequence">
<valueInteger value="27"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator Exclusions"/>
</extension>
<extension url="statement">
<valueString
value="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 ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="28"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator 1"/>
</extension>
<extension url="statement">
<valueString
value="define "Denominator 1":
"Initial Population 1""/>
</extension>
<extension url="displaySequence">
<valueInteger value="29"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has Allergy to Statin"/>
</extension>
<extension url="statement">
<valueString
value="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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Hospice"/>
</extension>
<extension url="name">
<valueString value="Has Hospice Services"/>
</extension>
<extension url="statement">
<valueString
value="define "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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="31"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="PalliativeCare"/>
</extension>
<extension url="name">
<valueString value="Has Palliative Care in the Measurement Period"/>
</extension>
<extension url="statement">
<valueString
value="define "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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="32"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has Hepatitis or Liver Disease Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="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 ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="33"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has Statin Associated Muscle Symptoms"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Statin Associated Muscle Symptoms":
exists ( [ConditionProblemsHealthConcerns: "Statin Associated Muscle Symptoms"] StatinMuscleSymptom
where StatinMuscleSymptom.prevalenceInterval ( ) overlaps day of "Measurement Period"
and StatinMuscleSymptom.isVerified ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="34"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has ESRD Diagnosis"/>
</extension>
<extension url="statement">
<valueString
value="define "Has ESRD Diagnosis":
exists ( [ConditionProblemsHealthConcerns: "End Stage Renal Disease"] ESRD
where ESRD.prevalenceInterval ( ) overlaps day of "Measurement Period"
and ESRD.isVerified ( )
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="35"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Has Adverse Reaction to Statin"/>
</extension>
<extension url="statement">
<valueString
value="define "Has Adverse Reaction to Statin":
exists ( [AdverseEvent: "Statin Allergen"] StatinReaction
where Coalesce(StatinReaction.date, StatinReaction.recordedDate) during day of "Measurement Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="36"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString
value="Has Medical Reason for Not Ordering Statin Therapy"/>
</extension>
<extension url="statement">
<valueString
value="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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="37"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="Denominator Exceptions"/>
</extension>
<extension url="statement">
<valueString
value="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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="38"/>
</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<"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]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="39"/>
</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<"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>"/>
</extension>
<extension url="displaySequence">
<valueInteger value="40"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CMS347FHIRStatinPreventionTxCVD"/>
</extension>
<extension url="name">
<valueString value="isVerified"/>
</extension>
<extension url="statement">
<valueString
value="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"
)"/>
</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="toInterval"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval<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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="42"/>
</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."start" is null then
Interval(period."start".value, period."end".value]
else
Interval[period."start".value, period."end".value]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="43"/>
</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="44"/>
</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="45"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="medicationRequestPeriod"/>
</extension>
<extension url="statement">
<valueString
value="define fluent function medicationRequestPeriod(Request "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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="46"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="Quantity"/>
</extension>
<extension url="statement">
<valueString
value="/**********************************************************************/
/* Functions in this region are copied from opioid-mme-r4 */
/**********************************************************************/
define function Quantity(value Decimal, unit String):
if value is not null then
System.Quantity { value: value, unit: unit }
else
null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="47"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="CumulativeMedicationDuration"/>
</extension>
<extension url="name">
<valueString value="ToDaily"/>
</extension>
<extension url="statement">
<valueString
value="/*
Goal is to get to number of days
Two broad approaches to the calculation:
1) Based on supply and frequency, calculate the number of expected days the medication will cover/has covered
2) Based on relevant period, determine a covered interval and calculate the length of that interval in days
This topic covers several use cases and illustrates how to calculate Cumulative
Medication Duration for each type of medication resource using the supply and
frequency approach.
