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                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">1.0.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Short Name</th> 
                           <td class="content-container">CMS135FHIR</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">GUID (Version Independent)</th> 
                           <td class="content-container">urn:uuid:86136d6c-dbe1-4b7f-89f3-406cb90f08d5</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">GUID (Version Specific)</th> 
                           <td class="content-container">urn:uuid:a0aa7f51-9882-4ceb-b4e5-bb94669b62ca</td> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CMS Identifier</th> 
                           <td class="content-container">135FHIR</td> 
                        </tr>   
                        <tr> 
                           <th scope="row" class="row-header">CMS Consensus Based Entity Identifier</th> 
                           <td class="content-container">0081e</td> 
                        </tr>   
                        <tr> 
                           <th scope="row" class="row-header">Effective Period</th> 
                           <td class="content-container">2026-01-01 through 2026-12-31</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">American Heart Association</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Developer</th> 
                           <td class="content-container">American Heart Association</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Developer</th> 
                           <td class="content-container">American Medical Association (AMA)</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">
                              <p>Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) &lt;=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Copyright</th> 
                           <td class="content-container">
                              <p>Copyright 2025 American College of Cardiology and American Heart Association. All Rights Reserved.</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Disclaimer</th> 
                           <td class="content-container">
                              <p>The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.</p> 
                              <p>The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.</p> 
                              <p>Commercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.</p> 
                              <p>ACC and AHA encourage use of the Measure by other health care professionals, where appropriate. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.</p> 
                              <p>Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications.</p> 
                              <p>CPT(R) contained in the Measure specifications is copyright 2004-20234 American Medical Association. LOINC(R) is copyright 2004-20234 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-20234 International Health Terminology Standards Development Organisation. ICD-10 is copyright 20234 World Health Organization. All Rights Reserved.</p> 
                              <p>The American Medical Association’s and the PCPI(R) Foundation’s significant past efforts and contributions to the performance measure are gratefully acknowledged. Due to technical limitations, registered trademarks are indicated by (R) or [R].</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Rationale</th> 
                           <td class="content-container">
                              <p>Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor–intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Clinical Recommendation Statement</th> 
                           <td class="content-container">
                              <p>In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF, the use of angiotension-converting enzyme inhibitors (ACEi) is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022). ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).</p> 
                              <p>Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)</p> 
                              <table style="width: 1020px" class="rich-text-table"> 
                                 <colgroup> 
                                    <col style="width: 203px"></col> 
                                    <col style="width: 209px"></col> 
                                    <col style="width: 205px"></col> 
                                    <col style="width: 403px"></col> 
                                 </colgroup> 
                                 <tbody> 
                                    <tr> 
                                       <th colspan="1" rowspan="1" colwidth="203">
                                          <p>Drug</p>
                                       </th> 
                                       <th colspan="1" rowspan="1" colwidth="209">
                                          <p>Initial Daily Dose(s)</p>
                                       </th> 
                                       <th colspan="1" rowspan="1" colwidth="205">
                                          <p>Target Dose(s)</p>
                                       </th> 
                                       <th colspan="1" rowspan="1" colwidth="403">
                                          <p>Mean Doses Achieved in Clinical Trials</p>
                                       </th> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>
                                             <em> ACEi </em>
                                          </p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p></p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Captopril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>6.25 mg 3 times</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>50 mg 3 times</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>122.7 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Enalapril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>2.5 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>10 to 20 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>16.6 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Fosinopril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>5 to 10 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>40 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>N/A</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Lisinopril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>2.5 to 5 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>20 to 40 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>32.5 to 35.0 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Perindopril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>2 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>8 to 16 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>N/A</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Quinapril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>5 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>20 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>N/A</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Ramipril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>1.25 to 2.5 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>10 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>N/A</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Trandolapril</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>1 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>4 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>N/A</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>
                                             <em> ARB</em>
                                          </p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p></p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Candesartan</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>4 to 8 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>32 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>24 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Losartan</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>25 to 50 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>50 to 150 mg once</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>129 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Valsartan</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>20 to 40 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>160 mg twice</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>254 mg total daily</p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>
                                             <em> ARNI</em>
                                          </p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p></p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p></p>
                                       </td> 
                                    </tr> 
                                    <tr> 
                                       <td colspan="1" rowspan="1" colwidth="203">
                                          <p>Sacubitril-valsartan</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="209">
                                          <p>49/51 mg twice (sacubitril/valsartan)</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="205">
                                          <p>97/103 mg twice (sacubitril/valsartan)</p>
                                       </td> 
                                       <td colspan="1" rowspan="1" colwidth="403">
                                          <p>182/193 mg (sacubitril/valsartan) total daily</p>
                                          <p>(therapy may be initiated at 24/26 mg twice)</p>
                                       </td> 
                                    </tr> 
                                 </tbody> 
                              </table>
                           </td> 
                        </tr> 
                        <tr>   
                           <th scope="row" class="row-header">Citation</th>  
                           <td class="content-container">  
                              <p>Heidenreich, P.A., Bozkurt, B, Aguilar, D., ... Allen, L. A. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. doi: 10.1161/CIR.0000000000001063</p>   
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">Definition</th> 
                           <td class="content-container">Moderate or Severe LVSD: 
                              <p>LVEF &lt;=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:</p> 
                              <ol> 
                                 <li>
                                    <p>that provides a numerical value of LVSD or</p>
                                 </li> 
                                 <li>
                                    <p>that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.</p>
                                 </li> 
                              </ol>
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">Definition</th> 
                           <td class="content-container">Prescribed: 
                              <p>Denotes that a prescription has been given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR that the patient is already taking an ACE inhibitor or ARB or ARNI therapy as documented in their current medication list</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Guidance (Usage)</th> 
                           <td class="content-container">
                              <p>This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.</p> 
                              <p>The requirement of two or more visits is used to establish that the eligible clinician has an existing relationship with the patient.</p> 
                              <p>A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.</p> 
                              <p>In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of "below 40%" or "ejection fraction between 35 and 40%" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as "Moderate or Severe."</p> 
                              <p>Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.</p> 
                              <p>This FHIR-based measure has been derived from the QDM-based measure CMS135v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).</p>
                           </td> 
                        </tr>  
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th> 
                        </tr>   
                        <tr> 
                           <th scope="row" class="row-header">Basis</th> 
                           <td class="content-container">boolean</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Scoring</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-scoring#proportion: 'Proportion']</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-type#process: 'Process']</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Improvement Notation</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/measure-improvement-notation#increase: 'Increased score indicates improvement']</td> 
                        </tr>  
                        <tr>  
                           <th scope="row" class="row-header">Initial Population</th> 
                           <td class="content-container"> 
                              <em>ID</em>: InitialPopulation_1 
                              <br></br>  
                              <em>Description</em>: 
                              <p style="white-space: pre-line" class="tab-one">
                                 <p>All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter</p>
                              </p>   
                              <em>Logic Definition</em>: 
                              <a href="#primary-cms135fhiraceiorarborarniforhf-initial-population">Initial Population</a>  
                           </td> 
                        </tr>  
                        <tr>  
                           <th scope="row" class="row-header">Denominator</th> 
                           <td class="content-container"> 
                              <em>ID</em>: Denominator_1 
                              <br></br>  
                              <em>Description</em>: 
                              <p style="white-space: pre-line" class="tab-one">
                                 <p>Equals Initial Population with a current or prior LVEF &lt;= 40%</p>
                              </p>   
                              <em>Logic Definition</em>: 
                              <a href="#primary-cms135fhiraceiorarborarniforhf-denominator">Denominator</a>  
                           </td> 
                        </tr>  
                        <tr>  
                           <th scope="row" class="row-header">Denominator Exclusion</th> 
                           <td class="content-container"> 
                              <em>ID</em>: DenominatorExclusion_1 
                              <br></br>  
                              <em>Description</em>: 
                              <p style="white-space: pre-line" class="tab-one">
                                 <p>Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD</p>
                              </p>   
                              <em>Logic Definition</em>: 
                              <a href="#primary-cms135fhiraceiorarborarniforhf-denominator-exclusions">Denominator Exclusions</a>  
                           </td> 
                        </tr>  
                        <tr>  
                           <th scope="row" class="row-header">Numerator</th> 
                           <td class="content-container"> 
                              <em>ID</em>: Numerator_1 
                              <br></br>  
                              <em>Description</em>: 
                              <p style="white-space: pre-line" class="tab-one">
                                 <p>Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period</p>
                              </p>   
                              <em>Logic Definition</em>: 
                              <a href="#primary-cms135fhiraceiorarborarniforhf-numerator">Numerator</a>  
                           </td> 
                        </tr>  
                        <tr>  
                           <th scope="row" class="row-header">Denominator Exception</th> 
                           <td class="content-container"> 
                              <em>ID</em>: DenominatorException_1 
                              <br></br>  
                              <em>Description</em>: 
                              <p style="white-space: pre-line" class="tab-one">
                                 <ul> 
                                    <li>
                                       <p>Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).</p>
                                    </li> 
                                    <li>
                                       <p>Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).</p>
                                    </li> 
                                 </ul>
                              </p>   
                              <em>Logic Definition</em>: 
                              <a href="#primary-cms135fhiraceiorarborarniforhf-denominator-exceptions">Denominator Exceptions</a>  
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" class="row-header">Supplemental Data Guidance</th> 
                           <td class="content-container">
                              <p>For every patient evaluated by this measure also identify payer, race, ethnicity and sex</p>
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Supplemental Data Elements</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Supplemental Data Element</th> 
                           <td class="content-container"> 
                              <em>ID</em>: sde-ethnicity  
                              <br></br>   
                              <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                              <br></br>  
                              <em>Description</em>: SDE Ethnicity   
                              <br></br> 
                              <em>Logic Definition</em>: 
                              <a href="#cms135fhiraceiorarborarniforhf-sde-ethnicity">SDE Ethnicity</a>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Supplemental Data Element</th> 
                           <td class="content-container"> 
                              <em>ID</em>: sde-payer  
                              <br></br>   
                              <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                              <br></br>  
                              <em>Description</em>: SDE Payer   
                              <br></br> 
                              <em>Logic Definition</em>: 
                              <a href="#cms135fhiraceiorarborarniforhf-sde-payer">SDE Payer</a>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Supplemental Data Element</th> 
                           <td class="content-container"> 
                              <em>ID</em>: sde-race  
                              <br></br>   
                              <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                              <br></br>  
                              <em>Description</em>: SDE Race   
                              <br></br> 
                              <em>Logic Definition</em>: 
                              <a href="#cms135fhiraceiorarborarniforhf-sde-race">SDE Race</a>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Supplemental Data Element</th> 
                           <td class="content-container"> 
                              <em>ID</em>: sde-sex  
                              <br></br>   
                              <em>Usage Code</em>: [http://terminology.hl7.org/CodeSystem/measure-data-usage#supplemental-data]  
                              <br></br>  
                              <em>Description</em>: SDE Sex   
                              <br></br> 
                              <em>Logic Definition</em>: 
                              <a href="#cms135fhiraceiorarborarniforhf-sde-sex">SDE Sex</a>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Measure Logic</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Primary Library</th> 
                           <td class="content-container">https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Contents</th> 
                           <td class="content-container"> 
                              <em>
                                 <a href="#population-criteria">Population Criteria</a>
                              </em> 
                              <br></br> 
                              <em>
                                 <a href="#definitions">Logic Definitions</a>
                              </em> 
                              <br></br> 
                              <em>
                                 <a href="#terminology">Terminology</a>
                              </em> 
                              <br></br> 
                              <em>
                                 <a href="#dependencies">Dependencies</a>
                              </em> 
                              <br></br> 
                              <em>
                                 <a href="#data-requirements">Data Requirements</a>
                              </em> 
                              <br></br> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">
                              <a name="population-criteria"> </a>Population Criteria
                           </th> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Measure Group (Rate) (ID: Group_1)</th> 
                        </tr>                  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="primary-cms135fhiraceiorarborarniforhf-initial-population"> </a>  Initial Population  
                           </th> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
  AHA."Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"</code></pre> 
                           </td> 
                        </tr>                                                        
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="primary-cms135fhiraceiorarborarniforhf-denominator"> </a>  Denominator  
                           </th> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
  "Initial Population"
    and exists AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"</code></pre> 
                           </td> 
                        </tr>                                                               
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="primary-cms135fhiraceiorarborarniforhf-denominator-exclusions"> </a>  Denominator Exclusion  
                           </th> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
  AHA."Has Heart Transplant"
    or AHA."Has Heart Transplant Complications"
    or AHA."Has Left Ventricular Assist Device"
    or AHA."Has Left Ventricular Assist Device Complications"</code></pre> 
                           </td> 
                        </tr>                                        
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="primary-cms135fhiraceiorarborarniforhf-numerator"> </a>  Numerator  
                           </th> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  "Has ACEI or ARB or ARNI Ordered"
    or "Is Currently Taking ACEI or ARB or ARNI"</code></pre> 
                           </td> 
                        </tr>                                                                            
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="primary-cms135fhiraceiorarborarniforhf-denominator-exceptions"> </a>  Denominator Exception  
                           </th> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
  "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI"
    or "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient"
    or "Has Diagnosis of Allergy or Intolerance to ACEI or ARB"
    or "Has Diagnosis of Pregnancy"
    or "Has Diagnosis of Renal Failure Due to ACEI"</code></pre> 
                           </td> 
                        </tr>                      
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">
                              <a name="definitions"> </a>Logic Definitions
                           </th> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="supplementaldataelements-sde-sex"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> SupplementalDataElements
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end</code></pre> 
                           </td> 
                        </tr>        
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="supplementaldataelements-sde-payer"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> SupplementalDataElements
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="supplementaldataelements-sde-ethnicity"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> SupplementalDataElements
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }</code></pre> 
                           </td> 
                        </tr>    
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="supplementaldataelements-sde-race"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> SupplementalDataElements
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }</code></pre> 
                           </td> 
                        </tr>              
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-sde-sex"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Sex":
  SDE."SDE Sex"</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-acei-or-arb-or-arni-ordered"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has ACEI or ARB or ARNI Ordered":
  exists ( [MedicationRequest: medication in "ACE Inhibitor or ARB or ARNI"] ACEIOrARBOrARNIOrdered
      where ACEIOrARBOrARNIOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-is-currently-taking-acei-or-arb-or-arni"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Is Currently Taking ACEI or ARB or ARNI":
  exists ( [MedicationRequest: medication in "ACE Inhibitor or ARB or ARNI"] ActiveACEIOrARBOrARNI
      where ActiveACEIOrARBOrARNI.overlapsAfterHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-numerator"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  "Has ACEI or ARB or ARNI Ordered"
    or "Is Currently Taking ACEI or ARB or ARNI"</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-initial-population"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
  AHA."Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-denominator"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
  "Initial Population"
    and exists AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-sde-payer"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Payer":
  SDE."SDE Payer"</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-sde-ethnicity"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Ethnicity":
  SDE."SDE Ethnicity"</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-denominator-exclusions"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exclusions":
  AHA."Has Heart Transplant"
    or AHA."Has Heart Transplant Complications"
    or AHA."Has Left Ventricular Assist Device"
    or AHA."Has Left Ventricular Assist Device Complications"</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-sde-race"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "SDE Race":
  SDE."SDE Race"</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-medical-or-patient-reason-for-not-ordering-acei-or-arb-or-arni"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI":
  exists ( [MedicationNotRequested: medication in "ACE Inhibitor or ARB or ARNI"] NoACEIOrARBOrARNIOrdered
      where NoACEIOrARBOrARNIOrdered.isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter ( )
        and ( NoACEIOrARBOrARNIOrdered.reasonCode in "Medical Reason"
            or NoACEIOrARBOrARNIOrdered.reasonCode in "Patient Reason"
            or NoACEIOrARBOrARNIOrdered.reasonCode in "Patient Reason for ACE Inhibitor or ARB Decline"
        )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-allergy-or-intolerance-to-acei-or-arb-or-arni-ingredient"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient":
  exists ( ( [AllergyIntolerance: "ACE Inhibitor or ARB or ARNI Ingredient"]
      union [AllergyIntolerance: "Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"]
      union [AllergyIntolerance: "Substance with angiotensin II receptor antagonist mechanism of action (substance)"]
      union [AllergyIntolerance: "Substance with neprilysin inhibitor mechanism of action (substance)"] ) ACEIOrARBOrARNIAllergyIntolerance
      where ACEIOrARBOrARNIAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-diagnosis-of-allergy-or-intolerance-to-acei-or-arb"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Diagnosis of Allergy or Intolerance to ACEI or ARB":
  exists ( ( ( ["ConditionProblemsHealthConcerns": "Allergy to ACE Inhibitor or ARB"]
        union ["ConditionEncounterDiagnosis": "Allergy to ACE Inhibitor or ARB"]
    )
      union ( ["ConditionProblemsHealthConcerns": "Intolerance to ACE Inhibitor or ARB"] )
      union ["ConditionEncounterDiagnosis": "Intolerance to ACE Inhibitor or ARB"] ) ACEIOrARBAllergyOrIntoleranceDiagnosis
      where ACEIOrARBAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-diagnosis-of-pregnancy"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Diagnosis of Pregnancy":
  exists ( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
      union ["ConditionEncounterDiagnosis": "Pregnancy"] ) PregnancyDiagnosis
      with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that PregnancyDiagnosis.prevalenceInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
          and PregnancyDiagnosis.isVerified ( )
  )
    or exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
        with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
          such that PregnantObservation.effective.toInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
            and ( PregnantObservation.value in "Pregnancy"
                and PregnantObservation.status in { 'final', 'amended', 'corrected' }
            )
    )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-has-diagnosis-of-renal-failure-due-to-acei"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Diagnosis of Renal Failure Due to ACEI":
  exists ( ( [ConditionProblemsHealthConcerns: "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"]
      union [ConditionEncounterDiagnosis: "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"] ) RenalFailureDueToACEI
      where RenalFailureDueToACEI.overlapsHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="cms135fhiraceiorarborarniforhf-denominator-exceptions"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> CMS135FHIRACEIorARBorARNIforHF
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
  "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI"
    or "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient"
    or "Has Diagnosis of Allergy or Intolerance to ACEI or ARB"
    or "Has Diagnosis of Pregnancy"
    or "Has Diagnosis of Renal Failure Due to ACEI"</code></pre> 
                           </td> 
                        </tr>                            
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="qicorecommon-prevalenceinterval"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> QICoreCommon
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="qicorecommon-abatementinterval"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> QICoreCommon
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="qicorecommon-references"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> QICoreCommon
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resource Resource):
  resource.id = Last(Split(reference.reference, '/'))</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="qicorecommon-tointerval"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> QICoreCommon
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end</code></pre> 
                           </td> 
                        </tr>                    
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="fhirhelpers-tostring"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> FHIRHelpers
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function ToString(value uri): value.value</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="fhirhelpers-tointerval"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> FHIRHelpers
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]</code></pre> 
                           </td> 
                        </tr>     
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="fhirhelpers-tocode"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> FHIRHelpers
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="fhirhelpers-toconcept"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> FHIRHelpers
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }</code></pre> 
                           </td> 
                        </tr>    
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-outpatient-encounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Outpatient Encounter":
  ( [Encounter: "Care Services in Long Term Residential Facility"]
      union [Encounter: "Home Healthcare Services"]
      union [Encounter: "Nursing Facility Visit"]
      union [Encounter: "Office Visit"]
      union [Encounter: "Outpatient Consultation"]
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-heart-failure-outpatient-encounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns certain finished encounter types that overlap a Heart Failure condition and are during the measurement period: 
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
*/
define "Heart Failure Outpatient Encounter":
  "Outpatient Encounter" QualifyingEncounter
    with ( [ConditionProblemsHealthConcerns: "Heart Failure"]
      union [ConditionEncounterDiagnosis: "Heart Failure"] ) HeartFailure
      such that HeartFailure.prevalenceInterval ( ) overlaps day of QualifyingEncounter.period
        and HeartFailure.isVerified ( )
    where QualifyingEncounter.period during day of "Measurement Period"
      and QualifyingEncounter.isEncounterFinished ( )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-moderate-or-severe-lvsd-findings"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns a union  of the following:
                * Observations where the final, amended or correction ejection fraction result is &lt;= 40
                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active
*/
define "Moderate or Severe LVSD Findings":
  ( [ObservationClinicalResult: "Ejection Fraction"] EjectionFraction
      where EjectionFraction.value as Quantity &lt;= 40 '%'
        and EjectionFraction.status in { 'final', 'amended', 'corrected' }
  )
    union ( ( ( [ConditionProblemsHealthConcerns: "Moderate or Severe LVSD"]
          union [ConditionEncounterDiagnosis: "Moderate or Severe LVSD"]
      )
        union ( ( [ConditionProblemsHealthConcerns: "Left ventricular systolic dysfunction (disorder)"]
            union [ConditionEncounterDiagnosis: "Left ventricular systolic dysfunction (disorder)"] ) LVSDDiagnosis
            where LVSDDiagnosis.severity in "Moderate or Severe"
        ) ) ModerateOrSevereLVSD
        where ModerateOrSevereLVSD.isVerified ( )
    )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-heart-failure-outpatient-encounter-with-history-of-moderate-or-severe-lvsd"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns heart failure outpatient encounters that start before the end of a moderate or severe LVSD finding
*/
define "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD":
  "Heart Failure Outpatient Encounter" HFOutpatientEncounter
    with "Moderate or Severe LVSD Findings" LVSDFindings
      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of HFOutpatientEncounter.period</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-outpatient-encounter-or-patient-provider-interaction"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Outpatient Encounter or Patient Provider Interaction":
  "Outpatient Encounter"
    union [Encounter: "Patient Provider Interaction"]</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-qualifying-outpatient-encounter-during-measurement-period"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns certain finished encounter types that occurred during the measurement period: 
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * patient provider interactions (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012) 
*/
define "Qualifying Outpatient Encounter During Measurement Period":
  "Outpatient Encounter or Patient Provider Interaction" ValidEncounter
    where ValidEncounter.period during day of "Measurement Period"
      and ValidEncounter.isEncounterFinished ( )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-is-adult-with-two-qualifying-outpatient-encounters-and-one-heart-failure-outpatient-encounter-during-the-measurement-period"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the patient meets the following criteria:
                * 18 years of age or older,
                * Has two Qualifying Outpatient Encounters During Measurement Period
                * Has a Heart Failure Outpatient Encounter
*/
define "Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period":
  AgeInYearsAt(date from start of "Measurement Period") &gt;= 18
    and exists ( "Qualifying Outpatient Encounter During Measurement Period" Encounter1
        with "Qualifying Outpatient Encounter During Measurement Period" Encounter2
          such that Encounter2.id !~ Encounter1.id
    )
    and exists "Heart Failure Outpatient Encounter"</code></pre> 
                           </td> 
                        </tr>    
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-has-heart-transplant"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns completed heart tansplant procedures that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Heart Transplant":
  exists ( [Procedure: "Heart Transplant"] HeartTransplant
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that HeartTransplant.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplant.status = 'completed'
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-has-heart-transplant-complications"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if patient has confirmed heart transplant complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD 
*/
define "Has Heart Transplant Complications":
  exists ( ( [ConditionEncounterDiagnosis: "Heart Transplant Complications"]
      union [ConditionProblemsHealthConcerns: "Heart Transplant Complications"] ) HeartTransplantComplications
      let diagnosisStart: Coalesce(start of HeartTransplantComplications.prevalenceInterval(), HeartTransplantComplications.recordedDate)
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplantComplications.isVerified ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-has-left-ventricular-assist-device"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if patient has a completed LVAD placement that starts before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Left Ventricular Assist Device":
  exists ( [Procedure: "Left Ventricular Assist Device Placement"] LVADPlacement
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that LVADPlacement.performed.toInterval ( ) starts before day of end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADPlacement.status = 'completed'
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-has-left-ventricular-assist-device-complications"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if patient has active LVAD complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Left Ventricular Assist Device Complications":
  exists ( ( [ConditionEncounterDiagnosis: "Left Ventricular Assist Device Complications"]
      union [ConditionProblemsHealthConcerns: "Left Ventricular Assist Device Complications"] ) LVADComplications
      let diagnosisStart: Coalesce(start of LVADComplications.prevalenceInterval(), LVADComplications.recordedDate)
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADComplications.isVerified ( )
  )</code></pre> 
                           </td> 
                        </tr>      
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-isorderedduringheartfailureoutpatientencounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given MedicationRequest is ordered during the heart failure outpatient encounter with history of moderate or severe LVSD at any point
*/
define fluent function isOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-isverified"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given Condition has a verification status of "confirmed", "unconfirmed", "provisional", or "differential"
*/
define fluent function isVerified(condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon."confirmed"
      or condition.verificationStatus ~ QICoreCommon."unconfirmed"
      or condition.verificationStatus ~ QICoreCommon."provisional"
      or condition.verificationStatus ~ QICoreCommon."differential"
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-isencounterfinished"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given Encounter is finished
*/
define fluent function isEncounterFinished(Encounter Encounter):
  Encounter.status = 'finished'</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-overlapsafterheartfailureoutpatientencounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@overloaded
@description: Returns true if the given MedicationRequest overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where First((collapse(MedicationRequest.dosageInstruction.timing.repeat.bounds DoseTime
            return TimingBoundToInterval(MedicationRequest.authoredOn, DoseTime)
        )) DrugPeriods
          sort by start of $this
      ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-timingboundtointerval"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define function TimingBoundToInterval(startDate System.DateTime, choice Choice&lt;Quantity, Interval&lt;Quantity&gt;, Interval&lt;DateTime&gt;&gt;):
  case
    when choice is Interval&lt;DateTime&gt; then
        choice as Interval&lt;DateTime&gt;
    when choice is Interval&lt;Quantity&gt; then
        Interval[startDate + (choice.low as Quantity), startDate + (choice.high as Quantity)]
    when choice is Quantity then
        Interval[startDate, startDate + (choice as Quantity))
    else
		null as Interval&lt;DateTime&gt;
	end</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-ismedicationnotrequestedorderedduringheartfailureoutpatientencounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given MedicationNotRequested overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationNotRequested):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'completed', 'active' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-overlapsafterheartfailureoutpatientencounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@overloaded
@description: Returns true if the given AllergyIntolerance overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(AllergyIntolerance AllergyIntolerance):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Interval[start of AllergyIntolerance.onset.toInterval ( ), AllergyIntolerance.lastOccurrence]overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and AllergyIntolerance.isVerified ( )
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-isverified"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/
define fluent function isVerified(AllergyIntolerance AllergyIntolerance):
  AllergyIntolerance.verificationStatus is not null implies ( AllergyIntolerance.verificationStatus ~ QICoreCommon."allergy-confirmed"
      or AllergyIntolerance.verificationStatus ~ QICoreCommon."allergy-unconfirmed"
  )</code></pre> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" rowspan="2" class="row-header">  
                              <a name="ahaoverall-overlapsafterheartfailureoutpatientencounter"> </a> Logic Definition 
                           </th> 
                           <td class="content-container">
                              <em>Library Name:</em> AHAOverall
                           </td> 
                        </tr> 
                        <tr> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@overloaded
@description: Returns true if the given Condition overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(Condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Condition.prevalenceInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and Condition.isVerified ( )
  )</code></pre> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">
                              <a name="terminology"> </a>Terminology
                           </th> 
                        </tr>     
                        <tr>  
                           <th scope="row" class="row-header">Code System</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Code system SNOMEDCT  
                              <br></br>    
                              <em>Resource</em>: http://snomed.info/sct 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Code System</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Code system ConditionVerificationStatusCodes  
                              <br></br>    
                              <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-ver-status 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Code System</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Code system ConditionClinicalStatusCodes  
                              <br></br>    
                              <em>Resource</em>: http://terminology.hl7.org/CodeSystem/condition-clinical 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Code System</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Code system TaskCodeSystem  
                              <br></br>    
                              <em>Resource</em>: http://hl7.org/fhir/CodeSystem/task-code 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://hl7.org/fhir/CodeSystem/task-code</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Code System</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Code system AllergyIntoleranceVerificationStatusCodes  
                              <br></br>    
                              <em>Resource</em>: http://terminology.hl7.org/CodeSystem/allergyintolerance-verification 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set ACE Inhibitor or ARB or ARNI  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Care Services in Long Term Residential Facility  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Home Healthcare Services  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Nursing Facility Visit  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Office Visit  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Outpatient Consultation  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Heart Failure  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Ejection Fraction  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Moderate or Severe LVSD  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Moderate or Severe  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Patient Provider Interaction  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Payer Type  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591  
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Heart Transplant  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Heart Transplant Complications  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Left Ventricular Assist Device Placement  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Left Ventricular Assist Device Complications  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Medical Reason  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Patient Reason  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Patient Reason for ACE Inhibitor or ARB Decline  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set ACE Inhibitor or ARB or ARNI Ingredient  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Allergy to ACE Inhibitor or ARB  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Intolerance to ACE Inhibitor or ARB  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212</tt> 
                           </td> 
                        </tr> 
                        <tr>  
                           <th scope="row" class="row-header">Value Set</th>  
                           <td class="content-container"> 
                              <em>Description</em>: Value set Pregnancy  
                              <br></br>    
                              <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378</tt> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Male (finding) 
                              <br></br> 
                              <em>Code</em>: 248153007 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Female (finding) 
                              <br></br> 
                              <em>Code</em>: 248152002 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Confirmed 
                              <br></br> 
                              <em>Code</em>: confirmed 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Unconfirmed 
                              <br></br> 
                              <em>Code</em>: unconfirmed 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Provisional 
                              <br></br> 
                              <em>Code</em>: provisional 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Differential 
                              <br></br> 
                              <em>Code</em>: differential 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-ver-status</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Left ventricular systolic dysfunction (disorder) 
                              <br></br> 
                              <em>Code</em>: 134401001 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Active 
                              <br></br> 
                              <em>Code</em>: active 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Recurrence 
                              <br></br> 
                              <em>Code</em>: recurrence 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Relapse 
                              <br></br> 
                              <em>Code</em>: relapse 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/condition-clinical</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Fulfill 
                              <br></br> 
                              <em>Code</em>: fulfill 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://hl7.org/fhir/CodeSystem/task-code</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance) 
                              <br></br> 
                              <em>Code</em>: 372733002 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Substance with angiotensin II receptor antagonist mechanism of action (substance) 
                              <br></br> 
                              <em>Code</em>: 372913009 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Substance with neprilysin inhibitor mechanism of action (substance) 
                              <br></br> 
                              <em>Code</em>: 786886009 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Confirmed 
                              <br></br> 
                              <em>Code</em>: confirmed 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Unconfirmed 
                              <br></br> 
                              <em>Code</em>: unconfirmed 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-verification</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Direct Reference Code</th> 
                           <td class="content-container"> 
                              <em>Display</em>: Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder) 
                              <br></br> 
                              <em>Code</em>: 422593004 
                              <br></br> 
                              <em>System</em>: 
                              <tt>http://snomed.info/sct</tt> 
                           </td> 
                        </tr>  
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">
                              <a name="dependencies"> </a>Dependencies
                           </th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">Dependency</th> 
                           <td class="content-container"> 
                              <em>Description</em>: QICore model information  
                              <br></br>    
                              <em>Resource</em>: http://hl7.org/fhir/Library/QICore-ModelInfo 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>http://hl7.org/fhir/Library/QICore-ModelInfo</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Dependency</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Library SDE  
                              <br></br>    
                              <em>Resource</em>: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>https://madie.cms.gov/Library/SupplementalDataElements|5.1.000</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Dependency</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Library FHIRHelpers  
                              <br></br>    
                              <em>Resource</em>: https://madie.cms.gov/Library/FHIRHelpers|4.4.000 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>https://madie.cms.gov/Library/FHIRHelpers|4.4.000</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Dependency</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Library AHA  
                              <br></br>    
                              <em>Resource</em>: https://madie.cms.gov/Library/AHAOverall|4.1.000 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>https://madie.cms.gov/Library/AHAOverall|4.1.000</tt> 
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Dependency</th> 
                           <td class="content-container"> 
                              <em>Description</em>: Library QICoreCommon  
                              <br></br>    
                              <em>Resource</em>: https://madie.cms.gov/Library/QICoreCommon|4.0.000 
                              <br></br> 
                              <em>Canonical URL</em>: 
                              <tt>https://madie.cms.gov/Library/QICoreCommon|4.0.000</tt> 
                           </td> 
                        </tr>                
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">
                              <a name="data-requirements"> </a>Data Requirements
                           </th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Patient 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient 
                              <br></br>   
                              <em>Must Support Elements</em>: extension, birthDate, birthDate.value, url 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: status, period, id, id.value, status.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Observation 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-clinical-result 
                              <br></br>   
                              <em>Must Support Elements</em>: code, value, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Resource 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/StructureDefinition/Resource 
                              <br></br>   
                              <em>Must Support Elements</em>: id, id.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest 
                              <br></br>   
                              <em>Must Support Elements</em>: authoredOn, timing, repeat, bounds, authoredOn.value, status, status.value, intent, intent.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest 
                              <br></br>   
                              <em>Must Support Elements</em>: medication, timing, repeat, bounds 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: medication
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Task 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected 
                              <br></br>   
                              <em>Must Support Elements</em>: focus, code 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Coverage 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Procedure 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure 
                              <br></br>   
                              <em>Must Support Elements</em>: code, performed, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Procedure 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure 
                              <br></br>   
                              <em>Must Support Elements</em>: code, performed, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested 
                              <br></br>   
                              <em>Must Support Elements</em>: authoredOn, authoredOn.value, status, status.value, intent, intent.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested 
                              <br></br>   
                              <em>Must Support Elements</em>: medication, reasonCode 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: medication
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: verificationStatus, onset, lastOccurrence, lastOccurrence.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#372733002: 'Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#372913009: 'Substance with angiotensin II receptor antagonist mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#786886009: 'Substance with neprilysin inhibitor mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Observation 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus 
                              <br></br>   
                              <em>Must Support Elements</em>: effective, effective.value, value, status, status.value 
                              <br></br>  
                           </td> 
                        </tr>  
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
            <contained>
               <Library xmlns="http://hl7.org/fhir">
                  <id value="effective-data-requirements"></id>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="248153007"></code>
                        <display value="Male (finding)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="248152002"></code>
                        <display value="Female (finding)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                        <code value="confirmed"></code>
                        <display value="Confirmed"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                        <code value="unconfirmed"></code>
                        <display value="Unconfirmed"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                        <code value="provisional"></code>
                        <display value="Provisional"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                        <code value="differential"></code>
                        <display value="Differential"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="134401001"></code>
                        <display value="Left ventricular systolic dysfunction (disorder)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                        <code value="active"></code>
                        <display value="Active"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                        <code value="recurrence"></code>
                        <display value="Recurrence"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                        <code value="relapse"></code>
                        <display value="Relapse"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://hl7.org/fhir/CodeSystem/task-code"></system>
                        <code value="fulfill"></code>
                        <display value="Fulfill"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="372733002"></code>
                        <display value="Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="372913009"></code>
                        <display value="Substance with angiotensin II receptor antagonist mechanism of action (substance)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="786886009"></code>
                        <display value="Substance with neprilysin inhibitor mechanism of action (substance)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></system>
                        <code value="confirmed"></code>
                        <display value="Confirmed"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></system>
                        <code value="unconfirmed"></code>
                        <display value="Unconfirmed"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
                     <valueCoding>
                        <system value="http://snomed.info/sct"></system>
                        <code value="422593004"></code>
                        <display value="Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"></display>
                     </valueCoding>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="SupplementalDataElements"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Sex"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Sex&quot;:
  case
    when Patient.sex = '248153007' then &quot;Male (finding)&quot;
    when Patient.sex = '248152002' then &quot;Female (finding)&quot;
    else null
  end"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="0"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Sex"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Sex&quot;:
  SDE.&quot;SDE Sex&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="1"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Outpatient Encounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Outpatient Encounter&quot;:
  ( [Encounter: &quot;Care Services in Long Term Residential Facility&quot;]
      union [Encounter: &quot;Home Healthcare Services&quot;]
      union [Encounter: &quot;Nursing Facility Visit&quot;]
      union [Encounter: &quot;Office Visit&quot;]
      union [Encounter: &quot;Outpatient Consultation&quot;]
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="2"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Heart Failure Outpatient Encounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns certain finished encounter types that overlap a Heart Failure condition and are during the measurement period: 
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
*/
define &quot;Heart Failure Outpatient Encounter&quot;:
  &quot;Outpatient Encounter&quot; QualifyingEncounter
    with ( [ConditionProblemsHealthConcerns: &quot;Heart Failure&quot;]
      union [ConditionEncounterDiagnosis: &quot;Heart Failure&quot;] ) HeartFailure
      such that HeartFailure.prevalenceInterval ( ) overlaps day of QualifyingEncounter.period
        and HeartFailure.isVerified ( )
    where QualifyingEncounter.period during day of &quot;Measurement Period&quot;
      and QualifyingEncounter.isEncounterFinished ( )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="3"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Moderate or Severe LVSD Findings"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns a union  of the following:
                * Observations where the final, amended or correction ejection fraction result is &lt;= 40
                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active
*/
define &quot;Moderate or Severe LVSD Findings&quot;:
  ( [ObservationClinicalResult: &quot;Ejection Fraction&quot;] EjectionFraction
      where EjectionFraction.value as Quantity &lt;= 40 '%'
        and EjectionFraction.status in { 'final', 'amended', 'corrected' }
  )
    union ( ( ( [ConditionProblemsHealthConcerns: &quot;Moderate or Severe LVSD&quot;]
          union [ConditionEncounterDiagnosis: &quot;Moderate or Severe LVSD&quot;]
      )
        union ( ( [ConditionProblemsHealthConcerns: &quot;Left ventricular systolic dysfunction (disorder)&quot;]
            union [ConditionEncounterDiagnosis: &quot;Left ventricular systolic dysfunction (disorder)&quot;] ) LVSDDiagnosis
            where LVSDDiagnosis.severity in &quot;Moderate or Severe&quot;
        ) ) ModerateOrSevereLVSD
        where ModerateOrSevereLVSD.isVerified ( )
    )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="4"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns heart failure outpatient encounters that start before the end of a moderate or severe LVSD finding
*/
define &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot;:
  &quot;Heart Failure Outpatient Encounter&quot; HFOutpatientEncounter
    with &quot;Moderate or Severe LVSD Findings&quot; LVSDFindings
      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of HFOutpatientEncounter.period"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="5"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has ACEI or ARB or ARNI Ordered"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has ACEI or ARB or ARNI Ordered&quot;:
  exists ( [MedicationRequest: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] ACEIOrARBOrARNIOrdered
      where ACEIOrARBOrARNIOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="6"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Is Currently Taking ACEI or ARB or ARNI"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Is Currently Taking ACEI or ARB or ARNI&quot;:
  exists ( [MedicationRequest: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] ActiveACEIOrARBOrARNI
      where ActiveACEIOrARBOrARNI.overlapsAfterHeartFailureOutpatientEncounter ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="7"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Numerator"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Numerator&quot;:
  &quot;Has ACEI or ARB or ARNI Ordered&quot;
    or &quot;Is Currently Taking ACEI or ARB or ARNI&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="8"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Outpatient Encounter or Patient Provider Interaction"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Outpatient Encounter or Patient Provider Interaction&quot;:
  &quot;Outpatient Encounter&quot;
    union [Encounter: &quot;Patient Provider Interaction&quot;]"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="9"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Qualifying Outpatient Encounter During Measurement Period"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns certain finished encounter types that occurred during the measurement period: 
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * patient provider interactions (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012) 
*/
define &quot;Qualifying Outpatient Encounter During Measurement Period&quot;:
  &quot;Outpatient Encounter or Patient Provider Interaction&quot; ValidEncounter
    where ValidEncounter.period during day of &quot;Measurement Period&quot;
      and ValidEncounter.isEncounterFinished ( )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="10"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the patient meets the following criteria:
                * 18 years of age or older,
                * Has two Qualifying Outpatient Encounters During Measurement Period
                * Has a Heart Failure Outpatient Encounter
*/
define &quot;Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period&quot;:
  AgeInYearsAt(date from start of &quot;Measurement Period&quot;) &gt;= 18
    and exists ( &quot;Qualifying Outpatient Encounter During Measurement Period&quot; Encounter1
        with &quot;Qualifying Outpatient Encounter During Measurement Period&quot; Encounter2
          such that Encounter2.id !~ Encounter1.id
    )
    and exists &quot;Heart Failure Outpatient Encounter&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="11"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Initial Population"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Initial Population&quot;:
  AHA.&quot;Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="12"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Denominator"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Denominator&quot;:
  &quot;Initial Population&quot;
    and exists AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="13"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="SupplementalDataElements"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Payer"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Payer&quot;:
  [Coverage: type in &quot;Payer Type&quot;] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="14"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Payer"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Payer&quot;:
  SDE.&quot;SDE Payer&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="15"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="SupplementalDataElements"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Ethnicity"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Ethnicity&quot;:
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="16"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Ethnicity"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Ethnicity&quot;:
  SDE.&quot;SDE Ethnicity&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="17"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Heart Transplant"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns completed heart tansplant procedures that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define &quot;Has Heart Transplant&quot;:
  exists ( [Procedure: &quot;Heart Transplant&quot;] HeartTransplant
      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
        such that HeartTransplant.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplant.status = 'completed'
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="18"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Heart Transplant Complications"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if patient has confirmed heart transplant complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD 
*/
define &quot;Has Heart Transplant Complications&quot;:
  exists ( ( [ConditionEncounterDiagnosis: &quot;Heart Transplant Complications&quot;]
      union [ConditionProblemsHealthConcerns: &quot;Heart Transplant Complications&quot;] ) HeartTransplantComplications
      let diagnosisStart: Coalesce(start of HeartTransplantComplications.prevalenceInterval(), HeartTransplantComplications.recordedDate)
      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplantComplications.isVerified ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="19"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Left Ventricular Assist Device"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if patient has a completed LVAD placement that starts before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define &quot;Has Left Ventricular Assist Device&quot;:
  exists ( [Procedure: &quot;Left Ventricular Assist Device Placement&quot;] LVADPlacement
      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
        such that LVADPlacement.performed.toInterval ( ) starts before day of end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADPlacement.status = 'completed'
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="20"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Left Ventricular Assist Device Complications"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if patient has active LVAD complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define &quot;Has Left Ventricular Assist Device Complications&quot;:
  exists ( ( [ConditionEncounterDiagnosis: &quot;Left Ventricular Assist Device Complications&quot;]
      union [ConditionProblemsHealthConcerns: &quot;Left Ventricular Assist Device Complications&quot;] ) LVADComplications
      let diagnosisStart: Coalesce(start of LVADComplications.prevalenceInterval(), LVADComplications.recordedDate)
      with &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADComplications.isVerified ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="21"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Denominator Exclusions"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Denominator Exclusions&quot;:
  AHA.&quot;Has Heart Transplant&quot;
    or AHA.&quot;Has Heart Transplant Complications&quot;
    or AHA.&quot;Has Left Ventricular Assist Device&quot;
    or AHA.&quot;Has Left Ventricular Assist Device Complications&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="22"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="SupplementalDataElements"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Race"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Race&quot;:
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="23"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="SDE Race"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;SDE Race&quot;:
  SDE.&quot;SDE Race&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="24"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI&quot;:
  exists ( [MedicationNotRequested: medication in &quot;ACE Inhibitor or ARB or ARNI&quot;] NoACEIOrARBOrARNIOrdered
      where NoACEIOrARBOrARNIOrdered.isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter ( )
        and ( NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Medical Reason&quot;
            or NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Patient Reason&quot;
            or NoACEIOrARBOrARNIOrdered.reasonCode in &quot;Patient Reason for ACE Inhibitor or ARB Decline&quot;
        )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="25"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient&quot;:
  exists ( ( [AllergyIntolerance: &quot;ACE Inhibitor or ARB or ARNI Ingredient&quot;]
      union [AllergyIntolerance: &quot;Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)&quot;]
      union [AllergyIntolerance: &quot;Substance with angiotensin II receptor antagonist mechanism of action (substance)&quot;]
      union [AllergyIntolerance: &quot;Substance with neprilysin inhibitor mechanism of action (substance)&quot;] ) ACEIOrARBOrARNIAllergyIntolerance
      where ACEIOrARBOrARNIAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="26"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Diagnosis of Allergy or Intolerance to ACEI or ARB"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has Diagnosis of Allergy or Intolerance to ACEI or ARB&quot;:
  exists ( ( ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Allergy to ACE Inhibitor or ARB&quot;]
        union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Allergy to ACE Inhibitor or ARB&quot;]
    )
      union ( [&quot;ConditionProblemsHealthConcerns&quot;: &quot;Intolerance to ACE Inhibitor or ARB&quot;] )
      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Intolerance to ACE Inhibitor or ARB&quot;] ) ACEIOrARBAllergyOrIntoleranceDiagnosis
      where ACEIOrARBAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="27"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Diagnosis of Pregnancy"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has Diagnosis of Pregnancy&quot;:
  exists ( ( [ConditionProblemsHealthConcerns: &quot;Pregnancy&quot;]
      union [&quot;ConditionEncounterDiagnosis&quot;: &quot;Pregnancy&quot;] ) PregnancyDiagnosis
      with AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
        such that PregnancyDiagnosis.prevalenceInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
          and PregnancyDiagnosis.isVerified ( )
  )
    or exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
        with AHA.&quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
          such that PregnantObservation.effective.toInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
            and ( PregnantObservation.value in &quot;Pregnancy&quot;
                and PregnantObservation.status in { 'final', 'amended', 'corrected' }
            )
    )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="28"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Has Diagnosis of Renal Failure Due to ACEI"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Has Diagnosis of Renal Failure Due to ACEI&quot;:
  exists ( ( [ConditionProblemsHealthConcerns: &quot;Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)&quot;]
      union [ConditionEncounterDiagnosis: &quot;Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)&quot;] ) RenalFailureDueToACEI
      where RenalFailureDueToACEI.overlapsHeartFailureOutpatientEncounter ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="29"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="CMS135FHIRACEIorARBorARNIforHF"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="Denominator Exceptions"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define &quot;Denominator Exceptions&quot;:
  &quot;Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI&quot;
    or &quot;Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient&quot;
    or &quot;Has Diagnosis of Allergy or Intolerance to ACEI or ARB&quot;
    or &quot;Has Diagnosis of Pregnancy&quot;
    or &quot;Has Diagnosis of Renal Failure Due to ACEI&quot;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="30"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="FHIRHelpers"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="ToString"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define function ToString(value uri): value.value"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="31"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="isOrderedDuringHeartFailureOutpatientEncounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given MedicationRequest is ordered during the heart failure outpatient encounter with history of moderate or severe LVSD at any point
*/
define fluent function isOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( [&quot;TaskRejected&quot;] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;
        )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="32"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="FHIRHelpers"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="ToInterval"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period.&quot;start&quot; is null then
            Interval(period.&quot;start&quot;.value, period.&quot;end&quot;.value]
        else
            Interval[period.&quot;start&quot;.value, period.&quot;end&quot;.value]"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="33"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="isVerified"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given Condition has a verification status of &quot;confirmed&quot;, &quot;unconfirmed&quot;, &quot;provisional&quot;, or &quot;differential&quot;
*/
define fluent function isVerified(condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon.&quot;confirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;unconfirmed&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;provisional&quot;
      or condition.verificationStatus ~ QICoreCommon.&quot;differential&quot;
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="34"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="isEncounterFinished"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given Encounter is finished
*/
define fluent function isEncounterFinished(Encounter Encounter):
  Encounter.status = 'finished'"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="35"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="QICoreCommon"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="prevalenceInterval"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
if condition.clinicalStatus ~ &quot;active&quot;
  or condition.clinicalStatus ~ &quot;recurrence&quot;
  or condition.clinicalStatus ~ &quot;relapse&quot; then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="36"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="QICoreCommon"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="abatementInterval"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice&lt;&quot;ConditionEncounterDiagnosis&quot;, &quot;ConditionProblemsHealthConcerns&quot;&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="37"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="QICoreCommon"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="references"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resource Resource):
  resource.id = Last(Split(reference.reference, '/'))"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="38"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="overlapsAfterHeartFailureOutpatientEncounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@overloaded
@description: Returns true if the given MedicationRequest overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
      where First((collapse(MedicationRequest.dosageInstruction.timing.repeat.bounds DoseTime
            return TimingBoundToInterval(MedicationRequest.authoredOn, DoseTime)
        )) DrugPeriods
          sort by start of $this
      ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( [&quot;TaskRejected&quot;] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;
        )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="39"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="TimingBoundToInterval"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="define function TimingBoundToInterval(startDate System.DateTime, choice Choice&lt;Quantity, Interval&lt;Quantity&gt;, Interval&lt;DateTime&gt;&gt;):
  case
    when choice is Interval&lt;DateTime&gt; then
        choice as Interval&lt;DateTime&gt;
    when choice is Interval&lt;Quantity&gt; then
        Interval[startDate + (choice.low as Quantity), startDate + (choice.high as Quantity)]
    when choice is Quantity then
        Interval[startDate, startDate + (choice as Quantity))
    else
		null as Interval&lt;DateTime&gt;
	end"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="40"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="FHIRHelpers"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="ToCode"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="41"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="QICoreCommon"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="toInterval"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="42"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given MedicationNotRequested overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationNotRequested):
  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'completed', 'active' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( [&quot;TaskRejected&quot;] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;
        )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="43"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="FHIRHelpers"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="ToConcept"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="44"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="overlapsAfterHeartFailureOutpatientEncounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@overloaded
@description: Returns true if the given AllergyIntolerance overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(AllergyIntolerance AllergyIntolerance):
  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
      where Interval[start of AllergyIntolerance.onset.toInterval ( ), AllergyIntolerance.lastOccurrence]overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and AllergyIntolerance.isVerified ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="45"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="isVerified"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/
define fluent function isVerified(AllergyIntolerance AllergyIntolerance):
  AllergyIntolerance.verificationStatus is not null implies ( AllergyIntolerance.verificationStatus ~ QICoreCommon.&quot;allergy-confirmed&quot;
      or AllergyIntolerance.verificationStatus ~ QICoreCommon.&quot;allergy-unconfirmed&quot;
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="46"></valueInteger>
                     </extension>
                  </extension>
                  <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
                     <extension url="libraryName">
                        <valueString value="AHAOverall"></valueString>
                     </extension>
                     <extension url="name">
                        <valueString value="overlapsAfterHeartFailureOutpatientEncounter"></valueString>
                     </extension>
                     <extension url="statement">
                        <valueString value="/*
@overloaded
@description: Returns true if the given Condition overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(Condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  exists ( &quot;Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD&quot; ModerateOrSevereLVSDHFOutpatientEncounter
      where Condition.prevalenceInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and Condition.isVerified ( )
  )"></valueString>
                     </extension>
                     <extension url="displaySequence">
                        <valueInteger value="47"></valueInteger>
                     </extension>
                  </extension>
                  <name value="EffectiveDataRequirements"></name>
                  <status value="active"></status>
                  <type>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/library-type"></system>
                        <code value="module-definition"></code>
                     </coding>
                  </type>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="QICore model information"></display>
                     <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Library SDE"></display>
                     <resource value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Library FHIRHelpers"></display>
                     <resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Library AHA"></display>
                     <resource value="https://madie.cms.gov/Library/AHAOverall|4.1.000"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Library QICoreCommon"></display>
                     <resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Code system SNOMEDCT"></display>
                     <resource value="http://snomed.info/sct"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Code system ConditionVerificationStatusCodes"></display>
                     <resource value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Code system ConditionClinicalStatusCodes"></display>
                     <resource value="http://terminology.hl7.org/CodeSystem/condition-clinical"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Code system TaskCodeSystem"></display>
                     <resource value="http://hl7.org/fhir/CodeSystem/task-code"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Code system AllergyIntoleranceVerificationStatusCodes"></display>
                     <resource value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set ACE Inhibitor or ARB or ARNI"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Care Services in Long Term Residential Facility"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Home Healthcare Services"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Nursing Facility Visit"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Office Visit"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Outpatient Consultation"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Heart Failure"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
                     <display value="Value set Ejection Fraction"></display>
                     <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134"></resource>
                  </relatedArtifact>
                  <relatedArtifact>
                     <type value="depends-on"></type>
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                     <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
                     <mustSupport value="code"></mustSupport>
                     <codeFilter>
                        <path value="code"></path>
                        <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489"></valueSet>
                     </codeFilter>
                  </dataRequirement>
                  <dataRequirement>
                     <type value="AllergyIntolerance"></type>
                     <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
                     <mustSupport value="code"></mustSupport>
                     <codeFilter>
                        <path value="code"></path>
                        <code>
                           <system value="http://snomed.info/sct"></system>
                           <code value="372733002"></code>
                           <display value="Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"></display>
                        </code>
                     </codeFilter>
                  </dataRequirement>
                  <dataRequirement>
                     <type value="AllergyIntolerance"></type>
                     <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
                     <mustSupport value="code"></mustSupport>
                     <codeFilter>
                        <path value="code"></path>
                        <code>
                           <system value="http://snomed.info/sct"></system>
                           <code value="372913009"></code>
                           <display value="Substance with angiotensin II receptor antagonist mechanism of action (substance)"></display>
                        </code>
                     </codeFilter>
                  </dataRequirement>
                  <dataRequirement>
                     <type value="AllergyIntolerance"></type>
                     <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
                     <mustSupport value="code"></mustSupport>
                     <codeFilter>
                        <path value="code"></path>
                        <code>
                           <system value="http://snomed.info/sct"></system>
                           <code value="786886009"></code>
                           <display value="Substance with neprilysin inhibitor mechanism of action (substance)"></display>
                        </code>
                     </codeFilter>
                  </dataRequirement>
                  <dataRequirement>
                     <type value="Observation"></type>
                     <profile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus"></profile>
                     <mustSupport value="effective"></mustSupport>
                     <mustSupport value="effective.value"></mustSupport>
                     <mustSupport value="value"></mustSupport>
                     <mustSupport value="status"></mustSupport>
                     <mustSupport value="status.value"></mustSupport>
                  </dataRequirement>
               </Library>
            </contained>
            <extension id="supplementalDataGuidance" url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance">
               <extension url="guidance">
                  <valueString value="&lt;p&gt;For every patient evaluated by this measure also identify payer, race, ethnicity and sex&lt;/p&gt;"></valueString>
               </extension>
               <extension url="usage">
                  <valueCodeableConcept>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
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                     <text value="Supplemental Data Guidance"></text>
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               </extension>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
               <extension url="term">
                  <valueString value="Moderate or Severe LVSD"></valueString>
               </extension>
               <extension url="definition">
                  <valueMarkdown value="LVEF \&lt;=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:

1. that provides a numerical value of LVSD or

2. that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.

"></valueMarkdown>
               </extension>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
               <extension url="term">
                  <valueString value="Prescribed"></valueString>
               </extension>
               <extension url="definition">
                  <valueMarkdown value="Denotes that a prescription has been given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR that the patient is already taking an ACE inhibitor or ARB or ARNI therapy as documented in their current medication list
"></valueMarkdown>
               </extension>
            </extension>
            <extension url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
               <valueReference>
                  <reference value="#effective-data-requirements"></reference>
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            </extension>
            <url value="https://madie.cms.gov/Measure/CMS135FHIRACEIorARBorARNIforHF"></url>
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                  <coding>
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                     <code value="short-name"></code>
                     <display value="Short Name"></display>
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               <system value="https://madie.cms.gov/measure/shortName"></system>
               <value value="CMS135FHIR"></value>
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            <identifier>
               <use value="official"></use>
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                     <code value="endorser"></code>
                     <display value="Endorser"></display>
                  </coding>
               </type>
               <system value="https://madie.cms.gov/measure/cbeId"></system>
               <value value="0081e"></value>
               <assigner>
                  <display value="CMS Consensus Based Entity"></display>
               </assigner>
            </identifier>
            <identifier>
               <use value="official"></use>
               <type>
                  <coding>
                     <system value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"></system>
                     <code value="publisher"></code>
                     <display value="Publisher"></display>
                  </coding>
               </type>
               <system value="https://madie.cms.gov/measure/cmsId"></system>
               <value value="135FHIR"></value>
               <assigner>
                  <display value="CMS"></display>
               </assigner>
            </identifier>
            <version value="1.0.000"></version>
            <name value="CMS135FHIRACEIorARBorARNIforHF"></name>
            <title value="Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)FHIR
"></title>
            <status value="active"></status>
            <experimental value="false"></experimental>
            <date value="2025-08-22T19:19:00+00:00"></date>
            <publisher value="American Heart Association"></publisher>
            <contact>
               <telecom>
                  <system value="url"></system>
                  <value value="https://www.heart.org/"></value>
               </telecom>
            </contact>
            <description value="Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) \&lt;=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period
"></description>
            <usage value="This eCQM is to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.

The requirement of two or more visits is used to establish that the eligible clinician has an existing relationship with the patient.

A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.

In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of &quot;below 40%&quot; or &quot;ejection fraction between 35 and 40%&quot; will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as &quot;Moderate or Severe.&quot;

Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.

This FHIR-based measure has been derived from the QDM-based measure CMS135v14. Please refer to the HL7 QI-Core Implementation Guide (https://hl7.org/fhir/us/qicore/STU6/) for more information on QI-Core and mapping recommendations from QDM to QI-Core STU 6 (https://hl7.org/fhir/us/qicore/STU6/qdm-to-qicore.html).
"></usage>
            <copyright value="Copyright 2025 American College of Cardiology and American Heart Association. All Rights Reserved.
"></copyright>
            <effectivePeriod>
               <start value="2026-01-01"></start>
               <end value="2026-12-31"></end>
            </effectivePeriod>
            <author>
               <name value="American Heart Association"></name>
               <telecom>
                  <system value="url"></system>
                  <value value="https://www.heart.org/"></value>
               </telecom>
            </author>
            <author>
               <name value="American Medical Association (AMA)"></name>
               <telecom>
                  <system value="url"></system>
                  <value value="https://www.ama-assn.org/"></value>
               </telecom>
            </author>
            <relatedArtifact>
               <type value="citation"></type>
               <citation value="Heidenreich, P.A., Bozkurt, B, Aguilar, D., ... Allen, L. A. (2022). 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 145(18), e895-e1032. doi: 10.1161/CIR.0000000000001063
"></citation>
            </relatedArtifact>
            <library value="https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF"></library>
            <disclaimer value="The Measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications.

The Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain.

Commercial uses of the Measure require a license agreement between the user and the American College of Cardiology (ACC) or the American Heart Association (AHA). Neither the ACC, nor AHA, nor their members shall be responsible for any use of the Measure.

ACC and AHA encourage use of the Measure by other health care professionals, where appropriate. THE MEASURE AND SPECIFICATIONS ARE PROVIDED &quot;AS IS&quot; WITHOUT WARRANTY OF ANY KIND.

Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The ACC and AHA and their members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT\[R\]) or other coding contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-20234 American Medical Association. LOINC(R) is copyright 2004-20234 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT\[R\]) copyright 2004-20234 International Health Terminology Standards Development Organisation. ICD-10 is copyright 20234 World Health Organization. All Rights Reserved.

The American Medical Association's and the PCPI(R) Foundation's significant past efforts and contributions to the performance measure are gratefully acknowledged. Due to technical limitations, registered trademarks are indicated by (R) or \[R\].
"></disclaimer>
            <rationale value="Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor--intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.
"></rationale>
            <clinicalRecommendationStatement value="In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF, the use of angiotension-converting enzyme inhibitors (ACEi) is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022). In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (Heidenreich et al., 2022). ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022). ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).

Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)

|         Drug         |         Initial Daily Dose(s)         |             Target Dose(s)             |                           Mean Doses Achieved in Clinical Trials                           |
|----------------------|---------------------------------------|----------------------------------------|--------------------------------------------------------------------------------------------|
| *ACEi*               | &lt;br /&gt;                                | &lt;br /&gt;                                 | &lt;br /&gt;                                                                                     |
| Captopril            | 6.25 mg 3 times                       | 50 mg 3 times                          | 122.7 mg total daily                                                                       |
| Enalapril            | 2.5 mg twice                          | 10 to 20 mg twice                      | 16.6 mg total daily                                                                        |
| Fosinopril           | 5 to 10 mg once                       | 40 mg once                             | N/A                                                                                        |
| Lisinopril           | 2.5 to 5 mg once                      | 20 to 40 mg once                       | 32.5 to 35.0 mg total daily                                                                |
| Perindopril          | 2 mg once                             | 8 to 16 mg once                        | N/A                                                                                        |
| Quinapril            | 5 mg twice                            | 20 mg twice                            | N/A                                                                                        |
| Ramipril             | 1.25 to 2.5 mg once                   | 10 mg once                             | N/A                                                                                        |
| Trandolapril         | 1 mg once                             | 4 mg once                              | N/A                                                                                        |
| *ARB*                | &lt;br /&gt;                                | &lt;br /&gt;                                 | &lt;br /&gt;                                                                                     |
| Candesartan          | 4 to 8 mg once                        | 32 mg once                             | 24 mg total daily                                                                          |
| Losartan             | 25 to 50 mg once                      | 50 to 150 mg once                      | 129 mg total daily                                                                         |
| Valsartan            | 20 to 40 mg twice                     | 160 mg twice                           | 254 mg total daily                                                                         |
| *ARNI*               | &lt;br /&gt;                                | &lt;br /&gt;                                 | &lt;br /&gt;                                                                                     |
| Sacubitril-valsartan | 49/51 mg twice (sacubitril/valsartan) | 97/103 mg twice (sacubitril/valsartan) | 182/193 mg (sacubitril/valsartan) total daily (therapy may be initiated at 24/26 mg twice) |

"></clinicalRecommendationStatement>
            <group id="Group_1">
               <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-scoring">
                  <valueCodeableConcept>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-scoring"></system>
                        <code value="proportion"></code>
                        <display value="Proportion"></display>
                     </coding>
                  </valueCodeableConcept>
               </extension>
               <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-populationBasis">
                  <valueCode value="boolean"></valueCode>
               </extension>
               <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-type">
                  <valueCodeableConcept>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-type"></system>
                        <code value="process"></code>
                        <display value="Process"></display>
                     </coding>
                  </valueCodeableConcept>
               </extension>
               <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-improvementNotation">
                  <valueCodeableConcept>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-improvement-notation"></system>
                        <code value="increase"></code>
                        <display value="Increased score indicates improvement"></display>
                     </coding>
                  </valueCodeableConcept>
               </extension>
               <population id="InitialPopulation_1">
                  <code>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
                        <code value="initial-population"></code>
                        <display value="Initial Population"></display>
                     </coding>
                  </code>
                  <description value="All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter
"></description>
                  <criteria>
                     <language value="text/cql-identifier"></language>
                     <expression value="Initial Population"></expression>
                  </criteria>
               </population>
               <population id="Denominator_1">
                  <code>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
                        <code value="denominator"></code>
                        <display value="Denominator"></display>
                     </coding>
                  </code>
                  <description value="Equals Initial Population with a current or prior LVEF \&lt;= 40%
"></description>
                  <criteria>
                     <language value="text/cql-identifier"></language>
                     <expression value="Denominator"></expression>
                  </criteria>
               </population>
               <population id="DenominatorExclusion_1">
                  <code>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
                        <code value="denominator-exclusion"></code>
                        <display value="Denominator Exclusion"></display>
                     </coding>
                  </code>
                  <description value="Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD
"></description>
                  <criteria>
                     <language value="text/cql-identifier"></language>
                     <expression value="Denominator Exclusions"></expression>
                  </criteria>
               </population>
               <population id="Numerator_1">
                  <code>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
                        <code value="numerator"></code>
                        <display value="Numerator"></display>
                     </coding>
                  </code>
                  <description value="Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period
"></description>
                  <criteria>
                     <language value="text/cql-identifier"></language>
                     <expression value="Numerator"></expression>
                  </criteria>
               </population>
               <population id="DenominatorException_1">
                  <code>
                     <coding>
                        <system value="http://terminology.hl7.org/CodeSystem/measure-population"></system>
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                     </coding>
                  </code>
                  <description value="* Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).

* Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).

"></description>
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                     <language value="text/cql-identifier"></language>
                     <expression value="Denominator Exceptions"></expression>
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            </group>
            <supplementalData id="sde-ethnicity">
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                  <coding>
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                     <code value="supplemental-data"></code>
                  </coding>
               </usage>
               <description value="SDE Ethnicity
"></description>
               <criteria>
                  <language value="text/cql-identifier"></language>
                  <expression value="SDE Ethnicity"></expression>
               </criteria>
            </supplementalData>
            <supplementalData id="sde-payer">
               <usage>
                  <coding>
                     <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
                     <code value="supplemental-data"></code>
                  </coding>
               </usage>
               <description value="SDE Payer
"></description>
               <criteria>
                  <language value="text/cql-identifier"></language>
                  <expression value="SDE Payer"></expression>
               </criteria>
            </supplementalData>
            <supplementalData id="sde-race">
               <usage>
                  <coding>
                     <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
                     <code value="supplemental-data"></code>
                  </coding>
               </usage>
               <description value="SDE Race
"></description>
               <criteria>
                  <language value="text/cql-identifier"></language>
                  <expression value="SDE Race"></expression>
               </criteria>
            </supplementalData>
            <supplementalData id="sde-sex">
               <usage>
                  <coding>
                     <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
                     <code value="supplemental-data"></code>
                  </coding>
               </usage>
               <description value="SDE Sex
"></description>
               <criteria>
                  <language value="text/cql-identifier"></language>
                  <expression value="SDE Sex"></expression>
               </criteria>
            </supplementalData>
         </Measure>
      </resource>
      <request>
         <method value="POST"></method>
         <url value="Measure/CMS135FHIRACEIorARBorARNIforHF"></url>
      </request>
   </entry>
   <entry>
      <fullUrl value="https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF"></fullUrl>
      <resource>
         <Library xmlns="http://hl7.org/fhir">
            <id value="CMS135FHIRACEIorARBorARNIforHF"></id>
            <meta>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary"></profile>
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            <language value="en"></language>
            <text>
               <status value="extensions"></status>
               <div xmlns="http://www.w3.org/1999/xhtml" class="col-12"> 
                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">CMS135FHIRACEIorARBorARNIforHF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">1.0.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Identifier</th> 
                           <td class="content-container">CMS135FHIRACEIorARBorARNIforHF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">American Heart Association</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">CMS135FHIRACEIorARBorARNIforHF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/library-type#logic-library]</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#372733002: 'Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#372913009: 'Substance with angiotensin II receptor antagonist mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#786886009: 'Substance with neprilysin inhibitor mechanism of action (substance)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#422593004: 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Observation 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus 
                              <br></br>   
                              <em>Must Support Elements</em>: effective, effective.value, value, status, status.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Library Content</th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CQL Content</th> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">library CMS135FHIRACEIorARBorARNIforHF version '1.0.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers
include SupplementalDataElements version '5.1.000' called SDE
include QICoreCommon version '4.0.000' called QICoreCommon
include AHAOverall version '4.1.000' called AHA

codesystem "SNOMEDCT": 'http://snomed.info/sct'

valueset "ACE Inhibitor or ARB or ARNI Ingredient": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489'
valueset "ACE Inhibitor or ARB or ARNI": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139'
valueset "Allergy to ACE Inhibitor or ARB": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211'
valueset "Intolerance to ACE Inhibitor or ARB": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212'
valueset "Medical Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007'
valueset "Patient Reason": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008'
valueset "Patient Reason for ACE Inhibitor or ARB Decline": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140'
valueset "Pregnancy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378'

code "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)": '422593004' from "SNOMEDCT" display 'Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)'
code "Substance with angiotensin II receptor antagonist mechanism of action (substance)": '372913009' from "SNOMEDCT" display 'Substance with angiotensin II receptor antagonist mechanism of action (substance)'
code "Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)": '372733002' from "SNOMEDCT" display 'Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)'
code "Substance with neprilysin inhibitor mechanism of action (substance)": '786886009' from "SNOMEDCT" display 'Substance with neprilysin inhibitor mechanism of action (substance)'

parameter "Measurement Period" Interval&lt;DateTime&gt;

context Patient

define "Initial Population":
  AHA."Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period"

define "Denominator":
  "Initial Population"
    and exists AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD"

define "Denominator Exclusions":
  AHA."Has Heart Transplant"
    or AHA."Has Heart Transplant Complications"
    or AHA."Has Left Ventricular Assist Device"
    or AHA."Has Left Ventricular Assist Device Complications"

define "Numerator":
  "Has ACEI or ARB or ARNI Ordered"
    or "Is Currently Taking ACEI or ARB or ARNI"

define "Denominator Exceptions":
  "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI"
    or "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient"
    or "Has Diagnosis of Allergy or Intolerance to ACEI or ARB"
    or "Has Diagnosis of Pregnancy"
    or "Has Diagnosis of Renal Failure Due to ACEI"

define "SDE Ethnicity":
  SDE."SDE Ethnicity"

define "SDE Payer":
  SDE."SDE Payer"

define "SDE Race":
  SDE."SDE Race"

define "SDE Sex":
  SDE."SDE Sex"

define "Has ACEI or ARB or ARNI Ordered":
  exists ( [MedicationRequest: medication in "ACE Inhibitor or ARB or ARNI"] ACEIOrARBOrARNIOrdered
      where ACEIOrARBOrARNIOrdered.isOrderedDuringHeartFailureOutpatientEncounter ( )
  )

define "Has Allergy or Intolerance to ACEI or ARB or ARNI Ingredient":
  exists ( ( [AllergyIntolerance: "ACE Inhibitor or ARB or ARNI Ingredient"]
      union [AllergyIntolerance: "Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"]
      union [AllergyIntolerance: "Substance with angiotensin II receptor antagonist mechanism of action (substance)"]
      union [AllergyIntolerance: "Substance with neprilysin inhibitor mechanism of action (substance)"] ) ACEIOrARBOrARNIAllergyIntolerance
      where ACEIOrARBOrARNIAllergyIntolerance.overlapsAfterHeartFailureOutpatientEncounter ( )
  )

define "Has Diagnosis of Allergy or Intolerance to ACEI or ARB":
  exists ( ( ( ["ConditionProblemsHealthConcerns": "Allergy to ACE Inhibitor or ARB"]
        union ["ConditionEncounterDiagnosis": "Allergy to ACE Inhibitor or ARB"]
    )
      union ( ["ConditionProblemsHealthConcerns": "Intolerance to ACE Inhibitor or ARB"] )
      union ["ConditionEncounterDiagnosis": "Intolerance to ACE Inhibitor or ARB"] ) ACEIOrARBAllergyOrIntoleranceDiagnosis
      where ACEIOrARBAllergyOrIntoleranceDiagnosis.overlapsAfterHeartFailureOutpatientEncounter ( )
  )

define "Has Diagnosis of Pregnancy":
  exists ( ( [ConditionProblemsHealthConcerns: "Pregnancy"]
      union ["ConditionEncounterDiagnosis": "Pregnancy"] ) PregnancyDiagnosis
      with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that PregnancyDiagnosis.prevalenceInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
          and PregnancyDiagnosis.isVerified ( )
  )
    or exists ( [USCoreObservationPregnancyStatusProfile] PregnantObservation
        with AHA."Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
          such that PregnantObservation.effective.toInterval ( ) starts 9 months or less before or on start of ModerateOrSevereLVSDHFOutpatientEncounter.period
            and ( PregnantObservation.value in "Pregnancy"
                and PregnantObservation.status in { 'final', 'amended', 'corrected' }
            )
    )

define "Has Diagnosis of Renal Failure Due to ACEI":
  exists ( ( [ConditionProblemsHealthConcerns: "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"]
      union [ConditionEncounterDiagnosis: "Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"] ) RenalFailureDueToACEI
      where RenalFailureDueToACEI.overlapsHeartFailureOutpatientEncounter ( )
  )

define "Has Medical or Patient Reason for Not Ordering ACEI or ARB or ARNI":
  exists ( [MedicationNotRequested: medication in "ACE Inhibitor or ARB or ARNI"] NoACEIOrARBOrARNIOrdered
      where NoACEIOrARBOrARNIOrdered.isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter ( )
        and ( NoACEIOrARBOrARNIOrdered.reasonCode in "Medical Reason"
            or NoACEIOrARBOrARNIOrdered.reasonCode in "Patient Reason"
            or NoACEIOrARBOrARNIOrdered.reasonCode in "Patient Reason for ACE Inhibitor or ARB Decline"
        )
  )

define "Is Currently Taking ACEI or ARB or ARNI":
  exists ( [MedicationRequest: medication in "ACE Inhibitor or ARB or ARNI"] ActiveACEIOrARBOrARNI
      where ActiveACEIOrARBOrARNI.overlapsAfterHeartFailureOutpatientEncounter ( )
  )</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="422593004"></code>
                  <display value="Acute renal failure caused by angiotensin-converting-enzyme inhibitor (disorder)"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="372913009"></code>
                  <display value="Substance with angiotensin II receptor antagonist mechanism of action (substance)"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="372733002"></code>
                  <display value="Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="786886009"></code>
                  <display value="Substance with neprilysin inhibitor mechanism of action (substance)"></display>
               </valueCoding>
            </extension>
            <url value="https://madie.cms.gov/Library/CMS135FHIRACEIorARBorARNIforHF"></url>
            <identifier>
               <use value="official"></use>
               <system value="https://madie.cms.gov/login"></system>
               <value value="CMS135FHIRACEIorARBorARNIforHF"></value>
            </identifier>
            <version value="1.0.000"></version>
            <name value="CMS135FHIRACEIorARBorARNIforHF"></name>
            <title value="CMS135FHIRACEIorARBorARNIforHF"></title>
            <status value="active"></status>
            <experimental value="false"></experimental>
            <type>
               <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/library-type"></system>
                  <code value="logic-library"></code>
               </coding>
            </type>
            <date value="2025-08-22T19:19:02+00:00"></date>
            <publisher value="American Heart Association"></publisher>
            <description value="CMS135FHIRACEIorARBorARNIforHF"></description>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="QICore model information"></display>
               <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Library SDE"></display>
               <resource value="https://madie.cms.gov/Library/SupplementalDataElements|5.1.000"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Library AHA"></display>
               <resource value="https://madie.cms.gov/Library/AHAOverall|4.1.000"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system SNOMEDCT"></display>
               <resource value="http://snomed.info/sct"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set ACE Inhibitor or ARB or ARNI"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1139"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Medical Reason"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1007"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Patient Reason"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1008"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Patient Reason for ACE Inhibitor or ARB Decline"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1140"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set ACE Inhibitor or ARB or ARNI Ingredient"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Allergy to ACE Inhibitor or ARB"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1211"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Intolerance to ACE Inhibitor or ARB"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1212"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Pregnancy"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378"></resource>
            </relatedArtifact>
            <dataRequirement>
               <type value="AllergyIntolerance"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
               <mustSupport value="code"></mustSupport>
               <codeFilter>
                  <path value="code"></path>
                  <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1489"></valueSet>
               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="AllergyIntolerance"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
               <mustSupport value="code"></mustSupport>
               <codeFilter>
                  <path value="code"></path>
                  <code>
                     <system value="http://snomed.info/sct"></system>
                     <code value="372733002"></code>
                     <display value="Substance with angiotensin-converting enzyme inhibitor mechanism of action (substance)"></display>
                  </code>
               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="AllergyIntolerance"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
               <mustSupport value="code"></mustSupport>
               <codeFilter>
                  <path value="code"></path>
                  <code>
                     <system value="http://snomed.info/sct"></system>
                     <code value="372913009"></code>
                     <display value="Substance with angiotensin II receptor antagonist mechanism of action (substance)"></display>
                  </code>
               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="AllergyIntolerance"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
               <mustSupport value="code"></mustSupport>
               <codeFilter>
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               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="Observation"></type>
               <profile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-pregnancystatus"></profile>
               <mustSupport value="effective"></mustSupport>
               <mustSupport value="effective.value"></mustSupport>
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            <id value="SupplementalDataElements"></id>
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                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">SupplementalDataElements</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">5.1.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Identifier</th> 
                           <td class="content-container">67e5bc4d88f4d211353e632e</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">ICF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">This is the QI-Core 6.0.0 version of the Supplemental Data Elements library containing the CMS SDE definitions for Payer, Race, Ethnicity and Sex</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/library-type#logic-library]</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Patient 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient 
                              <br></br>   
                              <em>Must Support Elements</em>: extension, url 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Coverage 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Library Content</th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CQL Content</th> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*
@update: GCW 2025-03-27 -&gt;
Updated to reflect valueset name change from CMS Sex to Federal Administrative Sex
*/
library SupplementalDataElements version '5.1.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers

codesystem "SNOMEDCT": 'http://snomed.info/sct'

valueset "Ethnicity": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.837'
valueset "Federal Administrative Sex": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.121'
valueset "Payer Type": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591'
valueset "Race": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'

code "Male (finding)": '248153007' from "SNOMEDCT" display 'Male (finding)'
code "Female (finding)": '248152002' from "SNOMEDCT" display 'Female (finding)'

context Patient

define "SDE Ethnicity":
  Patient.ethnicity E
    return Tuple {
      codes: { E.ombCategory } union E.detailed,
      display: E.text
    }

define "SDE Payer":
  [Coverage: type in "Payer Type"] Payer
    return {
      code: Payer.type,
      period: Payer.period
    }

define "SDE Race":
  Patient.race R
    return Tuple {
      codes: R.ombCategory union R.detailed,
      display: R.text
    }

define "SDE Sex":
  case
    when Patient.sex = '248153007' then "Male (finding)"
    when Patient.sex = '248152002' then "Female (finding)"
    else null
  end</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="248153007"></code>
                  <display value="Male (finding)"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="248152002"></code>
                  <display value="Female (finding)"></display>
               </valueCoding>
            </extension>
            <url value="https://madie.cms.gov/Library/SupplementalDataElements"></url>
            <identifier>
               <use value="official"></use>
               <system value="https://madie.cms.gov/login"></system>
               <value value="67e5bc4d88f4d211353e632e"></value>
            </identifier>
            <version value="5.1.000"></version>
            <name value="SupplementalDataElements"></name>
            <title value="SupplementalDataElements"></title>
            <status value="active"></status>
            <experimental value="false"></experimental>
            <type>
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                  <system value="http://terminology.hl7.org/CodeSystem/library-type"></system>
                  <code value="logic-library"></code>
               </coding>
            </type>
            <date value="2025-08-22T19:19:03+00:00"></date>
            <publisher value="ICF"></publisher>
            <description value="This is the QI-Core 6.0.0 version of the Supplemental Data Elements library containing the CMS SDE definitions for Payer, Race, Ethnicity and Sex"></description>
            <relatedArtifact>
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               <display value="QICore model information"></display>
               <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"></resource>
            </relatedArtifact>
            <relatedArtifact>
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               <display value="Library FHIRHelpers"></display>
               <resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system SNOMEDCT"></display>
               <resource value="http://snomed.info/sct"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Value set Payer Type"></display>
               <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"></resource>
            </relatedArtifact>
            <dataRequirement>
               <type value="Patient"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"></profile>
               <mustSupport value="extension"></mustSupport>
               <mustSupport value="url"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="Coverage"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage"></profile>
               <mustSupport value="type"></mustSupport>
               <mustSupport value="period"></mustSupport>
               <codeFilter>
                  <path value="type"></path>
                  <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591"></valueSet>
               </codeFilter>
            </dataRequirement>
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               <data value="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"></data>
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         </Library>
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      <request>
         <method value="POST"></method>
         <url value="Library/SupplementalDataElements"></url>
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   </entry>
   <entry>
      <fullUrl value="https://madie.cms.gov/Library/AHAOverall"></fullUrl>
      <resource>
         <Library xmlns="http://hl7.org/fhir">
            <id value="AHAOverall"></id>
            <meta>
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               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablelibrary"></profile>
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               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/elm-xml-library"></profile>
            </meta>
            <language value="en"></language>
            <text>
               <status value="extensions"></status>
               <div xmlns="http://www.w3.org/1999/xhtml" class="col-12"> 
                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">AHAOverall</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">4.1.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Identifier</th> 
                           <td class="content-container">686690a2cea545775d8881ca</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">Telligen</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">This version of the AHAOverall library is patterned after HFCommonDefinitionsQDM library version '3.0.000'</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/library-type#logic-library]</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Observation 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-observation-clinical-result 
                              <br></br>   
                              <em>Must Support Elements</em>: code, value, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
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                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>   
                              <span class="tab-one">
                                 <em>Code(s)</em>:  http://snomed.info/sct#134401001: 'Left ventricular systolic dysfunction (disorder)'  
                              </span> 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Condition 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis 
                              <br></br>   
                              <em>Must Support Elements</em>: code 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: type, period, id, id.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: type
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Encounter 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter 
                              <br></br>   
                              <em>Must Support Elements</em>: status, period, id, id.value, status.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest 
                              <br></br>   
                              <em>Must Support Elements</em>: authoredOn, timing, repeat, bounds, authoredOn.value, status, status.value, intent, intent.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Task 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected 
                              <br></br>   
                              <em>Must Support Elements</em>: focus, code 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: AllergyIntolerance 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance 
                              <br></br>   
                              <em>Must Support Elements</em>: verificationStatus, onset, lastOccurrence, lastOccurrence.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Procedure 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure 
                              <br></br>   
                              <em>Must Support Elements</em>: performed, status, status.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Procedure 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure 
                              <br></br>   
                              <em>Must Support Elements</em>: code, performed, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Procedure 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure 
                              <br></br>   
                              <em>Must Support Elements</em>: code, performed, status, status.value 
                              <br></br>  
                              <em>Code Filter(s)</em>: 
                              <br></br>  
                              <span class="tab-one">
                                 <em>Path</em>: code
                              </span> 
                              <br></br>  
                              <span class="tab-one">
                                 <em>ValueSet</em>:
                              </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61 
                              <br></br>   
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Observation 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate 
                              <br></br>   
                              <em>Must Support Elements</em>: effective, status, status.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: MedicationRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested 
                              <br></br>   
                              <em>Must Support Elements</em>: authoredOn, authoredOn.value, status, status.value, intent, intent.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Library Content</th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CQL Content</th> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">library AHAOverall version '4.1.000'

using QICore version '6.0.0'
using USCore version '6.1.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers
include QICoreCommon version '4.0.000' called QICoreCommon

codesystem "SNOMEDCT": 'http://snomed.info/sct'

valueset "Care Services in Long Term Residential Facility": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014'
valueset "Ejection Fraction": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1134'
valueset "Heart Failure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.376'
valueset "Heart Transplant": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33'
valueset "Heart Transplant Complications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.56'
valueset "Home Healthcare Services": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016'
valueset "Left Ventricular Assist Device Complications": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.58'
valueset "Left Ventricular Assist Device Placement": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61'
valueset "Moderate or Severe": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1092'
valueset "Moderate or Severe LVSD": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1090'
valueset "Nursing Facility Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012'
valueset "Office Visit": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001'
valueset "Outpatient Consultation": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008'
valueset "Patient Provider Interaction": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012'

code "Left ventricular systolic dysfunction (disorder)": '134401001' from "SNOMEDCT" display 'Left ventricular systolic dysfunction (disorder)'

parameter "Measurement Period" Interval&lt;DateTime&gt;

context Patient

/*
@description: Returns certain finished encounter types that overlap a Heart Failure condition and are during the measurement period: 
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
*/
define "Heart Failure Outpatient Encounter":
  "Outpatient Encounter" QualifyingEncounter
    with ( [ConditionProblemsHealthConcerns: "Heart Failure"]
      union [ConditionEncounterDiagnosis: "Heart Failure"] ) HeartFailure
      such that HeartFailure.prevalenceInterval ( ) overlaps day of QualifyingEncounter.period
        and HeartFailure.isVerified ( )
    where QualifyingEncounter.period during day of "Measurement Period"
      and QualifyingEncounter.isEncounterFinished ( )

define "Outpatient Encounter":
  ( [Encounter: "Care Services in Long Term Residential Facility"]
      union [Encounter: "Home Healthcare Services"]
      union [Encounter: "Nursing Facility Visit"]
      union [Encounter: "Office Visit"]
      union [Encounter: "Outpatient Consultation"]
  ) 

/*
@description: Returns true if patient has confirmed heart transplant complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD 
*/
define "Has Heart Transplant Complications":
  exists ( ( [ConditionEncounterDiagnosis: "Heart Transplant Complications"]
      union [ConditionProblemsHealthConcerns: "Heart Transplant Complications"] ) HeartTransplantComplications
      let diagnosisStart: Coalesce(start of HeartTransplantComplications.prevalenceInterval(), HeartTransplantComplications.recordedDate)
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplantComplications.isVerified ( )
  )

/*
@description: Returns true if patient has a completed LVAD placement that starts before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Left Ventricular Assist Device":
  exists ( [Procedure: "Left Ventricular Assist Device Placement"] LVADPlacement
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that LVADPlacement.performed.toInterval ( ) starts before day of end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADPlacement.status = 'completed'
  )

/*
@description: Returns true if patient has active LVAD complications that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Left Ventricular Assist Device Complications":
  exists ( ( [ConditionEncounterDiagnosis: "Left Ventricular Assist Device Complications"]
      union [ConditionProblemsHealthConcerns: "Left Ventricular Assist Device Complications"] ) LVADComplications
      let diagnosisStart: Coalesce(start of LVADComplications.prevalenceInterval(), LVADComplications.recordedDate)
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that date from diagnosisStart on or before date from end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where LVADComplications.isVerified ( )
  )             

/*
@description: Returns certain finished encounter types that occurred during the measurement period: 
                * office visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001)
                * outpatient consultation (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1008)
                * nursing facility visits (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1012)
                * care services in long term residential facility (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1014)
                * home healthcare services (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1016)
                * patient provider interactions (http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1012) 
*/
define "Qualifying Outpatient Encounter During Measurement Period":
  "Outpatient Encounter or Patient Provider Interaction" ValidEncounter
    where ValidEncounter.period during day of "Measurement Period"
      and ValidEncounter.isEncounterFinished ( )

define "Outpatient Encounter or Patient Provider Interaction":
  "Outpatient Encounter"
    union [Encounter: "Patient Provider Interaction"]

/*
@description: Returns completed heart tansplant procedures that start before the end of a heart failure outpatient encounter with history of moderate or severe LVSD
*/
define "Has Heart Transplant":
  exists ( [Procedure: "Heart Transplant"] HeartTransplant
      with "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
        such that HeartTransplant.performed.toInterval ( ) starts before end of ModerateOrSevereLVSDHFOutpatientEncounter.period
      where HeartTransplant.status = 'completed'
  )

/*
@description: Returns heart failure outpatient encounters that start before the end of a moderate or severe LVSD finding
*/
define "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD":
  "Heart Failure Outpatient Encounter" HFOutpatientEncounter
    with "Moderate or Severe LVSD Findings" LVSDFindings
      such that Coalesce(LVSDFindings.prevalenceInterval(), LVSDFindings.effective.toInterval()) starts before end of HFOutpatientEncounter.period 

/*
@description: Returns a union  of the following:
                * Observations where the final, amended or correction ejection fraction result is &lt;= 40
                * Moderate or Severe LVSD conditions where the diagnosis has been confirmed as active
*/
define "Moderate or Severe LVSD Findings":
  ( [ObservationClinicalResult: "Ejection Fraction"] EjectionFraction
      where EjectionFraction.value as Quantity &lt;= 40 '%'
        and EjectionFraction.status in { 'final', 'amended', 'corrected' }
  )
    union ( ( ( [ConditionProblemsHealthConcerns: "Moderate or Severe LVSD"]
          union [ConditionEncounterDiagnosis: "Moderate or Severe LVSD"]
      )
        union ( ( [ConditionProblemsHealthConcerns: "Left ventricular systolic dysfunction (disorder)"]
            union [ConditionEncounterDiagnosis: "Left ventricular systolic dysfunction (disorder)"] ) LVSDDiagnosis
            where LVSDDiagnosis.severity in "Moderate or Severe"
        ) ) ModerateOrSevereLVSD
        where ModerateOrSevereLVSD.isVerified ( )
    ) 

/*
@description: Returns true if the patient meets the following criteria:
                * 18 years of age or older,
                * Has two Qualifying Outpatient Encounters During Measurement Period
                * Has a Heart Failure Outpatient Encounter
*/
define "Is Adult With Two Qualifying Outpatient Encounters and One Heart Failure Outpatient Encounter During the Measurement Period":
  AgeInYearsAt(date from start of "Measurement Period") &gt;= 18
    and exists ( "Qualifying Outpatient Encounter During Measurement Period" Encounter1
        with "Qualifying Outpatient Encounter During Measurement Period" Encounter2
          such that Encounter2.id !~ Encounter1.id
    )
    and exists "Heart Failure Outpatient Encounter"   


/*
@description: Returns true if the given Condition has a verification status of "confirmed", "unconfirmed", "provisional", or "differential"
*/
define fluent function isVerified(condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  condition.verificationStatus is not null implies ( condition.verificationStatus ~ QICoreCommon."confirmed"
      or condition.verificationStatus ~ QICoreCommon."unconfirmed"
      or condition.verificationStatus ~ QICoreCommon."provisional"
      or condition.verificationStatus ~ QICoreCommon."differential"
  )

/*
@description: Returns true if the given Encounter is finished
*/
define fluent function isEncounterFinished(Encounter Encounter):
  Encounter.status = 'finished'

/*
@description: Returns true if the given MedicationRequest is ordered during the heart failure outpatient encounter with history of moderate or severe LVSD at any point
*/
define fluent function isOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )

/*
@description: Returns true if the given MedicationNotRequested overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function isMedicationNotRequestedOrderedDuringHeartFailureOutpatientEncounter(MedicationRequest MedicationNotRequested):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where MedicationRequest.authoredOn during day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'completed', 'active' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )

/*
@description: Returns true if the given Condition overlaps the heart failure outpatient encounter with history of moderate or severe LVSD at any point
*/
define fluent function overlapsHeartFailureOutpatientEncounter(Condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Condition.prevalenceInterval ( ) overlaps day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and Condition.isVerified ( )
  )

/*
@overloaded
@description: Returns true if the given Condition overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(Condition Choice&lt;ConditionEncounterDiagnosis, ConditionProblemsHealthConcerns&gt;):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Condition.prevalenceInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and Condition.isVerified ( )
  )

/*
@overloaded
@description: Returns true if the given Procedure overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(Procedure Procedure):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Procedure.performed.toInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and Procedure.status = 'completed'
  )

/*
@overloaded
@description: Returns true if the given AllergyIntolerance overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(AllergyIntolerance AllergyIntolerance):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where Interval[start of AllergyIntolerance.onset.toInterval ( ), AllergyIntolerance.lastOccurrence]overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and AllergyIntolerance.isVerified ( )
  )
          
/*
@description: Returns true if the given condition either has no verification status or has a verification status of confirmed, unconfirmed, provisional, or differential
*/
define fluent function isVerified(AllergyIntolerance AllergyIntolerance):
  AllergyIntolerance.verificationStatus is not null implies ( AllergyIntolerance.verificationStatus ~ QICoreCommon."allergy-confirmed"
      or AllergyIntolerance.verificationStatus ~ QICoreCommon."allergy-unconfirmed"
  )

/*
@overloaded
@description: Returns true if the given MedicationRequest overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(MedicationRequest MedicationRequest):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where First((collapse(MedicationRequest.dosageInstruction.timing.repeat.bounds DoseTime
            return TimingBoundToInterval(MedicationRequest.authoredOn, DoseTime)
        )) DrugPeriods
          sort by start of $this
      ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and MedicationRequest.status in { 'active', 'completed' }
        and MedicationRequest.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( MedicationRequest )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )

/*
@overloaded
@description: Returns true if the given HeartRateObservation overlaps after the day of the heart failure outpatient encounter with history of moderate or severe LVSD
*/
define fluent function overlapsAfterHeartFailureOutpatientEncounter(HeartRateObservation USCoreHeartRateProfile):
  exists ( "Heart Failure Outpatient Encounter with History of Moderate or Severe LVSD" ModerateOrSevereLVSDHFOutpatientEncounter
      where HeartRateObservation.effective.toInterval ( ) overlaps after day of ModerateOrSevereLVSDHFOutpatientEncounter.period
        and HeartRateObservation.status in { 'final', 'amended', 'corrected' }
  )
 
define function TimingBoundToInterval(startDate System.DateTime, choice Choice&lt;Quantity, Interval&lt;Quantity&gt;, Interval&lt;DateTime&gt;&gt;):
  case
    when choice is Interval&lt;DateTime&gt; then
        choice as Interval&lt;DateTime&gt;
    when choice is Interval&lt;Quantity&gt; then
        Interval[startDate + (choice.low as Quantity), startDate + (choice.high as Quantity)]
    when choice is Quantity then
        Interval[startDate, startDate + (choice as Quantity))
    else
		null as Interval&lt;DateTime&gt;
	end</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
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               <mustSupport value="status.value"></mustSupport>
               <mustSupport value="intent"></mustSupport>
               <mustSupport value="intent.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="Task"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-taskrejected"></profile>
               <mustSupport value="focus"></mustSupport>
               <mustSupport value="code"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="AllergyIntolerance"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
               <mustSupport value="verificationStatus"></mustSupport>
               <mustSupport value="onset"></mustSupport>
               <mustSupport value="lastOccurrence"></mustSupport>
               <mustSupport value="lastOccurrence.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="Procedure"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"></profile>
               <mustSupport value="performed"></mustSupport>
               <mustSupport value="status"></mustSupport>
               <mustSupport value="status.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="Procedure"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"></profile>
               <mustSupport value="code"></mustSupport>
               <mustSupport value="performed"></mustSupport>
               <mustSupport value="status"></mustSupport>
               <mustSupport value="status.value"></mustSupport>
               <codeFilter>
                  <path value="code"></path>
                  <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.33"></valueSet>
               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="Procedure"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure"></profile>
               <mustSupport value="code"></mustSupport>
               <mustSupport value="performed"></mustSupport>
               <mustSupport value="status"></mustSupport>
               <mustSupport value="status.value"></mustSupport>
               <codeFilter>
                  <path value="code"></path>
                  <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.61"></valueSet>
               </codeFilter>
            </dataRequirement>
            <dataRequirement>
               <type value="Observation"></type>
               <profile value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-heart-rate"></profile>
               <mustSupport value="effective"></mustSupport>
               <mustSupport value="status"></mustSupport>
               <mustSupport value="status.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="MedicationRequest"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"></profile>
               <mustSupport value="authoredOn"></mustSupport>
               <mustSupport value="authoredOn.value"></mustSupport>
               <mustSupport value="status"></mustSupport>
               <mustSupport value="status.value"></mustSupport>
               <mustSupport value="intent"></mustSupport>
               <mustSupport value="intent.value"></mustSupport>
            </dataRequirement>
            <content>
               <contentType value="text/cql"></contentType>
               <data value="[encoded data, 24060 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+xml"></contentType>
               <data value="[encoded data, 526172 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+json"></contentType>
               <data value="[encoded data, 813512 characters]"></data>
            </content>
         </Library>
      </resource>
      <request>
         <method value="POST"></method>
         <url value="Library/AHAOverall"></url>
      </request>
   </entry>
   <entry>
      <fullUrl value="https://madie.cms.gov/Library/QICoreCommon"></fullUrl>
      <resource>
         <Library xmlns="http://hl7.org/fhir">
            <id value="QICoreCommon"></id>
            <meta>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-executablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/cql-library"></profile>
               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/elm-json-library"></profile>
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            </meta>
            <language value="en"></language>
            <text>
               <status value="extensions"></status>
               <div xmlns="http://www.w3.org/1999/xhtml" class="col-12"> 
                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">QICoreCommon</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">4.0.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Identifier</th> 
                           <td class="content-container">67cb33c19e9ab93ec36dad45</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">ICF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">Common terminologies and functions used in QI-Core-based CQL artifacts</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/library-type#logic-library]</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Resource 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/StructureDefinition/Resource 
                              <br></br>   
                              <em>Must Support Elements</em>: id, id.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: Patient 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient 
                              <br></br>   
                              <em>Must Support Elements</em>: birthDate, birthDate.value 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Data Requirement</th> 
                           <td class="content-container"> 
                              <em>Type</em>: DeviceRequest 
                              <br></br> 
                              <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest 
                              <br></br>   
                              <em>Must Support Elements</em>: modifierExtension 
                              <br></br>  
                           </td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Library Content</th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CQL Content</th> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">library QICoreCommon version '4.0.000'

using QICore version '6.0.0'

include FHIRHelpers version '4.4.000' called FHIRHelpers

codesystem "LOINC": 'http://loinc.org'
codesystem "SNOMEDCT": 'http://snomed.info/sct'
codesystem "ActCode": 'http://terminology.hl7.org/CodeSystem/v3-ActCode'
codesystem "RoleCode": 'http://terminology.hl7.org/CodeSystem/v3-RoleCode'
codesystem "Diagnosis Role": 'http://terminology.hl7.org/CodeSystem/diagnosis-role'
codesystem "RequestIntent": 'http://hl7.org/fhir/request-intent'
codesystem "MedicationRequestCategory": 'http://terminology.hl7.org/CodeSystem/medicationrequest-category'
codesystem "ConditionClinicalStatusCodes": 'http://terminology.hl7.org/CodeSystem/condition-clinical'
codesystem "ConditionVerificationStatusCodes": 'http://terminology.hl7.org/CodeSystem/condition-ver-status'
codesystem "AllergyIntoleranceClinicalStatusCodes": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical'
codesystem "AllergyIntoleranceVerificationStatusCodes": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification'
codesystem "ObservationCategoryCodes": 'http://terminology.hl7.org/CodeSystem/observation-category'
codesystem "USCoreObservationCategoryExtensionCodes": 'http://hl7.org/fhir/us/core/CodeSystem/us-core-observation-category'  
codesystem "ConditionCategory": 'http://terminology.hl7.org/CodeSystem/condition-category'
codesystem "USCoreConditionCategoryExtensionCodes": 'http://hl7.org/fhir/us/core/CodeSystem/condition-category'
codesystem "TaskCodeSystem": 'http://hl7.org/fhir/CodeSystem/task-code' 



code "Birthdate": '21112-8' from "LOINC" display 'Birth date'
code "Dead": '419099009' from "SNOMEDCT" display 'Dead'
code "ER": 'ER' from "RoleCode" display 'Emergency room'
code "ICU": 'ICU' from "RoleCode" display 'Intensive care unit'
code "Billing": 'billing' from "Diagnosis Role" display 'Billing'

