Thank you for your inquiry regarding CMS816v3 Hospital Harm – Severe Hypoglycemia. Regarding question 1) and 4) - only one numerator is counted per qualifying encounter regardless of the number of hypoglycemic events that occur during that encounter. We aim to capture the number of patients who experience harm, instead of the number of harms in a hospitalization, to simplify the measure while still capturing a signal of hospital quality. In your testcase scenario, the numerator would be met because there is at least one glucose result <40 mg/dL, and there was no subsequent glucose test with result >80 mg/dL within 5 minutes. Only one qualifying severe hypoglycemia event is counted: the earliest glucose result <40 mg/dL (i.e., 2345-7). Regarding question 2) for ‘Glucose Test with Result Less Than 40’, only the earliest glucose test result would be returned (i.e., 2345-7). For ‘Low Glucose Test Followed By Glucose Test Result Greater Than 80’, no glucose value would be returned because the earliest glucose result (i.e., 2345-7) started more than 5 minutes before glucose test result of 85 mg/dl (i.e., 2339-0). Regarding question 3) ”The Low Glucose Test Followed By Glucose Test Result Greater Than 80".id is false because the earliest glucose test result of < 40 mg/dl (i.e., 2345-7) and the earliest glucose test result > 80 mg/dl (i.e., 2339-0) are more than 5 minutes apart. We hope this helps.