*/
/*
For the first approach, we need to get from frequency to a frequency/day
So we define ToDaily
*/
/*
Calculates daily frequency given frequency within a period
*/
define function ToDaily(frequency System.Integer, period System.Quantity):
case period.unit
when 'h' then frequency * (24.0 / period.value)
when 'min' then frequency * (24.0 / period.value) * 60
when 's' then frequency * (24.0 / period.value) * 60 * 60
when 'd' then frequency * (24.0 / period.value) / 24
when 'wk' then frequency * (24.0 / period.value) / (24 * 7)
when 'mo' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'a' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hour' then frequency * (24.0 / period.value)
when 'minute' then frequency * (24.0 / period.value) * 60
when 'second' then frequency * (24.0 / period.value) * 60 * 60
when 'day' then frequency * (24.0 / period.value) / 24
when 'week' then frequency * (24.0 / period.value) / (24 * 7)
when 'month' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'year' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
when 'hours' then frequency * (24.0 / period.value)
when 'minutes' then frequency * (24.0 / period.value) * 60
when 'seconds' then frequency * (24.0 / period.value) * 60 * 60
when 'days' then frequency * (24.0 / period.value) / 24
when 'weeks' then frequency * (24.0 / period.value) / (24 * 7)
when 'months' then frequency * (24.0 / period.value) / (24 * 30) /* assuming 30 days in month */
when 'years' then frequency * (24.0 / period.value) / (24 * 365) /* assuming 365 days in year */
else Message(null, true, 'CMDLogic.ToDaily.UnknownUnit', ErrorLevel, 'Unknown unit ' & period.unit)
end"/>
</extension>
<extension url="displaySequence">
<valueInteger value="48"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isEncounterPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Encounter, Performed
//General usage unless required otherwise by measure intent (e.g., follow-up encounters)
define fluent function isEncounterPerformed(Enc List<Encounter>):
Enc E
where E.status = 'finished'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="49"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isAssessmentPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Assessment, Performed
define fluent function isAssessmentPerformed(Obs List<ObservationScreeningAssessment>):
Obs O
where O.status in { 'final', 'amended', 'corrected' }"/>
</extension>
<extension url="displaySequence">
<valueInteger value="50"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionOrder"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Order
define fluent function isInterventionOrder(ServiceRequest List<ServiceRequest>):
ServiceRequest S
where S.status in { 'active', 'completed' }
and S.intent in {'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order'}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="51"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="isInterventionPerformed"/>
</extension>
<extension url="statement">
<valueString
value="//Intervention, Performed
define fluent function isInterventionPerformed(Proc List<Procedure>):
Proc P
where P.status ~ 'completed'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="52"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="Status"/>
</extension>
<extension url="name">
<valueString value="verified"/>
</extension>
<extension url="statement">
<valueString
value="//This library contains functions used to constrain FHIR resource elements for measures authored by NCQA, based on QICore 6.0.0 resources including IG and authoring patterns. The functions may appear similar to some QICoreCommon functions but differ in that they have constraints that are relevant for measures authored by NCQA.
//Condition
//Returns conditions in the given list that either have no verification status or have a verification status of confirmed, unconfirmed, provisional, or differential
define fluent function verified(conditions List<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"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="53"/>
</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="54"/>
</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 QICoreCommon"/>
<resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"/>
</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 SDE"/>
<resource
value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library CMD"/>
<resource
value="https://madie.cms.gov/Library/CumulativeMedicationDuration|6.0.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Hospice"/>
<resource value="https://madie.cms.gov/Library/Hospice|6.18.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Status"/>
<resource value="https://madie.cms.gov/Library/Status|1.15.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library PalliativeCare"/>
<resource
value="https://madie.cms.gov/Library/PalliativeCare|1.18.000"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Code system ICD10CM"/>
<resource value="http://hl7.org/fhir/sid/icd-10-cm"/>
</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="Code system LOINC"/>
<resource value="http://loinc.org"/>
</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 AllergyIntoleranceClinicalStatusCodes"/>
<resource
value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Myocardial Infarction"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.101"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Cerebrovascular Disease Stroke or TIA"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.44"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Atherosclerosis and Peripheral Arterial Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.21"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Ischemic Heart Disease or Other Related Diagnoses"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.46"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Stable and Unstable Angina"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.47"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set PCI"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1045.67"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set CABG Surgeries"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.694"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Carotid Intervention"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.204"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set CABG or PCI Procedure"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1138.566"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Annual Wellness Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Office Visit"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Outpatient Consultation"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Outpatient Encounters for Preventive Care"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1576"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Established Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Individual Counseling"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1026"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Preventive Care Services Initial Office Visit, 18 and Up"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Preventive Care Services Other"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1150"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Telemedicine Services"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.276"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set LDL Cholesterol"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Familial Hypercholesterolemia"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.100"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Diabetes"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Low Intensity Statin Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Moderate Intensity Statin Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set High Intensity Statin Therapy"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572"/>
