{
  "_id": "5a57eb19942c6d1e61d33552",
  "bundle_id": "5a57e977942c6d1e61d32f14",
  "category": "Miscellaneous",
  "cms_id": "CMS134v6",
  "complexity": {
    "variables": [
      {
        "name": "Patient",
        "complexity": 1
      },
      {
        "name": "SDE Ethnicity",
        "complexity": 1
      },
      {
        "name": "SDE Payer",
        "complexity": 1
      },
      {
        "name": "SDE Race",
        "complexity": 1
      },
      {
        "name": "SDE Sex",
        "complexity": 1
      },
      {
        "name": "Renal Procedures",
        "complexity": 1
      },
      {
        "name": "Renal Interventions",
        "complexity": 1
      },
      {
        "name": "Qualifying Encounters",
        "complexity": 1
      },
      {
        "name": "Protein Urea Lab Test",
        "complexity": 1
      },
      {
        "name": "Nephropathy Diagnoses",
        "complexity": 1
      },
      {
        "name": "ESRD Encounter",
        "complexity": 1
      },
      {
        "name": "Active ACEI or ARB Medications",
        "complexity": 1
      },
      {
        "name": "Initial Population",
        "complexity": 1
      },
      {
        "name": "Denominator",
        "complexity": 1
      },
      {
        "name": "Nephropathy Screenings",
        "complexity": 1
      },
      {
        "name": "Numerator",
        "complexity": 3
      },
      {
        "name": "In Hospice",
        "complexity": 1
      },
      {
        "name": "Denominator Exclusions",
        "complexity": 1
      },
      {
        "name": "Patient",
        "complexity": 1
      },
      {
        "name": "ToDate",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInDaysAt",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInDays",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInMonthsAt",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInMonths",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInYearsAt",
        "complexity": 1
      },
      {
        "name": "CalendarAgeInYears",
        "complexity": 1
      },
      {
        "name": "Hospitalization",
        "complexity": 0
      },
      {
        "name": "LengthInDays",
        "complexity": 1
      },
      {
        "name": "TotalLengthOfStay",
        "complexity": 1
      },
      {
        "name": "Patient",
        "complexity": 1
      },
      {
        "name": "Has Hospice",
        "complexity": 3
      }
    ]
  },
  "continuous_variable": false,
  "cql": [
    "library DiabetesMedicalAttentionforNephropathy version '6.1.003'\r\n\r\nusing QDM version '5.3'\r\n\r\ninclude Hospice version '0.1.000' called Hospice\r\ninclude MATGlobalCommonFunctions version '1.0.000' called Global\r\n\r\nvalueset \"ONC Administrative Sex\": 'urn:oid:2.16.840.1.113762.1.4.1'\r\nvalueset \"Race\": 'urn:oid:2.16.840.1.114222.4.11.836'\r\nvalueset \"Ethnicity\": 'urn:oid:2.16.840.1.114222.4.11.837'\r\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591'\r\nvalueset \"ACE Inhibitor or ARB\": 'urn:oid:2.16.840.1.113883.3.526.3.1139'\r\nvalueset \"Annual Wellness Visit\": 'urn:oid:2.16.840.1.113883.3.526.3.1240'\r\nvalueset \"Diabetes\": 'urn:oid:2.16.840.1.113883.3.464.1003.103.12.1001'\r\nvalueset \"Diabetic Nephropathy\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1004'\r\nvalueset \"Dialysis Education\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1016'\r\nvalueset \"Dialysis Services\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1013'\r\nvalueset \"ESRD Monthly Outpatient Services\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1014'\r\nvalueset \"Face-to-Face Interaction\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1048'\r\nvalueset \"Glomerulonephritis and Nephrotic Syndrome\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1018'\r\nvalueset \"Home Healthcare Services\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1016'\r\nvalueset \"Hypertensive Chronic Kidney Disease\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1017'\r\nvalueset \"Kidney Transplant\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1012'\r\nvalueset \"Office Visit\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1001'\r\nvalueset \"Other Services Related to Dialysis\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1015'\r\nvalueset \"Preventive Care Services - Established Office Visit, 18 and Up\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1025'\r\nvalueset \"Preventive Care Services-Initial Office Visit, 18 and Up\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1023'\r\nvalueset \"Proteinuria\": 'urn:oid:2.16.840.1.113883.3.526.3.1003'\r\nvalueset \"Urine Protein Tests\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1024'\r\nvalueset \"Vascular Access for Dialysis\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1011'\r\nvalueset \"Kidney Failure\": 'urn:oid:2.16.840.1.113883.3.464.1003.109.12.1028'\r\n\r\nparameter \"Measurement Period\" Interval<DateTime>\r\n\r\ncontext Patient\r\n\r\ndefine \"SDE Ethnicity\":\r\n\t[\"Patient Characteristic Ethnicity\": \"Ethnicity\"]\r\n\r\ndefine \"SDE Payer\":\r\n\t[\"Patient Characteristic Payer\": \"Payer\"]\r\n\r\ndefine \"SDE Race\":\r\n\t[\"Patient Characteristic Race\": \"Race\"]\r\n\r\ndefine \"SDE Sex\":\r\n\t[\"Patient Characteristic Sex\": \"ONC Administrative Sex\"]\r\n\r\ndefine \"Renal Procedures\":\r\n\t( [\"Procedure, Performed\": \"Kidney Transplant\"]\r\n\t\t\tunion [\"Procedure, Performed\": \"Vascular Access for Dialysis\"]\r\n\t\t\tunion [\"Procedure, Performed\": \"Dialysis Services\"]\r\n\t)\r\n\r\ndefine \"Renal Interventions\":\r\n\t[\"Intervention, Performed\": \"Other Services Related to Dialysis\"]\r\n\t\tunion [\"Intervention, Performed\": \"Dialysis Education\"]\r\n\r\ndefine \"Qualifying Encounters\":\r\n\t( [\"Encounter, Performed\": \"Office Visit\"]\r\n\t\tunion [\"Encounter, Performed\": \"Face-to-Face Interaction\"]\r\n\t\tunion [\"Encounter, Performed\": \"Preventive Care Services - Established Office Visit, 18 and Up\"]\r\n\t\tunion [\"Encounter, Performed\": \"Preventive Care Services-Initial Office Visit, 18 and Up\"]\r\n\t\tunion [\"Encounter, Performed\": \"Home Healthcare Services\"]\r\n\t\tunion [\"Encounter, Performed\": \"Annual Wellness Visit\"] ) ValidEncounter\r\n\t\twhere ValidEncounter.relevantPeriod during \"Measurement Period\"\r\n\r\ndefine \"Protein Urea Lab Test\":\r\n\t[\"Laboratory Test, Performed\": \"Urine Protein Tests\"] ProteinUrea\r\n\t\twhere ProteinUrea.result is not null\r\n\r\ndefine \"Nephropathy Diagnoses\":\r\n\t( [\"Diagnosis\": \"Hypertensive Chronic Kidney Disease\"]\r\n\t\tunion [\"Diagnosis\": \"Kidney Failure\"]\r\n\t\tunion [\"Diagnosis\": \"Glomerulonephritis and Nephrotic Syndrome\"]\r\n\t\tunion [\"Diagnosis\": \"Diabetic Nephropathy\"]\r\n\t\tunion [\"Diagnosis\": \"Proteinuria\"] ) NephropathyDiagnoses\r\n\t\twhere NephropathyDiagnoses.prevalencePeriod overlaps \"Measurement Period\"\r\n\r\ndefine \"ESRD Encounter\":\r\n\t[\"Encounter, Performed\": \"ESRD Monthly Outpatient Services\"]\r\n\r\ndefine \"Active ACEI or ARB Medications\":\r\n\t[\"Medication, Active\": \"ACE Inhibitor or ARB\"] ACEIorARB\r\n\t\twhere ACEIorARB.relevantPeriod overlaps \"Measurement Period\"\r\n\r\ndefine \"Initial Population\":\r\n\texists [\"Patient Characteristic Birthdate\"] BirthDate\r\n\t\twhere Global.\"CalendarAgeInYearsAt\"(BirthDate.birthDatetime, start of \"Measurement Period\")>= 18\r\n\t\t\tand Global.\"CalendarAgeInYearsAt\"(BirthDate.birthDatetime, start of \"Measurement Period\")< 75\r\n\t\t\tand exists ( \"Qualifying Encounters\" )\r\n\t\t\tand exists ( [\"Diagnosis\": \"Diabetes\"] DiabetesDx\r\n\t\t\t\t\twhere DiabetesDx.prevalencePeriod overlaps \"Measurement Period\"\r\n\t\t\t)\r\n\r\ndefine \"Denominator\":\r\n\t\"Initial Population\"\r\n\r\ndefine \"Numerator\":\r\n\texists ( \"Active ACEI or ARB Medications\" )\r\n\t\tor exists ( \"Nephropathy Diagnoses\" )\r\n\t\tor exists ( \"Nephropathy Screenings\" )\r\n\r\ndefine \"In Hospice\":\r\n\tHospice.\"Has Hospice\"\r\n\r\ndefine \"Denominator Exclusions\":\r\n\t\"In Hospice\"\r\n\r\ndefine \"Nephropathy Screenings\":\r\n\t( \"Renal Procedures\"\r\n\t\tunion \"Renal Interventions\"\r\n\t\tunion \"ESRD Encounter\"\r\n\t\tunion \"Protein Urea Lab Test\" ) NephropathyScreenings\r\n\t\twhere NephropathyScreenings.relevantPeriod during \"Measurement Period\"\r\n",
    "library MATGlobalCommonFunctions version '1.0.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\n\r\nvalueset \"Emergency Department Visit\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.292'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\n\r\nparameter \"Measurement Period\" Interval<DateTime>\r\n\r\ncontext Patient\n\n/*ToDate takes a given DateTime value and returns a DateTime with the time components \"zeroed\", and the timezone of the input value, for example, given the DateTime @2012-01-01T06:30:00.0Z, this function will return @2012-01-01T00:00:00.0Z.*/\r\n\r\ndefine function \"ToDate\"(Value DateTime):\r\n\tDateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)\n\n/*CalendarAgeInDaysAt calculates the calendar age (meaning the age without considering time components) in days.*/\r\n\r\ndefine function \"CalendarAgeInDaysAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tdays between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInDays calculates the calendar age (meaning the age without considering time components) in days as of today*/\r\n\r\ndefine function \"CalendarAgeInDays\"(BirthDateTime DateTime):\r\n\tCalendarAgeInDaysAt(BirthDateTime, Today())\n\n/*CalendarAgeInMonthsAt calculates the calendar age (meaning the age without considering time components) in months.*/\r\n\r\ndefine function \"CalendarAgeInMonthsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tmonths between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInMonths calculates the calendar age (meaning the age without considering time components) in months as of today.*/\r\n\r\ndefine function \"CalendarAgeInMonths\"(BirthDateTime DateTime):\r\n\tCalendarAgeInMonthsAt(BirthDateTime, Today())\n\n/*CalendarAgeInYearsAt calculates the calendar age (meaning the age without considering time components) in years.*/\r\n\r\ndefine function \"CalendarAgeInYearsAt\"(BirthDateTime DateTime, AsOf DateTime):\r\n\tyears between ToDate(BirthDateTime)and ToDate(AsOf)\n\n/*CalendarAgeInYears calculates the calendar age (meaning the age without considering time components) in years as of today.*/\r\n\r\ndefine function \"CalendarAgeInYears\"(BirthDateTime DateTime):\r\n\tCalendarAgeInYearsAt(BirthDateTime, Today())\n\n/*Hospitalization returns the total interval for admission to discharge for the given encounter, or for the admission of any immediately prior emergency department visit to the discharge of the given encounter.*/\r\n\r\ndefine function \"Hospitalization\"(Encounter \"Encounter, Performed\"):\r\n\t( singleton from ( [\"Encounter, Performed\": \"Emergency Department Visit\"] EDVisit\r\n\t\t\twhere EDVisit.relevantPeriod ends 1 hour or less on or before start of Encounter.relevantPeriod\r\n\t) ) X\r\n\t\treturn if X is null then Encounter.relevantPeriod else Interval[start of X.relevantPeriod, end of Encounter.relevantPeriod]\n\n/*calculates the difference in calendar days between the start and end of the given interval.*/\r\n\r\ndefine function \"LengthInDays\"(Value Interval<DateTime>):\r\n\tdifference in days between start of Value and end of Value\n\n/*TotalLengthOfStay calculates the difference in calendar days between the start and end of the given stay interval.*/\r\n\r\ndefine function \"TotalLengthOfStay\"(Stay Interval<DateTime>):\r\n\tdifference in days between start of Stay and end of Stay\r\n",
    "library Hospice version '0.1.000'\r\n\r\nusing QDM version '5.3'\r\n\r\ncodesystem \"LOINC:2.46\": 'urn:oid:2.16.840.1.113883.6.1' version 'urn:hl7:version:2.46'\r\ncodesystem \"SNOMEDCT:2016-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2016-03'\r\ncodesystem \"SNOMEDCT:2017-03\": 'urn:oid:2.16.840.1.113883.6.96' version 'urn:hl7:version:2017-03'\r\n\r\nvalueset \"Discharged to Health Care Facility for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.207'\r\nvalueset \"Discharged to Home for Hospice Care\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.209'\r\nvalueset \"Encounter Inpatient\": 'urn:oid:2.16.840.1.113883.3.666.5.307'\r\nvalueset \"Hospice care ambulatory\": 'urn:oid:2.16.840.1.113762.1.4.1108.15'\r\n\r\ncode \"Birthdate\": '21112-8' from \"LOINC:2.46\" display 'Birth date'\r\ncode \"Dead\": '419099009' from \"SNOMEDCT:2016-03\" display 'Dead'\r\ncode \"Discharge to healthcare facility for hospice care (procedure)\": '428371000124100' from \"SNOMEDCT:2017-03\" display 'Discharge to healthcare facility for hospice care (procedure)'\r\ncode \"Discharge to home for hospice care (procedure)\": '428361000124107' from \"SNOMEDCT:2017-03\" display 'Discharge to home for hospice care (procedure)'\r\n\r\nparameter \"Measurement Period\" Interval<DateTime>\r\n\r\ncontext Patient\r\n\r\ndefine \"Has Hospice\":\r\n\texists ( [\"Encounter, Performed\": \"Encounter Inpatient\"] DischargeHospice\r\n\t\t\twhere ( DischargeHospice.dischargeDisposition as Code ~ \"Discharge to home for hospice care (procedure)\"\r\n\t\t\t\t\tor DischargeHospice.dischargeDisposition as Code ~ \"Discharge to healthcare facility for hospice care (procedure)\"\r\n\t\t\t)\r\n\t\t\t\tand DischargeHospice.relevantPeriod ends during \"Measurement Period\"\r\n\t)\r\n\t\tor exists ( [\"Intervention, Order\": \"Hospice care ambulatory\"] HospiceOrder\r\n\t\t\t\twhere HospiceOrder.authorDatetime during \"Measurement Period\"\r\n\t\t)\r\n\t\tor exists ( [\"Intervention, Performed\": \"Hospice care ambulatory\"] HospicePerformed\r\n\t\t\t\twhere HospicePerformed.relevantPeriod overlaps \"Measurement Period\"\r\n\t\t)\r\n"
  ],
  "cql_statement_dependencies": {
    "DiabetesMedicalAttentionforNephropathy": {
      "Patient": [

      ],
      "SDE Ethnicity": [

      ],
      "SDE Payer": [

      ],
      "SDE Race": [

      ],
      "SDE Sex": [

      ],
      "Renal Procedures": [

      ],
      "Renal Interventions": [

      ],
      "Qualifying Encounters": [

      ],
      "Protein Urea Lab Test": [

      ],
      "Nephropathy Diagnoses": [

      ],
      "ESRD Encounter": [

      ],
      "Active ACEI or ARB Medications": [

      ],
      "Initial Population": [
        {
          "library_name": "MATGlobalCommonFunctions",
          "statement_name": "CalendarAgeInYearsAt"
        },
        {
          "library_name": "MATGlobalCommonFunctions",
          "statement_name": "CalendarAgeInYearsAt"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Qualifying Encounters"
        }
      ],
      "Denominator": [
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Initial Population"
        }
      ],
      "Nephropathy Screenings": [
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Renal Procedures"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Renal Interventions"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "ESRD Encounter"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Protein Urea Lab Test"
        }
      ],
      "Numerator": [
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Active ACEI or ARB Medications"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Nephropathy Diagnoses"
        },
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "Nephropathy Screenings"
        }
      ],
      "In Hospice": [
        {
          "library_name": "Hospice",
          "statement_name": "Has Hospice"
        }
      ],
      "Denominator Exclusions": [
        {
          "library_name": "DiabetesMedicalAttentionforNephropathy",
          "statement_name": "In Hospice"
        }
      ]
    },
    "MATGlobalCommonFunctions": {
      "CalendarAgeInYearsAt": [
        {
          "library_name": "MATGlobalCommonFunctions",
          "statement_name": "ToDate"
        }
      ],
      "ToDate": [

      ]
    },
    "Hospice": {
      "Has Hospice": [

      ]
    }
  },
  "created_at": "2018-01-11T22:54:17.949Z",
  "data_criteria": {
    "Face_to_FaceInteraction_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e301a": {
      "title": "Face-to-FaceInteraction",
      "description": "Encounter, Performed: Face-to-FaceInteraction",
      "code_list_id": "2.16.840.1.113883.3.464.1003.101.12.1048",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "Face_to_FaceInteraction_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e301a_source",
      "variable": false
    },
    "DialysisServices_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300e": {
      "title": "DialysisServices",
      "description": "Procedure, Performed: DialysisServices",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1013",
      "type": "procedures",
      "definition": "procedure",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "DialysisServices_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300e_source",
      "variable": false
    },
    "KidneyTransplant_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300c": {
      "title": "KidneyTransplant",
      "description": "Procedure, Performed: KidneyTransplant",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1012",
      "type": "procedures",
      "definition": "procedure",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "KidneyTransplant_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300c_source",
      "variable": false
    },
    "ONCAdministrativeSex_PatientCharacteristicSex_629109a3_b658_4124_b1ac_c6396879f9a1": {
      "title": "ONCAdministrativeSex",
      "description": "Patient Characteristic Sex: ONCAdministrativeSex",
      "code_list_id": "2.16.840.1.113762.1.4.1",
      "property": "gender",
      "type": "characteristic",
      "definition": "patient_characteristic_gender",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "ONCAdministrativeSex_PatientCharacteristicSex_629109a3_b658_4124_b1ac_c6396879f9a1_source",
      "variable": false,
      "value": {
        "type": "CD",
        "system": "Administrative Sex",
        "code": "F"
      }
    },
    "ESRDMonthlyOutpatientServices_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3011": {
      "title": "ESRDMonthlyOutpatientServices",
      "description": "Encounter, Performed: ESRDMonthlyOutpatientServices",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1014",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "ESRDMonthlyOutpatientServices_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3011_source",
      "variable": false
    },
    "ACEInhibitororARB_MedicationActive_40280381_3d61_56a7_013e_62abf57e301b": {
      "title": "ACEInhibitororARB",
      "description": "Medication, Active: ACEInhibitororARB",
      "code_list_id": "2.16.840.1.113883.3.526.3.1139",
      "type": "medications",
      "definition": "medication",
      "status": "active",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "ACEInhibitororARB_MedicationActive_40280381_3d61_56a7_013e_62abf57e301b_source",
      "variable": false
    },
    "KidneyFailure_Diagnosis_96400e6f_2f81_4eb4_ab44_62586d331790": {
      "title": "KidneyFailure",
      "description": "Diagnosis: KidneyFailure",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1028",
      "type": "conditions",
      "definition": "diagnosis",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "KidneyFailure_Diagnosis_96400e6f_2f81_4eb4_ab44_62586d331790_source",
      "variable": false
    },
    "PreventiveCareServices_EstablishedOfficeVisit18andUp_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3020": {
      "title": "PreventiveCareServices-EstablishedOfficeVisit18andUp",
      "description": "Encounter, Performed: PreventiveCareServices-EstablishedOfficeVisit18andUp",
      "code_list_id": "2.16.840.1.113883.3.464.1003.101.12.1025",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "PreventiveCareServices_EstablishedOfficeVisit18andUp_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3020_source",
      "variable": false
    },
    "DiabeticNephropathy_Diagnosis_40280381_3d61_56a7_013e_62abf57e3014": {
      "title": "DiabeticNephropathy",
      "description": "Diagnosis: DiabeticNephropathy",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1004",
      "type": "conditions",
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            {
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            {
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            },
            {
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            {
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            },
            {
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            {
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            {
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            {
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            {
              "localId": "25",
              "locator": "31:1-31:82",
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            },
            {
              "localId": "26",
              "locator": "32:1-32:91",
              "name": "Vascular Access for Dialysis",
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            },
            {
              "localId": "27",
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          ]
        },
        "statements": {
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                  "templateId": "Patient",
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              }
            },
            {
              "localId": "32",
              "locator": "40:1-41:50",
              "name": "SDE Ethnicity",
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                {
                  "type": "Annotation",
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                      {
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                      },
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                                                          "relevantPeriod"
                                                        ]
                                                      }
                                                    ]
                                                  }
                                                ]
                                              },
                                              {
                                                "value": [
                                                  " ",
                                                  "overlaps",
                                                  " "
                                                ]
                                              },
                                              {
                                                "r": "55",
                                                "s": [
                                                  {
                                                    "value": [
                                                      "\"Measurement Period\""
                                                    ]
                                                  }
                                                ]
                                              }
                                            ]
                                          }
                                        ]
                                      }
                                    ]
                                  },
                                  {
                                    "value": [
                                      "\n\t\t)"
                                    ]
                                  }
                                ]
                              }
                            ]
                          }
                        ]
                      }
                    ]
                  }
                }
              ],
              "expression": {
                "localId": "59",
                "locator": "24:2-35:3",
                "type": "Or",
                "operand": [
                  {
                    "localId": "50",
                    "locator": "24:2-32:3",
                    "type": "Or",
                    "operand": [
                      {
                        "localId": "41",
                        "locator": "24:2-29:2",
                        "type": "Exists",
                        "operand": {
                          "localId": "40",
                          "locator": "24:9-29:2",
                          "type": "Query",
                          "source": [
                            {
                              "localId": "21",
                              "locator": "24:11-24:74",
                              "alias": "DischargeHospice",
                              "expression": {
                                "localId": "20",
                                "locator": "24:11-24:57",
                                "dataType": "{urn:healthit-gov:qdm:v5_3}PositiveEncounterPerformed",
                                "templateId": "PositiveEncounterPerformed",
                                "codeProperty": "code",
                                "type": "Retrieve",
                                "codes": {
                                  "name": "Encounter Inpatient",
                                  "type": "ValueSetRef"
                                }
                              }
                            }
                          ],
                          "relationship": [

                          ],
                          "where": {
                            "localId": "39",
                            "locator": "25:4-28:72",
                            "type": "And",
                            "operand": [
                              {
                                "localId": "34",
                                "locator": "25:10-27:4",
                                "type": "Or",
                                "operand": [
                                  {
                                    "localId": "27",
                                    "locator": "25:12-25:107",
                                    "type": "Equivalent",
                                    "operand": [
                                      {
                                        "localId": "25",
                                        "locator": "25:12-25:56",
                                        "strict": false,
                                        "type": "As",
                                        "operand": {
                                          "localId": "23",
                                          "locator": "25:12-25:48",
                                          "path": "dischargeDisposition",
                                          "scope": "DischargeHospice",
                                          "type": "Property"
                                        },
                                        "asTypeSpecifier": {
                                          "localId": "24",
                                          "locator": "25:53-25:56",
                                          "name": "{urn:hl7-org:elm-types:r1}Code",
                                          "type": "NamedTypeSpecifier"
                                        }
                                      },
                                      {
                                        "localId": "26",
                                        "locator": "25:60-25:107",
                                        "name": "Discharge to home for hospice care (procedure)",
                                        "type": "CodeRef"
                                      }
                                    ]
                                  },
                                  {
                                    "localId": "33",
                                    "locator": "26:9-26:119",
                                    "type": "Equivalent",
                                    "operand": [
                                      {
                                        "localId": "31",
                                        "locator": "26:9-26:53",
                                        "strict": false,
                                        "type": "As",
                                        "operand": {
                                          "localId": "29",
                                          "locator": "26:9-26:45",
                                          "path": "dischargeDisposition",
                                          "scope": "DischargeHospice",
                                          "type": "Property"
                                        },
                                        "asTypeSpecifier": {
                                          "localId": "30",
                                          "locator": "26:50-26:53",
                                          "name": "{urn:hl7-org:elm-types:r1}Code",
                                          "type": "NamedTypeSpecifier"
                                        }
                                      },
                                      {
                                        "localId": "32",
                                        "locator": "26:57-26:119",
                                        "name": "Discharge to healthcare facility for hospice care (procedure)",
                                        "type": "CodeRef"
                                      }
                                    ]
                                  }
                                ]
                              },
                              {
                                "localId": "38",
                                "locator": "28:9-28:72",
                                "type": "In",
                                "operand": [
                                  {
                                    "locator": "28:41-28:44",
                                    "type": "End",
                                    "operand": {
                                      "localId": "36",
                                      "locator": "28:9-28:39",
                                      "path": "relevantPeriod",
                                      "scope": "DischargeHospice",
                                      "type": "Property"
                                    }
                                  },
                                  {
                                    "localId": "37",
                                    "locator": "28:53-28:72",
                                    "name": "Measurement Period",
                                    "type": "ParameterRef"
                                  }
                                ]
                              }
                            ]
                          }
                        }
                      },
                      {
                        "localId": "49",
                        "locator": "30:6-32:3",
                        "type": "Exists",
                        "operand": {
                          "localId": "48",
                          "locator": "30:13-32:3",
                          "type": "Query",
                          "source": [
                            {
                              "localId": "43",
                              "locator": "30:15-30:77",
                              "alias": "HospiceOrder",
                              "expression": {
                                "localId": "42",
                                "locator": "30:15-30:64",
                                "dataType": "{urn:healthit-gov:qdm:v5_3}PositiveInterventionOrder",
                                "templateId": "PositiveInterventionOrder",
                                "codeProperty": "code",
                                "type": "Retrieve",
                                "codes": {
                                  "name": "Hospice care ambulatory",
                                  "type": "ValueSetRef"
                                }
                              }
                            }
                          ],
                          "relationship": [

