<Measure xmlns="http://hl7.org/fhir">
   <id value="TreatmentForAcuteMigraineAttacks"></id>
   <meta>
      <profile value="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-shareablemeasure"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/publishable-measure-cqfm"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/executable-measure-cqfm"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cql-measure-cqfm"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/elm-measure-cqfm"></profile>
      <profile value="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/proportion-measure-cqfm"></profile>
   </meta>
   <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">Treatment Prescribed for Acute Migraine Attacks</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Version</th> 
                  <td class="content-container">Draft based on 0.1.000</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Short Name</th> 
                  <td class="content-container">CMS1234TreatmentForAcuteMigraine</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">GUID (Version Independent)</th> 
                  <td class="content-container">urn:uuid:838e367b-1633-4f03-9746-7f78dd3f68a3</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">GUID (Version Specific)</th> 
                  <td class="content-container">urn:uuid:26bb2e8e-d539-480b-8522-8a20e12ea7b6</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">Status</th> 
                  <td class="content-container">draft</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Steward (Publisher)</th> 
                  <td class="content-container">American Academy of Neurology</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Developer</th> 
                  <td class="content-container">Lantana Consulting Group</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Description</th> 
                  <td class="content-container">Percentage of patients age 6 years and older with a diagnosis of migraine who were prescribed a guideline recommended or Food and Drug Administration (FDA) approved/cleared treatment for acute migraine attacks during the measurement period.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Purpose</th> 
                  <td class="content-container">Only 29% of patients are satisfied with their acute migraine treatment. Among people with episodic migraine, 18.31% reported current use of triptans for acute headache treatment. Triptan use increased with headache frequency, headache-related disability and allodynia, but decreased among people with depression. Less than 1 in 5 people with migraine in the US who were respondents to this survey used triptans for acute headache treatment over the course of a year. In a population sample of individuals with episodic migraine, more than 40% have at least one unmet need in the area of acute treatment. The leading reasons for unmet needs, which include headache-related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for people with episodic migraine (EM). In an analysis of data from the 2005 American Migraine Prevalence and Prevention (AMPP) study, authors reported that 91.7% of respondents meeting criteria for EM used acute treatment for their headaches. Of these respondents, only 36.1% used migraine-specific medications. Triptans were used by 18.3% of the sample, opioids were used by 11.7% of the sample, and barbiturate medications were used by 6.1% of the sample. According to another study, 21.87% of patients use triptans for acute treatment of migraine, 20% use ergots, 20.87% use opioids, and 13.52% use barbiturates. Using the guideline recommended first-line acute treatments would provide superior pain relief for migraine. Triptans and ergots are considered first-line acute treatments for migraine according to the latest American Headache Society guideline (2015). The leading reasons for unmet needs, which include headache related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for people with EM.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Copyright</th> 
                  <td class="content-container">Copyright: (C)2023 American Academy of Neurology Institute (AANI). All rights reserved.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Disclaimer</th> 
                  <td class="content-container">Quality Measures published by the American Academy of Neurology and its affiliates are assessments of current scientific and clinical information provided as an educational service. The information: 1) should not be considered inclusive of all proper treatments, methods of care, or as a statement of the standard of care; 2) is not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); 3) addresses only the question(s) or topic(s) specifically identified; 4) does not mandate any particular course of medical care; and 5) is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients. In all cases, the selected course of action should be considered by the treating provider in the context of treating the individual patient. Use of the information is voluntary. AAN provides this information on an “as is” basis, and makes no warranty, expressed or implied, regarding the information. AAN specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. AAN assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary coding sets should obtain all necessary licenses from the owners of these code sets. The AAN and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications. ICD10 copyright 2022 International Health Terminology Standards Development Organization CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Rationale</th> 
                  <td class="content-container">By providing appropriate guideline recommended treatments, it is anticipated that headache severity and duration of headache would be reduced for patients that have acute attacks.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Clinical Recommendation Statement</th> 
                  <td class="content-container">AANI, please provide.</td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Bigal ME, Buse DC, Hen YT, et al. Rates and predictors of starting a triptan: results from the American Migraine Prevalence and Prevention Study. Headache 2010; 50:1440-8   </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Bigal, M. E., Buse, D. C., Hen, Y. T., et al. (2010). Rates and predictors of starting a triptan: Results from the American Migraine Prevalence and Prevention Study. Headache: The Journal of Head and Face Pain, 50(9), 1440–1448 https://doi.org/10.1111/j.1526-4610.2010.01726.   </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Lipton, R. B., &amp; Stewart, W. F. (1999). Acute migraine therapy: Do doctors understand what patients with migraine want from therapy? Headache: The Journal of Head and Face Pain, 39(Suppl. 2), S20–S26. https://doi.org/10.1111/j.1526-4610.1999.390720    </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Lipton, R. B., Buse, D. C., Serrano, D., et al. (2009). Acute medication use patterns in episodic migraine: Results of the American Migraine Prevalence and Prevention (AMPP) study. Cephalalgia, 29(Suppl. 1), 17. Presented at the 14th Congress of the International Headache Society, September 10–13, 2009.    </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Lipton, R. B., Buse, D. C., Serrano, D., et al. (2013). Examination of unmet treatment needs among persons with episodic migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache: The Journal of Head and Face Pain, 53(8), 1300–1311. https://doi.org/10.1111/head.12154   </td> 
               </tr> 
               <tr>   
                  <th scope="row" class="row-header">Citation</th>  
                  <td class="content-container">  Marmura, M. J., Silberstein, S. D., &amp; Schwedt, T. J. (2015). The acute treatment of migraine in adults: The American Headache Society evidence assessment of migraine pharmacotherapies. Headache: The Journal of Head and Face Pain, 55(1), 3–20. https://doi.org/10.1111/head.12499    </td> 
               </tr>  
               <tr> 
                  <th scope="row" class="row-header">Definition</th> 
                  <td class="content-container">Definition: Guideline recommended or FDA approved/cleared acute migraine medications: include the following but are not limited to: triptans, dihydroergotamine (DHE), NSAIDs, D2 antagonists and may include neuromodulation.</td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Guidance (Usage)</th> 