</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 Breastfeeding"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Rhabdomyolysis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Statin Allergen"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Encounter Inpatient"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1003"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Care Ambulatory"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hospice Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Diagnosis"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Encounter"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1090"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Palliative Care Intervention"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1135"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hepatitis A"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Hepatitis B"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.67.1.101.1.269"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Liver Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Statin Associated Muscle Symptoms"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.85"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set End Stage Renal Disease"/>
<resource
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.353"/>
</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="ErrorLevel"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name value="Initial Population 1"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population 3"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Initial Population 4"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator 3"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Numerator"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator 4"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator Exclusions"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator 1"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Denominator Exceptions"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="SDE Race"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<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>
<dataRequirement>
<type value="Patient"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"/>
<mustSupport value="birthDate"/>
<mustSupport value="birthDate.value"/>
<mustSupport value="url"/>
<mustSupport value="extension"/>
</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/2.16.840.1.113762.1.4.1108.101"/>
</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"/>
<code>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="I22.2"/>
<display
value="Subsequent non-ST elevation (NSTEMI) myocardial infarction"/>
</code>
</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/2.16.840.1.113762.1.4.1047.44"/>
</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/2.16.840.1.113762.1.4.1047.21"/>
</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/2.16.840.1.113762.1.4.1047.46"/>
</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/2.16.840.1.113762.1.4.1047.47"/>
</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/2.16.840.1.113762.1.4.1047.100"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.103.12.1001"/>
</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/2.16.840.1.113762.1.4.1047.73"/>
</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/2.16.840.1.113762.1.4.1047.102"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1024"/>
</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/2.16.840.1.113883.3.67.1.101.1.269"/>
</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/2.16.840.1.113762.1.4.1047.42"/>
</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/2.16.840.1.113762.1.4.1108.85"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
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<profile
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<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
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</codeFilter>
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<dataRequirement>
<type value="Procedure"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
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<dataRequirement>
<type value="Procedure"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
<valueSet
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<dataRequirement>
<type value="Procedure"/>
<profile
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<mustSupport value="performed"/>
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<path value="code"/>
<valueSet
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<dataRequirement>
<type value="Procedure"/>
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<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
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<dataRequirement>
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<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
<valueSet
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<dataRequirement>
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<mustSupport value="performed"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
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<path value="code"/>
<valueSet
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<dataRequirement>
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<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</dataRequirement>
<dataRequirement>
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
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<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
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<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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</codeFilter>
</dataRequirement>
<dataRequirement>
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<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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<dataRequirement>
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<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1248.276"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"/>
<mustSupport value="type"/>
<mustSupport value="hospitalization"/>
<mustSupport value="hospitalization.dischargeDisposition"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"/>
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</dataRequirement>
<dataRequirement>
<type value="Encounter"/>
<profile
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<mustSupport value="type"/>
<mustSupport value="period"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="type"/>
<valueSet
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<dataRequirement>
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<mustSupport value="type"/>
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<codeFilter>
<path value="type"/>
<valueSet
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</dataRequirement>
<dataRequirement>
<type value="Observation"/>
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<mustSupport value="code"/>
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<mustSupport value="effective"/>
