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

: Anticoagulation Therapy for Atrial Fibrillation/FlutterFHIR - JSON Representation

Active as of 2025-08-25

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{
  "resourceType" : "Measure",
  "id" : "CMS71FHIRSTKAnticoagAFFlutter",
  "meta" : {
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      🔗 "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"🔗 ,
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" class=\"col-12\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n<td class=\"content-container\">Anticoagulation Therapy for Atrial Fibrillation/FlutterFHIR</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n<td class=\"content-container\">1.0.000</td>\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n<td class=\"content-container\">CMS71FHIR</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n<td class=\"content-container\">urn:uuid:bc80e4cf-d267-47bf-ad0d-4d37f8ae2328</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n<td class=\"content-container\">urn:uuid:48d6fe97-e70f-4688-b24f-79c3146975be</td>\n</tr>\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">CMS Identifier</th>\n\n\n<td class=\"content-container\">71FHIR</td>\n</tr>\n\n  \n\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n<td class=\"content-container\">2026-01-01 through 2026-12-31</td>\n</tr>\n\n  \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n<td class=\"content-container\">The Joint Commission</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Developer</th>\n\n\n<td class=\"content-container\">The Joint Commission</td>\n</tr>\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n<td class=\"content-container\">Ischemic stroke patients with atrial fibrillation/flutter who are prescribed or continuing to take anticoagulation therapy at hospital discharge</td>\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n<td class=\"content-container\"><p>Measure specifications are in the Public Domain.</p>\n<p>LOINC(R) 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 copyright 2024 World Health Organization. All Rights Reserved.</p></td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n<td class=\"content-container\">These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.</td>\n</tr>\n\n\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n<td class=\"content-container\">Nonvalvular atrial fibrillation (NVAF) is a common arrhythmia and an important risk factor for stroke. It is one of several conditions and lifestyle factors that have been identified as risk factors for stroke. It has been estimated that over 2 million adults in the United States have NVAF (Kornej, 2020). While the median age of patients with atrial fibrillation is 75 years, the incidence increases with advancing age. For example, The Framingham Heart Study noted a dramatic increase in stroke risk associated with atrial fibrillation with advancing age, from 1.5% for those 50 to 59 years of age to 23.5% for those 80 to 89 years of age. Furthermore, a prior stroke or transient ischemic attack (TIA) are among a limited number of predictors of high stroke risk within the population of patients with atrial fibrillation. Therefore, much emphasis has been placed on identifying methods for preventing recurrent ischemic stroke as well as preventing first stroke. Prevention strategies focus on the modifiable risk factors such as hypertension, smoking, and atrial fibrillation. Analysis of five placebo-controlled clinical trials investigating the efficacy of warfarin in the primary prevention of thromboembolic stroke, found the relative risk of thromboembolic stroke was reduced by 68% for atrial fibrillation patients treated with warfarin. The administration of anticoagulation therapy, unless there are contraindications, is an established effective strategy in preventing recurrent stroke in high stroke risk-atrial fibrillation patients with TIA or prior stroke.</td>\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n<td class=\"content-container\">The administration of anticoagulation therapy, unless there are contraindications, is an established effective strategy in preventing recurrent stroke in high stroke risk atrial fibrillation patients with TIA or prior stroke</td>\n</tr>\n\n\n\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Berge, E., Abdelnoor, M., Nakstad, P. H., et al. (2000, April 8). Low molecular-weight heparin versus aspirin in patients with acute ischaemic stroke and atrial fibrillation: A double-blind randomised study. Lancet, 355(9211), 1205-1210.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Centers for Disease Control and Prevention. (2009, May 1). Prevalence and most common causes of disability among adults- United States, 2005. Morbidity and Mortality Weekly Report, 58(16), 421-426.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Connolly, S. J., Ezekowitz, M. D., Yusuf, S., et al. (2009, September 17). Dabigatran versus warfarin in patients with atrial fibrillation. New England Journal of Medicine, 361(12), 1139-1151.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Fuster, V., Ryden, L. E., Asinger, R. W., et al. (2001, October). ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: Executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation). Journal of the American College of Cardiology, 38(4), 1231-1266.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Fuster, V., Ryden, L. E., Cannom, D. S., et al. (2006, August 15). ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation). Circulation, 114(7), e257-354.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Goldstein, L. B., Adams, R., Alberts, M. J., et al. (2006, June). Primary prevention of ischemic stroke: A guideline from the American Heart Association/American Stroke Association Stroke Council: Cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group: The American Academy of Neurology affirms the value of this guideline. Stroke, 37(6), 1583-1633.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Gorelick, P. B., Sacco, R. L., Smith, D. B., et al. (1999, March). Prevention of a first stroke: A review of guidelines and a multidisciplinary consensus statement from the National Stroke Association. JAMA, 281(12), 1112-1120.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Hart, R. G., Benavente, O., McBride R., et al. (1999, October 5). Antithrombotic therapy to prevent stroke in patients with atrial fibrillation: A meta-analysis. Annals of Internal Medicine, 131(7), 492-501.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Jauch, E. C., Saver, J. L., Adams, H. P., Jr., et al. (2013). Guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 44(3), 870-947.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Kernan, W. N., Ovbiagele, B., Black, H. R., et al. (2014, May). Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 45(7), 2160-2223.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft, K. M., Gutierrez, J., Lombardi-Hill, D., ... Williams, L. S. (2021). 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: A guideline from the American Heart Association/American Stroke Association. Stroke, 52(7), e364-e467. https://doi.org/10.1161/STR.0000000000000375\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Lin, H. J., Wolf, P. A., Kelly-Hayes, M., et al. (1996, October). Stroke severity in atrial fibrillation: The Framingham Study. Stroke 27(10), 1760-1764\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Penado, S., Cano, M., Acha, O., et al. (2003, February 15). Atrial fibrillation as a risk factor for stroke recurrence. American Journal of Medicine, 114 (3), 206-210.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Powers, W. J., Rabinstein, A. A., Ackerson, T., et al. (2018, January). 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for health care professionals from the American Heart Association/American Stroke Association. Stroke, 49, e31-e32.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Roger, V. L., Go, A. S., Lloyd-Jones, D. M., et al. (2012, January 3). Heart disease and stroke statistics- 2012 update: A report from the American Heart Association. Circulation, 125(1), e2-e220.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Saxena, R., &amp; Koudstaal, P. J. (2011). Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack (review). Cochrane Database of Systematic Reviews, (4), CD000185.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Saxena, R., Lewis, S., Berge, E., et al. (2001, October). Risk of early death and recurrent stroke and effect of heparin in 3,169 patients with acute ischemic stroke and atrial fibrillation in the International Stroke Trial. Stroke, 32(10), 2333-2337.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Van Walraven, C., Hart, R. G., Singer, D. E., et al. (2002, November 20).Oral anticoagulants vs. aspirin in nonvalvular atrial fibrillation: An individual patient meta-analysis. JAMA, 288(19), 2441-2448.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Citation</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    \n    \n    Wann, L. S., Curtis, A. B., Ellenbogen, K. A., et al. (2011, March 15). 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 57(11), 1330-1337.\n    \n    \n    \n    \n    \n  </td>\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n<td class=\"content-container\"><p>The &quot;Nonelective Inpatient Encounter&quot; value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the &quot;Inpatient Encounter&quot; value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions.</p>\n<p/>\n<p>New or continuing anticoagulant medications are included with the use of the MedicationRequest QI-Core Profile. The Profile's community and discharge category codes indicate that the medications should be taken by or given to the patient after being discharged.</p>\n<p/>\n<p>The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.</p>\n<p/>\n<p>This dQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This FHIR-based measure has been derived from the QDM-based measure: CMS71v15. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6. (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p></td>\n</tr>\n\n\n\n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Basis</th>\n\n\n<td class=\"content-container\">Encounter</td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Scoring</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td>\n</tr>\n\n\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Type</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td>\n</tr>\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rate Aggregation</th>\n\n\n<td class=\"content-container\"><p>None</p></td>\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n<td class=\"content-container\">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td>\n</tr>\n\n\n  \n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Initial Population</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: InitialPopulation_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, that ends during the measurement period</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms71fhirstkanticoagafflutter-initial-population\">Initial Population</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Denominator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke, and a history of atrial ablation, or current or history of atrial fibrillation/flutter</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms71fhirstkanticoagafflutter-denominator\">Denominator</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exclusion</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorExclusion_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><ul>\n <li><p>Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.</p></li>\n <li><p>Inpatient hospitalizations for patients discharged to another hospital</p></li>\n <li><p>Inpatient hospitalizations for patients who left against medical advice</p></li>\n <li><p>Inpatient hospitalizations for patients who expired</p></li>\n <li><p>Inpatient hospitalizations for patients discharged to home for hospice care</p></li>\n <li><p>Inpatient hospitalizations for patients discharged to a health care facility for hospice care</p></li>\n <li><p>Inpatient hospitalizations for patients with comfort measures documented</p></li>\n</ul></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms71fhirstkanticoagafflutter-denominator-exclusions\">Denominator Exclusions</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Numerator</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: Numerator_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Inpatient hospitalizations for patients prescribed or continuing to take anticoagulation therapy at hospital discharge</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms71fhirstkanticoagafflutter-numerator\">Numerator</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n    <tr>\n      \n        \n\n<th scope=\"row\" class=\"row-header\">Denominator Exception</th>\n\n\n      \n      <td class=\"content-container\">\n        \n        <em>ID</em>: DenominatorException_1\n        <br/>\n        \n        \n          <em>Description</em>:\n          <p style=\"white-space: pre-line\" class=\"tab-one\"><p>Inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge</p></p>\n        \n        \n          \n            \n            <em>Logic Definition</em>: <a href=\"#primary-cms71fhirstkanticoagafflutter-denominator-exceptions\">Denominator Exceptions</a> \n          \n        \n      </td>\n    </tr>\n  \n\n  \n\n\n  \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Guidance</th>\n\n\n<td class=\"content-container\"><p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p></td>\n</tr>\n\n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-ethnicity\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Ethnicity\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms71fhirstkanticoagafflutter-sde-ethnicity\">SDE Ethnicity</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-payer\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Payer\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms71fhirstkanticoagafflutter-sde-payer\">SDE Payer</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-race\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Race\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms71fhirstkanticoagafflutter-sde-race\">SDE Race</a> \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n      <em>ID</em>: sde-sex\n      \n      <br/>\n      \n    \n    \n      \n        \n          <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: SDE Sex\n    \n    \n      \n        <br/>\n        \n        <em>Logic Definition</em>: <a href=\"#cms71fhirstkanticoagafflutter-sde-sex\">SDE Sex</a> \n      \n    \n  </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n<td class=\"content-container\">https://madie.cms.gov/Library/CMS71FHIRSTKAnticoagAFFlutter</td>\n</tr>\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Contents</th>\n  <td class=\"content-container\">\n    <em><a href=\"#population-criteria\">Population Criteria</a></em>\n    <br/>\n    <em><a href=\"#definitions\">Logic Definitions</a></em>\n    <br/>\n    <em><a href=\"#terminology\">Terminology</a></em>\n    <br/>\n    <em><a href=\"#dependencies\">Dependencies</a></em>\n    <br/>\n    <em><a href=\"#data-requirements\">Data Requirements</a></em>\n    <br/>\n  </td>\n</tr>\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n  \n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: Group_1)</th>\n\n\n</tr>\n  \n  \n  \n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms71fhirstkanticoagafflutter-initial-population\"> </a>\n    \n    \n    Initial Population\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms71fhirstkanticoagafflutter-denominator\"> </a>\n    \n    \n    Denominator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Encounter With A History Of Atrial Ablation&quot;\n    union &quot;Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms71fhirstkanticoagafflutter-denominator-exclusions\"> </a>\n    \n    \n    Denominator Exclusion\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  ( &quot;Denominator&quot; Encounter\n      where Encounter.status = 'finished'\n        and ( Encounter.hospitalization.dischargeDisposition in &quot;Discharge To Acute Care Facility&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Left Against Medical Advice&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Patient Expired&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Discharged to Home for Hospice Care&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Discharged to Health Care Facility for Hospice Care&quot;\n        )\n  )\n    union &quot;Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter&quot;</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms71fhirstkanticoagafflutter-numerator\"> </a>\n    \n    \n    Numerator\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  &quot;Denominator&quot; Encounter\n    with [&quot;MedicationRequest&quot;: &quot;Anticoagulant Therapy&quot;] DischargeAnticoagulant\n      such that DischargeAnticoagulant.status in { 'active', 'completed' }\n        and DischargeAnticoagulant.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( DischargeAnticoagulant.isCommunity ( )\n            or DischargeAnticoagulant.isDischarge ( )\n        )\n        and DischargeAnticoagulant.authoredOn during Encounter.period\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( DischargeAnticoagulant )\n              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n        )</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n    \n      \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n            \n              \n            \n            <tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"primary-cms71fhirstkanticoagafflutter-denominator-exceptions\"> </a>\n    \n    \n    Denominator Exception\n    \n  </th>\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  &quot;Denominator&quot; Encounter\n    with &quot;Documented Reason For Not Giving Anticoagulant At Discharge&quot; NoDischargeAnticoagulant\n      such that NoDischargeAnticoagulant.authoredOn during Encounter.period</code></pre>\n  </td>\n\n</tr>\n\n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n          \n        \n      \n    \n  \n\n  \n  \n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n  \n  \n          \n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"tjcoverall-non-elective-inpatient-encounter-with-age\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> TJCOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Non Elective Inpatient Encounter With Age&quot;:\n  [&quot;Encounter&quot;: &quot;Nonelective Inpatient Encounter&quot;] NonElectiveEncounter\n        where AgeInYearsAt(date from start of NonElectiveEncounter.period ) &gt;= 18\n         and NonElectiveEncounter.period ends during day of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"tjcoverall-ischemic-stroke-encounter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> TJCOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Ischemic Stroke Encounter&quot;:\n  &quot;Non Elective Inpatient Encounter With Age&quot; NonElectiveEncounterWithAge\n   where NonElectiveEncounterWithAge.hasPrincipalDiagnosisOf(&quot;Ischemic Stroke&quot; )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"tjcoverall-intervention-comfort-measures\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> TJCOverall</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Intervention Comfort Measures&quot;:\n  ( [&quot;ServiceRequest&quot;: &quot;Comfort Measures&quot;] ComfortCare\n    where ComfortCare.status in { 'active', 'completed', 'on-hold' }\n      and ComfortCare.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )  \n  union ( [&quot;Procedure&quot;: &quot;Comfort Measures&quot;] ComfortCarePerformed\n        where ComfortCarePerformed.status in { 'completed', 'in-progress' }\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-sex\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n    when Patient.sex = '248153007' then &quot;Male (finding)&quot;\n    when Patient.sex = '248152002' then &quot;Female (finding)&quot;\n    else null\n  end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-payer\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  [Coverage: type in &quot;Payer Type&quot;] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  Patient.ethnicity E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"supplementaldataelements-sde-race\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  Patient.race R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-sde-sex\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-encounter-with-a-history-of-atrial-ablation\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Encounter With A History Of Atrial Ablation&quot;:\n  ( TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n      where exists ( [&quot;Procedure&quot;: &quot;Atrial Ablation&quot;] AtrialAblationProcedure\n          where AtrialAblationProcedure.status = 'completed'\n            and AtrialAblationProcedure.performed.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n      )\n  )\n    union ( TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n        with [&quot;ConditionProblemsHealthConcerns&quot;: &quot;History of Atrial Ablation&quot;] AtrialAblationDiagnosis\n          such that AtrialAblationDiagnosis.verificationStatus is not null implies ( AtrialAblationDiagnosis.verificationStatus !~ QICoreCommon.&quot;refuted&quot;\n              and AtrialAblationDiagnosis.verificationStatus !~ QICoreCommon.&quot;entered-in-error&quot;\n          )\n            and AtrialAblationDiagnosis.onset.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n    )\n    union ( TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n        with [&quot;SimpleObservation&quot;: &quot;History of Atrial Ablation&quot;] AtrialAblationObservation\n          such that AtrialAblationObservation.status in { 'final', 'amended', 'corrected' }\n            and AtrialAblationObservation.effective.earliest ( ) on or before end of IschemicStrokeEncounter.period\n    )\n    union ( TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n        with [&quot;ConditionEncounterDiagnosis&quot;: &quot;History of Atrial Ablation&quot;] AtrialAblationEncDiagnosis\n          such that AtrialAblationEncDiagnosis.verificationStatus is not null implies ( AtrialAblationEncDiagnosis.verificationStatus !~ QICoreCommon.&quot;refuted&quot;\n              and AtrialAblationEncDiagnosis.verificationStatus !~ QICoreCommon.&quot;entered-in-error&quot;\n          )\n            and AtrialAblationEncDiagnosis.onset.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-encounter-with-prior-or-present-diagnosis-of-atrial-fibrillation-or-flutter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter&quot;:\n  ( TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n      with [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Atrial Fibrillation or Flutter&quot;] AtrialFibrillationFlutter\n        such that AtrialFibrillationFlutter.verificationStatus is not null implies ( AtrialFibrillationFlutter.verificationStatus !~ QICoreCommon.&quot;refuted&quot;\n            and AtrialFibrillationFlutter.verificationStatus !~ QICoreCommon.&quot;entered-in-error&quot;\n        )\n          and AtrialFibrillationFlutter.onset.toInterval ( ) starts on or before end of IschemicStrokeEncounter.period\n  )\n    union TJC.&quot;Ischemic Stroke Encounter&quot; IschemicStrokeEncounter\n      where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n          where EncounterDiagnosis.code in &quot;Atrial Fibrillation or Flutter&quot;\n      )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-denominator\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n  &quot;Encounter With A History Of Atrial Ablation&quot;\n    union &quot;Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-numerator\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n  &quot;Denominator&quot; Encounter\n    with [&quot;MedicationRequest&quot;: &quot;Anticoagulant Therapy&quot;] DischargeAnticoagulant\n      such that DischargeAnticoagulant.status in { 'active', 'completed' }\n        and DischargeAnticoagulant.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( DischargeAnticoagulant.isCommunity ( )\n            or DischargeAnticoagulant.isDischarge ( )\n        )\n        and DischargeAnticoagulant.authoredOn during Encounter.period\n        and not exists ( [&quot;TaskRejected&quot;] TaskReject\n            where TaskReject.focus.references ( DischargeAnticoagulant )\n              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n        )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-sde-payer\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-initial-population\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n  TJC.&quot;Ischemic Stroke Encounter&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-sde-ethnicity\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-encounter-with-comfort-measures-during-hospitalization-for-patients-with-documented-atrial-fibrillation-or-flutter\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter&quot;:\n  &quot;Denominator&quot; Encounter\n    with TJC.&quot;Intervention Comfort Measures&quot; ComfortMeasure\n      such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during Encounter.hospitalizationWithObservation ( )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-denominator-exclusions\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusions&quot;:\n  ( &quot;Denominator&quot; Encounter\n      where Encounter.status = 'finished'\n        and ( Encounter.hospitalization.dischargeDisposition in &quot;Discharge To Acute Care Facility&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Left Against Medical Advice&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Patient Expired&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Discharged to Home for Hospice Care&quot;\n            or Encounter.hospitalization.dischargeDisposition in &quot;Discharged to Health Care Facility for Hospice Care&quot;\n        )\n  )\n    union &quot;Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-sde-race\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-documented-reason-for-not-giving-anticoagulant-at-discharge\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Documented Reason For Not Giving Anticoagulant At Discharge&quot;:\n  ( [&quot;MedicationNotRequested&quot;: &quot;Anticoagulant Therapy&quot;] NoAnticoagulant\n      where ( NoAnticoagulant.reasonCode in &quot;Medical Reason For Not Providing Treatment&quot;\n          or NoAnticoagulant.reasonCode in &quot;Patient Refusal&quot;\n      )\n        and ( NoAnticoagulant.isCommunity ( )\n            or NoAnticoagulant.isDischarge ( )\n        )\n        and NoAnticoagulant.status in { 'active', 'completed' }\n        and NoAnticoagulant.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )\n    union ( [&quot;MedicationRequest&quot;: &quot;Anticoagulant Therapy&quot;] MedReqAntiCoagulant\n        with [&quot;TaskRejected&quot;] TaskReject\n          such that TaskReject.focus.references ( MedReqAntiCoagulant )\n            and ( TaskReject.statusReason in &quot;Medical Reason For Not Providing Treatment&quot;\n                or TaskReject.statusReason in &quot;Patient Refusal&quot;\n            )\n            and MedReqAntiCoagulant.status in { 'active', 'completed' }\n            and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cms71fhirstkanticoagafflutter-denominator-exceptions\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CMS71FHIRSTKAnticoagAFFlutter</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exceptions&quot;:\n  &quot;Denominator&quot; Encounter\n    with &quot;Documented Reason For Not Giving Anticoagulant At Discharge&quot; NoDischargeAnticoagulant\n      such that NoDischargeAnticoagulant.authoredOn during Encounter.period</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.&quot;start&quot; is null then\n            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]\n        else\n            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-toconcept\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"fhirhelpers-tocode\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-references\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if any of the given references are to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(references List&lt;Reference&gt;, resource Resource):\n  exists (references R where R.references(resource))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-references\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n  resource.id = Last(Split(reference.reference, '/'))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-includescode\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given code is in the given codeList\n@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.