Common CQL Artifacts for FHIR (US-Based)
2.0.0-ballot - Informative 2 Ballot

Common CQL Artifacts for FHIR (US-Based) - Downloaded Version null See the Directory of published versions

## : Example Medical Necessity For Authorization Of Catheters Questionnaire

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

     a fhir:Questionnaire ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "MNACQuestionnaire"] ; #
      fhir:language [ fhir:v "en"] ; #
      fhir:text [
    fhir:status [ fhir:v "extensions" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire MNACQuestionnaire</b></p><a name=\"MNACQuestionnaire\"> </a><a name=\"hcMNACQuestionnaire\"> </a><b>Structure</b><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> MNACQuestionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">This is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form.</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">http://hl7.org/fhir/us/cql/Questionnaire/MNACQuestionnaire#2.0.0-ballot</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.request-info\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> request-info</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Request Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.request-info|date-of-request\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-date.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"date\" class=\"hierarchy\"/> request-info|date-of-request</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">DATE OF REQUEST</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-date\">date</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.diagnosis-info\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> diagnosis-info</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Diagnosis Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.diagnosis-info|diagnosis\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> diagnosis-info|diagnosis</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Diagnosis</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.item-requested\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> item-requested</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Item Requested</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.item-requested|item\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> item-requested|item</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Item requested</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.uti-history\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> uti-history</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">UTI History</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.uti-history|uti-last-year\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> uti-history|uti-last-year</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">The patient has|had documented recurrent urinary tract infections while on a program of clean cathing, twice within a 12 month period prior to beginning sterile cathing</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.uti-history|uti-dates\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> uti-history|uti-dates</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Dates of UTIs in the last year</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.uti-history|uti-last-year\">uti-history|uti-last-year</a> = true</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.uti-history|antibiotics-used\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> uti-history|antibiotics-used</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Antibiotics used for UTIs in the last year</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.uti-history|uti-last-year\">uti-history|uti-last-year</a> = true</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.symptoms-info\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> symptoms-info</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Symptoms Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)\" id=\"item.symptoms-info|symptoms\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> symptoms-info|symptoms</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Check those that apply to your patient</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..*</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.symptoms-info|symptoms\">7 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.symptoms-info|fever-temperature\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-decimal.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"decimal\" class=\"hierarchy\"/> symptoms-info|fever-temperature</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">If fever, state temperature in degrees</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal\">decimal</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Enable When: <span><a href=\"#item.symptoms-info|symptoms\">symptoms-info|symptoms</a> = Fever (MNACQuestionnaire-symptoms-info-symptoms#Fever)</span></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.catheterization-frequency\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> catheterization-frequency</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Catheterization Frequency</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.catheterization-frequency|frequency\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-coding.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"coding\" class=\"hierarchy\"/> catheterization-frequency|frequency</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">How many times per day does the patient catheterize?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice\">choice</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Options: <a href=\"#opt-item.catheterization-frequency|frequency\">4 options</a></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)\" id=\"item.additional-comments\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> additional-comments</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Additional Comments</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)\" id=\"item.additional-comments|comments\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vline.