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<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1573"/>
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</dataRequirement>
<dataRequirement>
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<mustSupport value="code"/>
<mustSupport value="value"/>
<mustSupport value="effective"/>
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<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="99055-6"/>
<display value="Cardiovascular disease 10Y risk [Likelihood]"/>
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</codeFilter>
</dataRequirement>
<dataRequirement>
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<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="79423-0"/>
<display
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</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
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<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="45755-6"/>
<display value="Hospice care [Minimum Data Set]"/>
</code>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
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<mustSupport value="value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<codeFilter>
<path value="code"/>
<code>
<system value="http://loinc.org"/>
<code value="71007-9"/>
<display
value="Functional Assessment of Chronic Illness Therapy - Palliative Care Questionnaire (FACIT-Pal)"/>
</code>
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</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
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<mustSupport value="authoredOn"/>
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<mustSupport value="dosageInstruction"/>
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<codeFilter>
<path value="medication"/>
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value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574"/>
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<dataRequirement>
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<dataRequirement>
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<codeFilter>
<path value="medication"/>
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</dataRequirement>
<dataRequirement>
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<profile
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<mustSupport value="medication.reference.value"/>
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</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-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.73"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
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<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.102"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1165"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Condition"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"/>
<mustSupport value="code"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.1167"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="AllergyIntolerance"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"/>
<mustSupport value="code"/>
<mustSupport value="onset"/>
<mustSupport value="clinicalStatus"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="ServiceRequest"/>
<profile
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<mustSupport value="code"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="intent"/>
<mustSupport value="intent.value"/>
<codeFilter>
<path value="code"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1584"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="AdverseEvent"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent"/>
<mustSupport value="event"/>
<mustSupport value="date"/>
<mustSupport value="date.value"/>
<mustSupport value="recordedDate"/>
<mustSupport value="recordedDate.value"/>
<codeFilter>
<path value="event"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.42"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1574"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
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<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1575"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="MedicationRequest"/>
<profile
value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"/>
<mustSupport value="medication"/>
<mustSupport value="authoredOn"/>
<mustSupport value="authoredOn.value"/>
<mustSupport value="status"/>
<mustSupport value="status.value"/>
<mustSupport value="reasonCode"/>
<codeFilter>
<path value="medication"/>
<valueSet
value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1572"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance" id="supplementalDataGuidance">
<extension url="guidance">
<valueString
value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"/>
</extension>
<extension url="usage">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-data-usage"/>
<code value="supplemental-data"/>
<display value="Supplemental Data"/>
</coding>
<text value="Supplemental Data Guidance"/>
</valueCodeableConcept>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Atherosclerotic Cardiovascular Disease (ASCVD) "/>
</extension>
<extension url="definition">
<valueMarkdown
value="Clinical ASCVD includes:
* Acute coronary syndromes
* History of myocardial infarction
* Stable or unstable angina
* Coronary or other arterial revascularization
* Stroke or transient ischemic attack (TIA)
* Peripheral arterial disease of atherosclerotic origin
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Lipoprotein Density Cholesterol (LDL-C) Result"/>
</extension>
<extension url="definition">
<valueMarkdown
value="A fasting or non-fasting LDL-C laboratory test performed and direct or calculated test result documented in the medical record. When both direct and calculated test results are available on the same day, the direct LDL-C test result should be used.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString
value="Statin Medication Therapy List (NOTE: List does NOT include dosage)"/>
</extension>
<extension url="definition">
<valueMarkdown
value="\[Generic name\] (Brand or trade name) and (-) Medication type, if applicable: \[Atorvastatin\] (Lipitor) - Statin \[Fluvastatin\] (Lescol XL or Lescol) - Statin \[Lovastatin (Mevinolin)\](Mevacor or Altoprev) - Statin \[Pitavastatin\] (Livalo or Zypitamag or Nikita) - Statin \[Pravastatin Sodium\] (Pravachol) - Statin \[Rosuvastatin Calcium\] (Crestor) - Statin \[Simvastatin\] (Zocor) - Statin \[Amlodipine Besylate/Atorvastatin Calcium\] (Caduet) -- Fixed Dose Combination \[Ezetimibe / Rosuvastatin\] (Roszet) -- Fixed Dose Combination \[Ezetimibe/Simvastatin\] (Vytorin) -- Fixed Dose Combination
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Statin Therapy"/>
</extension>
<extension url="definition">
<valueMarkdown
value="Administration of one or more of a group of medications that are used to lower plasma lipoprotein levels in the treatment of hyperlipoproteinemia
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
<extension url="term">
<valueString value="Statin-Associated Muscle Symptoms (SAMS)"/>
</extension>
<extension url="definition">
<valueMarkdown
value="The 2018 ACC/AHA/MS Guideline (Grundy et al., 2019) includes the following SAMS: myalgias, myositis, myopathy, or statin-associated autoimmune myopathy. Patients who experience significant or repeated statin-associated muscle symptoms may prefer not to take or continue statin therapy and therefore may be removed from the denominator.