//Task codes
code "Fulfill": 'fulfill' from "TaskCodeSystem" display 'Fulfill'

// Encounter Class Codes
code "ambulatory": 'AMB' from ActCode display 'ambulatory'
code "emergency": 'EMER' from ActCode display 'emergency'
code "field": 'FLD' from ActCode display 'field'
code "home health": 'HH' from ActCode display 'home health'
code "inpatient encounter": 'IMP' from ActCode display 'inpatient encounter'
code "inpatient acute": 'ACUTE' from ActCode display 'inpatient acute'
code "inpatient non-acute": 'NONAC' from ActCode display 'inpatient non-acute'
code "observation encounter": 'OBSENC' from ActCode display 'observation encounter'
code "pre-admission": 'PRENC' from ActCode display 'pre-admission'
code "short stay": 'SS' from ActCode display 'short stay'
code "virtual": 'VR' from ActCode display 'Virtual'

// Condition Category Codes
code "problem-list-item": 'problem-list-item' from "ConditionCategory" display 'Problem List Item'
code "encounter-diagnosis": 'encounter-diagnosis' from "ConditionCategory" display 'Encounter Diagnosis'
code "health-concern": 'health-concern' from "USCoreConditionCategoryExtensionCodes" display 'Health Concern'

// Condition Clinical Status Codes - Consider value sets for these
code "active": 'active' from "ConditionClinicalStatusCodes" display 'Active'
code "recurrence": 'recurrence' from "ConditionClinicalStatusCodes" display 'Recurrence'
code "relapse": 'relapse' from "ConditionClinicalStatusCodes" display 'Relapse'
code "inactive": 'inactive' from "ConditionClinicalStatusCodes" display 'Inactive'
code "remission": 'remission' from "ConditionClinicalStatusCodes" display 'Remission'
code "resolved": 'resolved' from "ConditionClinicalStatusCodes" display 'Resolved'

// Condition Verification Status Codes - Consider value sets for these
code "unconfirmed": 'unconfirmed' from ConditionVerificationStatusCodes display 'Unconfirmed'
code "provisional": 'provisional' from ConditionVerificationStatusCodes display 'Provisional'
code "differential": 'differential' from ConditionVerificationStatusCodes display 'Differential'
code "confirmed": 'confirmed' from ConditionVerificationStatusCodes display 'Confirmed'
code "refuted": 'refuted' from ConditionVerificationStatusCodes display 'Refuted'
code "entered-in-error": 'entered-in-error' from ConditionVerificationStatusCodes display 'Entered in Error'

code "allergy-active": 'active' from "AllergyIntoleranceClinicalStatusCodes" display 'Active'
code "allergy-inactive": 'inactive' from "AllergyIntoleranceClinicalStatusCodes" display 'Inactive'
code "allergy-resolved": 'resolved' from "AllergyIntoleranceClinicalStatusCodes" display 'Resolved'

// Allergy/Intolerance Verification Status Codes - Consider value sets for these
code "allergy-unconfirmed": 'unconfirmed' from AllergyIntoleranceVerificationStatusCodes display 'Unconfirmed'
code "allergy-confirmed": 'confirmed' from AllergyIntoleranceVerificationStatusCodes display 'Confirmed'
code "allergy-refuted": 'refuted' from AllergyIntoleranceVerificationStatusCodes display 'Refuted'

// MedicationRequest Category Codes
code "Inpatient": 'inpatient' from "MedicationRequestCategory" display 'Inpatient'
code "Outpatient": 'outpatient' from "MedicationRequestCategory" display 'Outpatient'
code "Community": 'community' from "MedicationRequestCategory" display 'Community'
code "Discharge": 'discharge' from "MedicationRequestCategory" display 'Discharge'

// Diagnosis Role Codes
code "AD": 'AD' from "Diagnosis Role" display 'Admission diagnosis'
code "DD": 'DD' from "Diagnosis Role" display 'Discharge diagnosis'
code "CC": 'CC' from "Diagnosis Role" display 'Chief complaint'
code "CM": 'CM' from "Diagnosis Role" display 'Comorbidity diagnosis'
code "pre-op": 'pre-op' from "Diagnosis Role" display 'pre-op diagnosis'
code "post-op": 'post-op' from "Diagnosis Role" display 'post-op diagnosis'
code "billing": 'billing' from "Diagnosis Role" display 'Billing'

// Observation Category Codes
code "social-history": 'social-history' from "ObservationCategoryCodes" display 'Social History'
code "vital-signs": 'vital-signs' from "ObservationCategoryCodes" display 'Vital Signs'
code "imaging": 'imaging' from "ObservationCategoryCodes" display 'Imaging'
code "laboratory": 'laboratory' from "ObservationCategoryCodes" display 'Laboratory'
code "procedure": 'procedure' from "ObservationCategoryCodes" display 'Procedure'
code "survey": 'survey' from "ObservationCategoryCodes" display 'Survey'
code "exam": 'exam' from "ObservationCategoryCodes" display 'Exam'
code "therapy": 'therapy' from "ObservationCategoryCodes" display 'Therapy'
code "activity": 'activity' from "ObservationCategoryCodes" display 'Activity'

context Patient

/* Candidates for FHIRCommon */

/*
@description: Returns true if the given condition has a clinical status of active, recurrence, or relapse
*/
define fluent function isActive(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
  condition.clinicalStatus ~ "active"
    or condition.clinicalStatus ~ "recurrence"
    or condition.clinicalStatus ~ "relapse"

/*
@description: Returns true if the given condition has the given category
*/
define fluent function hasCategory(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;, category Code):
  exists (condition.category C
    where C ~ category
  )

/*
@description: Returns true if the given condition is a problem list item.
*/
define fluent function isProblemListItem(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
  exists (condition.category C
    where C ~ "problem-list-item"
  )

/*
@description: Returns true if the given condition is an encounter diagnosis
*/
define fluent function isEncounterDiagnosis(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
  exists (condition.category C
    where C ~ "encounter-diagnosis"
  )

/*
@description: Returns true if the given condition is a health concern
*/
define fluent function isHealthConcern(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
  exists (condition.category C
    where C ~ "health-concern"
  )

/*
@description: Returns true if the given observation has the given category
*/
define fluent function hasCategory(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;, 
category Code):
  exists (observation.category C
    where C ~ category
  )

/*
@description: Returns true if the given observation is a social history observation
*/
define fluent function isSocialHistory(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "social-history"
  )

/*
@description: Returns true if the given observation is a vital sign
*/
define fluent function isVitalSign(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "vital-signs"
  )

/*
@description: Returns true if the given observation is an imaging observation
*/
define fluent function isImaging(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "imaging"
  )

/*
@description: Returns true if the given observation is a laboratory observation
*/
define fluent function isLaboratory(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "laboratory"
  )

/*
@description: Returns true if the given observation is a procedure observation
*/
define fluent function isProcedure(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "procedure"
  )

/*
@description: Returns true if the given observation is a survey observation
*/
define fluent function isSurvey(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "survey"
  )

/*
@description: Returns true if the given observation is an exam observation
*/
define fluent function isExam(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "exam"
  )

/*
@description: Returns true if the given observation is a therapy observation
*/
define fluent function isTherapy(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "therapy"
  )

/*
@description: Returns true if the given observation is an activity observation
*/
define fluent function isActivity(observation Choice&lt;"SimpleObservation", 
"ObservationCancelled",
"NonPatientObservation",
"LaboratoryResultObservation",
"ObservationClinicalResult",
"ObservationScreeningAssessment"&gt;):
  exists (observation.category C
    where C ~ "activity"
  )

/*
@description: Returns true if the given MedicationRequest has a category of Community
*/
define fluent function isCommunity(medicationRequest Choice&lt;MedicationRequest, MedicationNotRequested&gt;):
  exists (medicationRequest.category C
    where C ~ Community
  )

/*
@description: Returns true if the given MedicationRequest has a category of Discharge
*/
define fluent function isDischarge(medicationRequest Choice&lt;MedicationRequest, MedicationNotRequested&gt;):
  exists (medicationRequest.category C
    where C ~ Discharge
  )

/*
@description: Returns true if the given DeviceRequest is a negation (i.e. do not perform this order)
@deprecated: This function is no longer required in QICore 6.0.0 and above
*/
define fluent function doNotPerform(deviceRequest DeviceRequest):
  // KNOWN ISSUE: The translator reports this as an error but the execution still works, this is under investigation
  deviceRequest.doNotPerform

/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
@deprecated: This function is deprecated. Use the fluent function `toInterval()` instead
*/
define function ToInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end

/*
@description: Normalizes a value that is a choice of timing-valued types to an equivalent interval
@comment: Normalizes a choice type of DateTime, Quanitty, Interval&lt;DateTime&gt;, or Interval&lt;Quantity&gt; types
to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible
representations for timing-valued elements in QICore, allowing this function to be used across any resource.
The input can be provided as a DateTime, Quantity, Interval&lt;DateTime&gt; or Interval&lt;Quantity&gt;.
The intent of this function is to provide a clear and concise mechanism to treat single
elements that have multiple possible representations as intervals so that logic doesn't have to account
for the variability. More complex calculations (such as medication request period or dispense period
calculation) need specific guidance and consideration. That guidance may make use of this function, but
the focus of this function is on single element calculations where the semantics are unambiguous.
If the input is a DateTime, the result a DateTime Interval beginning and ending on that DateTime.
If the input is a Quantity, the quantity is expected to be a calendar-duration interpreted as an Age,
and the result is a DateTime Interval beginning on the Date the patient turned that age and ending immediately before one year later.
If the input is a DateTime Interval, the result is the input.
If the input is a Quantity Interval, the quantities are expected to be calendar-durations interpreted as an Age, and the result
is a DateTime Interval beginning on the date the patient turned the age given as the start of the quantity interval, and ending
immediately before one year later than the date the patient turned the age given as the end of the quantity interval.
If the input is a Timing, an error will be thrown indicating that Timing calculations are not implemented. Any other input will reslt in a null DateTime Interval
*/
define fluent function toInterval(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;, Timing&gt;):
  case
	  when choice is DateTime then
    	Interval[choice as DateTime, choice as DateTime]
		when choice is Interval&lt;DateTime&gt; then
  		choice as Interval&lt;DateTime&gt;
		when choice is Quantity then
		  Interval[Patient.birthDate + (choice as Quantity),
			  Patient.birthDate + (choice as Quantity) + 1 year)
		when choice is Interval&lt;Quantity&gt; then
		  Interval[Patient.birthDate + (choice.low as Quantity),
			  Patient.birthDate + (choice.high as Quantity) + 1 year)
		when choice is Timing then
      Message(null, true, 'NOT_IMPLEMENTED', 'Error', 'Calculation of an interval from a Timing value is not supported') as Interval&lt;DateTime&gt;
		else
			null as Interval&lt;DateTime&gt;
	end

/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
@deprecated: This function is deprecated. Use the fluent function `abatementInterval()` instead.
*/
define function ToAbatementInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;

/*
@description: Returns an interval representing the normalized abatement of a given Condition.
@comment: If the abatement element of the Condition is represented as a DateTime, the result
is an interval beginning and ending on that DateTime.
If the abatement is represented as a Quantity, the quantity is expected to be a calendar-duration and is interpreted as the age of the patient. The
result is an interval from the date the patient turned that age to immediately before one year later.
If the abatement is represented as a Quantity Interval, the quantities are expected to be calendar-durations and are interpreted as an age range during
which the abatement occurred. The result is an interval from the date the patient turned the starting age of the quantity interval, and ending immediately
before one year later than the date the patient turned the ending age of the quantity interval.
*/
define fluent function abatementInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
	if condition.abatement is DateTime then
	  Interval[condition.abatement as DateTime, condition.abatement as DateTime]
	else if condition.abatement is Quantity then
		Interval[Patient.birthDate + (condition.abatement as Quantity),
			Patient.birthDate + (condition.abatement as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;Quantity&gt; then
	  Interval[Patient.birthDate + (condition.abatement.low as Quantity),
		  Patient.birthDate + (condition.abatement.high as Quantity) + 1 year)
	else if condition.abatement is Interval&lt;DateTime&gt; then
	  Interval[condition.abatement.low, condition.abatement.high)
	else null as Interval&lt;DateTime&gt;

/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
@deprecated: This function is deprecated. Use the `prevalenceInterval()` fluent function instead
*/
define function ToPrevalenceInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of ToInterval(condition.onset), end of ToAbatementInterval(condition)]
else
   (end of ToAbatementInterval(condition)) abatementDate
    return if abatementDate is null then
      Interval[start of ToInterval(condition.onset), abatementDate)
    else
      Interval[start of ToInterval(condition.onset), abatementDate]

/*
@description: Returns an interval representing the normalized prevalence period of a given Condition.
@comment: Uses the ToInterval and ToAbatementInterval functions to determine the widest potential interval from
onset to abatement as specified in the given Condition. If the condition is active, or has an abatement date the resulting 
interval will have a closed ending boundary. Otherwise, the resulting interval will have an open ending boundary.
*/
define fluent function prevalenceInterval(condition Choice&lt;"ConditionEncounterDiagnosis", "ConditionProblemsHealthConcerns"&gt;):
if condition.clinicalStatus ~ "active"
  or condition.clinicalStatus ~ "recurrence"
  or condition.clinicalStatus ~ "relapse" then
  Interval[start of condition.onset.toInterval(), end of condition.abatementInterval()]
else
    (end of condition.abatementInterval()) abatementDate
    return if abatementDate is null then
      Interval[start of condition.onset.toInterval(), abatementDate)
    else
      Interval[start of condition.onset.toInterval(), abatementDate]

/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
@deprecated: This function is deprecated. Use the fluent function `getId()` instead
*/
define function GetId(uri String):
  Last(Split(uri, '/'))

/*
@description: Returns the tail of the given uri (i.e. everything after the last slash in the URI).
@comment: This function can be used to determine the logical id of a given resource. It can be used in
a single-server environment to trace references. However, this function does not attempt to resolve
or distinguish the base of the given url, and so cannot be used safely in multi-server environments.
*/
define fluent function getId(uri String):
  Last(Split(uri, '/'))

/*
@description: Returns true if the given reference is to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resource Resource):
  resource.id = Last(Split(reference.reference, '/'))  

/*
@description: Returns true if the given reference is to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of the given reference.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(reference Reference, resourceId String):
  resourceId = Last(Split(reference.reference, '/'))

/*
@description: Returns true if any of the given references are to the given resource
@comment: Returns true if the `id` element of the given resource exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List&lt;Reference&gt;, resource Resource):
  exists (references R where R.references(resource))
  
/*
@description: Returns true if any of the given references are to the given resourceId
@comment: Returns true if the `resourceId` parameter exactly equals the tail of any of the given references.
NOTE: This function assumes resources from the same source server.
*/
define fluent function references(references List&lt;Reference&gt;, resourceId String):
  exists (references R where R.references(resourceId))

/*
@description: Returns true if the given code is in the given codeList
@comment: Returns true if the `code` is equivalent to any of the codes in the given `codeList`, false otherwise.
*/
define fluent function includesCode(codeList List&lt;Concept&gt;, code Code):
  exists (codeList C where C ~ code)

/*
@description: Given an interval, return true if the interval has a starting boundary specified
(i.e. the start of the interval is not null and not the minimum DateTime value)
@deprecated: This function is deprecated. Uee the fluent function `hasStart()` instead
*/
define function "HasStart"(period Interval&lt;DateTime&gt; ):
  not ( start of period is null
      or start of period = minimum DateTime
  )

/*
@description: Given an interval, return true if the interval has a starting boundary specified
(i.e. the start of the interval is not null and not the minimum DateTime value)
*/
define fluent function hasStart(period Interval&lt;DateTime&gt; ):
  not ( start of period is null
      or start of period = minimum DateTime
  )

/*
@description: Given an interval, returns true if the interval has an ending boundary specified
(i.e. the end of the interval is not null and not the maximum DateTime value)
@deprecated: This function is deprecated. Use the fluent function `hasEnd()` instead
*/
define function "HasEnd"(period Interval&lt;DateTime&gt; ):
  not (
    end of period is null
      or end of period = maximum DateTime
  )

/*
@description: Given an interval, returns true if the interval has an ending boundary specified
(i.e. the end of the interval is not null and not the maximum DateTime value)
*/
define fluent function hasEnd(period Interval&lt;DateTime&gt; ):
  not (
    end of period is null
      or end of period = maximum DateTime
  )

/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
@deprecated: This function is deprecated. Use the fluent function `latest()` instead
*/
define function "Latest"(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (HasEnd(period)) then end of period
      else start of period

/*
@description: Given an interval, returns the ending point if the interval has an ending boundary specified,
otherwise, returns the starting point
*/
define fluent function latest(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (period."hasEnd"()) then end of period
      else start of period

/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
@deprecated: This function is deprecated. Use the fluent function `earliest()` instead
*/
define function "Earliest"(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (HasStart(period)) then start of period
      else end of period

/*
@description: Given an interval, return the starting point if the interval has a starting boundary specified,
otherwise, return the ending point
*/
define fluent function earliest(choice Choice&lt;DateTime, Quantity, Interval&lt;DateTime&gt;, Interval&lt;Quantity&gt;&gt; ):
  (choice.toInterval()) period
    return
      if (period."hasStart"()) then start of period
      else end of period

/*
@description: Creates a list of integers from 1 to how many days are in the interval. Note, this wont create an index for
the final day if it is less than 24 hours. This also includes the first 24 hour period.
@deprecated: This function is deprecated. Use the fluent function `toDayNumbers()` instead
*/
define function "Interval To Day Numbers"(Period Interval&lt;DateTime&gt;):
  ( expand { Interval[1, duration in days between start of Period and end of Period]} ) DayNumber
    return end of DayNumber