\n*/\ndefine fluent function includesCode(codeList List&lt;Concept&gt;, code Code):\n  exists (codeList C where C ~ code)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-references\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given reference is to the given resourceId\n@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resourceId String):\n  resourceId = Last(Split(reference.reference, '/'))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-tointerval\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval\n*/\ndefine fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval&lt;DateTime&gt; then\n  \t\tchoice as Interval&lt;DateTime&gt;\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval&lt;Quantity&gt; then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;\n\t\telse\n\t\t\tnull as Interval&lt;DateTime&gt;\n\tend</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-earliest\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):\n  (choice.toInterval()) period\n    return\n      if (period.&quot;hasStart&quot;()) then start of period\n      else end of period</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-hasstart\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Given an interval, return true if the interval has a starting boundary specified\n(i.e. the start of the interval is not null and not the minimum DateTime value)\n*/\ndefine fluent function hasStart(period Interval&lt;DateTime&gt; ):\n  not ( start of period is null\n      or start of period = minimum DateTime\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-iscommunity\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given MedicationRequest has a category of Community\n*/\ndefine fluent function isCommunity(medicationRequest Choice&lt;MedicationRequest, MedicationNotRequested&gt;):\n  exists (medicationRequest.category C\n    where C ~ Community\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"qicorecommon-isdischarge\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> QICoreCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns true if the given MedicationRequest has a category of Discharge\n*/\ndefine fluent function isDischarge(medicationRequest Choice&lt;MedicationRequest, MedicationNotRequested&gt;):\n  exists (medicationRequest.category C\n    where C ~ Discharge\n  )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-hasprincipaldiagnosisof\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n @description: Returns the condition that is specified as the principal diagnosis for the encounter and has a code in the given valueSet.\n @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n */\n define fluent function hasPrincipalDiagnosisOf(encounter Encounter, valueSet ValueSet):\n   (encounter.principalDiagnosis()) PD\n     return PD.diagnosis in valueSet\n       or PD.diagnosis.getCondition().code in valueSet</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-principaldiagnosis\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the claim diagnosis element that is specified as the principal diagnosis for the encounter\n @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n*/\ndefine fluent function principalDiagnosis(encounter Encounter):\nsingleton from (\n     (encounter.claimDiagnosis()) CD\n       where CD.type.includesCode(&quot;Principal Diagnosis&quot;)\n   )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-claimdiagnosis\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the claim diagnosis elements for the given encounter\n@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n*/\ndefine fluent function claimDiagnosis(encounter Encounter):\n  encounter E\n    let \n      claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),\n      claimItem: (claim.item I where I.encounter.references(E))\n    return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-getcondition\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Returns the Condition resource for the given reference\n*/\ndefine fluent function getCondition(reference Reference):\n  singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-encounterdiagnosis\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*  \n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  \n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n  Encounter.reasonReference D\n    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    \n      \n      <a name=\"cqmcommon-hospitalizationwithobservation\"> </a>\n    \n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> CQMCommon</td>\n\n</tr>\n<tr>\n\n  <td>\n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter\n*/\ndefine fluent function hospitalizationWithObservation(TheEncounter Encounter ):\n  TheEncounter Visit\n  \t\tlet ObsVisit: Last([Encounter: &quot;Observation Services&quot;] LastObs\n  \t\t\t\twhere LastObs.status = 'finished'\n            and LastObs.period ends 1 hour or less on or before start of Visit.period\n  \t\t\t\tsort by end of period\n  \t\t\t),\n  \t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n  \t\t\tEDVisit: Last([Encounter: &quot;Emergency Department Visit&quot;] LastED\n  \t\t\t\twhere LastED.status = 'finished'\n            and LastED.period ends 1 hour or less on or before VisitStart\n  \t\t\t\tsort by end of period\n  \t\t\t)\n  \t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]</code></pre>\n  </td>\n\n</tr>\n\n\n\n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n  \n  \n  \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system SNOMEDCT\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://snomed.info/sct\n    <br/>\n    <em>Canonical URL</em>: <tt>http://snomed.info/sct</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system Diagnosis Type\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/ex-diagnosistype\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system ConditionVerificationStatusCodes\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system MedicationRequestCategory\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://terminology.hl7.org/CodeSystem/medicationrequest-category\n    <br/>\n    <em>Canonical URL</em>: <tt>http://terminology.hl7.org/CodeSystem/medicationrequest-category</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system TaskCodeSystem\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://hl7.org/fhir/CodeSystem/task-code\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Nonelective Inpatient Encounter\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Ischemic Stroke\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Atrial Ablation\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.203\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.203</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set History of Atrial Ablation\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Atrial Fibrillation or Flutter\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Anticoagulant Therapy\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.200\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.200</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Payer Type\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Discharge To Acute Care Facility\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Left Against Medical Advice\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Patient Expired\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.309</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Discharged to Home for Hospice Care\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.209</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Discharged to Health Care Facility for Hospice Care\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.207</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Comfort Measures\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Observation Services\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Emergency Department Visit\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Medical Reason For Not Providing Treatment\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Patient Refusal\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93</tt>\n    \n  </td>\n</tr>\n \n\n\n  \n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Male (finding)\n        <br/>\n      \n      <em>Code</em>: 248153007\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Female (finding)\n        <br/>\n      \n      <em>Code</em>: 248152002\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Principal Diagnosis\n        <br/>\n      \n      <em>Code</em>: principal\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/ex-diagnosistype</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Refuted\n        <br/>\n      \n      <em>Code</em>: refuted\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Entered in Error\n        <br/>\n      \n      <em>Code</em>: entered-in-error\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Community\n        <br/>\n      \n      <em>Code</em>: community\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/medicationrequest-category</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Discharge\n        <br/>\n      \n      <em>Code</em>: discharge\n      <br/>\n      <em>System</em>: <tt>http://terminology.hl7.org/CodeSystem/medicationrequest-category</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Fulfill\n        <br/>\n      \n      <em>Code</em>: fulfill\n      <br/>\n      <em>System</em>: <tt>http://hl7.org/fhir/CodeSystem/task-code</tt>\n    </td>\n  </tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n  \n  \n  \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: QICore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library SDE\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRHelpers\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library TJC\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/TJCOverall|8.25.