"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url value="https://madie.cms.gov/Measure/CMS347FHIRStatinPreventionTxCVD"/>
<identifier>
<use value="usual"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="short-name"/>
<display value="Short Name"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/shortName"/>
<value value="CMS347FHIR"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-independent"/>
<display value="Version Independent"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:4d3066c5-88f7-48d2-8a93-9f946e1a41a6"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="version-specific"/>
<display value="Version Specific"/>
</coding>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:uuid:bcebaf84-db66-4cc4-ab1b-5c95eb02d300"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"/>
<code value="publisher"/>
<display value="Publisher"/>
</coding>
</type>
<system value="https://madie.cms.gov/measure/cmsId"/>
<value value="347FHIR"/>
<assigner>
<display value="CMS"/>
</assigner>
</identifier>
<version value="1.0.000"/>
<name value="CMS347FHIRStatinPreventionTxCVD"/>
<title
value="Statin Therapy for the Prevention and Treatment of Cardiovascular DiseaseFHIR
"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-08-20T20:17:23+00:00"/>
<publisher value="Centers for Medicare &amp; Medicaid Services (CMS)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cms.gov/"/>
</telecom>
</contact>
<description
value="Percentage of the following patients - all considered at high risk of cardiovascular events - who were prescribed or were on statin therapy during the measurement period:
* All patients who were previously diagnosed with or currently have a diagnosis of clinical atherosclerotic cardiovascular disease (ASCVD), including an ASCVD procedure; OR
* Patients aged 20 to 75 years who have ever had a low-density lipoprotein cholesterol (LDL-C) level \>= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia; OR
* Patients aged 40-75 years with a diagnosis of diabetes; OR
* Patients aged 40 to 75 with a 10-year ASCVD risk score of \>= 20 percent.
"/>
<usage
value="Initial Population Guidance: The initial population covers four distinct populations. Use the following process to prevent counting patients more than once. Initial Population 1: All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period.
* If YES, meets Initial Population 1 risk category.
* If NO, screen for next risk category.
Initial Population 2:
Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory test result of LDL-C \>= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.
* If YES, meets Initial Population 2 risk category.
* If NO, screen for next risk category.
Initial Population 3:
Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period.
* If YES, meets Initial Population 3 risk category.
* If NO, screen for next risk category.
Initial Population 4:
Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score of \>= 20 percent during the measurement period.
* If YES, meets Initial Population 4 risk category.
* If NO, patient does NOT meet Initial Population criteria and is NOT eligible for measure inclusion.
Initial Population Guidance for Encounter:
In order for the patient to be included in the Initial Population, the patient must have ONE initial population-eligible visit, defined as follows: outpatient visit, initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit.
LDL-C Laboratory test result options:
The measure can be reported for all patients with a documented LDL-C level recorded as follows:
To meet Initial Population 1:
There is no LDL-C result required.
To meet Initial Population 2:
If a patient has ANY previous laboratory result of LDL-C \>= 190 mg/dL, report the highest value \>= 190 mg/dL.
To meet Initial Population 3:
There is no LDL-C result required.
To meet Initial Population 4:
There is no LDL-C result required.
The 10-year ASCVD risk assessment options:
The 10-year ASCVD risk score is calculated using the Pooled Cohort Equations: 1) the 2013 ACC/AHA ASCVD Risk Estimator (maps to LOINC Code 79423-0) OR 2) the ACC Risk Estimator Plus (maps to LOINC Code 99055-6). If your EHR does not have either of these risk calculators, we recommend that you use the on-line versions. The 10-year ASCVD risk score (quantitative result, i.e., result.value, "%") must be documented in a structured field. The 10-year ASCVD risk assessment must be performed during the measurement period. Any documentation of a 10-year ASCVD risk score \>=20 will qualify patient for the denominator population, even if risk score changes later in the measurement period.
Numerator instructions and guidance:
* Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.
* ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).
* Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.
* Statin medication "samples" provided to patients can be documented as "current statin therapy" if documented in the medication list in health/medical record.
* Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure unless they have an allowable denominator exception. Patients with an allowable denominator exception should be removed from the denominator of the measure and reported as a valid exception.
* There is only one performance rate calculated for this measure: the weighted average of the four populations.
* Adherence to statin therapy is not calculated in this measure.
* It may not be appropriate to prescribe statin therapy for some patients (see exceptions and exclusions for the complete list).
Intensity of statin therapy in primary and secondary prevention:
The expert panel of the 2018 ACC/AHA/MS Guidelines (Grundy et al., 2019) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.
Lifestyle modification coaching:
A healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.
Millimoles per liter (mmol/L) must be converted to milligrams per deciliter (mg/dL) for reporting this measure.
This eCQM is a patient-based measure.
