Quality Measure Implementation Guide (STU3 Ballot)
2.1.0 - ballot

This page is part of the Quality Measure STU2 for FHIR R4 Implementation Guide (v2.1.0: STU3 Ballot 1) based on FHIR R4. The current version which supercedes this version is 3.0.0. For a full list of available versions, see the Directory of published versions

: Pneumococcal Vaccination Status for Older Adults - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Measure;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "PVSComponent"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm>     ], [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm";
       fhir:index 1;
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm>     ]
  ];
  fhir:Resource.language [ fhir:value "en"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">PVSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\">http://hl7.org/fhir/us/cqfmeasures/Measure/PVSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.0.001</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">PVSComponent</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">Pneumococcal Vaccination Status for Older Adults</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">draft</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">true</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Scoring: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-scoring</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>proportion</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>display: </b> <span>Proportion</span>\n                        </p>\n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Improvement Notation: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-improvement-notation</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>increase</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span>http://terminology.hl7.org/CodeSystem/measure-type</span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>process</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2021-04-03T13:00:06-06:00</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">Clinical Quality Information WG</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">This is an example only.</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Parameters: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>name</b></th><th><b>use</b></th><th><b>min</b></th><th><b>max</b></th><th><b>type</b></th></tr>\n                    \n                    <tr>\n                        <td>Measurement Period</td>\n                        <td>in</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>Period</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>SDE Sex</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>Coding</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Numerator</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>boolean</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Denominator</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>boolean</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Initial Population</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>boolean</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Patient</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>Patient</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Qualifying Encounters</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Encounter</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>SDE Payer</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Any</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>SDE Ethnicity</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Coding</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Denominator Exclusions</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>boolean</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>Has Hospice</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>1</td>\n                        <td>boolean</td>\n                    </tr>\n                    \n                    <tr>\n                        <td>SDE Race</td>\n                        <td>out</td>\n                        <td>0</td>\n                        <td>*</td>\n                        <td>Coding</td>\n                    </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Data Requirements: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>type</b></th><th><b>path</b></th><th><b>valueSet or system</b></th><th><b>code</b></th></tr>\n                    \n                        <tr>\n                            <td>Immunization</td>\n                            <td>vaccineCode</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Procedure</td>\n                            <td>code</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Patient</td>\n                            <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Coverage</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Patient</td>\n                            <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Encounter</td>\n                            <td>type</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>ServiceRequest</td>\n                            <td>code</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                        <tr>\n                            <td>Procedure</td>\n                            <td>code</td>\n                            \n                                <td>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</td>\n                                <td></td>\n                            \n                            \n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Direct Reference Codes: </b></th>\n          <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>display</b></th><th><b>code</b></th><th><b>system</b></th></tr>\n                    \n                        <tr>\n                            <td>Discharge to home for hospice care (procedure)</td>\n                            <td>428361000124107</td>\n                            <td>http://snomed.info/sct/731000124108/version/201709</td>\n                        </tr>\n                    \n                        <tr>\n                            <td>Discharge to healthcare facility for hospice care (procedure)</td>\n                            <td>428371000124100</td>\n                            <td>http://snomed.info/sct/731000124108/version/201709</td>\n                        </tr>\n                    \n                </table>\n          </td>\n        </tr>\n        \n        \n            <tr>\n                <th scope=\"row\"><b>Supplemental Data: </b></th>\n                <td style=\"padding-left: 4px;\">\n                    <table class=\"grid-dict\">\n                        <tr><th><b>expression</b></th><th><b>system</b></th></tr>\n                        \n                        <tr>\n                            <td>SDE Ethnicity</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Payer</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Race</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                        <tr>\n                            <td>SDE Sex</td>\n                            <td>http://terminology.hl7.org/CodeSystem/measure-data-usage</td>\n                        </tr>\n                        \n                    </table>\n                </td>\n            </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 25px;\">US</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Effective Period: </b></th>\n            <td style=\"padding-left: 4px;\">2022-01-01..2022-12-31</td>\n        </tr>\n        \n        \n        <tr>\n          <th scope=\"row\"><b>Related Artifacts: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n            \n            \n            <p><b>Dependencies</b></p>\n            <ul>\n              \n                <li>http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000</li>\n              \n                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>\n              \n                <li>http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000</li>\n              \n                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>\n              \n                <li>http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000</li>\n              \n                <li>http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1</li>\n              \n                <li>http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000</li>\n              \n                <li>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</li>\n              \n                <li>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</li>\n              \n            </ul>\n            \n            \n            \n            \n            \n          </td>\n        </tr>\n        \n        \n        \n        \n        \n        <tr>\n          <th scope=\"row\"><b>Logic Definitions: </b></th>\n          <td style=\"padding-left: 4px;\">\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>SDE Sex</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Sex\":\n  SDE.\"SDE Sex\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>SupplementalDataElements</td>\n                        \n                        \n                            <td>SDE Sex</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Sex\":\n  case\n      when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n      when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n      else null\n    end</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Numerator</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Numerator\":\n  exists ( [Immunization: \"Pneumococcal Vaccine\"] PneumococcalVaccine\n        where PneumococcalVaccine.status = 'completed'\n          and PneumococcalVaccine.occurrence as dateTime on or before\n          end of \"Measurement Period\"\n    )\n      or exists ( [Procedure: \"Pneumococcal Vaccine Administered\"] PneumococcalVaccineGiven\n          where PneumococcalVaccineGiven.status = 'completed'\n            and PneumococcalVaccineGiven.performed as Period on or before\n            end of \"Measurement Period\"\n      )</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Denominator</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Denominator\":\n  \"Initial Population\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\":\n  Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) &gt;= 65\n      and exists \"Qualifying Encounters\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Qualifying Encounters</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Qualifying Encounters\":\n  ( [Encounter: \"Office Visit\"]\n      union [Encounter: \"Annual Wellness Visit\"]\n      union [Encounter: \"Preventive Care Services - Established Office Visit, 18 and Up\"]\n      union [Encounter: \"Preventive Care Services-Initial Office Visit, 18 and Up\"]\n      union [Encounter: \"Home Healthcare Services\"]\n      union [Encounter: \"Discharge Services - Nursing Facility\"]\n      union [Encounter: \"Nursing Facility Visit\"]\n      union [Encounter: \"Care Services in Long-Term Residential Facility\"] ) ValidEncounter\n      where ValidEncounter.period during \"Measurement Period\"\n        and ValidEncounter.status = 'finished'</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>SDE Payer</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Payer\":\n  SDE.\"SDE Payer\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>SupplementalDataElements</td>\n                        \n                        \n                            <td>SDE Payer</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Payer\":\n  [Coverage: type in \"Payer\"] Payer\n        return {\n          code: Payer.type,\n          period: Payer.period\n        }</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Initial Population</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Initial Population\":\n  Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) &gt;= 65\n      and exists \"Qualifying Encounters\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>SDE Ethnicity</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>SupplementalDataElements</td>\n                        \n                        \n                            <td>SDE Ethnicity</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Ethnicity\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>Denominator Exclusions</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Denominator Exclusions\":\n  Hospice.