Quality Measure Implementation Guide
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## : EXM124 - Cervical Cancer Screening

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    {
      "resourceType" : "Measure",
      "id" : "EXM124-FHIR",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-proportionmeasure"🔗 ,
          "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"🔗 ,
          "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-publishablemeasure"🔗 ,
          "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-cqlmeasure"🔗 ,
          "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-computablemeasure"
        ]
      },
      "language" : "en",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <table class=\"narrative-table\">\n    <tbody>\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Metadata</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Title</th>\n\n\n\n<td class=\"content-container\">EXM124 - Cervical Cancer Screening</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Version</th>\n\n\n\n<td class=\"content-container\">9.0.000</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Short Name</th>\n\n\n\n<td class=\"content-container\">Cervical Cancer Screening</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Independent)</th>\n\n\n\n<td class=\"content-container\">http://example.org/fhir/us/cqm/Measure/EXM124-FHIR</td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">GUID (Version Specific)</th>\n\n\n\n<td class=\"content-container\">http://example.org/fhir/us/cqm/Measure/CMS124v7</td>\n\n\n</tr>\n\n\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Identifier</th>\n\n\n\n<td class=\"content-container\">124</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Identifier</th>\n\n\n\n<td class=\"content-container\">309</td>\n\n\n</tr>\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Identifier</th>\n\n\n\n<td class=\"content-container\">urn:oid:2.16.840.1.113883.4.642.40.61.29.4</td>\n\n\n</tr>\n\n\n\n  \n    \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Effective Period</th>\n\n\n\n<td class=\"content-container\">2018-01-01 through 2018-12-31</td>\n\n\n</tr>\n\n  \n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Approval Date</th>\n\n\n\n<td class=\"content-container\">2016-01-01</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Last Review Date</th>\n\n\n\n<td class=\"content-container\">2016-09-01</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Experimental</th>\n\n\n\n<td class=\"content-container\">true</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Use Context</th>\n\n\n\n<td class=\"content-container\">\n    Clinical Venue\n\n = \n    EC\n\n\n</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Jurisdiction</th>\n\n\n\n<td class=\"content-container\">\n    001 from <a href=\"http://unstats.un.org/unsd/methods/m49/m49.htm\">http://unstats.un.org/unsd/methods/m49/m49.htm</a> \n\n\n</td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Topic</th>\n\n\n\n<td class=\"content-container\">\n    Health Quality Measure Document\n\n\n</td>\n\n\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Steward (Publisher)</th>\n\n\n\n<td class=\"content-container\">HL7 International / Clinical Quality Information</td>\n\n\n</tr>\n\n\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Description</th>\n\n\n\n<td class=\"content-container\"><div><p>Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria:</p>\n<ul>\n<li>Women age 21-64 who had cervical cytology performed every 3 years</li>\n<li>Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years</li>\n</ul>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Purpose</th>\n\n\n\n<td class=\"content-container\"><div><p>This measure has been developed to support improvement in clinical care.</p>\n</div></td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Copyright</th>\n\n\n\n<td class=\"content-container\"><div><p>This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved.\nLimited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications.\nCPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Disclaimer</th>\n\n\n\n<td class=\"content-container\"><div><p>The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND.\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].</p>\n</div></td>\n\n\n</tr>\n\n\n\n  \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Measure Basis</th>\n\n\n\n<td class=\"content-container\">boolean</td>\n\n\n</tr>\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Measure Scoring</th>\n\n\n\n<td class=\"content-container\">\n    Proportion\n\n\n</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Improvement Notation</th>\n\n\n\n<td class=\"content-container\">\n    Increased score indicates improvement\n\n\n</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Measure Type</th>\n\n\n\n<td class=\"content-container\">\n    process from <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-measure-type.html\">http://terminology.hl7.org/CodeSystem/measure-type</a> \n\n\n</td>\n\n\n</tr>\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Rationale</th>\n\n\n\n<td class=\"content-container\"><div><p>Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Howlader et al, 2016). In 2013, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Howlader et al, 2016).\nWhile there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Howlader et al, 2016). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 235; by age 50 it becomes 1 in 54; by age 60, it is 1 in 25 (National Business Group on Health, 2011).\nIn the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (National Business Group on Health, 2011). If breast cancer is detected through mammography screening and diagnosed in its earliest stages, treatment may be less expensive (Feig, 2011).</p>\n</div></td>\n\n\n</tr>\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Clinical Recommendation Statement</th>\n\n\n\n<td class=\"content-container\"><div><p>The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation).<br/>\nThe decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016)\nThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016)\nThe USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016)<br/>\nThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)</p>\n</div></td>\n\n\n</tr>\n\n\n\n\n\n\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Guidance (Usage)</th>\n\n\n\n<td class=\"content-container\">To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23. \n Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1. \n Include only cytology and HPV &quot;co-testing&quot;; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure.</td>\n\n\n</tr>\n\n\n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: primary)</th>\n\n\n</tr>\n  \n  \n    \n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Summary</th>\n\n\n\n<td class=\"content-container\">Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: \n*  Women age 21-64 who had cervical cytology performed every 3 years \n*  Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years</td>\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  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Supplemental Data Elements</th>\n\n\n</tr>\n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: No description provided\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#exm124-sde-ethnicity\">SDE Ethnicity</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: No description provided\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#exm124-sde-payer\">SDE Payer</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: Race\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#exm124-sde-race\">SDE Race</a> \n        \n      \n    \n  </td>\n</tr>\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Supplemental Data Element</th>\n\n\n  <td class=\"content-container\">\n    \n    \n      \n        \n          <em>Usage Code</em>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/measure-data-usage supplemental-data}\">Supplemental Data</span>\n        \n        <br/>\n      \n    \n    \n      <em>Description</em>: No description provided\n    \n    \n      \n        <br/>\n        \n          \n          <em>Logic Definition</em>: <a href=\"#exm124-sde-sex\">SDE Sex</a> \n        \n      \n    \n  </td>\n</tr>\n\n\n<tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Logic</th>\n\n\n</tr>\n\n<tr>\n\n\n<th scope=\"row\" class=\"row-header\">Primary Library</th>\n\n\n\n<td class=\"content-container\"><a href=\"Library-EXM124.html\">EXM124 - Cervical Cancer Screening Library</a></td>\n\n\n</tr>\n\n\n\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Contents</th>\n  <td class=\"content-container\">\n    <em><a href=\"#population-criteria\">Population Criteria</a></em>\n    <br/>\n    <em><a href=\"#definitions\">Logic Definitions</a></em>\n    <br/>\n    <em><a href=\"#terminology\">Terminology</a></em>\n    <br/>\n    <em><a href=\"#dependencies\">Dependencies</a></em>\n    <br/>\n    <em><a href=\"#data-requirements\">Data Requirements</a></em>\n    <br/>\n    <em><a href=\"#parameters\">Parameters</a></em>\n    <br/>\n  </td>\n</tr>\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"population-criteria\"> </a>Population Criteria</th>\n\n\n</tr>\n  \n  \n  \n\n  \n  \n  \n    \n    <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\">Measure Group (Rate) (ID: primary)</th>\n\n\n</tr>\n  \n  \n  \n\n  \n\n\n  \n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"definitions\"> </a>Logic Definitions</th>\n\n\n</tr>\n  \n  \n          \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> AdultOutpatientEncounters</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"adultoutpatientencounters-qualifying-encounters\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Qualifying Encounters&quot;:\n  ([Encounter: &quot;Office Visit&quot;]\n    union [Encounter: &quot;Annual Wellness Visit&quot;]\n    union [Encounter: &quot;Preventive Care Services - Established Office Visit, 18 and Up&quot;]\n    union [Encounter: &quot;Preventive Care Services-Initial Office Visit, 18 and Up&quot;]\n    union [Encounter: &quot;Home Healthcare Services&quot;]\n  ) ValidEncounter\n    where ValidEncounter.period during &quot;Measurement Period&quot;\n      and ValidEncounter.status  = 'finished'</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> Hospice</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"hospice-has-hospice\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Has Hospice&quot;:\n\texists (\n    [Encounter: &quot;Encounter Inpatient&quot;] DischargeHospice\n\t\t\twhere DischargeHospice.status = 'finished'\n\t\t    and (\n\t        DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to home for hospice care (procedure)&quot;\n\t\t\t\t    or DischargeHospice.hospitalization.dischargeDisposition ~ &quot;Discharge to healthcare facility for hospice care (procedure)&quot;\n\t    \t)\n\t\t\t\tand DischargeHospice.period ends during &quot;Measurement Period&quot;\n\t)\n    or exists (\n      [ServiceRequest: &quot;Hospice care ambulatory&quot;] HospiceOrder\n        where HospiceOrder.intent = 'order'\n            and HospiceOrder.authoredOn in &quot;Measurement Period&quot;\n    )\n    or exists (\n      [Procedure: &quot;Hospice care ambulatory&quot;] HospicePerformed\n        where HospicePerformed.status = 'completed'\n          and Global.&quot;Normalize Interval&quot;(HospicePerformed.performed) overlaps &quot;Measurement Period&quot;\n    )</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  case\n      when Patient.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  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  [Coverage: type in &quot;Payer&quot;] Payer\n        return {\n          code: Payer.type,\n          period: Payer.period\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\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  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> SupplementalDataElements</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"supplementaldataelements-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\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  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-sde-sex\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Sex&quot;:\n  SDE.&quot;SDE Sex&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-cervical-cytology-within-3-years\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Cervical Cytology Within 3 Years&quot;:\n\t[Observation: &quot;Pap Test&quot;] CervicalCytology\n\t\twhere CervicalCytology.value is not null\n\t\t\tand CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }\n\t\t  and Global.&quot;Normalize Interval&quot;(CervicalCytology.effective) ends 3 years or less on or before end of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-hpv-test-within-5-years-for-women-age-30-and-older\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;HPV Test Within 5 Years for Women Age 30 and Older&quot;:\n\t[Observation: &quot;HPV Test&quot;] HPVTest\n      where HPVTest.value is not null\n        and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }\n        and  Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of Global.&quot;Normalize Interval&quot;(HPVTest.effective))&gt;= 30\n        and Global.&quot;Normalize Interval&quot;(HPVTest.effective) ends 5 years or less on or before end of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-numerator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Numerator&quot;:\n\texists &quot;Cervical Cytology Within 3 Years&quot;\n\t\tor exists &quot;HPV Test Within 5 Years for Women Age 30 and Older&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-initial-population\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Initial Population&quot;:\n\tPatient.gender = 'female'\n\t\tand Global.&quot;CalendarAgeInYearsAt&quot;(FHIRHelpers.ToDate(Patient.birthDate), start of &quot;Measurement Period&quot;) in Interval[23, 64]\n\t\tand exists AdultOutpatientEncounters.&quot;Qualifying Encounters&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-denominator\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator&quot;:\n\t&quot;Initial Population&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-sde-payer\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Payer&quot;:\n  SDE.&quot;SDE Payer&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-sde-ethnicity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Ethnicity&quot;:\n  SDE.&quot;SDE Ethnicity&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-absence-of-cervix\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Absence of Cervix&quot;:\n  ([Procedure: &quot;Hysterectomy with No Residual Cervix&quot;] NoCervixProcedure\n   where Global.&quot;Normalize Interval&quot;(NoCervixProcedure.performed) ends on or before end of &quot;Measurement Period&quot;\n     and NoCervixProcedure.status = 'completed'\n     )\n  union [Condition : &quot;Congenital absence of cervix (disorder)&quot;] NoCervixBirth\n\t\twhere Global.&quot;Normalize Interval&quot;(NoCervixBirth.onset) starts on or before end of &quot;Measurement Period&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-denominator-exclusion\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;Denominator Exclusion&quot;:\n\tHospice.&quot;Has Hospice&quot;\n\t\tor exists &quot;Absence of Cervix&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> EXM124</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"exm124-sde-race\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define &quot;SDE Race&quot;:\n  SDE.&quot;SDE Race&quot;</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> MATGlobalCommonFunctions</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"matglobalcommonfunctions-normalize-interval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n*\n*    CQFMeasures Common Logic\n*\n*/\n\ndefine function &quot;Normalize Interval&quot;(choice Choice&lt;FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range&gt;):\n  case\n\t  when choice is FHIR.dateTime then\n    \tInterval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n\t\twhen choice is FHIR.Period then\n  \t\tFHIRHelpers.ToInterval(choice as FHIR.Period)\n\t\twhen choice is FHIR.instant then\n\t\t\tInterval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n\t\twhen choice is FHIR.Age then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n\t\twhen choice is FHIR.Range then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n\t\twhen choice is FHIR.Timing then\n\t\t  Message(null as Interval&lt;DateTime&gt;, true, '1', 'Error', 'Cannot compute a single interval from a Timing type')\n    when choice is FHIR.string then\n      Message(null as Interval&lt;DateTime&gt;, true, '1', 'Error', 'Cannot compute an interval from a String value')\n\t\telse\n\t\t\tnull as Interval&lt;DateTime&gt;\n\tend</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> MATGlobalCommonFunctions</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"matglobalcommonfunctions-calendarageinyearsat\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function &quot;CalendarAgeInYearsAt&quot;(BirthDateTime DateTime, AsOf DateTime):\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> MATGlobalCommonFunctions</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"matglobalcommonfunctions-todate\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function &quot;ToDate&quot;(Value DateTime):\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n\n        \n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value AdministrativeGender): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ObservationStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value dateTime): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tointerval\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.&quot;start&quot; is null then\n            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]\n        else\n            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todatetime\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDateTime(value instant): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-todate\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToDate(value date): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toquantity\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocalendarunit\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n\n        \n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value EncounterStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value uri): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-toconcept\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tocode\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ServiceRequestIntent): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n        \n\n\n<tr>\n  <th scope=\"row\" rowspan=\"2\" class=\"row-header\">\n    Logic Definition\n  </th>\n\n  <td class=\"content-container\"><em>Library Name:</em> FHIRHelpers</td>\n\n</tr>\n<tr>\n\n  <td>\n    \n    \n    \n    \n      <a name=\"fhirhelpers-tostring\"> </a>\n    \n    <pre style=\"border: none;\" class=\"content-container highlight language-cql\"><code class=\"language-cql\">define function ToString(value ProcedureStatus): value.value</code></pre>\n  </td>\n\n</tr>\n\n\n\n\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"terminology\"> </a>Terminology</th>\n\n\n</tr>\n  \n  \n  \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n<tr>\n  \n  \n  \n\n<th scope=\"row\" class=\"row-header\">Code System</th>\n\n\n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Code system SNOMEDCT:2017-09\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <code>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</code>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Pap Test\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1017/expansion\">Pap Test</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set HPV Test\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1059/expansion\">HPV Test</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Office Visit\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Annual Wellness Visit\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Preventive Care Services - Established Office Visit, 18 and Up\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Preventive Care Services-Initial Office Visit, 18 and Up\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Home Healthcare Services\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Payer\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Encounter Inpatient\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Hospice care ambulatory\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n  \n\n<th scope=\"row\" class=\"row-header\">Value Set</th>\n\n\n  \n  \n  <td class=\"content-container\">\n    \n    <em>Description</em>: Value set Hysterectomy with No Residual Cervix\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1014/expansion\">Hysterectomy with No Residual Cervix</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014</tt>\n    \n  </td>\n</tr>\n \n\n\n  \n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Discharge to home for hospice care (procedure)\n        <br/>\n      \n      <em>Code</em>: 428361000124107\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Discharge to healthcare facility for hospice care (procedure)\n        <br/>\n      \n      <em>Code</em>: 428371000124100\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  <tr>\n    <th scope=\"row\" class=\"row-header\">Direct Reference Code</th>\n    <td class=\"content-container\">\n      \n        <em>Display</em>: Congenital absence of cervix (disorder)\n        <br/>\n      \n      <em>Code</em>: 37687000\n      <br/>\n      <em>System</em>: <tt>http://snomed.info/sct</tt>\n    </td>\n  </tr>\n\n  \n  \n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"dependencies\"> </a>Dependencies</th>\n\n\n</tr>\n  \n  \n  \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: 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  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library SDE\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-SupplementalDataElements.html\">Supplemental Data Elementsversion: null2.0.000)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library FHIRHelpers\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"http://hl7.org/fhir/uv/cql/STU2/Library-FHIRHelpers.html\">http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library Global\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-MATGlobalCommonFunctions.html\">MAT Global Common Functions FHIR Libraryversion: null5.0.000)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library AdultOutpatientEncounters\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-AdultOutpatientEncounters.html\">Adult Outpatient Encounters Common Libraryversion: null2.0.000)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000</tt>\n    \n  </td>\n</tr>\n \n\n\n<tr>\n  \n\n<th scope=\"row\" class=\"row-header\">Dependency</th>\n\n\n  <td class=\"content-container\">\n    \n    <em>Description</em>: Library Hospice\n    \n    <br/>\n    \n    \n    \n    \n    \n    \n    <em>Resource</em>: <a href=\"Library-Hospice.html\">Hospice FHIR Libraryversion: null2.0.000)</a>\n    <br/>\n    <em>Canonical URL</em>: <tt>http://hl7.org/fhir/uv/cqm/Library/Hospice|2.0.000</tt>\n    \n  </td>\n</tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n\n  \n  \n\n\n\n\n\n\n  <tr>\n\n\n<th colspan=\"2\" scope=\"row\" class=\"row-header\"><a name=\"data-requirements\"> </a>Data Requirements</th>\n\n\n</tr>\n  \n  \n  \n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Patient\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/patient.html\">Patient</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: url, extension, value\n    <br/>\n   \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/observation.html\">Observation</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, value, status, effective\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.108.12.1017/expansion\">Pap Test</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Observation\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/observation.html\">Observation</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, value, status, effective\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.110.12.1059/expansion\">HPV Test</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1001/expansion\">Office Visit</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.1240/expansion\">Annual Wellness Visit</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1025/expansion\">Preventive Care Services Established Office Visit, 18 and Up</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1023/expansion\">Preventive Care Services Initial Office Visit, 18 and Up</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.101.12.1016/expansion\">Home Healthcare Services</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Encounter\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/encounter.html\">Encounter</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, status, hospitalization, hospitalization.dischargeDisposition, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.666.5.307/expansion\">Encounter Inpatient</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Coverage\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/coverage.html\">Coverage</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: type, period\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: type</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.3591/expansion\">Payer Type</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: ServiceRequest\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/servicerequest.html\">ServiceRequest</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, intent, authoredOn\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, status, performed\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1108.15/expansion\">Hospice Care Ambulatory</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Procedure\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/procedure.html\">Procedure</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, performed, status\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n    <span class=\"tab-one\"><em>ValueSet</em>:</span> <a href=\"https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.198.12.1014/expansion\">Hysterectomy with No Residual Cervix</a>\n    <br/> \n  \n  \n  \n   \n  </td>\n</tr>\n\n<tr>\n  <th scope=\"row\" class=\"row-header\">Data Requirement</th>\n  <td class=\"content-container\">\n    <em>Type</em>: Condition\n    <br/>\n  \n    <em>Profile(s)</em>: \n  \n    <a href=\"http://hl7.org/fhir/R4/condition.html\">Condition</a>\n    <br/>        \n  \n   \n   \n    <em>Must Support Elements</em>: code, onset\n    <br/>\n   \n  \n    <em>Code Filter(s)</em>: \n    <br/>\n  \n  \n    <span class=\"tab-one\"><em>Path</em>: code</span>\n    <br/>\n  \n  \n  \n  \n    <span class=\"tab-one\"><em>Code(s)</em>: \n    \n      \n      <a href=\"http://snomed.info/id/37687000\">SNOMED CT: 37687000</a> (Congenital absence of cervix (disorder)) (version = http://snomed.info/sct/731000124108/version/201709 )\n      \n    \n    </span>\n    <br/>\n  \n  \n   \n  </td>\n</tr>\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\"/>\n\n\n  <td class=\"content-container\">\n    <table>\n      <thead>\n        <tr>\n          <td><em>Name</em></td>\n          <td><em>Use</em></td>\n          <td><em>Card.</em></td>\n          <td><em>Type</em></td>\n          <td><em>Documentation</em></td>\n        </tr>\n      </thead>\n      <tbody>\n      \n        <tr>\n          <td>Measurement Period</td>\n          <td>In</td>\n          <td>0..1</td>\n          <td>Period</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Sex</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>Coding</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Numerator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Payer</td>\n          <td>Out</td>\n          <td>0..*</td>\n          <td>Resource</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Initial Population</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Ethnicity</td>\n          <td>Out</td>\n          <td>0..*</td>\n          <td>Coding</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>Denominator Exclusion</td>\n          <td>Out</td>\n          <td>0..1</td>\n          <td>boolean</td>\n          <td/>\n        </tr>\n      \n        <tr>\n          <td>SDE Race</td>\n          <td>Out</td>\n          <td>0..*</td>\n          <td>Coding</td>\n          <td/>\n        </tr>\n      \n      </tbody>\n    </table>\n  </td>\n</tr>\n\n  \n  \n\n<tr>\n  <th colspan=\"2\" scope=\"row\" class=\"row-header\">Generated using version 0.5.4 of the sample-content-ig Liquid templates</th>\n</tr>\n\n    </tbody>\n  </table>\n</div>"
      },
      "contained" : [
        {
          "resourceType" : "Library",
          "id" : "effective-data-requirements",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "version" : "http://snomed.info/sct/731000124108/version/201709",
                "code" : "428361000124107",
                "display" : "Discharge to home for hospice care (procedure)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "version" : "http://snomed.info/sct/731000124108/version/201709",
                "code" : "428371000124100",
                "display" : "Discharge to healthcare facility for hospice care (procedure)"
              }
            },
            {
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode",
              "valueCoding" : {
                "system" : "http://snomed.info/sct",
                "version" : "http://snomed.info/sct/731000124108/version/201709",
                "code" : "37687000",
                "display" : "Congenital absence of cervix (disorder)"
              }
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Sex"
                },
                {
                  "url" : "statement",
                  "valueString" : "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"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 0
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Sex"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Sex\":\n  SDE.\"SDE Sex\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 1
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Cervical Cytology Within 3 Years"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Cervical Cytology Within 3 Years\":\n\t[Observation: \"Pap Test\"] CervicalCytology\n\t\twhere CervicalCytology.value is not null\n\t\t\tand CervicalCytology.status in { 'final', 'amended', 'corrected', 'preliminary' }\n\t\t  and Global.\"Normalize Interval\"(CervicalCytology.effective) ends 3 years or less on or before end of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 2
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "HPV Test Within 5 Years for Women Age 30 and Older"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"HPV Test Within 5 Years for Women Age 30 and Older\":\n\t[Observation: \"HPV Test\"] HPVTest\n      where HPVTest.value is not null\n        and HPVTest.status in { 'final', 'amended', 'corrected', 'preliminary' }\n        and  Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of Global.\"Normalize Interval\"(HPVTest.effective))>= 30\n        and Global.\"Normalize Interval\"(HPVTest.effective) ends 5 years or less on or before end of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 3
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Numerator"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Numerator\":\n\texists \"Cervical Cytology Within 3 Years\"\n\t\tor exists \"HPV Test Within 5 Years for Women Age 30 and Older\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 4
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "AdultOutpatientEncounters"
                },
                {
                  "url" : "name",
                  "valueString" : "Qualifying Encounters"
                },
                {
                  "url" : "statement",
                  "valueString" : "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  ) ValidEncounter\n    where ValidEncounter.period during \"Measurement Period\"\n      and ValidEncounter.status  = 'finished'"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 5
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Initial Population"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Initial Population\":\n\tPatient.gender = 'female'\n\t\tand Global.\"CalendarAgeInYearsAt\"(FHIRHelpers.ToDate(Patient.birthDate), start of \"Measurement Period\") in Interval[23, 64]\n\t\tand exists AdultOutpatientEncounters.\"Qualifying Encounters\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 6
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator\":\n\t\"Initial Population\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 7
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Payer"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Payer\":\n  [Coverage: type in \"Payer\"] Payer\n        return {\n          code: Payer.type,\n          period: Payer.period\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 8
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Payer"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Payer\":\n  SDE.\"SDE Payer\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 9
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Ethnicity"
                },
                {
                  "url" : "statement",
                  "valueString" : "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"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 10
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Ethnicity"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Ethnicity\":\n  SDE.\"SDE Ethnicity\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 11
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "Hospice"
                },
                {
                  "url" : "name",
                  "valueString" : "Has Hospice"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Has Hospice\":\n\texists (\n    [Encounter: \"Encounter Inpatient\"] DischargeHospice\n\t\t\twhere DischargeHospice.status = 'finished'\n\t\t    and (\n\t        DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to home for hospice care (procedure)\"\n\t\t\t\t    or DischargeHospice.hospitalization.dischargeDisposition ~ \"Discharge to healthcare facility for hospice care (procedure)\"\n\t    \t)\n\t\t\t\tand DischargeHospice.period ends during \"Measurement Period\"\n\t)\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    )"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 12
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Absence of Cervix"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Absence of Cervix\":\n  ([Procedure: \"Hysterectomy with No Residual Cervix\"] NoCervixProcedure\n   where Global.\"Normalize Interval\"(NoCervixProcedure.performed) ends on or before end of \"Measurement Period\"\n     and NoCervixProcedure.status = 'completed'\n     )\n  union [Condition : \"Congenital absence of cervix (disorder)\"] NoCervixBirth\n\t\twhere Global.\"Normalize Interval\"(NoCervixBirth.onset) starts on or before end of \"Measurement Period\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 13
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "Denominator Exclusion"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"Denominator Exclusion\":\n\tHospice.\"Has Hospice\"\n\t\tor exists \"Absence of Cervix\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 14
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "SupplementalDataElements"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Race"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Race\":\n  (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"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 15
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "EXM124"
                },
                {
                  "url" : "name",
                  "valueString" : "SDE Race"
                },
                {
                  "url" : "statement",
                  "valueString" : "define \"SDE Race\":\n  SDE.\"SDE Race\""
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 16
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value AdministrativeGender): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 17
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ObservationStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 18
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "MATGlobalCommonFunctions"
                },
                {
                  "url" : "name",
                  "valueString" : "Normalize Interval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n*\n*    CQFMeasures Common Logic\n*\n*/\n\ndefine function \"Normalize Interval\"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>):\n  case\n\t  when choice is FHIR.dateTime then\n    \tInterval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)]\n\t\twhen choice is FHIR.Period then\n  \t\tFHIRHelpers.ToInterval(choice as FHIR.Period)\n\t\twhen choice is FHIR.instant then\n\t\t\tInterval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)]\n\t\twhen choice is FHIR.Age then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year)\n\t\twhen choice is FHIR.Range then\n\t\t  Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low),\n\t\t\t  FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year)\n\t\twhen choice is FHIR.Timing then\n\t\t  Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type')\n    when choice is FHIR.string then\n      Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value')\n\t\telse\n\t\t\tnull as Interval<DateTime>\n\tend"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 19
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDateTime"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDateTime(value dateTime): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 20
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToInterval"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)\nvalue to a CQL DateTime Interval\n@comment: If the start value of the given period is unspecified, the starting\nboundary of the resulting interval will be open (meaning the start of the interval\nis unknown, as opposed to interpreted as the beginning of time).\n*/\ndefine function ToInterval(period FHIR.Period):\n    if period is null then\n        null\n    else\n        if period.\"start\" is null then\n            Interval(period.\"start\".value, period.\"end\".value]\n        else\n            Interval[period.\"start\".value, period.\"end\".value]"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 21
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDateTime"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDateTime(value instant): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 22