/*
@description: Creates a list of integers from 1 to how many days are in the interval. Note, this wont create an index for
the final day if it is less than 24 hours. This also includes the first 24 hour period.
*/
define fluent function toDayNumbers(Period Interval&lt;DateTime&gt;):
  ( expand { Interval[1, duration in days between start of Period and end of Period]} ) DayNumber
    return end of DayNumber

/*
@description: Creates a list of 24 hour long intervals in an interval paired with the index (1 indexed) to which 24 hour interval it is.
Note that the result will include intervals that are closed at the beginning and open at the end
@deprecated: This function is deprecated. Use the fluent function `daysInPeriod()` instead
*/
define function "Days In Period"(Period Interval&lt;DateTime&gt;):
  ( "Interval To Day Numbers"(Period)) DayIndex
    let startPeriod: start of Period + (24 hours * (DayIndex - 1)),
    endPeriod: if (hours between startPeriod and end of Period &lt; 24) then startPeriod
      else start of Period + (24 hours * DayIndex)
    return Tuple {
      dayIndex: DayIndex,
      dayPeriod: Interval[startPeriod, endPeriod)
    }

/*
@description: Creates a list of 24 hour long intervals in an interval paired with the index (1 indexed) to which 24 hour interval it is.
Note that the result will include intervals that are closed at the beginning and open at the end
*/
define fluent function daysInPeriod(Period Interval&lt;DateTime&gt;):
  ( "Interval To Day Numbers"(Period)) DayIndex
    let startPeriod: start of Period + (24 hours * (DayIndex - 1)),
    endPeriod: if (hours between startPeriod and end of Period &lt; 24) then startPeriod
      else start of Period + (24 hours * DayIndex)
    return Tuple {
      dayIndex: DayIndex,
      dayPeriod: Interval[startPeriod, endPeriod)
    }</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://loinc.org"></system>
                  <code value="21112-8"></code>
                  <display value="Birthdate"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://snomed.info/sct"></system>
                  <code value="419099009"></code>
                  <display value="Dead"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"></system>
                  <code value="ER"></code>
                  <display value="ER"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"></system>
                  <code value="ICU"></code>
                  <display value="ICU"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="billing"></code>
                  <display value="Billing"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://hl7.org/fhir/CodeSystem/task-code"></system>
                  <code value="fulfill"></code>
                  <display value="Fulfill"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="AMB"></code>
                  <display value="ambulatory"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="EMER"></code>
                  <display value="emergency"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="FLD"></code>
                  <display value="field"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="HH"></code>
                  <display value="home health"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="IMP"></code>
                  <display value="inpatient encounter"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="ACUTE"></code>
                  <display value="inpatient acute"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="NONAC"></code>
                  <display value="inpatient non-acute"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="OBSENC"></code>
                  <display value="observation encounter"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="PRENC"></code>
                  <display value="pre-admission"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="SS"></code>
                  <display value="short stay"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"></system>
                  <code value="VR"></code>
                  <display value="virtual"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-category"></system>
                  <code value="problem-list-item"></code>
                  <display value="problem-list-item"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-category"></system>
                  <code value="encounter-diagnosis"></code>
                  <display value="encounter-diagnosis"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"></system>
                  <code value="health-concern"></code>
                  <display value="health-concern"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="active"></code>
                  <display value="active"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="recurrence"></code>
                  <display value="recurrence"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="relapse"></code>
                  <display value="relapse"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="inactive"></code>
                  <display value="inactive"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="remission"></code>
                  <display value="remission"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-clinical"></system>
                  <code value="resolved"></code>
                  <display value="resolved"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="unconfirmed"></code>
                  <display value="unconfirmed"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="provisional"></code>
                  <display value="provisional"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="differential"></code>
                  <display value="differential"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="confirmed"></code>
                  <display value="confirmed"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="refuted"></code>
                  <display value="refuted"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/condition-ver-status"></system>
                  <code value="entered-in-error"></code>
                  <display value="entered-in-error"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"></system>
                  <code value="active"></code>
                  <display value="allergy-active"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"></system>
                  <code value="inactive"></code>
                  <display value="allergy-inactive"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"></system>
                  <code value="resolved"></code>
                  <display value="allergy-resolved"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></system>
                  <code value="unconfirmed"></code>
                  <display value="allergy-unconfirmed"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></system>
                  <code value="confirmed"></code>
                  <display value="allergy-confirmed"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/allergyintolerance-verification"></system>
                  <code value="refuted"></code>
                  <display value="allergy-refuted"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"></system>
                  <code value="inpatient"></code>
                  <display value="Inpatient"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"></system>
                  <code value="outpatient"></code>
                  <display value="Outpatient"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"></system>
                  <code value="community"></code>
                  <display value="Community"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"></system>
                  <code value="discharge"></code>
                  <display value="Discharge"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="AD"></code>
                  <display value="AD"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="DD"></code>
                  <display value="DD"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="CC"></code>
                  <display value="CC"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="CM"></code>
                  <display value="CM"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="pre-op"></code>
                  <display value="pre-op"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="post-op"></code>
                  <display value="post-op"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/diagnosis-role"></system>
                  <code value="billing"></code>
                  <display value="billing"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="social-history"></code>
                  <display value="social-history"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="vital-signs"></code>
                  <display value="vital-signs"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="imaging"></code>
                  <display value="imaging"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="laboratory"></code>
                  <display value="laboratory"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="procedure"></code>
                  <display value="procedure"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="survey"></code>
                  <display value="survey"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="exam"></code>
                  <display value="exam"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="therapy"></code>
                  <display value="therapy"></display>
               </valueCoding>
            </extension>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
               <valueCoding>
                  <system value="http://terminology.hl7.org/CodeSystem/observation-category"></system>
                  <code value="activity"></code>
                  <display value="activity"></display>
               </valueCoding>
            </extension>
            <url value="https://madie.cms.gov/Library/QICoreCommon"></url>
            <identifier>
               <use value="official"></use>
               <system value="https://madie.cms.gov/login"></system>
               <value value="67cb33c19e9ab93ec36dad45"></value>
            </identifier>
            <version value="4.0.000"></version>
            <name value="QICoreCommon"></name>
            <title value="QICoreCommon"></title>
            <status value="active"></status>
            <experimental value="false"></experimental>
            <type>
               <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/library-type"></system>
                  <code value="logic-library"></code>
               </coding>
            </type>
            <date value="2025-08-22T19:19:03+00:00"></date>
            <publisher value="ICF"></publisher>
            <description value="Common terminologies and functions used in QI-Core-based CQL artifacts"></description>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="QICore model information"></display>
               <resource value="http://hl7.org/fhir/Library/QICore-ModelInfo"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Library FHIRHelpers"></display>
               <resource value="https://madie.cms.gov/Library/FHIRHelpers|4.4.000"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system USCoreConditionCategoryExtensionCodes"></display>
               <resource value="http://hl7.org/fhir/us/core/CodeSystem/condition-category"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system ObservationCategoryCodes"></display>
               <resource value="http://terminology.hl7.org/CodeSystem/observation-category"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system ConditionClinicalStatusCodes"></display>
               <resource value="http://terminology.hl7.org/CodeSystem/condition-clinical"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system MedicationRequestCategory"></display>
               <resource value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"></resource>
            </relatedArtifact>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="Code system ConditionCategory"></display>
               <resource value="http://terminology.hl7.org/CodeSystem/condition-category"></resource>
            </relatedArtifact>
            <dataRequirement>
               <type value="Resource"></type>
               <profile value="http://hl7.org/fhir/StructureDefinition/Resource"></profile>
               <mustSupport value="id"></mustSupport>
               <mustSupport value="id.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="Patient"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"></profile>
               <mustSupport value="birthDate"></mustSupport>
               <mustSupport value="birthDate.value"></mustSupport>
            </dataRequirement>
            <dataRequirement>
               <type value="DeviceRequest"></type>
               <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest"></profile>
               <mustSupport value="modifierExtension"></mustSupport>
            </dataRequirement>
            <content>
               <contentType value="text/cql"></contentType>
               <data value="[encoded data, 43100 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+xml"></contentType>
               <data value="[encoded data, 1733416 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+json"></contentType>
               <data value="[encoded data, 2930368 characters]"></data>
            </content>
         </Library>
      </resource>
      <request>
         <method value="POST"></method>
         <url value="Library/QICoreCommon"></url>
      </request>
   </entry>
   <entry>
      <fullUrl value="https://madie.cms.gov/Library/FHIRHelpers"></fullUrl>
      <resource>
         <Library xmlns="http://hl7.org/fhir">
            <id value="FHIRHelpers"></id>
            <meta>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-computablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-publishablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-executablelibrary"></profile>
               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/cql-library"></profile>
               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/elm-json-library"></profile>
               <profile value="http://hl7.org/fhir/uv/cql/StructureDefinition/elm-xml-library"></profile>
            </meta>
            <language value="en"></language>
            <text>
               <status value="extensions"></status>
               <div xmlns="http://www.w3.org/1999/xhtml" class="col-12"> 
                  <table class="narrative-table"> 
                     <tbody> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Metadata</th> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Title</th> 
                           <td class="content-container">FHIRHelpers</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Version</th> 
                           <td class="content-container">4.4.000</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Identifier</th> 
                           <td class="content-container">660d90bc01598d085de46056</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Steward (Publisher)</th> 
                           <td class="content-container">ICF</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Description</th> 
                           <td class="content-container">This library defines functions to convert between FHIR
 data types and CQL system-defined types, as well as functions to support FHIRPath implementation. For more information, the FHIRHelpers wiki page:
 https://github.com/cqframework/clinical_quality_language/wiki/FHIRHelpers</td> 
                        </tr> 
                        <tr> 
                           <th scope="row" class="row-header">Type</th> 
                           <td class="content-container">[http://terminology.hl7.org/CodeSystem/library-type#logic-library]</td> 
                        </tr> 
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Library Content</th> 
                        </tr>  
                        <tr> 
                           <th scope="row" class="row-header">CQL Content</th> 
                           <td> 
                              <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">library FHIRHelpers version '4.4.000'

using FHIR version '4.0.1'

/*
@description: Converts the given [Period](https://hl7.org/fhir/datatypes.html#Period)
value to a CQL DateTime Interval
@comment: If the start value of the given period is unspecified, the starting
boundary of the resulting interval will be open (meaning the start of the interval
is unknown, as opposed to interpreted as the beginning of time).
*/
define function ToInterval(period FHIR.Period):
    if period is null then
        null
    else
        if period."start" is null then
            Interval(period."start".value, period."end".value]
        else
            Interval[period."start".value, period."end".value]

/*
@description: Converts a UCUM definite duration unit to a CQL calendar duration
unit using conversions specified in the [quantities](https://cql.hl7.org/02-authorsguide.html#quantities) 
topic of the CQL specification.
@comment: Note that for durations above days (or weeks), the conversion is understood to be approximate
*/
define function ToCalendarUnit(unit System.String):
    case unit
        when 'ms' then 'millisecond'
        when 's' then 'second'
        when 'min' then 'minute'
        when 'h' then 'hour'
        when 'd' then 'day'
        when 'wk' then 'week'
        when 'mo' then 'month'
        when 'a' then 'year'
        else unit
    end

/*
@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) 
value to a CQL Quantity
@comment: If the given quantity has a comparator specified, a runtime error is raised. If the given quantity
has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units (i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`)
an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function is used.
@seealso: ToCalendarUnit
*/
define function ToQuantity(quantity FHIR.Quantity):
    case
        when quantity is null then null
        when quantity.value is null then null
        when quantity.comparator is not null then
            Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.')
        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
        else
            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
    end

/*
@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Quantity, ignoring
the comparator element. This function should only be used when an application is justified in ignoring the comparator value (i.e. the
context is looking for boundary).
@comment: If the given quantity has a system other than UCUM (i.e. `http://unitsofmeasure.org`) or CQL calendar units 
(i.e. `http://hl7.org/fhirpath/CodeSystem/calendar-units`) an error is raised. For UCUM to calendar units, the `ToCalendarUnit` function 
is used.
@seealso: ToCalendarUnit
*/
define function ToQuantityIgnoringComparator(quantity FHIR.Quantity):
    case
        when quantity is null then null
        when quantity.value is null then null
        when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org'
              or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then
            System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) }
        else
            Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' &amp; quantity.unit.value &amp; ' (' &amp; quantity.system.value &amp; '|' &amp; quantity.code.value &amp; ')')
    end

/*
@description: Converts the given FHIR [Quantity](https://hl7.org/fhir/datatypes.html#Quantity) value to a CQL Interval of Quantity.
@comment: If the given quantity has a comparator, it is used to construct an interval based on the value of the comparator. If the comparator
is less than, the resulting interval will start with a null closed boundary and end with an open boundary on the quantity. If the comparator
is less than or equal, the resulting interval will start with a null closed boundary and end with a closed boundary on the quantity. If the 
comparator is greater or equal, the resulting interval will start with a closed boundary on the quantity and end with a closed null boundary.
If the comparator is greatter than, the resulting interval will start with an open boundary on the quantity and end with a closed null boundary.
If no comparator is specified, the resulting interval will start and end with a closed boundary on the quantity.
*/
define function ToInterval(quantity FHIR.Quantity):
    if quantity is null then null else
        case quantity.comparator.value
            when '&lt;' then
                Interval[
                    null,
                    ToQuantityIgnoringComparator(quantity)
                )
            when '&lt;=' then
                Interval[
                    null,
                    ToQuantityIgnoringComparator(quantity)
                ]
            when '&gt;=' then
                Interval[
                    ToQuantityIgnoringComparator(quantity),
                    null
                ]
            when '&gt;' then
                Interval(
                    ToQuantityIgnoringComparator(quantity),
                    null
                ]
            else
                Interval[ToQuantity(quantity), ToQuantity(quantity)]
        end

/*
@description: Converts the given FHIR [Ratio](https://hl7.org/fhir/datatypes.html#Ratio) value to a CQL Ratio.
*/
define function ToRatio(ratio FHIR.Ratio):
    if ratio is null then
        null
    else
        System.Ratio { numerator: ToQuantity(ratio.numerator), denominator: ToQuantity(ratio.denominator) }

/*
@description: Converts the given FHIR [Range](https://hl7.org/fhir/datatypes.html#Range) value to a CQL Interval of Quantity
*/
define function ToInterval(range FHIR.Range):
    if range is null then
        null
    else
        Interval[ToQuantity(range.low), ToQuantity(range.high)]

/*
@description: Converts the given FHIR [Coding](https://hl7.org/fhir/datatypes.html#Coding) value to a CQL Code.
*/
define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }

/*
@description: Converts the given FHIR [CodeableConcept](https://hl7.org/fhir/datatypes.html#CodeableConcept) value to a CQL Concept.
*/
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }

/*
@description: Converts the given value (assumed to be a URI) to a CQL [ValueSet](https://cql.hl7.org/09-b-cqlreference.html#valueset)
*/
define function ToValueSet(uri String):
    if uri is null then
        null
    else
        System.ValueSet {
            id: uri
        }

/*
@description: Constructs a FHIR [Reference](https://hl7.org/fhir/datatypes.html#Reference) from the given reference (assumed to be a FHIR resource URL)
*/
define function reference(reference String):
    if reference is null then
        null
    else
        Reference { reference: string { value: reference } }

/*
@description: Converts the given value to a CQL value using the appropriate accessor or conversion function.
@comment: TODO: document conversion
*/
define function ToValue(value Choice&lt;base64Binary,
        boolean,
        canonical,
        code,
        date,
        dateTime,
        decimal,
        id,
        instant,
        integer,
        markdown,
        oid,
        positiveInt,
        string,
        time,
        unsignedInt,
        uri,
        url,
        uuid,
        Address,
        Age,
        Annotation,
        Attachment,
        CodeableConcept,
        Coding,
        ContactPoint,
        Count,
        Distance,
        Duration,
        HumanName,
        Identifier,
        Money,
        Period,
        Quantity,
        Range,
        Ratio,
        Reference,
        SampledData,
        Signature,
        Timing,
        ContactDetail,
        Contributor,
        DataRequirement,
        Expression,
        ParameterDefinition,
        RelatedArtifact,
        TriggerDefinition,
        UsageContext,
        Dosage,
        Meta&gt;):
    case
      when value is base64Binary then (value as base64Binary).value
      when value is boolean then (value as boolean).value
      when value is canonical then (value as canonical).value
      when value is code then (value as code).value
      when value is date then (value as date).value
      when value is dateTime then (value as dateTime).value
      when value is decimal then (value as decimal).value
      when value is id then (value as id).value
      when value is instant then (value as instant).value
      when value is integer then (value as integer).value
      when value is markdown then (value as markdown).value
      when value is oid then (value as oid).value
      when value is positiveInt then (value as positiveInt).value
      when value is string then (value as string).value
      when value is time then (value as time).value
      when value is unsignedInt then (value as unsignedInt).value
      when value is uri then (value as uri).value
      when value is url then (value as url).value
      when value is uuid then (value as uuid).value
      when value is Age then ToQuantity(value as Age)
      when value is CodeableConcept then ToConcept(value as CodeableConcept)
      when value is Coding then ToCode(value as Coding)
      when value is Count then ToQuantity(value as Count)
      when value is Distance then ToQuantity(value as Distance)
      when value is Duration then ToQuantity(value as Duration)
      when value is Quantity then ToQuantity(value as Quantity)
      when value is Range then ToInterval(value as Range)
      when value is Period then ToInterval(value as Period)
      when value is Ratio then ToRatio(value as Ratio)
      else value as Choice&lt;Address,
        Annotation,
        Attachment,
        ContactPoint,
        HumanName,
        Identifier,
        Money,
        Reference,
        SampledData,
        Signature,
        Timing,
        ContactDetail,
        Contributor,
        DataRequirement,
        Expression,
        ParameterDefinition,
        RelatedArtifact,
        TriggerDefinition,
        UsageContext,
        Dosage,
        Meta&gt;
    end