This FHIR-based measure has been derived from the QDM-based measure CMS347v9. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
"/>
<copyright
value="This electronic clinical quality measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare \& 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="'Zhang, H., Plutzky, J., Shubina, M., \& Turchin, A. (2016). Drivers of the Sex Disparity in Statin Therapy in Patients with Coronary Artery Disease: A Cohort Study. PloS one, 11(5), e0155228. doi:10.1371/journal.pone.0155228
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., ...Munter, P. (2018). Heart disease and stroke statistics---2018 update: A report from the American Heart Association. Circulation, 137(12), e67-e492. doi.10.1161/CIR.0000000000000558
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Ference, B.A. (2015). Statins and the risk of developing new-onset Type 2 diabetes: Expert analysis. Retrieved from https://www.acc.org/latest-in-cardiology/articles/2015/03/10/08/10/statins-and-the-risk-of-developing-new-onset-type-2-diabetes
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., ...Yeboah, J. (2019) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Journal of the American College of Cardiology, 73 (24), e286-e343. doi.10.1016/j.jacc.2018.11.003
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Gu, A., Kamat, S., Argulian, E. (2018). Trends and disparities in statin use and low-density lipoprotein cholesterol levels among US patients with diabetes, 1999--2014. Diabetes Research and Clinical Practice, 139, 1-10. doi:10.1016/j.diabres.2018.02.019
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Jacobson, T. A. (2014). Executive summary: NLA Task Force on Statin Safety---2014 update. Journal of Clinical Lipidology, 8(3 Suppl.), S1-S4. doi:10.1016/jacl.2014.03.002
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Nanna, M. G., Navar, A. M., Wang, Y. T., Li, S., Virani, S. S., Li, Z., ... Peterson, E. D. (2019a). Practice-Level Variation in Statin use and Low-Density Lipoprotein Cholesterol Control in the United States: Results from the Patient and Provider Assessment of Lipid Management (PALM) Registry. American Heart Journal, 214, 113--124. doi:10.1016/j.ahj.2019.05.009
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Nanna, M. G., Wang, T. Y., Xiang, Q., Goldberg, A. C., Robinson, J. G., Roger, V. L., ... Navar, A. M. (2019b). Sex Differences in the use of Statins in Community Practice. Circulation. Cardiovascular Quality \& Outcomes, 12(8), e005562. doi:10.1161/CIRCOUTCOMES.118.005562
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Navar, M., Wang, T. Y., Li, S.,Robinson, J. G., Goldberg, A. C., Virani, S., ...Peterson, E. D. (2017). Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry. American Heart Journal, 193, 84-92. doi.10.1016/j.ahj.2017.08.005
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="Puri, R., Nissen, S. E., Shao, M., Ballantyne, C. M., Barter, P. J., Chapman, M. J., ... Nicholls, S. J. (2014). Sex-related differences of coronary atherosclerosis regression following maximally intensive statin therapy: insights from SATURN. JACC. Cardiovascular imaging, 7(10), 1013--1022. doi:10.1016/j.jcmg.2014.04.019
"/>
</relatedArtifact>
<relatedArtifact>
<type value="citation"/>
<citation
value="U.S. Preventive Services Task Force (USPSTF) (2022). Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. Journal of American Medical Association; 328(8):746-753. doi:10.1001/jama.2022.13044
"/>
</relatedArtifact>
<library
value="https://madie.cms.gov/Library/CMS347FHIRStatinPreventionTxCVD"/>
<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 "AS IS" 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=""Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 3 deaths in the United States in 2015. In 2015, stroke caused approximately 1 of every 19 deaths in the United States and the estimated annual costs for CVD and stroke were $329.7 billion, including $199.2 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $130.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group" (Benjamin et al., 2018). Data collected between 2011 and 2014 indicates that more than 94.6 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 28.5 million had levels 240 mg/dL or more (Benjamin et al., 2018). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015). In 2018, updated guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (Grundy et al., 2019). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The American College of Cardiology (ACC)/American Heart Association (AHA)/Multi-society (MS) Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of ASCVD in patients of all ages. The document concludes that the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C \>= 190 mg/dL, with diabetes, or individuals with \>= 20 percent risk of ASCVD as determined via use of an ASCVD risk estimator derived from the Pooled Cohort Equations (Grundy et al., 2019). One study surveying U.S. cardiology, primary care, and endocrinology practices found that 1 in 4 guideline-eligible patients were not on a statin and less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment (Navar et al., 2017). In a follow-up study authored by Nanna et al., the same clinics were divided into tertiles based on the percentage of patients with guideline-recommended statin use. The researchers found that patients in the high-tertile clinics were more likely to achieve target LDL-C levels than patients at the low- or mid-tertile clinics, and this held true when patients were stratified by primary and secondary prevention (Nanna et al., 2019a). Research also indicates that certain populations are far less likely to receive guideline-recommended statin therapy than others. A retrospective study of the National Health and Nutrition Examination Survey found that Black and Hispanic race or ethnicity, low income, lack of health insurance coverage, poor health care access, young age, and female gender are predictors of lower statin utilization (Gu et al., 2018). In particular, there is extensive evidence that women are far less likely than men to be prescribed guideline-recommended statin therapy (Nanna et al., 2019b), despite research showing that female patients with cardiovascular disease derive the same or greater benefit from statin therapy as male patients with cardiovascular disease (Puri et al., 2014). The Statin Safety Expert Panel that participated in a National Lipid Association (NLA) Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweigh any potential harm related to the drug (Jacobson, 2014).
"/>
<clinicalRecommendationStatement
value="This electronic clinical quality measure is intended to align with the 2018 ACC/AHA/MS Guideline on the Management of Blood Cholesterol (Grundy et al., 2019), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations. Recommendations for Management of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment: Secondary Prevention:
1. In patients who are 75 years of age or younger with clinical ASCVD, high-intensity statin therapy should be initiated or continued with the aim of achieving a 50 percent or greater reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).
2. In patients with clinical ASCVD in whom high-intensity statin therapy is contraindicated or who experience statin-associated side effects, moderate-intensity statin therapy should be initiated or continued with the aim of achieving a 30 to 49 percent reduction in LDL-C levels (Class I Recommendation), (Grundy et al., 2019).
3. In patients older than 75 years of age with clinical ASCVD, it is reasonable to initiate moderate- or high-intensity statin therapy after evaluation of the potential for ASCVD risk reduction, adverse effects, and drug--drug interactions, as well as patient frailty and patient preferences (Class IIa Recommendation), (Grundy et al., 2019).
Primary Prevention
1. In patients 20 to 75 years of age with an LDL-C level of 190 mg/dL or higher (\>= 4.9 mmol/L), maximally tolerated statin therapy is recommended. (Class I Recommendation), (Grundy et al., 2019).
2. In adults 40 to 75 years of age with diabetes mellitus, regardless of estimated 10-year ASCVD risk, moderate-intensity statin therapy is indicated (Class I Recommendation), (Grundy et al., 2019).
3. To facilitate decisions about preventive interventions, it is recommended to screen for traditional ASCVD risk factors and apply the race- and sex-specific Pooled Cohort Equations (PCE) to estimate 10-year ASCVD risk for asymptomatic adults 40 to 75 years of age. The higher the estimated risk, the more likely the patient is to benefit from statin treatment (Grundy et al., 2019).
The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that statin use for the prevention of CVD events and all-cause mortality in adults aged 40 to 75 years with no history of CVD and who have 1 or more of these CVD risk factors and an estimated 10-year CVD event risk of 7.5 percent to less than 10 percent has at least a small net benefit (USPSTF 2022).
Statin Safety and Statin-Associated Side Effects
A clinician--patient risk discussion is recommended before initiation of statin therapy to review net clinical benefit, weighing the potential for ASCVD risk reduction against the potential for statin-associated side effects, statin--drug interactions, and safety, while emphasizing that side effects can be addressed successfully (Class I Recommendation), (Grundy et al., 2019).
"/>
<group id="Group_1">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueString
value="This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged \>= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C \>= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ \[(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)\]
"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure before the end of the measurement period and were taking a statin medication during the measure period
"/>
<population id="InitialPopulation_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="All patients who were previously diagnosed with or currently have a diagnosis of clinical ASCVD, including an ASCVD procedure
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population 1"/>
</criteria>
</population>
<population id="Denominator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator 1"/>
</criteria>
</population>
<population id="DenominatorExclusion_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Patients who are breastfeeding at any time during the measurement period.
* Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_1">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period
"/>
<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="* Patients with statin-associated muscle symptoms or an allergy to statin medication.
* Patients who are receiving palliative or hospice care.
* Patients with active liver disease or hepatic disease or insufficiency.
* Patients with end-stage renal disease (ESRD). Patients with documentation of a medical reason for not being prescribed statin therapy.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exceptions"/>
</criteria>
</population>
</group>
<group id="Group_2">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueString
value="This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged \>= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C \>= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ \[(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)\]
"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C \>=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia and were taking a statin medication during the measure period
"/>
<population id="InitialPopulation_2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Patients aged 20 to 75 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C \>=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population 2"/>
</criteria>
</population>
<population id="Denominator_2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator 2"/>
</criteria>
</population>
<population id="DenominatorExclusion_2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Patients who are breastfeeding at any time during the measurement period.
* Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="DenominatorException_2">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<description
value="* Patients with statin-associated muscle symptoms or an allergy to statin medication.
* Patients who are receiving palliative or hospice care.
* Patients with active liver disease or hepatic disease or insufficiency.
* Patients with end-stage renal disease (ESRD).
* Patients with documentation of a medical reason for not being prescribed statin therapy.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exceptions"/>
</criteria>
</population>
</group>
<group id="Group_3">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation">
<valueString
value="This measure is intended to have one reporting rate, which aggregates the following populations into a single performance rate for reporting purposes: Population 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure. Population 2: Patients aged \>= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C \>= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. Population 3: Patients aged 40 to 75 years at the beginning of the measurement period with an active diagnosis of Type 1 or Type 2 diabetes at any time during the measurement period. For the purposes of this measure, a single performance rate can be calculated as follows: Performance Rate = (Numerator 1 + Numerator 2 +Numerator 3)/ \[(Denominator 1 - Denominator Exclusions 1- Denominator Exceptions 1) + (Denominator 2 - Denominator Exclusions 2 - Denominator Exceptions 2) +(Denominator 3 - Denominator Exclusions 3 - Denominator Exceptions 3)\]
"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and were taking a statin medication during the measure period
"/>
<population id="InitialPopulation_3">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population 3"/>
</criteria>
</population>
<population id="Denominator_3">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator 3"/>
</criteria>
</population>
<population id="DenominatorExclusion_3">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Patients who are breastfeeding at any time during the measurement period.
* Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_3">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="DenominatorException_3">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<description
value="* Patients with statin-associated muscle symptoms or an allergy to statin medication.
* Patients who are receiving palliative or hospice care.
* Patients with active liver disease or hepatic disease or insufficiency.
* Patients with end-stage renal disease (ESRD).
* Patients with documentation of a medical reason for not being prescribed statin therapy.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exceptions"/>
</criteria>
</population>
</group>
<group id="Group_4">
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-scoring"/>
<code value="proportion"/>
<display value="Proportion"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
<valueCode value="boolean"/>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/measure-type"/>
<code value="process"/>
<display value="Process"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"/>
<code value="increase"/>
<display value="Increased score indicates improvement"/>
</coding>
</valueCodeableConcept>
</extension>
<description
value="Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of \>= 20 percent and were taking a statin medication during the measure period
"/>
<population id="InitialPopulation_4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="initial-population"/>
<display value="Initial Population"/>
</coding>
</code>
<description
value="Patients aged 40 to 75 at the beginning of the measurement period with a 10-year ASCVD risk score (i.e., 2013 ACC/AHA ASCVD Risk Estimator or the ACC Risk Estimator Plus) of \>= 20 percent during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Initial Population 4"/>
</criteria>
</population>
<population id="Denominator_4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator"/>
<display value="Denominator"/>
</coding>
</code>
<description value="Equals Initial Population
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator 4"/>
</criteria>
</population>
<population id="DenominatorExclusion_4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exclusion"/>
<display value="Denominator Exclusion"/>
</coding>
</code>
<description
value="* Patients who are breastfeeding at any time during the measurement period.
* Patients who have a diagnosis of rhabdomyolysis at any time during the measurement period.
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Denominator Exclusions"/>
</criteria>
</population>
<population id="Numerator_4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="numerator"/>
<display value="Numerator"/>
</coding>
</code>
<description
value="Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period
"/>
<criteria>
<language value="text/cql-identifier"/>
<expression value="Numerator"/>
</criteria>
</population>
<population id="DenominatorException_4">
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/measure-population"/>
<code value="denominator-exception"/>
<display value="Denominator Exception"/>
</coding>
</code>
<description
value="* Patients with statin-associated muscle symptoms or an allergy to statin medication.
* Patients who are receiving palliative or hospice care.
* Patients with active liver disease or hepatic disease or insufficiency. Patients with end-stage renal disease (ESRD).
* Patients with documentation of a medical reason for not being prescribed statin therapy.
"/>
<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>