                  <td class="content-container">Acute treatment prescribed for migraine – Acute treatments include, but are not limited to: triptans, dihydroergotamine, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), D2 antagonists. Guideline recommended or FDA approved/cleared acute migraine attack treatment may include neuromodulation. A patient and/or caregiver reserve the right to decline a prescription. Some patients may have contraindications to all medications or medications are ineffective. Patients may already be on an effective over the counter medication or have an acute migraine treatment prescribed by another clinician. Patients with a history of acute migraine medication overuse or no pain with migraine may require a different treatment approach. Clinicians should use their best judgment to prescribe a treatment for acute migraine attacks to meet the specific needs of the individual patient. Note: The list of acute migraine medications/treatments are based on clinical guidelines and other evidence and may not be all-inclusive or current. Physicians and other health care professionals should refer to the Food and Drug Administration’s (FDA) web site page entitled “Drug Safety Communications” for up-to-date drug recall and alert information when prescribing medications. Emergency department and urgent care visits on date of presentation are not included.</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">patients age 6 years or older with a diagnosis of migraine and who have an office visit, telephone consultation, or outpatient consultation during the measurement period.</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-treatmentforacutemigraineattacks-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">Initial Population</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-treatmentforacutemigraineattacks-denominator">Denominator</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">Patients who were prescribed a guideline recommended or FDA approved/cleared treatment* for acute migraine attacks once during the measurement period.</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-treatmentforacutemigraineattacks-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">Migraine Medication Not Ordered Due To Patient Or Medical Reasons or Patient Has An Allergy Or Adverse Event To Migraine Treatment or Patient Has a History of Migraine Treatment Overuse or Patient Reports Acute Migraine without Pain</p>   
                     <em>Logic Definition</em>: 
                     <a href="#primary-treatmentforacutemigraineattacks-denominator-exceptions">Denominator Exceptions</a>  
                  </td> 
               </tr>   
               <tr> 
                  <th scope="row" class="row-header">Supplemental Data Guidance</th> 
                  <td class="content-container">For every patient evaluated by this measure also identify payer, race, ethnicity and sex</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="#treatmentforacutemigraineattacks-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="#treatmentforacutemigraineattacks-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="#treatmentforacutemigraineattacks-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="#treatmentforacutemigraineattacks-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/TreatmentForAcuteMigraineAttacks</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-treatmentforacutemigraineattacks-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":
  exists ( "Acute Migraine Encounter During Measurement Period For Ages 6 And Older" )</code></pre> 
                  </td> 
               </tr>                                      
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-treatmentforacutemigraineattacks-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"</code></pre> 
                  </td> 
               </tr>                                  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-treatmentforacutemigraineattacks-numerator"> </a>  Numerator  
                  </th> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  exists ( "FDA Approved Medication Or Neuromodulation During Measurement Period" )</code></pre> 
                  </td> 
               </tr>                                                    
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="primary-treatmentforacutemigraineattacks-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 Migraine Medication Not Ordered Due To Patient Or Medical Reasons"
    or "Has Allergy Or Adverse Event To Migraine Treatment"
    or "Has Migraine Treatment Overuse"
    or "Has Acute Migraine Without Pain"
    or "Has No Neuromodulation Device Due To Patient Or Medical Reason"</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="treatmentforacutemigraineattacks-sde-sex"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </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="treatmentforacutemigraineattacks-fda-approved-medication"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "FDA Approved Medication":
  [MedicationRequest: "Prescribable NSAIDs and Acute Migraine Attack Medication"] FDAApprovedTX
    where FDAApprovedTX.authoredOn during "Measurement Period"</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-neuromodulation-device"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Neuromodulation Device":
  ( [DeviceRequest: "Neuromodulation for migraine"] NeuroDeviceOrder
      where NeuroDeviceOrder.authoredOn during day of "Measurement Period"
        and NeuroDeviceOrder.intent ~ 'order'
        and NeuroDeviceOrder.status in { 'active', 'completed' }
        and not exists ( ["TaskRejected"] TaskReject
            where TaskReject.focus.references ( NeuroDeviceOrder )
              and TaskReject.code ~ QICoreCommon."Fulfill"
        )
  )
    union ( [Procedure: "Neuromodulation for migraine"] ProcedurePerformed
        where ProcedurePerformed.performed.toInterval ( ) during day of "Measurement Period"
          and ProcedurePerformed.status ~ 'completed'
    )
    union ( [DeviceUseStatement] DeviceInUse
      where DeviceInUse.recordedOn during day of "Measurement Period"
        and DeviceInUse.status ~ 'active' ) DeviceUse
      where exists ( [Device: "Neuromodulation for migraine"] )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-fda-approved-medication-or-neuromodulation-during-measurement-period"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Numerator


define "FDA Approved Medication Or Neuromodulation During Measurement Period":
  ( "FDA Approved Medication"
      union "Neuromodulation Device"
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-numerator"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Numerator":
  exists ( "FDA Approved Medication Or Neuromodulation During Measurement Period" )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-acute-migraine-encounter-during-measurement-period-for-ages-6-and-older"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Acute Migraine Encounter During Measurement Period For Ages 6 And Older":
  ( [Encounter: "Office Visit"]
    union [Encounter: "Online Evaluation and Management Encounters"]
    union [Encounter: "Telephone Visits All"] ) MigraineEncounter
    where ( MigraineEncounter.reasonCode in "Migraine Diagnosis (ICD)"
        or MigraineEncounter.encounterDiagnosis ( ).code in "Migraine Diagnosis (ICD)"
    )
      and AgeInYearsAt(date from start of MigraineEncounter.period) &gt;= 6
      and MigraineEncounter.period during "Measurement Period"
      and not exists ( [Encounter: "Emergency Department Visit"] EDVisit
          where EDVisit.period during day of MigraineEncounter.period
      )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-initial-population"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Initial Population":
  exists ( "Acute Migraine Encounter During Measurement Period For Ages 6 And Older" )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-denominator"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator":
  "Initial Population"</code></pre> 
                  </td> 
               </tr>  
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-sde-payer"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </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="treatmentforacutemigraineattacks-sde-ethnicity"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </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="treatmentforacutemigraineattacks-sde-race"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </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="treatmentforacutemigraineattacks-has-migraine-medication-not-ordered-due-to-patient-or-medical-reasons"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">//Exceptions


define "Has Migraine Medication Not Ordered Due To Patient Or Medical Reasons":
  exists ( [MedicationNotRequested: "Prescribable NSAIDs and Acute Migraine Attack Medication"] FDAApprovedTX
      where FDAApprovedTX.reasonCode in "Medical Reason"
        or FDAApprovedTX.reasonCode in "Patient Refusal of Medication (SNOMED)"
          and FDAApprovedTX.status = 'completed'
          and FDAApprovedTX.doNotPerform is true
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-has-allergy-or-adverse-event-to-migraine-treatment"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Allergy Or Adverse Event To Migraine Treatment":
  exists ( [AllergyIntolerance: "Prescribable NSAIDs and Acute Migraine Attack Medication"] AllergyToTx
      with "Acute Migraine Encounter During Measurement Period For Ages 6 And Older" ValidEncounter
        such that AllergyToTx.clinicalStatus is null
          or ( AllergyToTx.clinicalStatus ~ QICoreCommon."allergy-active"
              and AllergyToTx.onset before end of "Measurement Period"
          )
  )
    or exists ( [AdverseEvent: "Prescribable NSAIDs and Acute Migraine Attack Medication"] AdverseEventToTX
        where AdverseEventToTX.recordedDate before end of "Measurement Period"
          and AdverseEventToTX.actuality ~ 'actual'
    )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-has-migraine-treatment-overuse"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Migraine Treatment Overuse":
  exists ( [ConditionProblemsHealthConcerns: "Acute migraine medication overuse"] Overuse
      where Overuse.prevalenceInterval ( ) starts during "Measurement Period"
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-has-acute-migraine-without-pain"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has Acute Migraine Without Pain":
  exists ( ( [ConditionProblemsHealthConcerns: "Acute migraine (disorder)"] AcuteMigraine
        where not exists [ConditionProblemsHealthConcerns: "Pain (finding)"] Pain
          and AcuteMigraine.prevalenceInterval ( ) starts during "Measurement Period"
    )
      union ( [ConditionProblemsHealthConcerns: "Migraine aura without headache (disorder)"] NoHA
          where NoHA.prevalenceInterval ( ) starts during "Measurement Period"
      )
  )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-has-no-neuromodulation-device-due-to-patient-or-medical-reason"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Has No Neuromodulation Device Due To Patient Or Medical Reason":
  exists ( [DeviceNotRequested: "Neuromodulation for migraine"] DeviceNotRequested
      where DeviceNotRequested.authoredOn during day of "Measurement Period"
        and DeviceNotRequested.doNotPerformReason in "Medical Reason For Not Providing Treatment"
        and DeviceNotRequested.status ~ 'completed'
  )
    or exists ( [ProcedureNotDone: "Neuromodulation for migraine"] NoProcedure
        where NoProcedure.recorded during day of "Measurement Period"
          or NoProcedure.statusReason in "Medical Reason For Not Providing Treatment"
            and NoProcedure.status ~ 'not-done'
    )
    or exists ( from
        ( [DeviceRequest: "Neuromodulation for migraine"] ) DeviceOrderReject,
        [TaskRejected] T
        where DeviceOrderReject.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and DeviceOrderReject.status = 'active'
          and T.focus.references ( DeviceOrderReject )
          and T.code ~ QICoreCommon."Fulfill"
          and DeviceOrderReject.authoredOn during day of "Measurement Period"
          and ( T.statusReason in "Medical Reason For Not Providing Treatment"
              or T.statusReason in "Patient Refusal"
          )
        return {
          id: DeviceOrderReject.id,
          requestStatusReason: T.statusReason,
          authoredOn: DeviceOrderReject.authoredOn
        }
    )</code></pre> 
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="treatmentforacutemigraineattacks-denominator-exceptions"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> TreatmentForAcuteMigraineAttacks
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">define "Denominator Exceptions":
  "Has Migraine Medication Not Ordered Due To Patient Or Medical Reasons"
    or "Has Allergy Or Adverse Event To Migraine Treatment"
    or "Has Migraine Treatment Overuse"
    or "Has Acute Migraine Without Pain"
    or "Has No Neuromodulation Device Due To Patient Or Medical Reason"</code></pre> 
                  </td> 
               </tr>                    
               <tr> 
                  <th scope="row" rowspan="2" class="row-header">  
                     <a name="cqmcommon-encounterdiagnosis"> </a> Logic Definition 
                  </th> 
                  <td class="content-container">
                     <em>Library Name:</em> CQMCommon
                  </td> 
               </tr> 
               <tr> 
                  <td> 
                     <pre style="border: none;" class="content-container highlight language-cql"><code class="language-cql">/*  
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
  Encounter.reasonReference D
    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))</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-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="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-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="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="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 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, '/'))</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 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 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 AllergyIntoleranceClinicalStatusCodes  
                     <br></br>    
                     <em>Resource</em>: http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</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">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Prescribable NSAIDs and Acute Migraine Attack Medication  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Neuromodulation for migraine  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641</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/2.16.840.1.113883.3.464.1003.101.11.1005 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Online Evaluation and Management Encounters  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Telephone Visits All  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Migraine Diagnosis (ICD)  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.663 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.663</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Emergency Department Visit  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292</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 Medical Reason  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.313 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.313</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Patient Refusal of Medication (SNOMED)  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.221 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.221</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Acute migraine medication overuse  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.579 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.579</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Medical Reason For Not Providing Treatment  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473</tt> 
                  </td> 
               </tr> 
               <tr>  
                  <th scope="row" class="row-header">Value Set</th>  
                  <td class="content-container"> 
                     <em>Description</em>: Value set Patient Refusal  
                     <br></br>    
                     <em>Resource</em>: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93</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>: 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>: Active 
                     <br></br> 
                     <em>Code</em>: active 
                     <br></br> 
                     <em>System</em>: 
                     <tt>http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical</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>: Acute migraine (disorder) 
                     <br></br> 
                     <em>Code</em>: 471661000124108 
                     <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>: Pain (finding) 
                     <br></br> 
                     <em>Code</em>: 22253000 
                     <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>: Migraine aura without headache (disorder) 
                     <br></br> 
                     <em>Code</em>: 230465000 
                     <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 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 scope="row" class="row-header">Dependency</th> 
                  <td class="content-container"> 
                     <em>Description</em>: Library CQMCommon  
                     <br></br>    
                     <em>Resource</em>: https://madie.cms.gov/Library/CQMCommon|4.1.000 
                     <br></br> 
                     <em>Canonical URL</em>: 
                     <tt>https://madie.cms.gov/Library/CQMCommon|4.1.000</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>: MedicationRequest 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest 
                     <br></br>   
                     <em>Must Support Elements</em>: medication, authoredOn, authoredOn.value 
                     <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/2.16.840.1.113762.1.4.1034.664 
                     <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.reference.value, authoredOn, authoredOn.value 
                     <br></br>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Medication 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication 
                     <br></br>   
                     <em>Must Support Elements</em>: id.value, code 
                     <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>: DeviceRequest 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest 
                     <br></br>   
                     <em>Must Support Elements</em>: code, authoredOn, authoredOn.value, intent, intent.value, status, status.value, id, id.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/2.16.840.1.113762.1.4.1034.641 
                     <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, statusReason 
                     <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/2.16.840.1.113762.1.4.1034.641 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-deviceusestatement 
                     <br></br>   
                     <em>Must Support Elements</em>: recordedOn, recordedOn.value, status, status.value 
                     <br></br>  
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: Device 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device 
                     <br></br>   
                     <em>Must Support Elements</em>: type 
                     <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/2.16.840.1.113762.1.4.1034.641 
                     <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>   
                  </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>   
                  </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/2.16.840.1.113762.1.4.1034.579 
                     <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#471661000124108: 'Acute migraine (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>Code(s)</em>:  http://snomed.info/sct#22253000: 'Pain (finding)'  
                     </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>Code(s)</em>:  http://snomed.info/sct#230465000: 'Migraine aura without headache (disorder)'  
                     </span> 
                     <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, reasonCode, 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/2.16.840.1.113883.3.464.1003.101.11.1005 
                     <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, reasonCode, 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/2.16.840.1.113762.1.4.1034.539 
                     <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, reasonCode, 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/2.16.840.1.113762.1.4.1260.161 
                     <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, reasonCode 
                     <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/2.16.840.1.113883.3.117.1.7.1.292 
                     <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>: 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, status, status.value, doNotPerform, doNotPerform.value 
                     <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/2.16.840.1.113762.1.4.1034.664 
                     <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, clinicalStatus, onset 
                     <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/2.16.840.1.113762.1.4.1034.664 
                     <br></br>   
                  </td> 
               </tr> 
               <tr> 
                  <th scope="row" class="row-header">Data Requirement</th> 
                  <td class="content-container"> 
                     <em>Type</em>: AdverseEvent 
                     <br></br> 
                     <em>Profile(s)</em>:  http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent 
                     <br></br>   
                     <em>Must Support Elements</em>: event, recordedDate, recordedDate.value, actuality, actuality.value 
                     <br></br>  
                     <em>Code Filter(s)</em>: 
                     <br></br>  
                     <span class="tab-one">
                        <em>Path</em>: event
                     </span> 
                     <br></br>  
                     <span class="tab-one">
                        <em>ValueSet</em>:
                     </span> http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664 
                     <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-devicenotrequested 
                     <br></br>   
                     <em>Must Support Elements</em>: code, authoredOn, authoredOn.value, extension, 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/2.16.840.1.113762.1.4.1034.641 
                     <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-procedurenotdone 
                     <br></br>   
                     <em>Must Support Elements</em>: code, extension, statusReason, 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/2.16.840.1.113762.1.4.1034.641 
                     <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://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/allergyintolerance-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="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://snomed.info/sct"></system>
               <code value="471661000124108"></code>
               <display value="Acute migraine (disorder)"></display>
            </valueCoding>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
               <system value="http://snomed.info/sct"></system>
               <code value="22253000"></code>
               <display value="Pain (finding)"></display>
            </valueCoding>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-directReferenceCode">
            <valueCoding>
               <system value="http://snomed.info/sct"></system>
               <code value="230465000"></code>
               <display value="Migraine aura without headache (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="TreatmentForAcuteMigraineAttacks"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="FDA Approved Medication"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;FDA Approved Medication&quot;:
  [MedicationRequest: &quot;Prescribable NSAIDs and Acute Migraine Attack Medication&quot;] FDAApprovedTX
    where FDAApprovedTX.authoredOn during &quot;Measurement Period&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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Neuromodulation Device"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Neuromodulation Device&quot;:
  ( [DeviceRequest: &quot;Neuromodulation for migraine&quot;] NeuroDeviceOrder
      where NeuroDeviceOrder.authoredOn during day of &quot;Measurement Period&quot;
        and NeuroDeviceOrder.intent ~ 'order'
        and NeuroDeviceOrder.status in { 'active', 'completed' }
        and not exists ( [&quot;TaskRejected&quot;] TaskReject
            where TaskReject.focus.references ( NeuroDeviceOrder )
              and TaskReject.code ~ QICoreCommon.&quot;Fulfill&quot;
        )
  )
    union ( [Procedure: &quot;Neuromodulation for migraine&quot;] ProcedurePerformed
        where ProcedurePerformed.performed.toInterval ( ) during day of &quot;Measurement Period&quot;
          and ProcedurePerformed.status ~ 'completed'
    )
    union ( [DeviceUseStatement] DeviceInUse
      where DeviceInUse.recordedOn during day of &quot;Measurement Period&quot;
        and DeviceInUse.status ~ 'active' ) DeviceUse
      where exists ( [Device: &quot;Neuromodulation for migraine&quot;] )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="FDA Approved Medication Or Neuromodulation During Measurement Period"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="//Numerator


define &quot;FDA Approved Medication Or Neuromodulation During Measurement Period&quot;:
  ( &quot;FDA Approved Medication&quot;
      union &quot;Neuromodulation Device&quot;