                          ],
                          "where": {
                            "localId": "47",
                            "locator": "31:5-31:65",
                            "type": "In",
                            "operand": [
                              {
                                "localId": "45",
                                "locator": "31:11-31:37",
                                "path": "authorDatetime",
                                "scope": "HospiceOrder",
                                "type": "Property"
                              },
                              {
                                "localId": "46",
                                "locator": "31:46-31:65",
                                "name": "Measurement Period",
                                "type": "ParameterRef"
                              }
                            ]
                          }
                        }
                      }
                    ]
                  },
                  {
                    "localId": "58",
                    "locator": "33:6-35:3",
                    "type": "Exists",
                    "operand": {
                      "localId": "57",
                      "locator": "33:13-35:3",
                      "type": "Query",
                      "source": [
                        {
                          "localId": "52",
                          "locator": "33:15-33:85",
                          "alias": "HospicePerformed",
                          "expression": {
                            "localId": "51",
                            "locator": "33:15-33:68",
                            "dataType": "{urn:healthit-gov:qdm:v5_3}PositiveInterventionPerformed",
                            "templateId": "PositiveInterventionPerformed",
                            "codeProperty": "code",
                            "type": "Retrieve",
                            "codes": {
                              "name": "Hospice care ambulatory",
                              "type": "ValueSetRef"
                            }
                          }
                        }
                      ],
                      "relationship": [