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/TJCOverall|8.25.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library CQMCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/CQMCommon|4.1.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/CQMCommon|4.1.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library QICoreCommon\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000\n    <br/>\n    <em>Canonical URL</em>: <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt>\n    \n  </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n  \n  \n  \n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: extension, birthDate, birthDate.value, url\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, status, status.value, period, diagnosis, diagnosis.code, hospitalization, hospitalization.dischargeDisposition\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1111.143\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, status, status.value, period, diagnosis, diagnosis.code, hospitalization, hospitalization.dischargeDisposition\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, diagnosis, diagnosis.code, status, status.value, hospitalization, hospitalization.dischargeDisposition\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Resource\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/StructureDefinition/Resource\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: id, id.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Claim\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: status, status.value, use, use.value, item\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, verificationStatus, onset\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis\n    <br/>        \n  \n   \n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, verificationStatus, onset\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, verificationStatus, onset\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status, status.value, performed\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.203\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status, status.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-simple-observation\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status, status.value, effective\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, status, status.value, intent, intent.value, authoredOn, authoredOn.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.200\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication.reference.value, status, status.value, intent, intent.value, authoredOn, authoredOn.value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Medication\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: id.value, code\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Task\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: focus, code, statusReason\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Coverage\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: ServiceRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status, status.value, intent, intent.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/1.3.6.1.4.1.33895.1.3.0.45\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: MedicationRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: medication, reasonCode, status, status.value, intent, intent.value\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: medication</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.200\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n  \n  \n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "effective-data-requirements",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248153007",
            "display" : "Male (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://snomed.info/sct",
            "code" : "248152002",
            "display" : "Female (finding)"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
            "code" : "principal",
            "display" : "Principal Diagnosis"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "refuted",
            "display" : "Refuted"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/condition-ver-status",
            "code" : "entered-in-error",
            "display" : "Entered in Error"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
            "code" : "community",
            "display" : "Community"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
            "code" : "discharge",
            "display" : "Discharge"
          }
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
          "valueCoding" : {
            "system" : "http://hl7.org/fhir/CodeSystem/task-code",
            "code" : "fulfill",
            "display" : "Fulfill"
          }
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  case\n    when Patient.sex = '248153007' then \"Male (finding)\"\n    when Patient.sex = '248152002' then \"Female (finding)\"\n    else null\n  end"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 0
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "SDE Sex"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Sex\":\n  SDE.\"SDE Sex\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 1
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TJCOverall"
            },
            {
              "url" : "name",
              "valueString" : "Non Elective Inpatient Encounter With Age"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Non Elective Inpatient Encounter With Age\":\n  [\"Encounter\": \"Nonelective Inpatient Encounter\"] NonElectiveEncounter\n        where AgeInYearsAt(date from start of NonElectiveEncounter.period ) >= 18\n         and NonElectiveEncounter.period ends during day of \"Measurement Period\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 2
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TJCOverall"
            },
            {
              "url" : "name",
              "valueString" : "Ischemic Stroke Encounter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Ischemic Stroke Encounter\":\n  \"Non Elective Inpatient Encounter With Age\" NonElectiveEncounterWithAge\n   where NonElectiveEncounterWithAge.hasPrincipalDiagnosisOf(\"Ischemic Stroke\" )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 3
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Encounter With A History Of Atrial Ablation"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Encounter With A History Of Atrial Ablation\":\n  ( TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n      where exists ( [\"Procedure\": \"Atrial Ablation\"] AtrialAblationProcedure\n          where AtrialAblationProcedure.status = 'completed'\n            and AtrialAblationProcedure.performed.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n      )\n  )\n    union ( TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n        with [\"ConditionProblemsHealthConcerns\": \"History of Atrial Ablation\"] AtrialAblationDiagnosis\n          such that AtrialAblationDiagnosis.verificationStatus is not null implies ( AtrialAblationDiagnosis.verificationStatus !~ QICoreCommon.\"refuted\"\n              and AtrialAblationDiagnosis.verificationStatus !~ QICoreCommon.\"entered-in-error\"\n          )\n            and AtrialAblationDiagnosis.onset.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n    )\n    union ( TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n        with [\"SimpleObservation\": \"History of Atrial Ablation\"] AtrialAblationObservation\n          such that AtrialAblationObservation.status in { 'final', 'amended', 'corrected' }\n            and AtrialAblationObservation.effective.earliest ( ) on or before end of IschemicStrokeEncounter.period\n    )\n    union ( TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n        with [\"ConditionEncounterDiagnosis\": \"History of Atrial Ablation\"] AtrialAblationEncDiagnosis\n          such that AtrialAblationEncDiagnosis.verificationStatus is not null implies ( AtrialAblationEncDiagnosis.verificationStatus !~ QICoreCommon.\"refuted\"\n              and AtrialAblationEncDiagnosis.verificationStatus !~ QICoreCommon.\"entered-in-error\"\n          )\n            and AtrialAblationEncDiagnosis.onset.toInterval ( ) starts before start of IschemicStrokeEncounter.period\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 4