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDate"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToDate(value date): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 23
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToQuantity"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) \nvalue to a CQL Quantity\n@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity\nhas a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)\nan error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.\n@seealso: ToCalendarUnit\n*/\ndefine function ToQuantity(quantity FHIR.Quantity):\n    case\n        when quantity is null then null\n        when quantity.value is null then null\n        when quantity.comparator is not null then\n            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')\n        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'\n              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then\n            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }\n        else\n            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')')\n    end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 24
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToCalendarUnit"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts a UCUM definite duration unit to a CQL calendar duration\nunit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) \ntopic of the CQL specification.\n@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate\n*/\ndefine function ToCalendarUnit(unit System.String):\n    case unit\n        when 'ms' then 'millisecond'\n        when 's' then 'second'\n        when 'min' then 'minute'\n        when 'h' then 'hour'\n        when 'd' then 'day'\n        when 'wk' then 'week'\n        when 'mo' then 'month'\n        when 'a' then 'year'\n        else unit\n    end"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 25
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "MATGlobalCommonFunctions"
                },
                {
                  "url" : "name",
                  "valueString" : "CalendarAgeInYearsAt"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 26
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "MATGlobalCommonFunctions"
                },
                {
                  "url" : "name",
                  "valueString" : "ToDate"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function \"ToDate\"(Value DateTime):\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 27
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value EncounterStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 28
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value uri): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 29
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToConcept"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.\n*/\ndefine function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 30
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToCode"
                },
                {
                  "url" : "statement",
                  "valueString" : "/*\n@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.\n*/\ndefine function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 31
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ServiceRequestIntent): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 32
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            },
            {
              "extension" : [
                {
                  "url" : "libraryName",
                  "valueString" : "FHIRHelpers"
                },
                {
                  "url" : "name",
                  "valueString" : "ToString"
                },
                {
                  "url" : "statement",
                  "valueString" : "define function ToString(value ProcedureStatus): value.value"
                },
                {
                  "url" : "displaySequence",
                  "valueInteger" : 33
                }
              ],
              "url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
            }
          ],
          "name" : "EffectiveDataRequirements",
          "status" : "active",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/library-type",
                "code" : "module-definition"
              }
            ]
          },
          "relatedArtifact" : [
            {
              "type" : "depends-on",
              "display" : "FHIR model information",
              "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"
            },
            {
              "type" : "depends-on",
              "display" : "Library SDE",
              "resource" : "http://hl7.org/fhir/uv/cqm/Library/SupplementalDataElements|2.0.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library FHIRHelpers",
              "resource" : "http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1"
            },
            {
              "type" : "depends-on",
              "display" : "Library Global",
              "resource" : "http://hl7.org/fhir/uv/cqm/Library/MATGlobalCommonFunctions|5.0.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library AdultOutpatientEncounters",
              "resource" : "http://hl7.org/fhir/uv/cqm/Library/AdultOutpatientEncounters|2.0.000"
            },
            {
              "type" : "depends-on",
              "display" : "Library Hospice",
              "resource" : "http://hl7.org/fhir/uv/cqm/Library/Hospice|2.0.000"
            },
            {
              "type" : "depends-on",
              "display" : "Code system SNOMEDCT:2017-09",
              "resource" : "http://snomed.info/sct|http://snomed.info/sct/731000124108/version/201709"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Pap Test",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"
            },
            {
              "type" : "depends-on",
              "display" : "Value set HPV Test",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Office Visit",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Annual Wellness Visit",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preventive Care Services - Established Office Visit, 18 and Up",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Preventive Care Services-Initial Office Visit, 18 and Up",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Home Healthcare Services",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Payer",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Encounter Inpatient",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Hospice care ambulatory",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
            },
            {
              "type" : "depends-on",
              "display" : "Value set Hysterectomy with No Residual Cervix",
              "resource" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014"
            }
          ],
          "parameter" : [
            {
              "name" : "Measurement Period",
              "use" : "in",
              "min" : 0,
              "max" : "1",
              "type" : "Period"
            },
            {
              "name" : "SDE Sex",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "Coding"
            },
            {
              "name" : "Numerator",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "Denominator",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Payer",
              "use" : "out",
              "min" : 0,
              "max" : "*",
              "type" : "Resource"
            },
            {
              "name" : "Initial Population",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Ethnicity",
              "use" : "out",
              "min" : 0,
              "max" : "*",
              "type" : "Coding"
            },
