The "2014 CMS QRDA III Implementation Guides for Eligible Professionals Clinical Quality Measures" zip file contains a QRDA-III sample file for the CPC program. This sample file is valid against the CMS 2014 QRDA-III implementation guide and additionally, it conforms to the CPC program's specific requirements. The zip file is available for download from the CMS eCQM Library web site
http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eCQM_Library.html. You could modify this sample file so it conforms to the MU specific requirements.