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> additional-comments|comments</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Additional Comment</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)\" id=\"item.physician-info\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-group.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"group\" class=\"hierarchy\"/> physician-info</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Physician Information</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-group\">group</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.physician-info|name\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> physician-info|name</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Physician's Name</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.physician-info|mobile\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> physician-info|mobile</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Telephone</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.physician-info|fax\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> physician-info|fax</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">FAX</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.physician-info|signature\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-attachment.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"attachment\" class=\"hierarchy\"/> physician-info|signature</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Physician's Signature</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-attachment\">attachment</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)\" id=\"item.physician-info|phone-referring\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> physician-info|phone-referring</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Referring Physician Telephone</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)\" id=\"item.physician-info|date\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_blank.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"string\" class=\"hierarchy\"/> physician-info|date</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Date</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string\">string</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name=\"opt-item.symptoms-info|symptoms\"> </a><p><b>Answer options for symptoms-info|symptoms </b></p><ul><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Fever (\"Fever; state temperature in degree\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#UrinaryUrgencyFrequency (\"Change in urinary urgency, frequency, or incontinence\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#AutonomicDysreflexia (\"Appearance of new or increase in autonomic dysreflexia\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#PhysicalSignsProstatitis (\"Physical signs of prostatitis, epididymitis, orchitis\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Immunosuppressed (\"The patient is immunosuppressed\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Pyuria (\"Pyuria\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#SystemicLeukocytosis (\"Systemic leukocytosis\")</li></ul><a name=\"opt-item.catheterization-frequency|frequency\"> </a><p><b>Answer options for catheterization-frequency|frequency </b></p><ul><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#2-4Times (\"2-4 times\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#4-6Times (\"4-6 times\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#6-8Times (\"6-8 times\")</li><li style=\"font-size: 11px\">http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#8TimesOrMore (\"8 times or more\")</li></ul><h2>Contained Resources</h2><hr/>\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\n\n\n\n\n\n\n\n\n\n\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 scope=\"row\" class=\"row-header\">Type</th>\n\n\n\n<td class=\"content-container\">\n    module-definition from <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-library-type.html\">http://terminology.hl7.org/CodeSystem/library-type</a> \n\n\n</td>\n\n\n</tr>\n\n\n\n<tr>\n  \n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: USCore model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-USCore-ModelInfo.html\">US Core Model Informationversion: null6.1.0-derived)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived</tt>\n    \n    \n    \n  </td>\n</tr>\n\n<tr>\n  \n  \n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: FHIR model information\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIR-ModelInfo.html\">http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1</tt>\n    \n    \n    \n  </td>\n</tr>\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"parameters\"> </a>Parameters</th>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Parameter</th>\n\n\n\n<td class=\"content-container\">None</td>\n\n\n</tr>\n\n\n\n\n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.3-cibuild of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:contained ( [
    a fhir:Library ;
    fhir:id [ fhir:v "effective-data-requirements" ] ;
    fhir:name [ fhir:v "EffectiveDataRequirements" ] ;
    fhir:status [ fhir:v "active" ] ;
    fhir:type [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/library-type>         ] ;
    fhir:code [ fhir:v "module-definition" ]       ] )     ] ;
        ( fhir:relatedArtifact [
    fhir:type [ fhir:v "depends-on" ] ;
    fhir:display [ fhir:v "USCore model information" ] ;
    fhir:resource [
    fhir:v "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo?version=6.1.0-derived>       ]     ] [
    fhir:type [ fhir:v "depends-on" ] ;
    fhir:display [ fhir:v "FHIR model information" ] ;
