Thank you for your inquiry for CMS156v11 Use of High-Risk Medications in Older Adults (2023 Performance Period). Your interpretation is correct. This logic is used to capture instances where a patient is ordered a high-risk medication with a refill, so there is not a separate, discrete order for another high-risk medication on a different day. For the first part of the "such that... or..." statement, the function looks for one instance of Medication Order where the authorDatetime is during the measurement period and there is one or more refills as part of the order. This would satisfy two orders of high-risk medications from the same drug class, because this refill would count as a second order, per the definition field. For the second part of the "such that... or..." statement, the function looks for two instances of Medication Order where both occurred during the measurement period but on different dates. This captures instances where two high-risk medications in the same drug class are ordered on different days. Hope this helps.