                      ],
                      "where": {
                        "localId": "56",
                        "locator": "34:5-34:71",
                        "type": "Overlaps",
                        "operand": [
                          {
                            "localId": "54",
                            "locator": "34:11-34:41",
                            "path": "relevantPeriod",
                            "scope": "HospicePerformed",
                            "type": "Property"
                          },
                          {
                            "localId": "55",
                            "locator": "34:52-34:71",
                            "name": "Measurement Period",
                            "type": "ParameterRef"
                          }
                        ]
                      }
                    }
                  }
                ]
              }
            }
          ]
        }
      }
    }
  ],
  "elm_annotations": {
    "DiabetesMedicalAttentionforNephropathy": {
      "statements": [
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"SDE Ethnicity\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Ethnicity\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Ethnicity\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "31"
                }
              ],
              "ref_id": "32"
            }
          ],
          "define_name": "SDE Ethnicity"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"SDE Payer\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Payer\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Payer\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "33"
                }
              ],
              "ref_id": "34"
            }
          ],
          "define_name": "SDE Payer"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"SDE Race\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Race\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Race\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "35"
                }
              ],
              "ref_id": "36"
            }
          ],
          "define_name": "SDE Race"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"SDE Sex\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Sex\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"ONC Administrative Sex\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "37"
                }
              ],
              "ref_id": "38"
            }
          ],
          "define_name": "SDE Sex"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Renal Procedures\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "( "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "[\"Procedure, Performed\": "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Kidney Transplant\""
                                        }
                                      ]
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "text": "]"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "39"
                            },
                            {
                              "children": [
                                {
                                  "text": "\n      union "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "[\"Procedure, Performed\": "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Vascular Access for Dialysis\""
                                        }
                                      ]
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "text": "]"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "40"
                            }
                          ],
                          "node_type": "Union",
                          "ref_id": "41"
                        },
                        {
                          "children": [
                            {
                              "text": "\n      union "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Procedure, Performed\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Dialysis Services\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "42"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "43"
                    },
                    {
                      "children": [
                        {
                          "text": "\n  )"
                        }
                      ]
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "43"
                }
              ],
              "ref_id": "44"
            }
          ],
          "define_name": "Renal Procedures"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Renal Interventions\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Intervention, Performed\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Other Services Related to Dialysis\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": "]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "45"
                    },
                    {
                      "children": [
                        {
                          "text": "\n    union "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Intervention, Performed\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Dialysis Education\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": "]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "46"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "47"
                }
              ],
              "ref_id": "48"
            }
          ],
          "define_name": "Renal Interventions"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Qualifying Encounters\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "[\"Encounter, Performed\": "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Office Visit\""
                                                                }
                                                              ]
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "]"
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "node_type": "Retrieve",
                                                      "ref_id": "49"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\n    union "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "[\"Encounter, Performed\": "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Face-to-Face Interaction\""
                                                                }
                                                              ]
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "]"
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "node_type": "Retrieve",
                                                      "ref_id": "50"
                                                    }
                                                  ],
                                                  "node_type": "Union",
                                                  "ref_id": "51"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\n    union "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "[\"Encounter, Performed\": "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Preventive Care Services - Established Office Visit, 18 and Up\""
                                                            }
                                                          ]
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "]"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Retrieve",
                                                  "ref_id": "52"
                                                }
                                              ],
                                              "node_type": "Union",
                                              "ref_id": "53"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n    union "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "[\"Encounter, Performed\": "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"Preventive Care Services-Initial Office Visit, 18 and Up\""
                                                        }
                                                      ]
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "]"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "54"
                                            }
                                          ],
                                          "node_type": "Union",
                                          "ref_id": "55"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\n    union "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Encounter, Performed\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Home Healthcare Services\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "56"
                                        }
                                      ],
                                      "node_type": "Union",
                                      "ref_id": "57"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n    union "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "[\"Encounter, Performed\": "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Annual Wellness Visit\""
                                                }
                                              ]
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "]"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "58"
                                    }
                                  ],
                                  "node_type": "Union",
                                  "ref_id": "59"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Union",
                              "ref_id": "59"
                            },
                            {
                              "children": [
                                {
                                  "text": " ValidEncounter"
                                }
                              ]
                            }
                          ],
                          "ref_id": "60"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n    "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "ValidEncounter"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "61"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "relevantPeriod"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "62"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "62"
                            },
                            {
                              "children": [
                                {
                                  "text": " during "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "63"
                            }
                          ],
                          "ref_id": "64"
                        }
                      ],
                      "ref_id": "64"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "65"
                }
              ],
              "ref_id": "66"
            }
          ],
          "define_name": "Qualifying Encounters"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Protein Urea Lab Test\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Laboratory Test, Performed\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Urine Protein Tests\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "67"
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "67"
                            },
                            {
                              "children": [
                                {
                                  "text": " ProteinUrea"
                                }
                              ]
                            }
                          ],
                          "ref_id": "68"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n    "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "ProteinUrea"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "69"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "result"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "70"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "70"
                            },
                            {
                              "children": [
                                {
                                  "text": " is not null"
                                }
                              ]
                            }
                          ],
                          "ref_id": "71"
                        }
                      ],
                      "ref_id": "71"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "72"
                }
              ],
              "ref_id": "73"
            }
          ],
          "define_name": "Protein Urea Lab Test"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Nephropathy Diagnoses\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "[\"Diagnosis\": "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Hypertensive Chronic Kidney Disease\""
                                                            }
                                                          ]
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "]"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Retrieve",
                                                  "ref_id": "74"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\n    union "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "[\"Diagnosis\": "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Kidney Failure\""
                                                            }
                                                          ]
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "]"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Retrieve",
                                                  "ref_id": "75"
                                                }
                                              ],
                                              "node_type": "Union",
                                              "ref_id": "76"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n    union "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "[\"Diagnosis\": "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"Glomerulonephritis and Nephrotic Syndrome\""
                                                        }
                                                      ]
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "]"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "77"
                                            }
                                          ],
                                          "node_type": "Union",
                                          "ref_id": "78"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\n    union "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Diagnosis\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Diabetic Nephropathy\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "79"
                                        }
                                      ],
                                      "node_type": "Union",
                                      "ref_id": "80"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n    union "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "[\"Diagnosis\": "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Proteinuria\""
                                                }
                                              ]
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "]"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "81"
                                    }
                                  ],
                                  "node_type": "Union",
                                  "ref_id": "82"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Union",
                              "ref_id": "82"
                            },
                            {
                              "children": [
                                {
                                  "text": " NephropathyDiagnoses"
                                }
                              ]
                            }
                          ],
                          "ref_id": "83"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n    "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "NephropathyDiagnoses"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "84"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "prevalencePeriod"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "85"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "85"
                            },
                            {
                              "children": [
                                {
                                  "text": " overlaps "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "86"
                            }
                          ],
                          "ref_id": "87"
                        }
                      ],
                      "ref_id": "87"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "88"
                }
              ],
              "ref_id": "89"
            }
          ],
          "define_name": "Nephropathy Diagnoses"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"ESRD Encounter\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Encounter, Performed\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"ESRD Monthly Outpatient Services\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "90"
                }
              ],
              "ref_id": "91"
            }
          ],
          "define_name": "ESRD Encounter"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Active ACEI or ARB Medications\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Medication, Active\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"ACE Inhibitor or ARB\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "92"
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "92"
                            },
                            {
                              "children": [
                                {
                                  "text": " ACEIorARB"
                                }
                              ]
                            }
                          ],
                          "ref_id": "93"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n    "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "ACEIorARB"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "94"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "relevantPeriod"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "95"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "95"
                            },
                            {
                              "children": [
                                {
                                  "text": " overlaps "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "96"
                            }
                          ],
                          "ref_id": "97"
                        }
                      ],
                      "ref_id": "97"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "98"
                }
              ],
              "ref_id": "99"
            }
          ],
          "define_name": "Active ACEI or ARB Medications"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Initial Population\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "[\"Patient Characteristic Birthdate\"]"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "100"
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "100"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " BirthDate"
                                    }
                                  ]
                                }
                              ],
                              "ref_id": "101"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": "\n    "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "where "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "Global"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "ref_id": "102"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "."
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"CalendarAgeInYearsAt\"("
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "BirthDate"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "ref_id": "103"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "."
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "birthDatetime"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "Property",
                                                          "ref_id": "104"
                                                        }
                                                      ],
                                                      "node_type": "Property",
                                                      "ref_id": "104"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": ", "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "start of "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Measurement Period\""
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "ParameterRef",
                                                          "ref_id": "105"
                                                        }
                                                      ],
                                                      "node_type": "Start",
                                                      "ref_id": "106"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": ")"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "FunctionRef",
                                                  "ref_id": "107"
                                                }
                                              ],
                                              "node_type": "FunctionRef",
                                              "ref_id": "107"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "&gt;= 18"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "GreaterOrEqual",
                                          "ref_id": "109"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\n      and "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "Global"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "ref_id": "110"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "."
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"CalendarAgeInYearsAt\"("
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "BirthDate"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "ref_id": "111"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "."
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "birthDatetime"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "Property",
                                                          "ref_id": "112"
                                                        }
                                                      ],
                                                      "node_type": "Property",
                                                      "ref_id": "112"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": ", "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "start of "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Measurement Period\""
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "ParameterRef",