            {
              "name" : "Denominator Exclusion",
              "use" : "out",
              "min" : 0,
              "max" : "1",
              "type" : "boolean"
            },
            {
              "name" : "SDE Race",
              "use" : "out",
              "min" : 0,
              "max" : "*",
              "type" : "Coding"
            }
          ],
          "dataRequirement" : [
            {
              "type" : "Patient",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Patient"
              ],
              "mustSupport" : [
                "url",
                "extension",
                "value"
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Observation"
              ],
              "mustSupport" : [
                "code",
                "value",
                "status",
                "effective"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.108.12.1017"
                }
              ]
            },
            {
              "type" : "Observation",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Observation"
              ],
              "mustSupport" : [
                "code",
                "value",
                "status",
                "effective"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.110.12.1059"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1240"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "period",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"
                }
              ]
            },
            {
              "type" : "Encounter",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Encounter"
              ],
              "mustSupport" : [
                "type",
                "status",
                "hospitalization",
                "hospitalization.dischargeDisposition",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.666.5.307"
                }
              ]
            },
            {
              "type" : "Coverage",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Coverage"
              ],
              "mustSupport" : [
                "type",
                "period"
              ],
              "codeFilter" : [
                {
                  "path" : "type",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"
                }
              ]
            },
            {
              "type" : "ServiceRequest",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/ServiceRequest"
              ],
              "mustSupport" : [
                "code",
                "intent",
                "authoredOn"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
              ],
              "mustSupport" : [
                "code",
                "status",
                "performed"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15"
                }
              ]
            },
            {
              "type" : "Procedure",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Procedure"
              ],
              "mustSupport" : [
                "code",
                "performed",
                "status"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "valueSet" : "http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.198.12.1014"
                }
              ]
            },
            {
              "type" : "Condition",
              "profile" : [
                🔗 "http://hl7.org/fhir/StructureDefinition/Condition"
              ],
              "mustSupport" : [
                "code",
                "onset"
              ],
              "codeFilter" : [
                {
                  "path" : "code",
                  "code" : [
                    {
                      "system" : "http://snomed.info/sct",
                      "version" : "http://snomed.info/sct/731000124108/version/201709",
                      "code" : "37687000",
                      "display" : "Congenital absence of cervix (disorder)"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ],
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/uv/cqm/StructureDefinition/cqm-populationBasis",
          "valueCode" : "boolean"
        },
        {
          "url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
          "valueCanonical" : "#effective-data-requirements"
        }
      ],
      "url" : "http://hl7.org/fhir/uv/cqm/Measure/EXM124-FHIR",
      "identifier" : [
        {
          "use" : "official",
          "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/cms",
          "value" : "124"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                "code" : "version-independent",
                "display" : "Version Independent"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "http://example.org/fhir/us/cqm/Measure/EXM124-FHIR"
        },
        {
          "use" : "official",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                "code" : "version-specific",
                "display" : "Version Specific"
              }
            ]
          },
          "system" : "urn:ietf:rfc:3986",
          "value" : "http://example.org/fhir/us/cqm/Measure/CMS124v7"
        },
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/artifact-identifier-type",
                "code" : "short-name",
                "display" : "Short Name"
              }
            ]
          },
          "value" : "Cervical Cancer Screening"
        },
        {
          "use" : "official",
          "system" : "http://example.org/fhir/cqi/ecqm/Measure/Identifier/mips",
          "value" : "309"
        },
        {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:oid:2.16.840.1.113883.4.642.40.61.29.4"
        }
      ],
      "version" : "9.0.000",
      "name" : "EXM124",
      "title" : "EXM124 - Cervical Cancer Screening",
      "status" : "active",
      "experimental" : true,
      "date" : "2025-08-13",
      "publisher" : "HL7 International / Clinical Quality Information",
      "contact" : [
        {
          "telecom" : [
            {
              "system" : "url",
              "value" : "http://www.hl7.org/Special/committees/cqi"
            }
          ]
        }
      ],
      "description" : "Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: \n*  Women age 21-64 who had cervical cytology performed every 3 years \n*  Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years",
      "useContext" : [
        {
          "code" : {
            "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
            "code" : "venue",
            "display" : "Clinical Venue"
          },
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/uv/cqm/CodeSystem/intended-venue-codes",
                "code" : "ec",
                "display" : "EC"
              }
            ]
          }
        }
      ],
      "jurisdiction" : [
        {
          "coding" : [
            {
              "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
              "code" : "001"
            }
          ]
        }
      ],
      "purpose" : "This measure has been developed to support improvement in clinical care.",
      "usage" : "To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23. \n Patient self-report for procedures as well as diagnostic studies should be recorded in 'Procedure, Performed' template or 'Diagnostic Study, Performed' template in QRDA-1. \n Include only cytology and HPV \"co-testing\"; in co-testing, both cytology and HPV tests are performed (i.e., the samples are collected and both tests are ordered, regardless of the cytology result) on the same date of service. Do not include reflex testing. In addition, if the medical record indicates the HPV test was performed only after determining the cytology result, this is considered reflex testing and does not meet criteria for the measure.",