\"Has Hospice\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>Hospice</td>\n                        \n                        \n                            <td>Has Hospice</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"Has Hospice\":\n	exists (\n    [Encounter: \"Encounter Inpatient\"] DischargeHospice\n			where DischargeHospice.status = 'finished'\n		    and (\n	        DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n				    or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n	    	)\n				and DischargeHospice.period ends during \"Measurement Period\"\n	)\n    or exists (\n      [ServiceRequest: \"Hospice care ambulatory\"] HospiceOrder\n        where HospiceOrder.intent = 'order'\n            and HospiceOrder.authoredOn in \"Measurement Period\"\n    )\n    or exists (\n      [Procedure: \"Hospice care ambulatory\"] HospicePerformed\n        where HospicePerformed.status = 'completed'\n          and Global.\"Normalize Interval\"(HospicePerformed.performed) overlaps \"Measurement Period\"\n    )</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>PVSComponent</td>\n                        \n                        \n                            <td>SDE Race</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Race\":\n  SDE.\"SDE Race\"</code></pre>\n                \n                <br/><br/>\n            \n                <table class=\"grid-dict\">\n                    <tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>\n                    <tr>\n                        \n                            <td>SupplementalDataElements</td>\n                        \n                        \n                            <td>SDE Race</td>\n                        \n                        \n                    </tr>\n                </table>\n                \n                    <pre><code class=\"language-cql\">define \"SDE Race\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding</code></pre>\n                \n                <br/><br/>\n            \n          </td>\n        </tr>\n        \n    </table>\n</div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis" ];
     fhir:Extension.valueCode [ fhir:value "boolean" ]
  ], [
     fhir:index 1;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Measurement Period" ];
       fhir:ParameterDefinition.use [ fhir:value "in" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "Period" ]     ]
  ], [
     fhir:index 2;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "SDE Sex" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "Coding" ]     ]
  ], [
     fhir:index 3;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Numerator" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "boolean" ]     ]
  ], [
     fhir:index 4;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Denominator" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "boolean" ]     ]
  ], [
     fhir:index 5;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Initial Population" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "boolean" ]     ]
  ], [
     fhir:index 6;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Patient" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "Patient" ]     ]
  ], [
     fhir:index 7;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Qualifying Encounters" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "*" ];
       fhir:ParameterDefinition.type [ fhir:value "Encounter" ]     ]
  ], [
     fhir:index 8;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "SDE Payer" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "*" ];
       fhir:ParameterDefinition.type [ fhir:value "Any" ]     ]
  ], [
     fhir:index 9;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "SDE Ethnicity" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "*" ];
       fhir:ParameterDefinition.type [ fhir:value "Coding" ]     ]
  ], [
     fhir:index 10;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Denominator Exclusions" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "boolean" ]     ]
  ], [
     fhir:index 11;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "Has Hospice" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "1" ];
       fhir:ParameterDefinition.type [ fhir:value "boolean" ]     ]
  ], [
     fhir:index 12;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-parameter" ];
     fhir:Extension.valueParameterDefinition [
       fhir:ParameterDefinition.name [ fhir:value "SDE Race" ];
       fhir:ParameterDefinition.use [ fhir:value "out" ];
       fhir:ParameterDefinition.min [ fhir:value "0"^^xsd:integer ];
       fhir:ParameterDefinition.max [ fhir:value "*" ];
       fhir:ParameterDefinition.type [ fhir:value "Coding" ]     ]
  ], [
     fhir:index 13;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Immunization" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Immunization";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Immunization>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "vaccineCode" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027>         ]       ]     ]
  ], [
     fhir:index 14;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Procedure" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Procedure";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Procedure>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "code" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034>         ]       ]     ]
  ], [
     fhir:index 15;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Patient" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Patient";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Patient>       ]     ]
  ], [
     fhir:index 16;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001>         ]       ]     ]
  ], [
     fhir:index 17;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240>         ]       ]     ]
  ], [
     fhir:index 18;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025>         ]       ]     ]
  ], [
     fhir:index 19;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023>         ]       ]     ]
  ], [
     fhir:index 20;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016>         ]       ]     ]
  ], [
     fhir:index 21;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065>         ]       ]     ]
  ], [
     fhir:index 22;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012>         ]       ]     ]
  ], [
     fhir:index 23;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014>         ]       ]     ]
  ], [
     fhir:index 24;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Coverage" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Coverage";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Coverage>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>         ]       ]     ]