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter\":\n  ( TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n      with [\"ConditionProblemsHealthConcerns\": \"Atrial Fibrillation or Flutter\"] AtrialFibrillationFlutter\n        such that AtrialFibrillationFlutter.verificationStatus is not null implies ( AtrialFibrillationFlutter.verificationStatus !~ QICoreCommon.\"refuted\"\n            and AtrialFibrillationFlutter.verificationStatus !~ QICoreCommon.\"entered-in-error\"\n        )\n          and AtrialFibrillationFlutter.onset.toInterval ( ) starts on or before end of IschemicStrokeEncounter.period\n  )\n    union TJC.\"Ischemic Stroke Encounter\" IschemicStrokeEncounter\n      where exists ( ( IschemicStrokeEncounter.encounterDiagnosis ( ) ) EncounterDiagnosis\n          where EncounterDiagnosis.code in \"Atrial Fibrillation or Flutter\"\n      )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 5
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Denominator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator\":\n  \"Encounter With A History Of Atrial Ablation\"\n    union \"Encounter With Prior Or Present Diagnosis Of Atrial Fibrillation Or Flutter\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 6
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Numerator"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Numerator\":\n  \"Denominator\" Encounter\n    with [\"MedicationRequest\": \"Anticoagulant Therapy\"] DischargeAnticoagulant\n      such that DischargeAnticoagulant.status in { 'active', 'completed' }\n        and DischargeAnticoagulant.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n        and ( DischargeAnticoagulant.isCommunity ( )\n            or DischargeAnticoagulant.isDischarge ( )\n        )\n        and DischargeAnticoagulant.authoredOn during Encounter.period\n        and not exists ( [\"TaskRejected\"] TaskReject\n            where TaskReject.focus.references ( DischargeAnticoagulant )\n              and TaskReject.code ~ QICoreCommon.\"Fulfill\"\n        )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 7
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  [Coverage: type in \"Payer Type\"] Payer\n    return {\n      code: Payer.type,\n      period: Payer.period\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 8
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "SDE Payer"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 9
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Initial Population"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Initial Population\":\n  TJC.\"Ischemic Stroke Encounter\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 10
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  Patient.ethnicity E\n    return Tuple {\n      codes: { E.ombCategory } union E.detailed,\n      display: E.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 11
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "SDE Ethnicity"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 12
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "TJCOverall"
            },
            {
              "url" : "name",
              "valueString" : "Intervention Comfort Measures"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Intervention Comfort Measures\":\n  ( [\"ServiceRequest\": \"Comfort Measures\"] ComfortCare\n    where ComfortCare.status in { 'active', 'completed', 'on-hold' }\n      and ComfortCare.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )  \n  union ( [\"Procedure\": \"Comfort Measures\"] ComfortCarePerformed\n        where ComfortCarePerformed.status in { 'completed', 'in-progress' }\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 13
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter\":\n  \"Denominator\" Encounter\n    with TJC.\"Intervention Comfort Measures\" ComfortMeasure\n      such that Coalesce(start of ComfortMeasure.performed.toInterval(), ComfortMeasure.authoredOn) during Encounter.hospitalizationWithObservation ( )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 14
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exclusions"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exclusions\":\n  ( \"Denominator\" Encounter\n      where Encounter.status = 'finished'\n        and ( Encounter.hospitalization.dischargeDisposition in \"Discharge To Acute Care Facility\"\n            or Encounter.hospitalization.dischargeDisposition in \"Left Against Medical Advice\"\n            or Encounter.hospitalization.dischargeDisposition in \"Patient Expired\"\n            or Encounter.hospitalization.dischargeDisposition in \"Discharged to Home for Hospice Care\"\n            or Encounter.hospitalization.dischargeDisposition in \"Discharged to Health Care Facility for Hospice Care\"\n        )\n  )\n    union \"Encounter With Comfort Measures During Hospitalization For Patients With Documented Atrial Fibrillation Or Flutter\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 15
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "SupplementalDataElements"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  Patient.race R\n    return Tuple {\n      codes: R.ombCategory union R.detailed,\n      display: R.text\n    }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 16
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "SDE Race"
            },
            {
              "url" : "statement",
              "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 17
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Documented Reason For Not Giving Anticoagulant At Discharge"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Documented Reason For Not Giving Anticoagulant At Discharge\":\n  ( [\"MedicationNotRequested\": \"Anticoagulant Therapy\"] NoAnticoagulant\n      where ( NoAnticoagulant.reasonCode in \"Medical Reason For Not Providing Treatment\"\n          or NoAnticoagulant.reasonCode in \"Patient Refusal\"\n      )\n        and ( NoAnticoagulant.isCommunity ( )\n            or NoAnticoagulant.isDischarge ( )\n        )\n        and NoAnticoagulant.status in { 'active', 'completed' }\n        and NoAnticoagulant.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }\n  )\n    union ( [\"MedicationRequest\": \"Anticoagulant Therapy\"] MedReqAntiCoagulant\n        with [\"TaskRejected\"] TaskReject\n          such that TaskReject.focus.references ( MedReqAntiCoagulant )\n            and ( TaskReject.statusReason in \"Medical Reason For Not Providing Treatment\"\n                or TaskReject.statusReason in \"Patient Refusal\"\n            )\n            and MedReqAntiCoagulant.status in { 'active', 'completed' }\n            and TaskReject.code ~ QICoreCommon.\"Fulfill\"\n    )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 18
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CMS71FHIRSTKAnticoagAFFlutter"
            },
            {
              "url" : "name",
              "valueString" : "Denominator Exceptions"
            },
            {
              "url" : "statement",
              "valueString" : "define \"Denominator Exceptions\":\n  \"Denominator\" Encounter\n    with \"Documented Reason For Not Giving Anticoagulant At Discharge\" NoDischargeAnticoagulant\n      such that NoDischargeAnticoagulant.authoredOn during Encounter.period"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 19
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToString"
            },
            {
              "url" : "statement",
              "valueString" : "define function ToString(value uri): value.value"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 20
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 21
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "hasPrincipalDiagnosisOf"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n @description: Returns the condition that is specified as the principal diagnosis for the encounter and has a code in the given valueSet.\n @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n */\n define fluent function hasPrincipalDiagnosisOf(encounter Encounter, valueSet ValueSet):\n   (encounter.principalDiagnosis()) PD\n     return PD.diagnosis in valueSet\n       or PD.diagnosis.getCondition().code in valueSet"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 22
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "principalDiagnosis"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the claim diagnosis element that is specified as the principal diagnosis for the encounter\n @comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n*/\ndefine fluent function principalDiagnosis(encounter Encounter):\nsingleton from (\n     (encounter.claimDiagnosis()) CD\n       where CD.type.includesCode(\"Principal Diagnosis\")\n   )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 23
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "claimDiagnosis"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the claim diagnosis elements for the given encounter\n@comment: See the QICore 6 Authoring Patterns discussion on [Principal Diagnosis and Present on Admission](https://github.com/cqframework/CQL-Formatting-and-Usage-Wiki/wiki/Authoring-Patterns-QICore-v6.0.0#conditions-present-on-admission-and-principal-diagnoses) for more information\n*/\ndefine fluent function claimDiagnosis(encounter Encounter):\n  encounter E\n    let \n      claim: ([Claim] C where C.status = 'active' and C.use = 'claim' and exists (C.item I where I.encounter.references(E))),\n      claimItem: (claim.item I where I.encounter.references(E))\n    return claim.diagnosis D where D.sequence in claimItem.diagnosisSequence"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 24
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "references"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if any of the given references are to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(references List<Reference>, resource Resource):\n  exists (references R where R.references(resource))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 25