  )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Numerator"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Numerator&quot;:
  exists ( &quot;FDA Approved Medication Or Neuromodulation During Measurement Period&quot; )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Acute Migraine Encounter During Measurement Period For Ages 6 And Older"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Acute Migraine Encounter During Measurement Period For Ages 6 And Older&quot;:
  ( [Encounter: &quot;Office Visit&quot;]
    union [Encounter: &quot;Online Evaluation and Management Encounters&quot;]
    union [Encounter: &quot;Telephone Visits All&quot;] ) MigraineEncounter
    where ( MigraineEncounter.reasonCode in &quot;Migraine Diagnosis (ICD)&quot;
        or MigraineEncounter.encounterDiagnosis ( ).code in &quot;Migraine Diagnosis (ICD)&quot;
    )
      and AgeInYearsAt(date from start of MigraineEncounter.period) &gt;= 6
      and MigraineEncounter.period during &quot;Measurement Period&quot;
      and not exists ( [Encounter: &quot;Emergency Department Visit&quot;] EDVisit
          where EDVisit.period during day of MigraineEncounter.period
      )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Initial Population"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Initial Population&quot;:
  exists ( &quot;Acute Migraine Encounter During Measurement Period For Ages 6 And Older&quot; )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Denominator"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Denominator&quot;:
  &quot;Initial Population&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="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="9"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="TreatmentForAcuteMigraineAttacks"></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="10"></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="11"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="TreatmentForAcuteMigraineAttacks"></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="12"></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="13"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="TreatmentForAcuteMigraineAttacks"></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="14"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Has Migraine Medication Not Ordered Due To Patient Or Medical Reasons"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="//Exceptions


define &quot;Has Migraine Medication Not Ordered Due To Patient Or Medical Reasons&quot;:
  exists ( [MedicationNotRequested: &quot;Prescribable NSAIDs and Acute Migraine Attack Medication&quot;] FDAApprovedTX
      where FDAApprovedTX.reasonCode in &quot;Medical Reason&quot;
        or FDAApprovedTX.reasonCode in &quot;Patient Refusal of Medication (SNOMED)&quot;
          and FDAApprovedTX.status = 'completed'
          and FDAApprovedTX.doNotPerform is true
  )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Has Allergy Or Adverse Event To Migraine Treatment"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Has Allergy Or Adverse Event To Migraine Treatment&quot;:
  exists ( [AllergyIntolerance: &quot;Prescribable NSAIDs and Acute Migraine Attack Medication&quot;] AllergyToTx
      with &quot;Acute Migraine Encounter During Measurement Period For Ages 6 And Older&quot; ValidEncounter
        such that AllergyToTx.clinicalStatus is null
          or ( AllergyToTx.clinicalStatus ~ QICoreCommon.&quot;allergy-active&quot;
              and AllergyToTx.onset before end of &quot;Measurement Period&quot;
          )
  )
    or exists ( [AdverseEvent: &quot;Prescribable NSAIDs and Acute Migraine Attack Medication&quot;] AdverseEventToTX
        where AdverseEventToTX.recordedDate before end of &quot;Measurement Period&quot;
          and AdverseEventToTX.actuality ~ 'actual'
    )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Has Migraine Treatment Overuse"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Has Migraine Treatment Overuse&quot;:
  exists ( [ConditionProblemsHealthConcerns: &quot;Acute migraine medication overuse&quot;] Overuse
      where Overuse.prevalenceInterval ( ) starts during &quot;Measurement Period&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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Has Acute Migraine Without Pain"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Has Acute Migraine Without Pain&quot;:
  exists ( ( [ConditionProblemsHealthConcerns: &quot;Acute migraine (disorder)&quot;] AcuteMigraine
        where not exists [ConditionProblemsHealthConcerns: &quot;Pain (finding)&quot;] Pain
          and AcuteMigraine.prevalenceInterval ( ) starts during &quot;Measurement Period&quot;
    )
      union ( [ConditionProblemsHealthConcerns: &quot;Migraine aura without headache (disorder)&quot;] NoHA
          where NoHA.prevalenceInterval ( ) starts during &quot;Measurement Period&quot;
      )
  )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Has No Neuromodulation Device Due To Patient Or Medical Reason"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Has No Neuromodulation Device Due To Patient Or Medical Reason&quot;:
  exists ( [DeviceNotRequested: &quot;Neuromodulation for migraine&quot;] DeviceNotRequested
      where DeviceNotRequested.authoredOn during day of &quot;Measurement Period&quot;
        and DeviceNotRequested.doNotPerformReason in &quot;Medical Reason For Not Providing Treatment&quot;
        and DeviceNotRequested.status ~ 'completed'
  )
    or exists ( [ProcedureNotDone: &quot;Neuromodulation for migraine&quot;] NoProcedure
        where NoProcedure.recorded during day of &quot;Measurement Period&quot;
          or NoProcedure.statusReason in &quot;Medical Reason For Not Providing Treatment&quot;
            and NoProcedure.status ~ 'not-done'
    )
    or exists ( from
        ( [DeviceRequest: &quot;Neuromodulation for migraine&quot;] ) DeviceOrderReject,
        [TaskRejected] T
        where DeviceOrderReject.intent in { 'order', 'original-order', 'reflex-order', 'filler-order', 'instance-order' }
          and DeviceOrderReject.status = 'active'
          and T.focus.references ( DeviceOrderReject )
          and T.code ~ QICoreCommon.&quot;Fulfill&quot;
          and DeviceOrderReject.authoredOn during day of &quot;Measurement Period&quot;
          and ( T.statusReason in &quot;Medical Reason For Not Providing Treatment&quot;
              or T.statusReason in &quot;Patient Refusal&quot;
          )
        return {
          id: DeviceOrderReject.id,
          requestStatusReason: T.statusReason,
          authoredOn: DeviceOrderReject.authoredOn
        }
    )"></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="TreatmentForAcuteMigraineAttacks"></valueString>
            </extension>
            <extension url="name">
               <valueString value="Denominator Exceptions"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="define &quot;Denominator Exceptions&quot;:
  &quot;Has Migraine Medication Not Ordered Due To Patient Or Medical Reasons&quot;
    or &quot;Has Allergy Or Adverse Event To Migraine Treatment&quot;
    or &quot;Has Migraine Treatment Overuse&quot;
    or &quot;Has Acute Migraine Without Pain&quot;
    or &quot;Has No Neuromodulation Device Due To Patient Or Medical Reason&quot;"></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="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="21"></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="22"></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="23"></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="24"></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="25"></valueInteger>
            </extension>
         </extension>
         <extension url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
            <extension url="libraryName">
               <valueString value="CQMCommon"></valueString>
            </extension>
            <extension url="name">
               <valueString value="encounterDiagnosis"></valueString>
            </extension>
            <extension url="statement">
               <valueString value="/*  
@description: Returns the Condition resources referenced by the diagnosis element of the Encounter  
*/
define fluent function encounterDiagnosis(Encounter Encounter ):
  Encounter.reasonReference D
    return singleton from (([ConditionEncounterDiagnosis] union [ConditionProblemsHealthConcerns]) C where D.references(C.id))"></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="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 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, '/'))"></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="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="28"></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="29"></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="30"></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 QICoreCommon"></display>
