"Are the codes alone in the valueset "ACE Inhibitor or ARB or ARNI Ingredient" enough to identify an allergy? To me the valueset is a list of actual medications...not linked to a reason of not given due to an allergy?" If an allergy or intolerance to any option listed in the “ACE Inhibitor or ARB or ARNI Ingredient” value set is documented in a patient’s medical record, then the patient can be determined to have an allergy or intolerance to an ACE-I or ARB or ARNI ingredient and can be excepted from the denominator for the measure. The value set contains ingredients from acceptable prescribable ACE-I, ARB, or ARNI that a patient may have an allergy or intolerance to. "Can you clarify why the valueset that has the 'ingredients' are exceptions while the valuesets that are just ACE/ARB/ARNI are numerator MET?" Related to the above response, if a patient has an allergy or intolerance to an ingredient listed in the value set, they can be excepted from the measure. If a patient has an ACE-I, ARB, or ARNI prescribed or active then they would meet the criteria for the value set used for the numerator. Each value set is evaluating different documentation for the patient (new or active allergy/intolerance vs new or active/prescribed therapy).