​Thank you for your question on CMS154v11: Appropriate Treatment for Upper Respiratory Infection (URI). The language in the header specifying the denominator exclusion criteria for an active prescription of antibiotics states: "Exclude URI episodes when the patient had an active prescription of antibiotics in the 30 days prior to the episode date but is still active on the same day of the encounter." To meet the exclusion criteria, an active prescription of antibiotics must be present within the 30 days prior to the episode date, which is correctly specified in the logic. If the specified active prescription remains active on the day of the encounter, it still counts as an exclusion. This timing criteria is evaluated in the logic using the overlaps operator to check if the active medication period overlaps with the 30-day period prior to the episode date, as per the logic specification. For additional clarification, two scenarios are provided below: 1. Consider an EncounterWithURI on 12/31/2012 and an ActiveAntibiotic prescription with an interval of 9/30/2012-1/31/2013. In this scenario, the active antibiotic prescription meets the denominator exclusion criteria because it overlaps with the 30-day period preceding the episode date and continues to be active on the day of the encounter. 2. Consider an EncounterWithURI on 12/31/2012 and an ActiveAntibiotic prescription with an interval of 12/31/2012-3/31/2013. In this case, the active antibiotic prescription does not meet the denominator exclusion criteria. Although it is active on the episode date, it does not overlap with the 30-day period prior to the episode date.

 with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic     such that ( Global."NormalizeInterval" ( ActiveAntibiotic.relevantDatetime, ActiveAntibiotic.relevantPeriod ) overlaps day of Interval[start of EncounterWithURI.relevantPeriod - 30 days, start of EncounterWithURI.relevantPeriod - 1 day])   return EncounterWithURI