      "copyright" : "This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. \n Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. \n CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R] ) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.",
      "approvalDate" : "2016-01-01",
      "lastReviewDate" : "2016-09-01",
      "effectivePeriod" : {
        "start" : "2018-01-01",
        "end" : "2018-12-31"
      },
      "topic" : [
        {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "57024-2",
              "display" : "Health Quality Measure Document"
            }
          ]
        }
      ],
      "library" : [
        🔗 "http://hl7.org/fhir/uv/cqm/Library/EXM124"
      ],
      "disclaimer" : "The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND. \n Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
      "scoring" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
            "code" : "proportion",
            "display" : "Proportion"
          }
        ]
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/measure-type",
              "code" : "process"
            }
          ]
        }
      ],
      "rationale" : "Breast cancer is one of the most common types of cancers, accounting for 15 percent of all new cancer diagnoses in the U.S. (Howlader et al, 2016). In 2013, over 3 million women were estimated to be living with breast cancer in the U.S. and it is estimated that 12 percent of women will be diagnosed with breast cancer at some point during their lifetime (Howlader et al, 2016). \n While there are other factors that affect a woman's risk of developing breast cancer, advancing age is a primary risk factor. Breast cancer is most frequently diagnosed among women ages 55-64; the median age at diagnosis is 62 years (Howlader et al, 2016). The chance of a woman being diagnosed with breast cancer in a given year increases with age. By age 40, the chances are 1 in 235; by age 50 it becomes 1 in 54; by age 60, it is 1 in 25 (National Business Group on Health, 2011). \n In the U.S., costs associated with a diagnosis of breast cancer range from $451 to $2,520, factoring in continued testing, multiple office visits and procedures. The total costs related to breast cancer add up to nearly $7 billion per year in the U.S., including $2 billion spent on late-stage treatment (National Business Group on Health, 2011). If breast cancer is detected through mammography screening and diagnosed in its earliest stages, treatment may be less expensive (Feig, 2011).",
      "clinicalRecommendationStatement" : "The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50-74 years (B recommendation).  \n The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). (USPSTF, 2016) \n The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). (USPSTF, 2016) \n The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I Statement). (USPSTF, 2016)  \n The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging, DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram (I statement). (USPSTF, 2016)",
      "improvementNotation" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
            "code" : "increase",
            "display" : "Increased score indicates improvement"
          }
        ]
      },
      "group" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.linkId",
              "valueString" : "primary"
            }
          ],
          "description" : "Percentage of women 21-64 years of age who were screened for cervical cancer using either of the following criteria: \n*  Women age 21-64 who had cervical cytology performed every 3 years \n*  Women age 30-64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years",
          "population" : [
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
                  "valueString" : "primary-exm124-initial-population"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "initial-population",
                    "display" : "Initial Population"
                  }
                ]
              },
              "description" : "Women 23-64 years of age with a visit during the measurement period",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Initial Population"
              }
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
                  "valueString" : "primary-exm124-numerator"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "numerator",
                    "display" : "Numerator"
                  }
                ]
              },
              "description" : "Women with one or more screenings for cervical cancer. Appropriate screenings are defined by any one of the following criteria:\n* Cervical cytology performed during the measurement period or the two years prior to the measurement period for women who are at least 21 years old at the time of the test\n* Cervical human papillomavirus (HPV) testing performed during the measurement period or the four years prior to the measurement period for women who are 30 years or older at the time of the test",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Numerator"
              }
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
                  "valueString" : "primary-exm124-denominator"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator",
                    "display" : "Denominator"
                  }
                ]
              },
              "description" : "Equals Initial Population",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator"
              }
            },
            {
              "extension" : [
                {
                  "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.group.population.linkId",
                  "valueString" : "primary-exm124-denominator-exclusion"
                }
              ],
              "code" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/measure-population",
                    "code" : "denominator-exclusion",
                    "display" : "Denominator Exclusion"
                  }
                ]
              },
              "description" : "Women who had a hysterectomy with no residual cervix or a congenital absence of cervix.\nExclude patients who are in hospice care for any part of the measurement period.\nExclude patients receiving palliative care during the measurement period.",
              "criteria" : {
                "language" : "text/cql-identifier",
                "expression" : "Denominator Exclusion"
              }
            }
          ]
        }
      ],
      "supplementalData" : [
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
              "valueString" : "primary-sde-ethnicity"
            }
          ],
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Ethnicity"
          }
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
              "valueString" : "primary-sde-payer"
            }
          ],
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Payer"
          }
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
              "valueString" : "primary-sde-race"
            }
          ],
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "description" : "Race",
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Race"
          }
        },
        {
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/5.0/StructureDefinition/extension-Measure.supplementalData.linkId",
              "valueString" : "primary-sde-sex"
            }
          ],
          "code" : {
            "text" : "Sex"
          },
          "usage" : [
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/measure-data-usage",
                  "code" : "supplemental-data"
                }
              ]
            }
          ],
          "criteria" : {
            "language" : "text/cql-identifier",
            "expression" : "SDE Sex"
          }
        }
      ]
    }