                                                          "ref_id": "113"
                                                        }
                                                      ],
                                                      "node_type": "Start",
                                                      "ref_id": "114"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": ")"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "FunctionRef",
                                                  "ref_id": "115"
                                                }
                                              ],
                                              "node_type": "FunctionRef",
                                              "ref_id": "115"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "&lt; 75"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Less",
                                          "ref_id": "117"
                                        }
                                      ],
                                      "node_type": "And",
                                      "ref_id": "118"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n      and "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "exists "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "( "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Qualifying Encounters\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ExpressionRef",
                                              "ref_id": "119"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " )"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ExpressionRef",
                                          "ref_id": "119"
                                        }
                                      ],
                                      "node_type": "Exists",
                                      "ref_id": "120"
                                    }
                                  ],
                                  "node_type": "And",
                                  "ref_id": "121"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\n      and "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "exists "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "( "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "[\"Diagnosis\": "
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "\"Diabetes\""
                                                                    }
                                                                  ]
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "]"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "Retrieve",
                                                          "ref_id": "122"
                                                        }
                                                      ],
                                                      "node_type": "Retrieve",
                                                      "ref_id": "122"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": " DiabetesDx"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "ref_id": "123"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n          "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "where "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "DiabetesDx"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "ref_id": "124"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "."
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "prevalencePeriod"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "Property",
                                                          "ref_id": "125"
                                                        }
                                                      ],
                                                      "node_type": "Property",
                                                      "ref_id": "125"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": " overlaps "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Measurement Period\""
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "node_type": "ParameterRef",
                                                      "ref_id": "126"
                                                    }
                                                  ],
                                                  "ref_id": "127"
                                                }
                                              ],
                                              "ref_id": "127"
                                            }
                                          ],
                                          "node_type": "Query",
                                          "ref_id": "128"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\n      )"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Query",
                                      "ref_id": "128"
                                    }
                                  ],
                                  "node_type": "Exists",
                                  "ref_id": "129"
                                }
                              ],
                              "ref_id": "130"
                            }
                          ],
                          "ref_id": "130"
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "131"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "132"
                }
              ],
              "ref_id": "133"
            }
          ],
          "define_name": "Initial Population"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Denominator\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "\"Initial Population\""
                        }
                      ]
                    }
                  ],
                  "node_type": "ExpressionRef",
                  "ref_id": "134"
                }
              ],
              "ref_id": "135"
            }
          ],
          "define_name": "Denominator"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Nephropathy Screenings\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Renal Procedures\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ExpressionRef",
                                              "ref_id": "141"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n    union "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Renal Interventions\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ExpressionRef",
                                              "ref_id": "142"
                                            }
                                          ],
                                          "node_type": "Union",
                                          "ref_id": "143"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\n    union "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"ESRD Encounter\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ExpressionRef",
                                          "ref_id": "144"
                                        }
                                      ],
                                      "node_type": "Union",
                                      "ref_id": "145"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n    union "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Protein Urea Lab Test\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "146"
                                    }
                                  ],
                                  "node_type": "Union",
                                  "ref_id": "147"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Union",
                              "ref_id": "147"
                            },
                            {
                              "children": [
                                {
                                  "text": " NephropathyScreenings"
                                }
                              ]
                            }
                          ],
                          "ref_id": "148"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n    "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "NephropathyScreenings"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "149"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "relevantPeriod"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "150"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "150"
                            },
                            {
                              "children": [
                                {
                                  "text": " during "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "151"
                            }
                          ],
                          "ref_id": "152"
                        }
                      ],
                      "ref_id": "152"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "153"
                }
              ],
              "ref_id": "154"
            }
          ],
          "define_name": "Nephropathy Screenings"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Numerator\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "exists "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Active ACEI or ARB Medications\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "136"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "136"
                            }
                          ],
                          "node_type": "Exists",
                          "ref_id": "137"
                        },
                        {
                          "children": [
                            {
                              "text": "\n    or "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "exists "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Nephropathy Diagnoses\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "138"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "138"
                            }
                          ],
                          "node_type": "Exists",
                          "ref_id": "139"
                        }
                      ],
                      "node_type": "Or",
                      "ref_id": "140"
                    },
                    {
                      "children": [
                        {
                          "text": "\n    or "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "exists "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "( "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Nephropathy Screenings\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "155"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "155"
                        }
                      ],
                      "node_type": "Exists",
                      "ref_id": "156"
                    }
                  ],
                  "node_type": "Or",
                  "ref_id": "157"
                }
              ],
              "ref_id": "158"
            }
          ],
          "define_name": "Numerator"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"In Hospice\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "Hospice"
                            }
                          ]
                        }
                      ],
                      "ref_id": "159"
                    },
                    {
                      "children": [
                        {
                          "text": "."
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Has Hospice\""
                            }
                          ]
                        }
                      ],
                      "node_type": "ExpressionRef",
                      "ref_id": "160"
                    }
                  ],
                  "node_type": "ExpressionRef",
                  "ref_id": "160"
                }
              ],
              "ref_id": "161"
            }
          ],
          "define_name": "In Hospice"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Denominator Exclusions\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "\"In Hospice\""
                        }
                      ]
                    }
                  ],
                  "node_type": "ExpressionRef",
                  "ref_id": "162"
                }
              ],
              "ref_id": "163"
            }
          ],
          "define_name": "Denominator Exclusions"
        }
      ],
      "identifier": {
        "id": "DiabetesMedicalAttentionforNephropathy",
        "version": "6.1.003"
      }
    },
    "MATGlobalCommonFunctions": {
      "statements": [
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"ToDate\"(Value "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "12"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "DateTime("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "year from "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "13"
                            }
                          ],
                          "ref_id": "14"
                        },
                        {
                          "children": [
                            {
                              "text": ", "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "month from "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "15"
                            }
                          ],
                          "ref_id": "16"
                        },
                        {
                          "children": [
                            {
                              "text": ", "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "day from "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "17"
                            }
                          ],
                          "ref_id": "18"
                        },
                        {
                          "children": [
                            {
                              "text": ", 0, 0, 0, 0, "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "timezone from "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "23"
                            }
                          ],
                          "ref_id": "24"
                        },
                        {
                          "children": [
                            {
                              "text": ")"
                            }
                          ]
                        }
                      ],
                      "node_type": "DateTime",
                      "ref_id": "25"
                    }
                  ],
                  "node_type": "DateTime",
                  "ref_id": "25"
                }
              ],
              "ref_id": "26"
            }
          ],
          "define_name": "ToDate"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInDaysAt\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "27"
                },
                {
                  "children": [
                    {
                      "text": ", AsOf "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "28"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "days between "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "BirthDateTime"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "29"
                            },
                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
                            }
                          ],
                          "node_type": "FunctionRef",
                          "ref_id": "30"
                        },
                        {
                          "children": [
                            {
                              "text": "and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "AsOf"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "31"
                            },
                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
                            }
                          ],
                          "node_type": "FunctionRef",
                          "ref_id": "32"
                        }
                      ],
                      "node_type": "DurationBetween",
                      "ref_id": "33"
                    }
                  ],
                  "node_type": "DurationBetween",
                  "ref_id": "33"
                }
              ],
              "ref_id": "34"
            }
          ],
          "define_name": "CalendarAgeInDaysAt"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInDays\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "35"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "CalendarAgeInDaysAt("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "BirthDateTime"
                                }
                              ]
                            }
                          ],
                          "node_type": "OperandRef",
                          "ref_id": "36"
                        },
                        {
                          "children": [
                            {
                              "text": ", "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "Today()"
                                }
                              ]
                            }
                          ],
                          "node_type": "Today",
                          "ref_id": "37"
                        },
                        {
                          "children": [
                            {
                              "text": ")"
                            }
                          ]
                        }
                      ],
                      "node_type": "FunctionRef",
                      "ref_id": "38"
                    }
                  ],
                  "node_type": "FunctionRef",
                  "ref_id": "38"
                }
              ],
              "ref_id": "39"
            }
          ],
          "define_name": "CalendarAgeInDays"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInMonthsAt\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "40"
                },
                {
                  "children": [
                    {
                      "text": ", AsOf "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "41"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "months between "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "BirthDateTime"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "42"
                            },
                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
                            }
                          ],
                          "node_type": "FunctionRef",
                          "ref_id": "43"
                        },
                        {
                          "children": [
                            {
                              "text": "and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "AsOf"
                                    }
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                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "44"
                            },
                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
                            }
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                          "node_type": "FunctionRef",
                          "ref_id": "45"
                        }
                      ],
                      "node_type": "DurationBetween",
                      "ref_id": "46"
                    }
                  ],
                  "node_type": "DurationBetween",
                  "ref_id": "46"
                }
              ],
              "ref_id": "47"
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          ],
          "define_name": "CalendarAgeInMonthsAt"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInMonths\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "48"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "CalendarAgeInMonthsAt("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "BirthDateTime"
                                }
                              ]
                            }
                          ],
                          "node_type": "OperandRef",
                          "ref_id": "49"
                        },
                        {
                          "children": [
                            {
                              "text": ", "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "Today()"
                                }
                              ]
                            }
                          ],
                          "node_type": "Today",
                          "ref_id": "50"
                        },
                        {
                          "children": [
                            {
                              "text": ")"
                            }
                          ]
                        }
                      ],
                      "node_type": "FunctionRef",
                      "ref_id": "51"
                    }
                  ],
                  "node_type": "FunctionRef",
                  "ref_id": "51"
                }
              ],
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          ],
          "define_name": "CalendarAgeInMonths"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInYearsAt\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "53"
                },
                {
                  "children": [
                    {
                      "text": ", AsOf "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "54"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "years between "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "BirthDateTime"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "55"
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                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
                            }
                          ],
                          "node_type": "FunctionRef",
                          "ref_id": "56"
                        },
                        {
                          "children": [
                            {
                              "text": "and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "ToDate("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "AsOf"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "57"
                            },
                            {
                              "children": [
                                {
                                  "text": ")"
                                }
                              ]
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                          "node_type": "FunctionRef",
                          "ref_id": "58"
                        }
                      ],
                      "node_type": "DurationBetween",
                      "ref_id": "59"
                    }
                  ],
                  "node_type": "DurationBetween",
                  "ref_id": "59"
                }