    fhir:resource [
    fhir:v "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo?version=4.0.1>       ]     ] )
      ] ) ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-library"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-library>     ] ;
    fhir:value [
    a fhir:Canonical ;
    fhir:v "http://hl7.org/fhir/us/cql/Library/MNACInitialExpressions"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/cql/Library/MNACInitialExpressions>     ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "name"^^xsd:anyURI ;
    fhir:l fhir:name       ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext>         ] ;
    fhir:code [ fhir:v "patient" ] ;
    fhir:display [ fhir:v "Patient" ]       ]     ] [
    fhir:url [
    fhir:v "type"^^xsd:anyURI ;
    fhir:l fhir:type       ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "Patient"       ]     ] [
    fhir:url [
    fhir:v "description"^^xsd:anyURI ;
    fhir:l fhir:description       ] ;
    fhir:value [
    a fhir:String ;
    fhir:v "The patient that is to be used to pre-populate the form"       ]     ] ) ;
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext>     ]
      ] [
        ( fhir:extension [
    fhir:url [
    fhir:v "name"^^xsd:anyURI ;
    fhir:l fhir:name       ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/additionalLaunchContext"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/additionalLaunchContext>         ] ;
    fhir:code [ fhir:v "ServiceRequest" ] ;
    fhir:display [ fhir:v "ServiceRequest" ]       ]     ] [
    fhir:url [
    fhir:v "type"^^xsd:anyURI ;
    fhir:l fhir:type       ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "ServiceRequest"       ]     ] [
    fhir:url [
    fhir:v "description"^^xsd:anyURI ;
    fhir:l fhir:description       ] ;
    fhir:value [
    a fhir:String ;
    fhir:v "The ServiceRequest that is to be used to pre-populate the form"       ]     ] ) ;
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext>     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "cds"     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements>     ] ;
    fhir:value [
    a fhir:Canonical ;
    fhir:v "#effective-data-requirements"^^xsd:anyURI ;
    fhir:l <#effective-data-requirements>     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "informative" ;
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>         ] ;
    fhir:value [
    a fhir:Canonical ;
    fhir:v "http://hl7.org/fhir/us/cql/ImplementationGuide/hl7.fhir.us.cql"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/cql/ImplementationGuide/hl7.fhir.us.cql>         ]       ] )     ]
      ] ) ; #
      fhir:url [
    fhir:v "http://hl7.org/fhir/us/cql/Questionnaire/MNACQuestionnaire"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/cql/Questionnaire/MNACQuestionnaire>
      ] ; #
      fhir:version [ fhir:v "2.0.0-ballot"] ; #
      fhir:name [ fhir:v "MNACQuestionnaire"] ; #
      fhir:title [ fhir:v "Example Medical Necessity For Authorization Of Catheters Questionnaire"] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:experimental [ fhir:v true] ; #
      fhir:date [ fhir:v "2024-01-17T00:00:00+00:00"^^xsd:dateTime] ; #
      fhir:publisher [ fhir:v "HL7 International / Clinical Decision Support"] ; #
      fhir:contact ( [
        ( fhir:telecom [
    fhir:system [ fhir:v "url" ] ;
    fhir:value [ fhir:v "http://www.hl7.org/Special/committees/dss" ]     ] )
      ] ) ; #
      fhir:description [ fhir:v "This is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form."] ; #
      fhir:jurisdiction ( [
        ( fhir:coding [
    fhir:system [
    fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ;
    fhir:l <urn:iso:std:iso:3166>       ] ;
    fhir:code [ fhir:v "US" ] ;
    fhir:display [ fhir:v "United States of America" ]     ] )
      ] ) ; #
      fhir:copyright [ fhir:v "This content is informed by the following source, used with permission: https://www.hca.wa.gov/assets/billers-and-providers/13-760.pdf"] ; #
      fhir:item ( [
    fhir:linkId [ fhir:v "request-info" ] ;
    fhir:text [ fhir:v "Request Information" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Date of Request" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "request-info|date-of-request" ] ;
    fhir:text [ fhir:v "DATE OF REQUEST" ] ;
    fhir:type [ fhir:v "date" ]     ] )
      ] [
    fhir:linkId [ fhir:v "diagnosis-info" ] ;
    fhir:text [ fhir:v "Diagnosis Information" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Diagnosis" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "diagnosis-info|diagnosis" ] ;
    fhir:text [ fhir:v "Diagnosis" ] ;
    fhir:type [ fhir:v "string" ]     ] )
      ] [
    fhir:linkId [ fhir:v "item-requested" ] ;
    fhir:text [ fhir:v "Item Requested" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Item Requested" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "item-requested|item" ] ;
    fhir:text [ fhir:v "Item requested" ] ;
    fhir:type [ fhir:v "string" ]     ] )
      ] [
    fhir:linkId [ fhir:v "uti-history" ] ;
    fhir:text [ fhir:v "UTI History" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "UTI in Last Year" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "uti-history|uti-last-year" ] ;
    fhir:text [ fhir:v "The patient has|had documented recurrent urinary tract infections while on a program of clean cathing, twice within a 12 month period prior to beginning sterile cathing" ] ;
    fhir:type [ fhir:v "boolean" ]     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Dates of UTIs" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "uti-history|uti-dates" ] ;
    fhir:text [ fhir:v "Dates of UTIs in the last year" ] ;
    fhir:type [ fhir:v "string" ] ;
          ( fhir:enableWhen [
    fhir:question [ fhir:v "uti-history|uti-last-year" ] ;
    fhir:operator [ fhir:v "=" ] ;
    fhir:answer [
    a fhir:Boolean ;