            <resource value="https://madie.cms.gov/Library/QICoreCommon|4.0.000"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Library CQMCommon"></display>
            <resource value="https://madie.cms.gov/Library/CQMCommon|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="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 AllergyIntoleranceClinicalStatusCodes"></display>
            <resource value="http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"></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="Value set Prescribable NSAIDs and Acute Migraine Attack Medication"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Neuromodulation for migraine"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Office Visit"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Online Evaluation and Management Encounters"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Telephone Visits All"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Migraine Diagnosis (ICD)"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.663"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Emergency Department Visit"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"></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>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Medical Reason"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.313"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Patient Refusal of Medication (SNOMED)"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.221"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Acute migraine medication overuse"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.579"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Medical Reason For Not Providing Treatment"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.473"></resource>
         </relatedArtifact>
         <relatedArtifact>
            <type value="depends-on"></type>
            <display value="Value set Patient Refusal"></display>
            <resource value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.93"></resource>
         </relatedArtifact>
         <parameter>
            <name value="Measurement Period"></name>
            <use value="in"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Period"></type>
         </parameter>
         <parameter>
            <name value="Numerator"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="boolean"></type>
         </parameter>
         <parameter>
            <name value="Denominator"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="boolean"></type>
         </parameter>
         <parameter>
            <name value="Initial Population"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="boolean"></type>
         </parameter>
         <parameter>
            <name value="Denominator Exceptions"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="boolean"></type>
         </parameter>
         <parameter>
            <name value="SDE Sex"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Coding"></type>
         </parameter>
         <parameter>
            <name value="SDE Payer"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="*"></max>
            <type value="Resource"></type>
         </parameter>
         <parameter>
            <name value="SDE Ethnicity"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Resource"></type>
         </parameter>
         <parameter>
            <name value="SDE Race"></name>
            <use value="out"></use>
            <min value="0"></min>
            <max value="1"></max>
            <type value="Resource"></type>
         </parameter>
         <dataRequirement>
            <type value="Patient"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient"></profile>
            <mustSupport value="extension"></mustSupport>
            <mustSupport value="birthDate"></mustSupport>
            <mustSupport value="birthDate.value"></mustSupport>
            <mustSupport value="url"></mustSupport>
         </dataRequirement>
         <dataRequirement>
            <type value="MedicationRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"></profile>
            <mustSupport value="medication"></mustSupport>
            <mustSupport value="authoredOn"></mustSupport>
            <mustSupport value="authoredOn.value"></mustSupport>
            <codeFilter>
               <path value="medication"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="MedicationRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest"></profile>
            <mustSupport value="medication.reference.value"></mustSupport>
            <mustSupport value="authoredOn"></mustSupport>
            <mustSupport value="authoredOn.value"></mustSupport>
         </dataRequirement>
         <dataRequirement>
            <type value="Medication"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medication"></profile>
            <mustSupport value="id.value"></mustSupport>
            <mustSupport value="code"></mustSupport>
         </dataRequirement>
         <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="DeviceRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicerequest"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="authoredOn"></mustSupport>
            <mustSupport value="authoredOn.value"></mustSupport>
            <mustSupport value="intent"></mustSupport>
            <mustSupport value="intent.value"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <mustSupport value="id"></mustSupport>
            <mustSupport value="id.value"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </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>
            <mustSupport value="statusReason"></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/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-deviceusestatement"></profile>
            <mustSupport value="recordedOn"></mustSupport>
            <mustSupport value="recordedOn.value"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
         </dataRequirement>
         <dataRequirement>
            <type value="Device"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device"></profile>
            <mustSupport value="type"></mustSupport>
            <codeFilter>
               <path value="type"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-encounter-diagnosis"></profile>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"></profile>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"></profile>
            <mustSupport value="code"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.579"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"></profile>
            <mustSupport value="code"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <code>
                  <system value="http://snomed.info/sct"></system>
                  <code value="471661000124108"></code>
                  <display value="Acute migraine (disorder)"></display>
               </code>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"></profile>
            <mustSupport value="code"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <code>
                  <system value="http://snomed.info/sct"></system>
                  <code value="22253000"></code>
                  <display value="Pain (finding)"></display>
               </code>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Condition"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-condition-problems-health-concerns"></profile>
            <mustSupport value="code"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <code>
                  <system value="http://snomed.info/sct"></system>
                  <code value="230465000"></code>
                  <display value="Migraine aura without headache (disorder)"></display>
               </code>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Encounter"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"></profile>
            <mustSupport value="type"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <mustSupport value="period"></mustSupport>
            <codeFilter>
               <path value="type"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.11.1005"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Encounter"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"></profile>
            <mustSupport value="type"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <mustSupport value="period"></mustSupport>
            <codeFilter>
               <path value="type"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.539"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Encounter"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"></profile>
            <mustSupport value="type"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <mustSupport value="period"></mustSupport>
            <codeFilter>
               <path value="type"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1260.161"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Encounter"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter"></profile>
            <mustSupport value="type"></mustSupport>
            <mustSupport value="period"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <codeFilter>
               <path value="type"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.117.1.7.1.292"></valueSet>
            </codeFilter>
         </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>
         <dataRequirement>
            <type value="MedicationRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"></profile>
            <mustSupport value="medication"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <mustSupport value="doNotPerform"></mustSupport>
            <mustSupport value="doNotPerform.value"></mustSupport>
            <codeFilter>
               <path value="medication"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="MedicationRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationnotrequested"></profile>
            <mustSupport value="medication"></mustSupport>
            <mustSupport value="reasonCode"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <mustSupport value="doNotPerform"></mustSupport>
            <mustSupport value="doNotPerform.value"></mustSupport>
            <codeFilter>
               <path value="medication"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="AllergyIntolerance"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-allergyintolerance"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="clinicalStatus"></mustSupport>
            <mustSupport value="onset"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="AdverseEvent"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-adverseevent"></profile>
            <mustSupport value="event"></mustSupport>
            <mustSupport value="recordedDate"></mustSupport>
            <mustSupport value="recordedDate.value"></mustSupport>
            <mustSupport value="actuality"></mustSupport>
            <mustSupport value="actuality.value"></mustSupport>
            <codeFilter>
               <path value="event"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.664"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="DeviceRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicenotrequested"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="authoredOn"></mustSupport>
            <mustSupport value="authoredOn.value"></mustSupport>
            <mustSupport value="extension"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="DeviceRequest"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-devicenotrequested"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="authoredOn"></mustSupport>
            <mustSupport value="authoredOn.value"></mustSupport>
            <mustSupport value="extension"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Procedure"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="extension"></mustSupport>
            <mustSupport value="statusReason"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
         <dataRequirement>
            <type value="Procedure"></type>
            <profile value="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedurenotdone"></profile>
            <mustSupport value="code"></mustSupport>
            <mustSupport value="extension"></mustSupport>
            <mustSupport value="statusReason"></mustSupport>
            <mustSupport value="status"></mustSupport>
            <mustSupport value="status.value"></mustSupport>
            <codeFilter>
               <path value="code"></path>
               <valueSet value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1034.641"></valueSet>
            </codeFilter>
         </dataRequirement>
      </Library>
   </contained>
   <extension id="supplementalDataGuidance" url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-supplementalDataGuidance">
      <extension url="guidance">
         <valueString value="For every patient evaluated by this measure also identify payer, race, ethnicity and sex"></valueString>
      </extension>
      <extension url="usage">
         <valueCodeableConcept>
            <coding>
               <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
               <code value="supplemental-data"></code>
               <display value="Supplemental Data"></display>
            </coding>
            <text value="Supplemental Data Guidance"></text>
         </valueCodeableConcept>
      </extension>
   </extension>
   <extension url="http://hl7.org/fhir/StructureDefinition/cqf-definitionTerm">
      <extension url="term">
         <valueString value="Definition"></valueString>
      </extension>
      <extension url="definition">
         <valueMarkdown value="Guideline recommended or FDA approved/cleared acute migraine medications: include the following but are not limited to: triptans, dihydroergotamine (DHE), NSAIDs, D2 antagonists and may include neuromodulation."></valueMarkdown>
      </extension>
   </extension>
   <extension url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements">
      <valueReference>
         <reference value="#effective-data-requirements"></reference>
      </valueReference>
   </extension>
   <url value="https://madie.cms.gov/Measure/TreatmentForAcuteMigraineAttacks"></url>
   <identifier>
      <use value="usual"></use>
      <type>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"></system>
            <code value="short-name"></code>
            <display value="Short Name"></display>
         </coding>
      </type>
      <system value="https://madie.cms.gov/measure/shortName"></system>
      <value value="CMS1234TreatmentForAcuteMigraine"></value>
   </identifier>
   <identifier>
      <use value="official"></use>
      <type>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"></system>
            <code value="version-independent"></code>
            <display value="Version Independent"></display>
         </coding>
      </type>
      <system value="urn:ietf:rfc:3986"></system>
      <value value="urn:uuid:838e367b-1633-4f03-9746-7f78dd3f68a3"></value>
   </identifier>
   <identifier>
      <use value="official"></use>
      <type>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/artifact-identifier-type"></system>
            <code value="version-specific"></code>
            <display value="Version Specific"></display>
         </coding>
      </type>
      <system value="urn:ietf:rfc:3986"></system>
      <value value="urn:uuid:26bb2e8e-d539-480b-8522-8a20e12ea7b6"></value>
   </identifier>
   <version value="Draft based on 0.1.000"></version>
   <name value="TreatmentForAcuteMigraineAttacks"></name>
   <title value="Treatment Prescribed for Acute Migraine Attacks"></title>
   <status value="draft"></status>
   <experimental value="false"></experimental>
   <date value="2025-07-23T15:03:42+00:00"></date>
   <publisher value="American Academy of Neurology"></publisher>
   <contact>
      <telecom>
         <system value="url"></system>
         <value value="www.aan.com"></value>
      </telecom>
   </contact>
   <description value="Percentage of patients age 6 years and older with a diagnosis of migraine who were prescribed a guideline recommended or Food and Drug Administration (FDA) approved/cleared treatment for acute migraine attacks during the measurement period."></description>
   <purpose value="Only 29% of patients are satisfied with their acute migraine treatment. Among people with episodic migraine, 18.31% reported current use of triptans for acute headache treatment. Triptan use increased with headache frequency, headache-related disability and allodynia, but decreased among people with depression. Less than 1 in 5 people with migraine in the US who were respondents to this survey used triptans for acute headache treatment over the course of a year. In a population sample of individuals with episodic migraine, more than 40% have at least one unmet need in the area of acute treatment. The leading reasons for unmet needs, which include headache-related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for people with episodic migraine (EM). In an analysis of data from the 2005 American Migraine Prevalence and Prevention (AMPP) study, authors reported that 91.7% of respondents meeting criteria for EM used acute treatment for their headaches. Of these respondents, only 36.1% used migraine-specific medications. Triptans were used by 18.3% of the sample, opioids were used by 11.7% of the sample, and barbiturate medications were used by 6.1% of the sample. According to another study, 21.87% of patients use triptans for acute treatment of migraine, 20% use ergots, 20.87% use opioids, and 13.52% use barbiturates. Using the guideline recommended first-line acute treatments would provide superior pain relief for migraine. Triptans and ergots are considered first-line acute treatments for migraine according to the latest American Headache Society guideline (2015). The leading reasons for unmet needs, which include headache related disability and dissatisfaction with current acute treatment, suggest opportunities for improving outcomes for people with EM."></purpose>