              ],
              "ref_id": "60"
            }
          ],
          "define_name": "CalendarAgeInYearsAt"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"CalendarAgeInYears\"(BirthDateTime "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "DateTime"
                        }
                      ]
                    }
                  ],
                  "ref_id": "61"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "CalendarAgeInYearsAt("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "BirthDateTime"
                                }
                              ]
                            }
                          ],
                          "node_type": "OperandRef",
                          "ref_id": "62"
                        },
                        {
                          "children": [
                            {
                              "text": ", "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "Today()"
                                }
                              ]
                            }
                          ],
                          "node_type": "Today",
                          "ref_id": "63"
                        },
                        {
                          "children": [
                            {
                              "text": ")"
                            }
                          ]
                        }
                      ],
                      "node_type": "FunctionRef",
                      "ref_id": "64"
                    }
                  ],
                  "node_type": "FunctionRef",
                  "ref_id": "64"
                }
              ],
              "ref_id": "65"
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          ],
          "define_name": "CalendarAgeInYears"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"Hospitalization\"(Encounter "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "\"Encounter, Performed\""
                        }
                      ]
                    }
                  ],
                  "ref_id": "66"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "( "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "singleton from "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "( "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "[\"Encounter, Performed\": "
                                                                    }
                                                                  ]
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "\"Emergency Department Visit\""
                                                                        }
                                                                      ]
                                                                    }
                                                                  ]
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "]"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "node_type": "Retrieve",
                                                              "ref_id": "67"
                                                            }
                                                          ],
                                                          "node_type": "Retrieve",
                                                          "ref_id": "67"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": " EDVisit"
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "ref_id": "68"
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\n      "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "where "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "EDVisit"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "ref_id": "69"
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "."
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "relevantPeriod"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "node_type": "Property",
                                                              "ref_id": "70"
                                                            }
                                                          ],
                                                          "node_type": "Property",
                                                          "ref_id": "70"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": " "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "ends "
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "1 hour"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "node_type": "Quantity",
                                                              "ref_id": "74"
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": " or less on or before"
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "ref_id": "75"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": " "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "start of "
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "Encounter"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "ref_id": "71"
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "."
                                                                    }
                                                                  ]
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "relevantPeriod"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "node_type": "Property",
                                                                  "ref_id": "72"
                                                                }
                                                              ],
                                                              "node_type": "Property",
                                                              "ref_id": "72"
                                                            }
                                                          ],
                                                          "node_type": "Start",
                                                          "ref_id": "73"
                                                        }
                                                      ],
                                                      "ref_id": "75"
                                                    }
                                                  ],
                                                  "ref_id": "75"
                                                }
                                              ],
                                              "node_type": "Query",
                                              "ref_id": "76"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n  )"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Query",
                                          "ref_id": "76"
                                        }
                                      ],
                                      "node_type": "SingletonFrom",
                                      "ref_id": "77"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " )"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "SingletonFrom",
                                  "ref_id": "77"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " X"
                                    }
                                  ]
                                }
                              ],
                              "ref_id": "78"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": "\n    "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "return "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "if "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "X"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "AliasRef",
                                      "ref_id": "79"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " is null"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "IsNull",
                                  "ref_id": "80"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " then "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "Encounter"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "81"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "relevantPeriod"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "82"
                                    }
                                  ],
                                  "ref_id": "82"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " else "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "Interval["
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "start of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "X"
                                                    }
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                                              ],
                                              "ref_id": "83"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
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                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "relevantPeriod"
                                                    }
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                                              ],
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                                          "ref_id": "84"
                                        }
                                      ],
                                      "ref_id": "85"
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                                      "children": [
                                        {
                                          "text": ", "
                                        }
                                      ]
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                                    {
                                      "children": [
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                                          "children": [
                                            {
                                              "text": "end of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "Encounter"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "86"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "relevantPeriod"
                                                    }
                                                  ]
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                                              ],
                                              "node_type": "Property",
                                              "ref_id": "87"
                                            }
                                          ],
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                                          "ref_id": "87"
                                        }
                                      ],
                                      "ref_id": "88"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "]"
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                                      ]
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                                  ],
                                  "ref_id": "89"
                                }
                              ],
                              "node_type": "If",
                              "ref_id": "90"
                            }
                          ],
                          "ref_id": "91"
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "92"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "92"
                }
              ],
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          ],
          "define_name": "Hospitalization"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"LengthInDays\"(Value "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "Interval&lt;"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "DateTime"
                            }
                          ]
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                      "ref_id": "94"
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                    {
                      "children": [
                        {
                          "text": "&gt;"
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                      ]
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                  ],
                  "ref_id": "95"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "difference in days between "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "start of "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "96"
                            }
                          ],
                          "node_type": "Start",
                          "ref_id": "97"
                        },
                        {
                          "children": [
                            {
                              "text": " and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "end of "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Value"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "98"
                            }
                          ],
                          "node_type": "End",
                          "ref_id": "99"
                        }
                      ],
                      "node_type": "DifferenceBetween",
                      "ref_id": "100"
                    }
                  ],
                  "node_type": "DifferenceBetween",
                  "ref_id": "100"
                }
              ],
              "ref_id": "101"
            }
          ],
          "define_name": "LengthInDays"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define function \"TotalLengthOfStay\"(Stay "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "Interval&lt;"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "DateTime"
                            }
                          ]
                        }
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                      "ref_id": "102"
                    },
                    {
                      "children": [
                        {
                          "text": "&gt;"
                        }
                      ]
                    }
                  ],
                  "ref_id": "103"
                },
                {
                  "children": [
                    {
                      "text": " ):\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "difference in days between "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "start of "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Stay"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "104"
                            }
                          ],
                          "node_type": "Start",
                          "ref_id": "105"
                        },
                        {
                          "children": [
                            {
                              "text": " and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "end of "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "Stay"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "OperandRef",
                              "ref_id": "106"
                            }
                          ],
                          "node_type": "End",
                          "ref_id": "107"
                        }
                      ],
                      "node_type": "DifferenceBetween",
                      "ref_id": "108"
                    }
                  ],
                  "node_type": "DifferenceBetween",
                  "ref_id": "108"
                }
              ],
              "ref_id": "109"
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          ],
          "define_name": "TotalLengthOfStay"
        }
      ],
      "identifier": {
        "id": "MATGlobalCommonFunctions",
        "version": "1.0.000"
      }
    },
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      "statements": [
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": "define \"Has Hospice\":\n  "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "exists "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "[\"Encounter, Performed\": "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Encounter Inpatient\""
                                                            }
                                                          ]
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "]"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Retrieve",
                                                  "ref_id": "20"
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "20"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " DischargeHospice"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "21"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n      "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "where "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "( "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "DischargeHospice"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "ref_id": "22"
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "."
                                                                    }
                                                                  ]
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "dischargeDisposition"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "node_type": "Property",
                                                                  "ref_id": "23"
                                                                }
                                                              ],
                                                              "node_type": "Property",
                                                              "ref_id": "23"
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": " as "
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "Code"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "ref_id": "24"
                                                            }
                                                          ],
                                                          "node_type": "As",
                                                          "ref_id": "25"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": " ~ "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Discharge to home for hospice care (procedure)\""
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "CodeRef",
                                                          "ref_id": "26"
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                                                      ],
                                                      "node_type": "Equivalent",
                                                      "ref_id": "27"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\n          or "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "DischargeHospice"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "ref_id": "28"
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "."
                                                                    }
                                                                  ]
                                                                },
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "children": [
                                                                        {
                                                                          "text": "dischargeDisposition"
                                                                        }
                                                                      ]
                                                                    }
                                                                  ],
                                                                  "node_type": "Property",
                                                                  "ref_id": "29"
                                                                }
                                                              ],
                                                              "node_type": "Property",
                                                              "ref_id": "29"
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": " as "
                                                                }
                                                              ]
                                                            },
                                                            {
                                                              "children": [
                                                                {
                                                                  "children": [
                                                                    {
                                                                      "text": "Code"
                                                                    }
                                                                  ]
                                                                }
                                                              ],
                                                              "ref_id": "30"
                                                            }
                                                          ],
                                                          "node_type": "As",
                                                          "ref_id": "31"
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "text": " ~ "
                                                            }
                                                          ]
                                                        },
                                                        {
                                                          "children": [
                                                            {
                                                              "children": [
                                                                {
                                                                  "text": "\"Discharge to healthcare facility for hospice care (procedure)\""
                                                                }
                                                              ]
                                                            }
                                                          ],
                                                          "node_type": "CodeRef",
                                                          "ref_id": "32"
                                                        }
                                                      ],
                                                      "node_type": "Equivalent",
                                                      "ref_id": "33"
                                                    }
                                                  ],
                                                  "node_type": "Or",
