Hello, we are currently in the middle of our CQM 2023 updates and we're nearly finished updating our CMS 156 logic changes. 

I noticed that in Cypress, the patient Juanita Rowe has 1 refill for one of her medication orders. However, in the XML it is expressed as <repeatNumber value="2"/>. This repeatNumber is what gets uploaded to our MongoDB and subsequently used in our Numerator1 calculations.

I was wondering if this was a defect in Cypress. According to Cypress, Juanita would NOT qualify for Numerator because of MedOrder1.daysSupplied = 30 and MedOrder2.supply = 30 * (1.0 + 1-refill), giving us a total of 90 which is not strictly greater than 90. 

But using repeatNumber=2 and the following calculation, she DOES qualify due to the (1 + Coalesce(AntiInfectives.refills, 0)) section. Using repeatNumber=2 would instead yield 120, which is of course greater than 90.

Two High Risk Medications with Prolonged Duration

• Sum(("More Than One Order"(["Medication, Order": "Anti Infectives, other"]))AntiInfectives
  let DaysSupply: Coalesce(AntiInfectives.daysSupplied, AntiInfectives.supply.value /(AntiInfectives.dosage.value * CMD.ToDaily(AntiInfectives.frequency)))*(1 + Coalesce(AntiInfectives.refills, 0))
  return all DaysSupply
  )> 90