   <usage value="Acute treatment prescribed for migraine – Acute treatments include, but are not limited to: triptans, dihydroergotamine, Nonsteroidal Anti-inflammatory Drugs (NSAIDs), D2 antagonists. Guideline recommended or FDA approved/cleared acute migraine attack treatment may include neuromodulation. A patient and/or caregiver reserve the right to decline a prescription. Some patients may have contraindications to all medications or medications are ineffective. Patients may already be on an effective over the counter medication or have an acute migraine treatment prescribed by another clinician. Patients with a history of acute migraine medication overuse or no pain with migraine may require a different treatment approach. Clinicians should use their best judgment to prescribe a treatment for acute migraine attacks to meet the specific needs of the individual patient. Note: The list of acute migraine medications/treatments are based on clinical guidelines and other evidence and may not be all-inclusive or current. Physicians and other health care professionals should refer to the Food and Drug Administration’s (FDA) web site page entitled “Drug Safety Communications” for up-to-date drug recall and alert information when prescribing medications. Emergency department and urgent care visits on date of presentation are not included."></usage>
   <copyright value="Copyright: (C)2023 American Academy of Neurology Institute (AANI). All rights reserved."></copyright>
   <effectivePeriod>
      <start value="2026-01-01"></start>
      <end value="2026-12-31"></end>
   </effectivePeriod>
   <author>
      <name value="Lantana Consulting Group"></name>
      <telecom>
         <system value="url"></system>
         <value value="https://www.lantanagroup.com/"></value>
      </telecom>
   </author>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Bigal ME, Buse DC, Hen YT, et al. Rates and predictors of starting a triptan: results from the American Migraine Prevalence and Prevention Study. Headache 2010; 50:1440-8"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Bigal, M. E., Buse, D. C., Hen, Y. T., et al. (2010). Rates and predictors of starting a triptan: Results from the American Migraine Prevalence and Prevention Study. Headache: The Journal of Head and Face Pain, 50(9), 1440–1448 https://doi.org/10.1111/j.1526-4610.2010.01726."></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Lipton, R. B., &amp;amp; Stewart, W. F. (1999). Acute migraine therapy: Do doctors understand what patients with migraine want from therapy? Headache: The Journal of Head and Face Pain, 39(Suppl. 2), S20–S26. https://doi.org/10.1111/j.1526-4610.1999.390720"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Lipton, R. B., Buse, D. C., Serrano, D., et al. (2009). Acute medication use patterns in episodic migraine: Results of the American Migraine Prevalence and Prevention (AMPP) study. Cephalalgia, 29(Suppl. 1), 17. Presented at the 14th Congress of the International Headache Society, September 10–13, 2009."></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Lipton, R. B., Buse, D. C., Serrano, D., et al. (2013). Examination of unmet treatment needs among persons with episodic migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Headache: The Journal of Head and Face Pain, 53(8), 1300–1311. https://doi.org/10.1111/head.12154"></citation>
   </relatedArtifact>
   <relatedArtifact>
      <type value="citation"></type>
      <citation value="Marmura, M. J., Silberstein, S. D., &amp;amp; Schwedt, T. J. (2015). The acute treatment of migraine in adults: The American Headache Society evidence assessment of migraine pharmacotherapies. Headache: The Journal of Head and Face Pain, 55(1), 3–20. https://doi.org/10.1111/head.12499"></citation>
   </relatedArtifact>
   <library value="https://madie.cms.gov/Library/TreatmentForAcuteMigraineAttacks"></library>
   <disclaimer value="Quality Measures published by the American Academy of Neurology and its affiliates are assessments of current scientific and clinical information provided as an educational service. The information: 1) should not be considered inclusive of all proper treatments, methods of care, or as a statement of the standard of care; 2) is not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); 3) addresses only the question(s) or topic(s) specifically identified; 4) does not mandate any particular course of medical care; and 5) is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients. In all cases, the selected course of action should be considered by the treating provider in the context of treating the individual patient. Use of the information is voluntary. AAN provides this information on an “as is” basis, and makes no warranty, expressed or implied, regarding the information. AAN specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. AAN assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary coding sets should obtain all necessary licenses from the owners of these code sets. The AAN and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications. ICD10 copyright 2022 International Health Terminology Standards Development Organization CPT(R) contained in the Measure specifications is copyright 2004-2022 American Medical Association. LOINC(R) is copyright 2004-2022 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2022 World Health Organization. All Rights Reserved."></disclaimer>
   <rationale value="By providing appropriate guideline recommended treatments, it is anticipated that headache severity and duration of headache would be reduced for patients that have acute attacks."></rationale>
   <clinicalRecommendationStatement value="AANI, please provide."></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="patients age 6 years or older with a diagnosis of migraine and who have an office visit, telephone consultation, or outpatient consultation during the measurement period."></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="Initial Population"></description>
         <criteria>
            <language value="text/cql-identifier"></language>
            <expression value="Denominator"></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 a guideline recommended or FDA approved/cleared treatment* for acute migraine attacks once 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>
               <code value="denominator-exception"></code>
               <display value="Denominator Exception"></display>
            </coding>
         </code>
         <description value="Migraine Medication Not Ordered Due To Patient Or Medical Reasons or Patient Has An Allergy Or Adverse Event To Migraine Treatment or Patient Has a History of Migraine Treatment Overuse or Patient Reports Acute Migraine without Pain"></description>
         <criteria>
            <language value="text/cql-identifier"></language>
            <expression value="Denominator Exceptions"></expression>
         </criteria>
      </population>
   </group>
   <supplementalData id="sde-ethnicity">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <usage>
         <coding>
            <system value="http://terminology.hl7.org/CodeSystem/measure-data-usage"></system>
            <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">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <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">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <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">
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="individual"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="subject-list"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="summary"></valueCode>
      </extension>
      <extension url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-includeInReportType">
         <valueCode value="data-collection"></valueCode>
      </extension>
      <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>