  ], [
     fhir:index 25;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Patient" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Patient";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Patient>       ]     ]
  ], [
     fhir:index 26;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Encounter" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Encounter";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Encounter>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "type" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307>         ]       ]     ]
  ], [
     fhir:index 27;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "ServiceRequest" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/ServiceRequest";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/ServiceRequest>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "code" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15>         ]       ]     ]
  ], [
     fhir:index 28;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-dataRequirement" ];
     fhir:Extension.valueDataRequirement [
       fhir:DataRequirement.type [ fhir:value "Procedure" ];
       fhir:DataRequirement.profile [
         fhir:value "http://hl7.org/fhir/StructureDefinition/Procedure";
         fhir:index 0;
         fhir:link <http://hl7.org/fhir/StructureDefinition/Procedure>       ];
       fhir:DataRequirement.codeFilter [
         fhir:index 0;
         fhir:DataRequirement.codeFilter.path [ fhir:value "code" ];
         fhir:DataRequirement.codeFilter.valueSet [
           fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15";
           fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15>         ]       ]     ]
  ], [
     fhir:index 29;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode" ];
     fhir:Extension.valueCoding [
       a sct:428361000124107;
       fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
       fhir:Coding.version [ fhir:value "http://snomed.info/sct/731000124108/version/201709" ];
       fhir:Coding.code [ fhir:value "428361000124107" ];
       fhir:Coding.display [ fhir:value "Discharge to home for hospice care (procedure)" ]     ]
  ], [
     fhir:index 30;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode" ];
     fhir:Extension.valueCoding [
       a sct:428371000124100;
       fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
       fhir:Coding.version [ fhir:value "http://snomed.info/sct/731000124108/version/201709" ];
       fhir:Coding.code [ fhir:value "428371000124100" ];
       fhir:Coding.display [ fhir:value "Discharge to healthcare facility for hospice care (procedure)" ]     ]
  ], [
     fhir:index 31;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Sex" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Sex\":\n  SDE.\"SDE Sex\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "0"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 32;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "SupplementalDataElements" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Sex" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Sex\":\n  case\n      when Patient.gender = 'male' then Code { code: 'M', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Male' }\n      when Patient.gender = 'female' then Code { code: 'F', system: 'http://hl7.org/fhir/v3/AdministrativeGender', display: 'Female' }\n      else null\n    end" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "1"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 33;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Numerator" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Numerator\":\n  exists ( [Immunization: \"Pneumococcal Vaccine\"] PneumococcalVaccine\n        where PneumococcalVaccine.status = 'completed'\n          and PneumococcalVaccine.occurrence as dateTime on or before\n          end of \"Measurement Period\"\n    )\n      or exists ( [Procedure: \"Pneumococcal Vaccine Administered\"] PneumococcalVaccineGiven\n          where PneumococcalVaccineGiven.status = 'completed'\n            and PneumococcalVaccineGiven.performed as Period on or before\n            end of \"Measurement Period\"\n      )" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "2"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 34;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Denominator" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Denominator\":\n  \"Initial Population\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "3"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 35;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Initial Population" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Initial Population\":\n  Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) >= 65\n      and exists \"Qualifying Encounters\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "4"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 36;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Qualifying Encounters" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Qualifying Encounters\":\n  ( [Encounter: \"Office Visit\"]\n      union [Encounter: \"Annual Wellness Visit\"]\n      union [Encounter: \"Preventive Care Services - Established Office Visit, 18 and Up\"]\n      union [Encounter: \"Preventive Care Services-Initial Office Visit, 18 and Up\"]\n      union [Encounter: \"Home Healthcare Services\"]\n      union [Encounter: \"Discharge Services - Nursing Facility\"]\n      union [Encounter: \"Nursing Facility Visit\"]\n      union [Encounter: \"Care Services in Long-Term Residential Facility\"] ) ValidEncounter\n      where ValidEncounter.period during \"Measurement Period\"\n        and ValidEncounter.status = 'finished'" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "5"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 37;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Payer" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Payer\":\n  SDE.\"SDE Payer\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "6"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 38;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "SupplementalDataElements" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Payer" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Payer\":\n  [Coverage: type in \"Payer\"] Payer\n        return {\n          code: Payer.type,\n          period: Payer.period\n        }" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "7"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 39;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Initial Population" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Initial Population\":\n  Global.\"CalendarAgeInYearsAt\" ( FHIRHelpers.ToDate ( Patient.birthDate ), start of \"Measurement Period\" ) >= 65\n      and exists \"Qualifying Encounters\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "8"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 40;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Ethnicity" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "9"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 41;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "SupplementalDataElements" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Ethnicity" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Ethnicity\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "10"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 42;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Denominator Exclusions" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Denominator Exclusions\":\n  Hospice.\"Has Hospice\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "11"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 43;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "Hospice" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "Has Hospice" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"Has Hospice\":\n	exists (\n    [Encounter: \"Encounter Inpatient\"] DischargeHospice\n			where DischargeHospice.status = 'finished'\n		    and (\n	        DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n				    or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n	    	)\n				and DischargeHospice.period ends during \"Measurement Period\"\n	)\n    or exists (\n      [ServiceRequest: \"Hospice care ambulatory\"] HospiceOrder\n        where HospiceOrder.intent = 'order'\n            and HospiceOrder.authoredOn in \"Measurement Period\"\n    )\n    or exists (\n      [Procedure: \"Hospice care ambulatory\"] HospicePerformed\n        where HospicePerformed.status = 'completed'\n          and Global.\"Normalize Interval\"(HospicePerformed.performed) overlaps \"Measurement Period\"\n    )" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "12"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 44;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "PVSComponent" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Race" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Race\":\n  SDE.\"SDE Race\"" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "13"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ], [
     fhir:index 45;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "libraryName" ];
       fhir:Extension.valueString [ fhir:value "SupplementalDataElements" ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "name" ];
       fhir:Extension.valueString [ fhir:value "SDE Race" ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "statement" ];
       fhir:Extension.valueString [ fhir:value "define \"SDE Race\":\n  (flatten (\n      Patient.extension Extension\n        where Extension.url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race'\n          return Extension.extension\n    )) E\n      where E.url = 'ombCategory'\n        or E.url = 'detailed'\n      return E.value as Coding" ]     ], [
       fhir:index 3;
       fhir:Extension.url [ fhir:value "displaySequence" ];
       fhir:Extension.valueInteger [ fhir:value "14"^^xsd:integer ]     ];
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition" ]
  ];
  fhir:Measure.url [ fhir:value "http://hl7.org/fhir/us/cqfmeasures/Measure/PVSComponent"];
  fhir:Measure.version [ fhir:value "0.0.001"];
  fhir:Measure.name [ fhir:value "PVSComponent"];
  fhir:Measure.title [ fhir:value "Pneumococcal Vaccination Status for Older Adults"];
  fhir:Measure.status [ fhir:value "draft"];
  fhir:Measure.experimental [ fhir:value "true"^^xsd:boolean];
  fhir:Measure.date [ fhir:value "2021-04-03T13:00:06-06:00"^^xsd:dateTime];
  fhir:Measure.publisher [ fhir:value "Clinical Quality Information WG"];
  fhir:Measure.contact [
     fhir:index 0;
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/cqi/index.cfm" ]     ]
  ];
  fhir:Measure.description [ fhir:value "This is an example only."];
  fhir:Measure.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ]     ]
  ];
  fhir:Measure.effectivePeriod [
     fhir:Period.start [ fhir:value "2022-01-01"^^xsd:date ];
     fhir:Period.end [ fhir:value "2022-12-31"^^xsd:date ]
  ];
  fhir:Measure.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library SDE" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000";
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/SupplementalDataElements|2.0.000>     ]
  ], [
     fhir:index 1;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library FHIRHelpers" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1";
       fhir:link <http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1>     ]
  ], [
     fhir:index 2;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library Global" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000";
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000>     ]
  ], [
     fhir:index 3;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library FHIRHelpers" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1";
       fhir:link <http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1>     ]
  ], [
     fhir:index 4;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library Hospice" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000";
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/Hospice|2.0.000>     ]
  ], [
     fhir:index 5;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library FHIRHelpers" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1";
       fhir:link <http://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1>     ]
  ], [
     fhir:index 6;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Library Global" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000";
       fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/MATGlobalCommonFunctions|5.0.000>     ]
  ], [
     fhir:index 7;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Code system SNOMEDCT:2017-09" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709";