    fhir:v true         ]       ] )     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Antibiotics Used" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "uti-history|antibiotics-used" ] ;
    fhir:text [ fhir:v "Antibiotics used for UTIs in the last year" ] ;
    fhir:type [ fhir:v "string" ] ;
          ( fhir:enableWhen [
    fhir:question [ fhir:v "uti-history|uti-last-year" ] ;
    fhir:operator [ fhir:v "=" ] ;
    fhir:answer [
    a fhir:Boolean ;
    fhir:v true         ]       ] )     ] )
      ] [
    fhir:linkId [ fhir:v "symptoms-info" ] ;
    fhir:text [ fhir:v "Symptoms Information" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Check Symptoms" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "symptoms-info|symptoms" ] ;
    fhir:text [ fhir:v "Check those that apply to your patient" ] ;
    fhir:type [ fhir:v "choice" ] ;
    fhir:repeats [ fhir:v true ] ;
          ( fhir:answerOption [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "Fever" ] ;
    fhir:display [ fhir:v "Fever; state temperature in degree" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "UrinaryUrgencyFrequency" ] ;
    fhir:display [ fhir:v "Change in urinary urgency, frequency, or incontinence" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "AutonomicDysreflexia" ] ;
    fhir:display [ fhir:v "Appearance of new or increase in autonomic dysreflexia" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "PhysicalSignsProstatitis" ] ;
    fhir:display [ fhir:v "Physical signs of prostatitis, epididymitis, orchitis" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "Immunosuppressed" ] ;
    fhir:display [ fhir:v "The patient is immunosuppressed" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "Pyuria" ] ;
    fhir:display [ fhir:v "Pyuria" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "SystemicLeukocytosis" ] ;
    fhir:display [ fhir:v "Systemic leukocytosis" ]         ]       ] )     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Fever Temperature" ]         ]       ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/questionnaire-unit"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/questionnaire-unit>         ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
    fhir:l <http://unitsofmeasure.org>           ] ;
    fhir:code [ fhir:v "deg" ] ;
    fhir:display [ fhir:v "deg" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "symptoms-info|fever-temperature" ] ;
    fhir:text [ fhir:v "If fever, state temperature in degrees" ] ;
    fhir:type [ fhir:v "decimal" ] ;
          ( fhir:enableWhen [
    fhir:question [ fhir:v "symptoms-info|symptoms" ] ;
    fhir:operator [ fhir:v "=" ] ;
    fhir:answer [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms>           ] ;
    fhir:code [ fhir:v "Fever" ]         ]       ] )     ] )
      ] [
    fhir:linkId [ fhir:v "catheterization-frequency" ] ;
    fhir:text [ fhir:v "Catheterization Frequency" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Catheterization Frequency" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "catheterization-frequency|frequency" ] ;
    fhir:text [ fhir:v "How many times per day does the patient catheterize?" ] ;
    fhir:type [ fhir:v "choice" ] ;
          ( fhir:answerOption [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency>           ] ;
    fhir:code [ fhir:v "2-4Times" ] ;
    fhir:display [ fhir:v "2-4 times" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency>           ] ;
    fhir:code [ fhir:v "4-6Times" ] ;
    fhir:display [ fhir:v "4-6 times" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency>           ] ;
    fhir:code [ fhir:v "6-8Times" ] ;
    fhir:display [ fhir:v "6-8 times" ]         ]       ] [
    fhir:value [
    a fhir:Coding ;
    fhir:system [
    fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ;
    fhir:l <http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency>           ] ;
    fhir:code [ fhir:v "8TimesOrMore" ] ;
    fhir:display [ fhir:v "8 times or more" ]         ]       ] )     ] )
      ] [
    fhir:linkId [ fhir:v "additional-comments" ] ;
    fhir:text [ fhir:v "Additional Comments" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Additional Comment" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "additional-comments|comments" ] ;
    fhir:text [ fhir:v "Additional Comment" ] ;
    fhir:type [ fhir:v "string" ]     ] )
      ] [
    fhir:linkId [ fhir:v "physician-info" ] ;
    fhir:text [ fhir:v "Physician Information" ] ;
    fhir:type [ fhir:v "group" ] ;
        ( fhir:item [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Physician Name" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "physician-info|name" ] ;
    fhir:text [ fhir:v "Physician's Name" ] ;
    fhir:type [ fhir:v "string" ]     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Physician Telephone" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "physician-info|mobile" ] ;
    fhir:text [ fhir:v "Telephone" ] ;
    fhir:type [ fhir:v "string" ]     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Physician Fax" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "physician-info|fax" ] ;
    fhir:text [ fhir:v "FAX" ] ;
    fhir:type [ fhir:v "string" ]     ] [
    fhir:linkId [ fhir:v "physician-info|signature" ] ;
    fhir:text [ fhir:v "Physician's Signature" ] ;
    fhir:type [ fhir:v "attachment" ]     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Referring Physician Telephone" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "physician-info|phone-referring" ] ;
    fhir:text [ fhir:v "Referring Physician Telephone" ] ;
    fhir:type [ fhir:v "string" ]     ] [
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression>         ] ;
    fhir:value [
    a fhir:Expression ;
    fhir:language [ fhir:v "text/cql-identifier" ] ;
    fhir:expression [ fhir:v "Date" ]         ]       ] ) ;
    fhir:linkId [ fhir:v "physician-info|date" ] ;
    fhir:text [ fhir:v "Date" ] ;
    fhir:type [ fhir:v "string" ]     ] )
      ] ) . #