Thanks for your question. The RXNORM code 114865 (28 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT Dry Powder Inhaler) is not included in the Preferred Asthma Therapy value set this year. During the 2017 annual update cycle, we'll make sure to include it in the 'Preferred Asthma Therapy' value set.  In short, SCDs are used based on the guidance in the ECQM Logic and Implementation Guidance document, available at: https://ecqi.healthit.gov/system/files/ecqm-logic-and-guidance-v-1-12-04-06-2016.pdf   From Section 5.2: Value sets referring to specific non-vaccine prescribable medications use generalized drug concepts (for example, RxNorm “SCD” - Semantic Clinical Drugs1). It is expected that vendors/providers will report the drug entities in patient data using the generalized drug concepts included in the defined value sets. This is in accordance with guidance from CMS about the preferred use of generalized drug concepts. Implementers should use the relationships found in RxNorm ( http://www.nlm.nih.gov/research/umls/rxnorm/index.html ) to support mapping between specific drug entities found in patient records to those found in the value sets provided.