/*
@description: Resolve the given reference as a url to a resource. If the item resolves, the Resource is returned, otherwise the result is null.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function resolve(reference String) returns Resource: external
/*
@description: Resolve the reference element of the given Reference. If the item resolves, the Resource is returned, otherwise the result is null.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function resolve(reference Reference) returns Resource: external
/*
@description: Constructs a Reference to the given Resource. The resulting reference will typically be relative, but implementations may provide a base URL if one can be unambiguously determined.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function reference(resource Resource) returns Reference: external
/*
@description: Returns any extensions with the given url defined on the given element.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function extension(element Element, url String) returns List&lt;Extension&gt;: external
/*
@description: Returns any extensions with the given url defined on the given resource.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function extension(resource DomainResource, url String) returns List&lt;Extension&gt;: external
/*
@description: Returns any modifier extensions with the given url defined on the given element.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function modifierExtension(element BackboneElement, url String) returns List&lt;Extension&gt;: external
/*
@description: Returns any modifier extensions with the given url defined on the given resource.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function modifierExtension(resource DomainResource, url String) returns List&lt;Extension&gt;: external
/*
@description: Returns true if the element is a FHIR primitive type with a value element (as opposed to having only extensions); false otherwise
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function hasValue(element Element) returns Boolean: external
/*
@description: Returns the value of the FHIR primitive; null otherwise
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function getValue(element Element) returns Any: external
/*
@description: Returns a list containing only those elements in the input that are of the given type, specified as a string.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function ofType(identifier String) returns List&lt;Any&gt;: external
/*
@description: Returns true if the input is of the given type; false otherwise
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function is(identifier String) returns Boolean: external
/*
@description: If the input is of the given type; returns the value as that type; null otherwise.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function as(identifier String) returns Any: external
/*
@description: Returns the FHIR element definition for the given element
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function elementDefinition(element Element) returns ElementDefinition: external
/*
@description: Returns the given slice as defined in the given structure definition. The structure argument is a uri that resolves to the structure definition, and the name must be the name of a slice within that structure definition. If the structure cannot be resolved, or the name of the slice within the resolved structure is not present, an error is thrown.
@comment: For every element in the input collection, if the resolved slice is present on the element, it will be returned. If the slice does not match any element in the input collection, or if the input collection is empty, the result is an empty collection ({ }).
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function slice(element Element, url String, name String) returns List&lt;Element&gt;: external
/*
@description: For each element in the input collection, verifies that there are no modifying extensions defined other than the ones given by the modifier argument. If the check passes, the input collection is returned. Otherwise, an error is thrown.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function checkModifiers(resource Resource) returns Resource: external
/*
@description: For each element in the input collection, verifies that there are no modifying extensions defined other than the ones given by the modifier argument. If the check passes, the input collection is returned. Otherwise, an error is thrown.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function checkModifiers(resource Resource, modifier String) returns Resource: external
/*
@description: For each element in the input collection, verifies that there are no modifying extensions defined other than the ones given by the modifier argument. If the check passes, the input collection is returned. Otherwise, an error is thrown.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function checkModifiers(element Element) returns Element: external
/*
@description: For each element in the input collection, verifies that there are no modifying extensions defined other than the ones given by the modifier argument. If the check passes, the input collection is returned. Otherwise, an error is thrown.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function checkModifiers(element Element, modifier String) returns Element: external
/*
@description: Returns true if the single input element conforms to the profile specified by the structure argument, and false otherwise. If the structure cannot be resolved to a valid profile, an error is thrown. If the input contains more than one element, an error is thrown. If the input is empty, the result is empty.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function conformsTo(resource Resource, structure String) returns Boolean: external
/*
@description: Returns true if the given code is equal to a code in the valueset, so long as the valueset only contains one codesystem. If the valueset contains more than one codesystem, an error is thrown.
@comment: If the valueset cannot be resolved as a uri to a value set, an error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
For example:
```fhirpath
Observation.component.where(code.memberOf('http://hl7.org/fhir/ValueSet/observation-vitalsignresult'))
```
This expression returns components that have a code that is a member of the observation-vitalsignresult valueset.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function memberOf(code code, valueSet String) returns Boolean: external
/*
@description: Returns true if the code is a member of the given valueset.
@comment: If the valueset cannot be resolved as a uri to a value set, an error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
For example:
```fhirpath
Observation.component.where(code.memberOf('http://hl7.org/fhir/ValueSet/observation-vitalsignresult'))
```
This expression returns components that have a code that is a member of the observation-vitalsignresult valueset.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function memberOf(coding Coding, valueSet String) returns Boolean: external
/*
@description: Returns true if any code in the concept is a member of the given valueset.
@comment: If the valueset cannot be resolved as a uri to a value set, an error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
For example:
```fhirpath
Observation.component.where(code.memberOf('http://hl7.org/fhir/ValueSet/observation-vitalsignresult'))
```
This expression returns components that have a code that is a member of the observation-vitalsignresult valueset.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function memberOf(concept CodeableConcept, valueSet String) returns Boolean: external
/*
@description: Returns true if the source code is equivalent to the given code, or if the source code subsumes the given code (i.e. the source code is an ancestor of the given code in a subsumption hierarchy), and false otherwise.
@comment: If the Codings are from different code systems, the relationships between the code systems must be well-defined or a run-time error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function subsumes(coding Coding, subsumedCoding Coding) returns Boolean: external
/*
@description: Returns true if any Coding in the source or given elements is equivalent to or subsumes the given code.
@comment: If the Codings are from different code systems, the relationships between the code systems must be well-defined or a run-time error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function subsumes(concept CodeableConcept, subsumedConcept CodeableConcept) returns Boolean: external
/*
@description: Returns true if the source code is equivalent to the given code, or if the source code is subsumed by the given code (i.e. the source code is a descendant of the given code in a subsumption hierarchy), and false otherwise.
@comment: If the Codings are from different code systems, the relationships between the code systems must be well-defined or a run-time error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function subsumedBy(coding Coding, subsumingCoding Coding) returns Boolean: external
/*
@description: Returns true if any Coding in the source or given elements is equivalent to or subsumed by the given code.
@comment: If the Codings are from different code systems, the relationships between the code systems must be well-defined or a run-time error is thrown.
Note that implementations are encouraged to make use of a terminology service to provide this functionality.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function subsumedBy(concept CodeableConcept, subsumingConcept CodeableConcept) returns Boolean: external
/*
@description: When invoked on an xhtml element, returns true if the rules around HTML usage are met, and false if they are not. The return value is undefined (null) on any other kind of element.
@seealso: https://hl7.org/fhir/fhirpath.html#functions
*/
define function htmlChecks(element Element) returns Boolean: external

define function ToString(value AccountStatus): value.value
define function ToString(value ActionCardinalityBehavior): value.value
define function ToString(value ActionConditionKind): value.value
define function ToString(value ActionGroupingBehavior): value.value
define function ToString(value ActionParticipantType): value.value
define function ToString(value ActionPrecheckBehavior): value.value
define function ToString(value ActionRelationshipType): value.value
define function ToString(value ActionRequiredBehavior): value.value
define function ToString(value ActionSelectionBehavior): value.value
define function ToString(value ActivityDefinitionKind): value.value
define function ToString(value ActivityParticipantType): value.value
define function ToString(value AddressType): value.value
define function ToString(value AddressUse): value.value
define function ToString(value AdministrativeGender): value.value
define function ToString(value AdverseEventActuality): value.value
define function ToString(value AggregationMode): value.value
define function ToString(value AllergyIntoleranceCategory): value.value
define function ToString(value AllergyIntoleranceCriticality): value.value
define function ToString(value AllergyIntoleranceSeverity): value.value
define function ToString(value AllergyIntoleranceType): value.value
define function ToString(value AppointmentStatus): value.value
define function ToString(value AssertionDirectionType): value.value
define function ToString(value AssertionOperatorType): value.value
define function ToString(value AssertionResponseTypes): value.value
define function ToString(value AuditEventAction): value.value
define function ToString(value AuditEventAgentNetworkType): value.value
define function ToString(value AuditEventOutcome): value.value
define function ToString(value BindingStrength): value.value
define function ToString(value BiologicallyDerivedProductCategory): value.value
define function ToString(value BiologicallyDerivedProductStatus): value.value
define function ToString(value BiologicallyDerivedProductStorageScale): value.value
define function ToString(value BundleType): value.value
define function ToString(value CapabilityStatementKind): value.value
define function ToString(value CarePlanActivityKind): value.value
define function ToString(value CarePlanActivityStatus): value.value
define function ToString(value CarePlanIntent): value.value
define function ToString(value CarePlanStatus): value.value
define function ToString(value CareTeamStatus): value.value
define function ToString(value CatalogEntryRelationType): value.value
define function ToString(value ChargeItemDefinitionPriceComponentType): value.value
define function ToString(value ChargeItemStatus): value.value
define function ToString(value ClaimResponseStatus): value.value
define function ToString(value ClaimStatus): value.value
define function ToString(value ClinicalImpressionStatus): value.value
define function ToString(value CodeSearchSupport): value.value
define function ToString(value CodeSystemContentMode): value.value
define function ToString(value CodeSystemHierarchyMeaning): value.value
define function ToString(value CommunicationPriority): value.value
define function ToString(value CommunicationRequestStatus): value.value
define function ToString(value CommunicationStatus): value.value
define function ToString(value CompartmentCode): value.value
define function ToString(value CompartmentType): value.value
define function ToString(value CompositionAttestationMode): value.value
define function ToString(value CompositionStatus): value.value
define function ToString(value ConceptMapEquivalence): value.value
define function ToString(value ConceptMapGroupUnmappedMode): value.value
define function ToString(value ConditionalDeleteStatus): value.value
define function ToString(value ConditionalReadStatus): value.value
define function ToString(value ConsentDataMeaning): value.value
define function ToString(value ConsentProvisionType): value.value
define function ToString(value ConsentState): value.value
define function ToString(value ConstraintSeverity): value.value
define function ToString(value ContactPointSystem): value.value
define function ToString(value ContactPointUse): value.value
define function ToString(value ContractPublicationStatus): value.value
define function ToString(value ContractStatus): value.value
define function ToString(value ContributorType): value.value
define function ToString(value CoverageStatus): value.value
define function ToString(value CurrencyCode): value.value
define function ToString(value DayOfWeek): value.value
define function ToString(value DaysOfWeek): value.value
define function ToString(value DetectedIssueSeverity): value.value
define function ToString(value DetectedIssueStatus): value.value
define function ToString(value DeviceMetricCalibrationState): value.value
define function ToString(value DeviceMetricCalibrationType): value.value
define function ToString(value DeviceMetricCategory): value.value
define function ToString(value DeviceMetricColor): value.value
define function ToString(value DeviceMetricOperationalStatus): value.value
define function ToString(value DeviceNameType): value.value
define function ToString(value DeviceRequestStatus): value.value
define function ToString(value DeviceUseStatementStatus): value.value
define function ToString(value DiagnosticReportStatus): value.value
define function ToString(value DiscriminatorType): value.value
define function ToString(value DocumentConfidentiality): value.value
define function ToString(value DocumentMode): value.value
define function ToString(value DocumentReferenceStatus): value.value
define function ToString(value DocumentRelationshipType): value.value
define function ToString(value EligibilityRequestPurpose): value.value
define function ToString(value EligibilityRequestStatus): value.value
define function ToString(value EligibilityResponsePurpose): value.value
define function ToString(value EligibilityResponseStatus): value.value
define function ToString(value EnableWhenBehavior): value.value
define function ToString(value EncounterLocationStatus): value.value
define function ToString(value EncounterStatus): value.value
define function ToString(value EndpointStatus): value.value
define function ToString(value EnrollmentRequestStatus): value.value
define function ToString(value EnrollmentResponseStatus): value.value
define function ToString(value EpisodeOfCareStatus): value.value
define function ToString(value EventCapabilityMode): value.value
define function ToString(value EventTiming): value.value
define function ToString(value EvidenceVariableType): value.value
define function ToString(value ExampleScenarioActorType): value.value
define function ToString(value ExplanationOfBenefitStatus): value.value
define function ToString(value ExposureState): value.value
define function ToString(value ExtensionContextType): value.value
define function ToString(value FHIRAllTypes): value.value
define function ToString(value FHIRDefinedType): value.value
define function ToString(value FHIRDeviceStatus): value.value
define function ToString(value FHIRResourceType): value.value
define function ToString(value FHIRSubstanceStatus): value.value
define function ToString(value FHIRVersion): value.value
define function ToString(value FamilyHistoryStatus): value.value
define function ToString(value FilterOperator): value.value
define function ToString(value FlagStatus): value.value
define function ToString(value GoalLifecycleStatus): value.value
define function ToString(value GraphCompartmentRule): value.value
define function ToString(value GraphCompartmentUse): value.value
define function ToString(value GroupMeasure): value.value
define function ToString(value GroupType): value.value
define function ToString(value GuidanceResponseStatus): value.value
define function ToString(value GuidePageGeneration): value.value
define function ToString(value GuideParameterCode): value.value
define function ToString(value HTTPVerb): value.value
define function ToString(value IdentifierUse): value.value
define function ToString(value IdentityAssuranceLevel): value.value
define function ToString(value ImagingStudyStatus): value.value
define function ToString(value ImmunizationEvaluationStatus): value.value
define function ToString(value ImmunizationStatus): value.value
define function ToString(value InvoicePriceComponentType): value.value
define function ToString(value InvoiceStatus): value.value
define function ToString(value IssueSeverity): value.value
define function ToString(value IssueType): value.value
define function ToString(value LinkType): value.value
define function ToString(value LinkageType): value.value
define function ToString(value ListMode): value.value
define function ToString(value ListStatus): value.value
define function ToString(value LocationMode): value.value
define function ToString(value LocationStatus): value.value
define function ToString(value MeasureReportStatus): value.value
define function ToString(value MeasureReportType): value.value
define function ToString(value MediaStatus): value.value
define function ToString(value MedicationAdministrationStatus): value.value
define function ToString(value MedicationDispenseStatus): value.value
define function ToString(value MedicationKnowledgeStatus): value.value
define function ToString(value MedicationRequestIntent): value.value
define function ToString(value MedicationRequestPriority): value.value
define function ToString(value MedicationRequestStatus): value.value
define function ToString(value MedicationStatementStatus): value.value
define function ToString(value MedicationStatus): value.value
define function ToString(value MessageSignificanceCategory): value.value
define function ToString(value Messageheader_Response_Request): value.value
define function ToString(value MimeType): value.value
define function ToString(value NameUse): value.value
define function ToString(value NamingSystemIdentifierType): value.value
define function ToString(value NamingSystemType): value.value
define function ToString(value NarrativeStatus): value.value
define function ToString(value NoteType): value.value
define function ToString(value NutritiionOrderIntent): value.value
define function ToString(value NutritionOrderStatus): value.value
define function ToString(value ObservationDataType): value.value
define function ToString(value ObservationRangeCategory): value.value
define function ToString(value ObservationStatus): value.value
define function ToString(value OperationKind): value.value
define function ToString(value OperationParameterUse): value.value
define function ToString(value OrientationType): value.value
define function ToString(value ParameterUse): value.value
define function ToString(value ParticipantRequired): value.value
define function ToString(value ParticipantStatus): value.value
define function ToString(value ParticipationStatus): value.value
define function ToString(value PaymentNoticeStatus): value.value
define function ToString(value PaymentReconciliationStatus): value.value
define function ToString(value ProcedureStatus): value.value
define function ToString(value PropertyRepresentation): value.value
define function ToString(value PropertyType): value.value
define function ToString(value ProvenanceEntityRole): value.value
define function ToString(value PublicationStatus): value.value
define function ToString(value QualityType): value.value
define function ToString(value QuantityComparator): value.value
define function ToString(value QuestionnaireItemOperator): value.value
define function ToString(value QuestionnaireItemType): value.value
define function ToString(value QuestionnaireResponseStatus): value.value
define function ToString(value ReferenceHandlingPolicy): value.value
define function ToString(value ReferenceVersionRules): value.value
define function ToString(value ReferredDocumentStatus): value.value
define function ToString(value RelatedArtifactType): value.value
define function ToString(value RemittanceOutcome): value.value
define function ToString(value RepositoryType): value.value
define function ToString(value RequestIntent): value.value
define function ToString(value RequestPriority): value.value
define function ToString(value RequestStatus): value.value
define function ToString(value ResearchElementType): value.value
define function ToString(value ResearchStudyStatus): value.value
define function ToString(value ResearchSubjectStatus): value.value
define function ToString(value ResourceType): value.value
define function ToString(value ResourceVersionPolicy): value.value
define function ToString(value ResponseType): value.value
define function ToString(value RestfulCapabilityMode): value.value
define function ToString(value RiskAssessmentStatus): value.value
define function ToString(value SPDXLicense): value.value
define function ToString(value SearchComparator): value.value
define function ToString(value SearchEntryMode): value.value
define function ToString(value SearchModifierCode): value.value
define function ToString(value SearchParamType): value.value
define function ToString(value SectionMode): value.value
define function ToString(value SequenceType): value.value
define function ToString(value ServiceRequestIntent): value.value
define function ToString(value ServiceRequestPriority): value.value
define function ToString(value ServiceRequestStatus): value.value
define function ToString(value SlicingRules): value.value
define function ToString(value SlotStatus): value.value
define function ToString(value SortDirection): value.value
define function ToString(value SpecimenContainedPreference): value.value
define function ToString(value SpecimenStatus): value.value
define function ToString(value Status): value.value
define function ToString(value StrandType): value.value
define function ToString(value StructureDefinitionKind): value.value
define function ToString(value StructureMapContextType): value.value
define function ToString(value StructureMapGroupTypeMode): value.value
define function ToString(value StructureMapInputMode): value.value
define function ToString(value StructureMapModelMode): value.value
define function ToString(value StructureMapSourceListMode): value.value
define function ToString(value StructureMapTargetListMode): value.value
define function ToString(value StructureMapTransform): value.value
define function ToString(value SubscriptionChannelType): value.value
define function ToString(value SubscriptionStatus): value.value
define function ToString(value SupplyDeliveryStatus): value.value
define function ToString(value SupplyRequestStatus): value.value
define function ToString(value SystemRestfulInteraction): value.value
define function ToString(value TaskIntent): value.value
define function ToString(value TaskPriority): value.value
define function ToString(value TaskStatus): value.value
define function ToString(value TestReportActionResult): value.value
define function ToString(value TestReportParticipantType): value.value
define function ToString(value TestReportResult): value.value
define function ToString(value TestReportStatus): value.value
define function ToString(value TestScriptRequestMethodCode): value.value
define function ToString(value TriggerType): value.value
define function ToString(value TypeDerivationRule): value.value
define function ToString(value TypeRestfulInteraction): value.value
define function ToString(value UDIEntryType): value.value
define function ToString(value UnitsOfTime): value.value
define function ToString(value Use): value.value
define function ToString(value VariableType): value.value
define function ToString(value VisionBase): value.value
define function ToString(value VisionEyes): value.value
define function ToString(value VisionStatus): value.value
define function ToString(value XPathUsageType): value.value
define function ToString(value base64Binary): value.value
define function ToBoolean(value boolean): value.value
define function ToDate(value date): value.value
define function ToDateTime(value dateTime): value.value
define function ToDecimal(value decimal): value.value
define function ToDateTime(value instant): value.value
define function ToInteger(value integer): value.value
define function ToString(value string): value.value
define function ToTime(value time): value.value
define function ToString(value uri): value.value
define function ToString(value xhtml): value.value</code></pre> 
                           </td> 
                        </tr>   
                        <tr> 
                           <th colspan="2" scope="row" class="row-header">Generated using version 0.4.8 of the sample-content-ig Liquid templates</th> 
                        </tr> 
                     </tbody> 
                  </table> 
               </div>
            </text>
            <url value="https://madie.cms.gov/Library/FHIRHelpers"></url>
            <identifier>
               <use value="official"></use>
               <system value="https://madie.cms.gov/login"></system>
               <value value="660d90bc01598d085de46056"></value>
            </identifier>
            <version value="4.4.000"></version>
            <name value="FHIRHelpers"></name>
            <title value="FHIRHelpers"></title>
            <status value="active"></status>
            <experimental value="false"></experimental>
            <type>
               <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/library-type"></system>
                  <code value="logic-library"></code>
               </coding>
            </type>
            <date value="2025-08-22T19:19:03+00:00"></date>
            <publisher value="ICF"></publisher>
            <description value="This library defines functions to convert between FHIR
 data types and CQL system-defined types, as well as functions to support
 FHIRPath implementation. For more information, the FHIRHelpers wiki page:
 https://github.com/cqframework/clinical_quality_language/wiki/FHIRHelpers"></description>
            <relatedArtifact>
               <type value="depends-on"></type>
               <display value="FHIR model information"></display>
               <resource value="http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"></resource>
            </relatedArtifact>
            <content>
               <contentType value="text/cql"></contentType>
               <data value="[encoded data, 52440 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+xml"></contentType>
               <data value="[encoded data, 1342916 characters]"></data>
            </content>
            <content>
               <contentType value="application/elm+json"></contentType>
               <data value="[encoded data, 2177516 characters]"></data>
            </content>
         </Library>
      </resource>
      <request>
         <method value="POST"></method>
         <url value="Library/FHIRHelpers"></url>
      </request>
   </entry>
</Bundle>