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "references"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given reference is to the given resource\n@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resource Resource):\n  resource.id = Last(Split(reference.reference, '/'))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 26
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "includesCode"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given code is in the given codeList\n@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.\n*/\ndefine fluent function includesCode(codeList List<Concept>, code Code):\n  exists (codeList C where C ~ code)"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 27
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToConcept"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 28
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "FHIRHelpers"
            },
            {
              "url" : "name",
              "valueString" : "ToCode"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 29
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "getCondition"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns the Condition resource for the given reference\n*/\ndefine fluent function getCondition(reference Reference):\n  singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where reference.references(C.id))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 30
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "references"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given reference is to the given resourceId\n@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.\nNOTE: This function assumes resources from the same source server.\n*/\ndefine fluent function references(reference Reference, resourceId String):\n  resourceId = Last(Split(reference.reference, '/'))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 31
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "toInterval"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval\n@comment: Normalizes a choice type of DateTime, Quanitty, Interval<DateTime>, or Interval<Quantity> types\nto an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible\nrepresentations for timing-valued elements in QICore, allowing this function to be used across any resource.\nThe input can be provided as a DateTime, Quantity, Interval<DateTime> or Interval<Quantity>.\nThe intent of this function is to provide a clear and concise mechanism to treat single\nelements that have multiple possible representations as intervals so that logic doesn't have to account\nfor the variability. More complex calculations (such as medication request period or dispense period\ncalculation) need specific guidance and consideration. That guidance may make use of this function, but\nthe focus of this function is on single element calculations where the semantics are unambiguous.\nIf the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.\nIf the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,\nand the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.\nIf the input is a DateTime Interval, the result is the input.\nIf the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result\nis a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending\nimmediately before one year later than the date the patient turned the age given as the end of the quantity interval.\nIf the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval\n*/\ndefine fluent function toInterval(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>, Timing>):\n  case\n\t  when choice is DateTime then\n    \tInterval[choice as DateTime, choice as DateTime]\n\t\twhen choice is Interval<DateTime> then\n  \t\tchoice as Interval<DateTime>\n\t\twhen choice is Quantity then\n\t\t  Interval[Patient.birthDate + (choice as Quantity),\n\t\t\t  Patient.birthDate + (choice as Quantity) + 1 year)\n\t\twhen choice is Interval<Quantity> then\n\t\t  Interval[Patient.birthDate + (choice.low as Quantity),\n\t\t\t  Patient.birthDate + (choice.high as Quantity) + 1 year)\n\t\twhen choice is Timing then\n      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval<DateTime>\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 32
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "earliest"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Given an interval, return the starting point if the interval has a starting boundary specified,\notherwise, return the ending point\n*/\ndefine fluent function earliest(choice Choice<DateTime, Quantity, Interval<DateTime>, Interval<Quantity>> ):\n  (choice.toInterval()) period\n    return\n      if (period.\"hasStart\"()) then start of period\n      else end of period"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 33
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "hasStart"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Given an interval, return true if the interval has a starting boundary specified\n(i.e. the start of the interval is not null and not the minimum DateTime value)\n*/\ndefine fluent function hasStart(period Interval<DateTime> ):\n  not ( start of period is null\n      or start of period = minimum DateTime\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 34
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "encounterDiagnosis"
            },
            {
              "url" : "statement",
              "valueString" : "/*  \n@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  \n*/\ndefine fluent function encounterDiagnosis(Encounter Encounter ):\n  Encounter.reasonReference D\n    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 35
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "isCommunity"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given MedicationRequest has a category of Community\n*/\ndefine fluent function isCommunity(medicationRequest Choice<MedicationRequest, MedicationNotRequested>):\n  exists (medicationRequest.category C\n    where C ~ Community\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 36
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "QICoreCommon"
            },
            {
              "url" : "name",
              "valueString" : "isDischarge"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Returns true if the given MedicationRequest has a category of Discharge\n*/\ndefine fluent function isDischarge(medicationRequest Choice<MedicationRequest, MedicationNotRequested>):\n  exists (medicationRequest.category C\n    where C ~ Discharge\n  )"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 37
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        },
        {
          "extension" : [
            {
              "url" : "libraryName",
              "valueString" : "CQMCommon"
            },
            {
              "url" : "name",
              "valueString" : "hospitalizationWithObservation"
            },
            {
              "url" : "statement",
              "valueString" : "/*\n@description: Hospitalization with Observation returns the total interval from the start of any immediately prior emergency department visit through the observation visit to the discharge of the given encounter\n*/\ndefine fluent function hospitalizationWithObservation(TheEncounter Encounter ):\n  TheEncounter Visit\n  \t\tlet ObsVisit: Last([Encounter: \"Observation Services\"] LastObs\n  \t\t\t\twhere LastObs.status = 'finished'\n            and LastObs.period ends 1 hour or less on or before start of Visit.period\n  \t\t\t\tsort by end of period\n  \t\t\t),\n  \t\t\tVisitStart: Coalesce(start of ObsVisit.period, start of Visit.period),\n  \t\t\tEDVisit: Last([Encounter: \"Emergency Department Visit\"] LastED\n  \t\t\t\twhere LastED.status = 'finished'\n            and LastED.period ends 1 hour or less on or before VisitStart\n  \t\t\t\tsort by end of period\n  \t\t\t)\n  \t\treturn Interval[Coalesce(start of EDVisit.period, VisitStart), end of Visit.period]"
            },
            {
              "url" : "displaySequence",
              "valueInteger" : 38
            }
          ],
          "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
        }
      ],
      "name" : "EffectiveDataRequirements",
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "module-definition"
          }
        ]
      },
      "relatedArtifact" : [
        {
          "type" : "depends-on",
          "display" : "QICore model information",
          "resource" : "http://hl7.org/fhir/Library/QICore-ModelInfo"
        },
        {
          "type" : "depends-on",
          "display" : "Library SDE",
          "resource" : "https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library FHIRHelpers",
          "resource" : "https://madie.cms.gov/Library/FHIRHelpers|4.4.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library TJC",
          "resource" : "https://madie.cms.gov/Library/TJCOverall|8.25.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library CQMCommon",
          "resource" : "https://madie.cms.gov/Library/CQMCommon|4.1.000"
        },
        {
          "type" : "depends-on",
          "display" : "Library QICoreCommon",
          "resource" : "https://madie.cms.gov/Library/QICoreCommon|4.0.000"
        },
        {
          "type" : "depends-on",
          "display" : "Code system SNOMEDCT",
          "resource" : "http://snomed.info/sct"
        },
        {
          "type" : "depends-on",
          "display" : "Code system Diagnosis Type",
          "resource" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype"
        },
        {
          "type" : "depends-on",
          "display" : "Code system ConditionVerificationStatusCodes",
          "resource" : "http://terminology.hl7.org/CodeSystem/condition-ver-status"
        },
        {
          "type" : "depends-on",
          "display" : "Code system MedicationRequestCategory",
          "resource" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category"
        },
        {
          "type" : "depends-on",
          "display" : "Code system TaskCodeSystem",
          "resource" : "http://hl7.org/fhir/CodeSystem/task-code"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Nonelective Inpatient Encounter",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.424"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Ischemic Stroke",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.247"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Atrial Ablation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.203"
        },
        {
          "type" : "depends-on",
          "display" : "Value set History of Atrial Ablation",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1110.76"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Atrial Fibrillation or Flutter",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.202"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Anticoagulant Therapy",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.200"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Payer Type",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Discharge To Acute Care Facility",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.87"
        },
        {
          "type" : "depends-on",
          "display" : "Value set Left Against Medical Advice",
          "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.308"
        },
        {
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  "experimental" : false,
  "date" : "2025-08-25T20:31:06+00:00",
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  "copyright" : "Measure specifications are in the Public Domain.\n\nLOINC(R) 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 copyright 2024 World Health Organization. All Rights Reserved.\n",
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  "relatedArtifact" : [
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    },
    {
      "type" : "citation",
      "citation" : "Saxena, R., Lewis, S., Berge, E., et al. (2001, October). Risk of early death and recurrent stroke and effect of heparin in 3,169 patients with acute ischemic stroke and atrial fibrillation in the International Stroke Trial. Stroke, 32(10), 2333-2337.\n"
    },
    {
      "type" : "citation",
      "citation" : "Van Walraven, C., Hart, R. G., Singer, D. E., et al. (2002, November 20).Oral anticoagulants vs. aspirin in nonvalvular atrial fibrillation: An individual patient meta-analysis. JAMA, 288(19), 2441-2448.\n"
    },
    {
      "type" : "citation",
      "citation" : "Wann, L. S., Curtis, A. B., Ellenbogen, K. A., et al. (2011, March 15). 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology, 57(11), 1330-1337.\n"
    }
  ],
  "library" : [
    🔗 "https://madie.cms.gov/Library/CMS71FHIRSTKAnticoagAFFlutter"
  ],
  "disclaimer" : "These performance measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The measures and specifications are provided without warranty.\n",
  "rationale" : "Nonvalvular atrial fibrillation (NVAF) is a common arrhythmia and an important risk factor for stroke. It is one of several conditions and lifestyle factors that have been identified as risk factors for stroke. It has been estimated that over 2 million adults in the United States have NVAF (Kornej, 2020). While the median age of patients with atrial fibrillation is 75 years, the incidence increases with advancing age. For example, The Framingham Heart Study noted a dramatic increase in stroke risk associated with atrial fibrillation with advancing age, from 1.5% for those 50 to 59 years of age to 23.5% for those 80 to 89 years of age. Furthermore, a prior stroke or transient ischemic attack (TIA) are among a limited number of predictors of high stroke risk within the population of patients with atrial fibrillation. Therefore, much emphasis has been placed on identifying methods for preventing recurrent ischemic stroke as well as preventing first stroke. Prevention strategies focus on the modifiable risk factors such as hypertension, smoking, and atrial fibrillation. Analysis of five placebo-controlled clinical trials investigating the efficacy of warfarin in the primary prevention of thromboembolic stroke, found the relative risk of thromboembolic stroke was reduced by 68% for atrial fibrillation patients treated with warfarin. The administration of anticoagulation therapy, unless there are contraindications, is an established effective strategy in preventing recurrent stroke in high stroke risk-atrial fibrillation patients with TIA or prior stroke.\n",
  "clinicalRecommendationStatement" : "The administration of anticoagulation therapy, unless there are contraindications, is an established effective strategy in preventing recurrent stroke in high stroke risk atrial fibrillation patients with TIA or prior stroke\n",
  "group" : [
    {
      "id" : "Group_1",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                "code" : "proportion",
                "display" : "Proportion"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis",
          "valueCode" : "Encounter"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
                "code" : "process",
                "display" : "Process"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-rateAggregation",
          "valueString" : "None\n"
        },
        {
          "url" : "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
                "code" : "increase",
                "display" : "Increased score indicates improvement"
              }
            ]
          }
        }
      ],
      "population" : [
        {
          "id" : "InitialPopulation_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "initial-population",
                "display" : "Initial Population"
              }
            ]
          },
          "description" : "Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, that ends during the measurement period\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Initial Population"
          }
        },
        {
          "id" : "Denominator_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator",
                "display" : "Denominator"
              }
            ]
          },
          "description" : "Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke, and a history of atrial ablation, or current or history of atrial fibrillation/flutter\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator"
          }
        },
        {
          "id" : "DenominatorExclusion_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exclusion",
                "display" : "Denominator Exclusion"
              }
            ]
          },
          "description" : "* Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.\n\n* Inpatient hospitalizations for patients discharged to another hospital\n\n* Inpatient hospitalizations for patients who left against medical advice\n\n* Inpatient hospitalizations for patients who expired\n\n* Inpatient hospitalizations for patients discharged to home for hospice care\n\n* Inpatient hospitalizations for patients discharged to a health care facility for hospice care\n\n* Inpatient hospitalizations for patients with comfort measures documented\n\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exclusions"
          }
        },
        {
          "id" : "Numerator_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "numerator",
                "display" : "Numerator"
              }
            ]
          },
          "description" : "Inpatient hospitalizations for patients prescribed or continuing to take anticoagulation therapy at hospital discharge\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Numerator"
          }
        },
        {
          "id" : "DenominatorException_1",
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                "code" : "denominator-exception",
                "display" : "Denominator Exception"
              }
            ]
          },
          "description" : "Inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge\n",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "Denominator Exceptions"
          }
        }
      ]
    }
  ],
  "supplementalData" : [
    {
      "id" : "sde-ethnicity",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Ethnicity\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Ethnicity"
      }
    },
    {
      "id" : "sde-payer",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Payer\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Payer"
      }
    },
    {
      "id" : "sde-race",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Race\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Race"
      }
    },
    {
      "id" : "sde-sex",
      "usage" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
              "code" : "supplemental-data"
            }
          ]
        }
      ],
      "description" : "SDE Sex\n",
      "criteria" : {
        "language" : "text/cql-identifier",
        "expression" : "SDE Sex"
      }
    }
  ]
}