Thank you for your inquiry about CMS156v13 (performance period 2025). The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class on different days. Therefore, only medications that are ordered by the physician are included in the numerator. Please reference the measure specification for the most updated list of high-risk medications considered for this measure as well as further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS156v13.html . If you need assistance reading an eCQM, please refer to the resources available at eCQI Resource Center, such as "Guide for Reading eCQMs" or "Implementation Checklist eCQM Annual Update": https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs .