Thank you for your inquiry about CMS146v11, Appropriate Testing for Pharyngitis. This measure identifies a strep test via QDM datatype "Laboratory Test, Performed" along with the value set "Group A Streptococcus Test", and identifies a non-null test result using via QDM attribute "result". A non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. This measure does not require a specific result (positive or negative) from the strep test. The denominator for the measure includes patients who were diagnosed with pharyngitis and who were dispensed an antibiotic. The numerator assesses whether these patients received a group A strep test, regardless of the result. The intent is to determine whether antibiotics are being ordered appropriately. An antibiotic must be ordered within the correct timeframe for a patient to fall into the denominator criteria regardless of their strep test result. Otherwise, if an antibiotic is not ordered within the required timeframe for the denominator, a patient will not meet measure criteria.