       fhir:link <http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709>     ]
  ], [
     fhir:index 8;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Pneumococcal Vaccine" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1027>     ]
  ], [
     fhir:index 9;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Pneumococcal Vaccine Administered" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1034>     ]
  ], [
     fhir:index 10;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Office Visit" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001>     ]
  ], [
     fhir:index 11;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Annual Wellness Visit" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240>     ]
  ], [
     fhir:index 12;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Preventive Care Services - Established Office Visit, 18 and Up" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025>     ]
  ], [
     fhir:index 13;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Preventive Care Services-Initial Office Visit, 18 and Up" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023>     ]
  ], [
     fhir:index 14;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Home Healthcare Services" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016>     ]
  ], [
     fhir:index 15;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Discharge Services - Nursing Facility" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1065>     ]
  ], [
     fhir:index 16;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Nursing Facility Visit" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012>     ]
  ], [
     fhir:index 17;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Care Services in Long-Term Residential Facility" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014>     ]
  ], [
     fhir:index 18;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Payer" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591>     ]
  ], [
     fhir:index 19;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Encounter Inpatient" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307>     ]
  ], [
     fhir:index 20;
     fhir:RelatedArtifact.type [ fhir:value "depends-on" ];
     fhir:RelatedArtifact.display [ fhir:value "Value set Hospice care ambulatory" ];
     fhir:RelatedArtifact.resource [
       fhir:value "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15";
       fhir:link <http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15>     ]
  ];
  fhir:Measure.library [
     fhir:value "http://hl7.org/fhir/us/cqfmeasures/Library/PVSComponent";
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/us/cqfmeasures/Library/PVSComponent>
  ];
  fhir:Measure.scoring [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-scoring" ];
       fhir:Coding.code [ fhir:value "proportion" ];
       fhir:Coding.display [ fhir:value "Proportion" ]     ]
  ];
  fhir:Measure.type [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-type" ];
       fhir:Coding.code [ fhir:value "process" ]     ]
  ];
  fhir:Measure.improvementNotation [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-improvement-notation" ];
       fhir:Coding.code [ fhir:value "increase" ]     ]
  ];
  fhir:Measure.group [
     fhir:index 0;
     fhir:Measure.group.population [
       fhir:index 0;
       fhir:Element.id [ fhir:value "FB55A109-7AC0-4385-AD01-ED3814C92697" ];
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "initial-population" ];
           fhir:Coding.display [ fhir:value "Initial Population" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql.identifier" ];
         fhir:Expression.expression [ fhir:value "Initial Population" ]       ]     ], [
       fhir:index 1;
       fhir:Element.id [ fhir:value "7BFE8E56-FD1F-4E35-A79F-0E2569819358" ];
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "denominator" ];
           fhir:Coding.display [ fhir:value "Denominator" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql.identifier" ];
         fhir:Expression.expression [ fhir:value "Denominator" ]       ]     ], [
       fhir:index 2;
       fhir:Element.id [ fhir:value "F74BB6AC-40CD-40BB-A9F8-06F4A4A0D2C5" ];
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "denominator-exclusion" ];
           fhir:Coding.display [ fhir:value "Denominator Exclusion" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql.identifier" ];
         fhir:Expression.expression [ fhir:value "Denominator Exclusions" ]       ]     ], [
       fhir:index 3;
       fhir:Element.id [ fhir:value "89B1D5A5-96B6-4002-B962-9989FED8A0E9" ];
       fhir:Measure.group.population.code [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-population" ];
           fhir:Coding.code [ fhir:value "numerator" ];
           fhir:Coding.display [ fhir:value "Numerator" ]         ]       ];
       fhir:Measure.group.population.criteria [
         fhir:Expression.language [ fhir:value "text/cql.identifier" ];
         fhir:Expression.expression [ fhir:value "Numerator" ]       ]     ]
  ];
  fhir:Measure.supplementalData [
     fhir:index 0;
     fhir:Element.id [ fhir:value "66567b90-12e8-4a1c-8425-2cb8106f9664" ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.language [ fhir:value "text/cql.identifier" ];
       fhir:Expression.expression [ fhir:value "SDE Ethnicity" ]     ]
  ], [
     fhir:index 1;
     fhir:Element.id [ fhir:value "d431e0e9-8d05-4ca7-a0b2-6cf72313c6d6" ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.language [ fhir:value "text/cql.identifier" ];
       fhir:Expression.expression [ fhir:value "SDE Payer" ]     ]
  ], [
     fhir:index 2;
     fhir:Element.id [ fhir:value "b5baeb14-bfba-4ad5-a150-8a5442d113f8" ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.language [ fhir:value "text/cql.identifier" ];
       fhir:Expression.expression [ fhir:value "SDE Race" ]     ]
  ], [
     fhir:index 3;
     fhir:Element.id [ fhir:value "54129f83-97a7-4149-82c8-92ab0e8060ed" ];
     fhir:Measure.supplementalData.usage [
       fhir:index 0;
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/measure-data-usage" ];
         fhir:Coding.code [ fhir:value "supplemental-data" ]       ]     ];
     fhir:Measure.supplementalData.criteria [
       fhir:Expression.language [ fhir:value "text/cql.identifier" ];
       fhir:Expression.expression [ fhir:value "SDE Sex" ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.