                                                  "ref_id": "34"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\n      )"
                                                    }
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                                              ],
                                              "node_type": "Or",
                                              "ref_id": "34"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\n        and "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "DischargeHospice"
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "ref_id": "35"
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "."
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "relevantPeriod"
                                                            }
                                                          ]
                                                        }
                                                      ],
                                                      "node_type": "Property",
                                                      "ref_id": "36"
                                                    }
                                                  ],
                                                  "node_type": "Property",
                                                  "ref_id": "36"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": " ends during "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"Measurement Period\""
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "ParameterRef",
                                                  "ref_id": "37"
                                                }
                                              ],
                                              "node_type": "In",
                                              "ref_id": "38"
                                            }
                                          ],
                                          "ref_id": "39"
                                        }
                                      ],
                                      "ref_id": "39"
                                    }
                                  ],
                                  "node_type": "Query",
                                  "ref_id": "40"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\n  )"
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                                }
                              ],
                              "node_type": "Query",
                              "ref_id": "40"
                            }
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                          "node_type": "Exists",
                          "ref_id": "41"
                        },
                        {
                          "children": [
                            {
                              "text": "\n    or "
                            }
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                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "exists "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "( "
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                                  ]
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                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "[\"Intervention, Order\": "
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "children": [
                                                            {
                                                              "text": "\"Hospice care ambulatory\""
                                                            }
                                                          ]
                                                        }
                                                      ]
                                                    },
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "]"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Retrieve",
                                                  "ref_id": "42"
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "42"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " HospiceOrder"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "43"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\n        "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "where "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "HospiceOrder"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "ref_id": "44"
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "."
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "authorDatetime"
                                                        }
                                                      ]
                                                    }
                                                  ],
                                                  "node_type": "Property",
                                                  "ref_id": "45"
                                                }
                                              ],
                                              "node_type": "Property",
                                              "ref_id": "45"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " during "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Measurement Period\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ParameterRef",
                                              "ref_id": "46"
                                            }
                                          ],
                                          "ref_id": "47"
                                        }
                                      ],
                                      "ref_id": "47"
                                    }
                                  ],
                                  "node_type": "Query",
                                  "ref_id": "48"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\n    )"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Query",
                              "ref_id": "48"
                            }
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                          "node_type": "Exists",
                          "ref_id": "49"
                        }
                      ],
                      "node_type": "Or",
                      "ref_id": "50"
                    },
                    {
                      "children": [
                        {
                          "text": "\n    or "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "exists "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "( "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "[\"Intervention, Performed\": "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"Hospice care ambulatory\""
                                                        }
                                                      ]
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": "]"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "51"
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "51"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " HospicePerformed"
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                                          ]
                                        }
                                      ],
                                      "ref_id": "52"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\n        "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "where "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "HospicePerformed"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "53"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "relevantPeriod"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Property",
                                              "ref_id": "54"
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "54"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " overlaps "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Measurement Period\""
                                                }
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                                          "node_type": "ParameterRef",
                                          "ref_id": "55"
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                                      ],
                                      "ref_id": "56"
                                    }
                                  ],
                                  "ref_id": "56"
                                }
                              ],
                              "node_type": "Query",
                              "ref_id": "57"
                            },
                            {
                              "children": [
                                {
                                  "text": "\n    )"
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                              ]
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "57"
                        }
                      ],
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                      "ref_id": "58"
                    }
                  ],
                  "node_type": "Or",
                  "ref_id": "59"
                }
              ],
              "ref_id": "60"
            }
          ],
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        }
      ],
      "identifier": {
        "id": "Hospice",
        "version": "0.1.000"
      }
    }
  },
  "episode_ids": null,
  "episode_of_care": false,
  "hqmf_id": "40280382-5FA6-FE85-0160-0918E74D2075",
  "hqmf_set_id": "7B2A9277-43DA-4D99-9BEE-6AC271A07747",
  "hqmf_version_number": 0,
  "id": "5a57eb19942c6d1e61d33552",
  "main_cql_library": "DiabetesMedicalAttentionforNephropathy",
  "measure_attributes": [
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    {
      "code": "COPY",
      "value": "This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. \n\nLimited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation. ICD-10 copyright 2016 World Health Organization. All Rights Reserved.\n\nThe American Hospital Association holds a copyright to the National Uniform Billing Committee (NUBC) codes contained in the measure specifications. The NUBC codes in the specifications are included with the permission of the AHA. The NUBC codes contained in the specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting Measure results or using Measure results for their internal quality improvement purposes. All other uses of the NUBC codes require a license from the AHA. Anyone desiring to use the NUBC codes in a commercial product to generate Measure results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@healthforum.com.",
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      },
      "value_obj": {
        "type": "ED",
        "value": "This Physician Performance Measure (Measure) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). The Measure is copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. (C) 2012-2017 National Committee for Quality Assurance. All Rights Reserved. \n\nLimited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.\n\nCPT(R) contained in the Measure specifications is copyright 2004-2016 American Medical Association. LOINC(R) copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation. ICD-10 copyright 2016 World Health Organization. All Rights Reserved.\n\nThe American Hospital Association holds a copyright to the National Uniform Billing Committee (NUBC) codes contained in the measure specifications. The NUBC codes in the specifications are included with the permission of the AHA. The NUBC codes contained in the specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting Measure results or using Measure results for their internal quality improvement purposes. All other uses of the NUBC codes require a license from the AHA. Anyone desiring to use the NUBC codes in a commercial product to generate Measure results, or for any other commercial use, must obtain a commercial use license directly from the AHA. To inquire about licensing, contact ub04@healthforum.com.",
        "media_type": "text/plain"
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    },
    {
      "code": "DISC",
      "value": "The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n \nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
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        "code": "DISC",
        "title": "Disclaimer"
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      "value_obj": {
        "type": "ED",
        "value": "The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.\n \nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
        "media_type": "text/plain"
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      "code": "STRAT",
      "value": "None",
      "name": "Stratification",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "STRAT",
        "title": "Stratification"
      },
      "value_obj": {
        "type": "ED",
        "value": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "MSRADJ",
      "value": "None",
      "name": "Risk Adjustment",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "MSRADJ",
        "title": "Risk Adjustment"
      },
      "value_obj": {
        "type": "ED",
        "value": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "MSRAGG",
      "value": "None",
      "name": "Rate Aggregation",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "MSRAGG",
        "title": "Rate Aggregation"
      },
      "value_obj": {
        "type": "ED",
        "value": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "RAT",
      "value": "As the seventh leading cause of death in the U.S., diabetes kills approximately 75,000 people a year (CDC FastStats 2015). Diabetes is a group of diseases marked by high blood glucose levels, resulting from the body's inability to produce or use insulin (CDC Statistics 2014, ADA Basics 2013). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney failure, amputation of toes, feet or legs, and premature death. (CDC Fact Sheet 2014). \n\nIn 2012, diabetes cost the U.S. an estimated $245 billion: $176 billion in direct medical costs and $69 billion in reduced productivity. This is a 41 percent increase from the estimated $174 billion spent on diabetes in 2007 (ADA Economic 2013).  \n\nIn 2011, diabetes accounted for 44% of new kidney failure cases. In the same year, 49,677 diabetics started treatment for kidney failure and 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant (CDC Statistics, 2014).",
      "name": "Rationale",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "RAT",
        "title": "Rationale"
      },
      "value_obj": {
        "type": "ED",
        "value": "As the seventh leading cause of death in the U.S., diabetes kills approximately 75,000 people a year (CDC FastStats 2015). Diabetes is a group of diseases marked by high blood glucose levels, resulting from the body's inability to produce or use insulin (CDC Statistics 2014, ADA Basics 2013). People with diabetes are at increased risk of serious health complications including vision loss, heart disease, stroke, kidney failure, amputation of toes, feet or legs, and premature death. (CDC Fact Sheet 2014). \n\nIn 2012, diabetes cost the U.S. an estimated $245 billion: $176 billion in direct medical costs and $69 billion in reduced productivity. This is a 41 percent increase from the estimated $174 billion spent on diabetes in 2007 (ADA Economic 2013).  \n\nIn 2011, diabetes accounted for 44% of new kidney failure cases. In the same year, 49,677 diabetics started treatment for kidney failure and 228,924 people of all ages with kidney failure due to diabetes were living on chronic dialysis or with a kidney transplant (CDC Statistics, 2014).",
        "media_type": "text/plain"
      }
    },
    {
      "code": "CRS",
      "value": "American Diabetes Association (2017):\n\nScreening\n- At least once a year, quantitatively assess urinary albumin (eg, spot urinary albumin-to-creatinine ratio [UACR]) and estimated glomerular filtration rate (eGFR) in patients with type 1 diabetes duration of greater than or equal to 5 years in all patients with type 2 diabetes, and in all patients with comorbid hypertension. (Level of evidence: B)\n\nTreatment\n- An angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) is not recommended for the primary prevention of diabetic kidney disease in patients with diabetes who have normal blood pressure, normal UACR (<30 mg/g), and normal estimated glomerular filtration rate. (Level of evidence: B)\n- Either an ACE inhibitor or ARB is suggested for the treatment of the nonpregnant patient with modestly elevated UACR (30-299 mg/day) (Level of evidence: C) and is strongly recommended for those with urinary albumin excretion >=300 mg/day. (Level of evidence: A)\n- When ACE inhibitors, ARBs, or diuretics are used, monitor serum creatinine and potassium levels for the development of increased creatinine or changes in potassium. (Level of evidence: E)\n- Continued monitoring of UACR in patients with albuminuria treated with an ACE inhibitor or ARBs is reasonable to assess progression of diabetic kidney disease. (Level of evidence: E)\n\nAmerican Association of Clinical Endocrinologists (2015): \n- Beginning 5 years after diagnosis in patients with type 1 diabetes (if diagnosed before age 30) or at diagnosis in patients with type 2 diabetes and those with type 1 diabetes diagnosed after age 30, annual assessment of serum creatinine to determine the estimated glomerular filtration rate (eGFR) and urine albumin excretion rate (AER) should be performed to identify, stage, and monitor progression of diabetic nephropathy (Grade C; best evidence level 3). \n- Patients with nephropathy should be counseled regarding the need for optimal glycemic control, blood pressure control, dyslipidemia control, and smoking cessation (Grade B; best evidence level 2). \n- In addition, they should have routine monitoring of albuminuria, kidney function electrolytes, and lipids (Grade B; best evidence level 2). \n- Associated conditions such as anemia and bone and mineral disorders should be assessed as kidney function declines (Grade D; best evidence level 4). \n- Referral to a nephrologist is recommended well before the need for renal replacement therapy (Grade D; best evidence level 4).",
      "name": "Clinical Recommendation Statement",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "CRS",
        "title": "Clinical Recommendation Statement"
      },
      "value_obj": {
        "type": "ED",
        "value": "American Diabetes Association (2017):\n\nScreening\n- At least once a year, quantitatively assess urinary albumin (eg, spot urinary albumin-to-creatinine ratio [UACR]) and estimated glomerular filtration rate (eGFR) in patients with type 1 diabetes duration of greater than or equal to 5 years in all patients with type 2 diabetes, and in all patients with comorbid hypertension. (Level of evidence: B)\n\nTreatment\n- An angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) is not recommended for the primary prevention of diabetic kidney disease in patients with diabetes who have normal blood pressure, normal UACR (<30 mg/g), and normal estimated glomerular filtration rate. (Level of evidence: B)\n- Either an ACE inhibitor or ARB is suggested for the treatment of the nonpregnant patient with modestly elevated UACR (30-299 mg/day) (Level of evidence: C) and is strongly recommended for those with urinary albumin excretion >=300 mg/day. (Level of evidence: A)\n- When ACE inhibitors, ARBs, or diuretics are used, monitor serum creatinine and potassium levels for the development of increased creatinine or changes in potassium. (Level of evidence: E)\n- Continued monitoring of UACR in patients with albuminuria treated with an ACE inhibitor or ARBs is reasonable to assess progression of diabetic kidney disease. (Level of evidence: E)\n\nAmerican Association of Clinical Endocrinologists (2015): \n- Beginning 5 years after diagnosis in patients with type 1 diabetes (if diagnosed before age 30) or at diagnosis in patients with type 2 diabetes and those with type 1 diabetes diagnosed after age 30, annual assessment of serum creatinine to determine the estimated glomerular filtration rate (eGFR) and urine albumin excretion rate (AER) should be performed to identify, stage, and monitor progression of diabetic nephropathy (Grade C; best evidence level 3). \n- Patients with nephropathy should be counseled regarding the need for optimal glycemic control, blood pressure control, dyslipidemia control, and smoking cessation (Grade B; best evidence level 2). \n- In addition, they should have routine monitoring of albuminuria, kidney function electrolytes, and lipids (Grade B; best evidence level 2). \n- Associated conditions such as anemia and bone and mineral disorders should be assessed as kidney function declines (Grade D; best evidence level 4). \n- Referral to a nephrologist is recommended well before the need for renal replacement therapy (Grade D; best evidence level 4).",
        "media_type": "text/plain"
      }
    },
    {
      "code": "IDUR",
      "value": "Higher score indicates better quality",
      "name": "Improvement Notation",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "IDUR",
        "title": "Improvement Notation"
      },
      "value_obj": {
        "type": "ED",
        "value": "Higher score indicates better quality",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "American Diabetes Association. Microvascular complications and foot care. Sec. 10. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1):S88-S98.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "American Diabetes Association. Microvascular complications and foot care. Sec. 10. In Standards of Medical Care in Diabetes-2017. Diabetes Care 2017;40(Suppl. 1):S88-S98.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "American Diabetes Association. 2013. Diabetes Basics. www.diabetes.org/diabetes-basics/?loc=GlobalNavDB.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "American Diabetes Association. 2013. Diabetes Basics. www.diabetes.org/diabetes-basics/?loc=GlobalNavDB.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "American Diabetes Association (ADA). April 2013. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. Vol. 36 no. 4 \n1033-46. http://care.diabetesjournals.org/content/36/4/1033.full.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "American Diabetes Association (ADA). April 2013. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. Vol. 36 no. 4 \n1033-46. http://care.diabetesjournals.org/content/36/4/1033.full.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Centers for Disease Control and Prevention (CDC). 2014. National Diabetes Statistics Report. \nhttp://www.cdc.gov/diabetes/pdfs/data/2014-report-estimates-of-diabetes-and-its-burden-in-the-united-states.pdf",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Centers for Disease Control and Prevention (CDC). 2014. National Diabetes Statistics Report. \nhttp://www.cdc.gov/diabetes/pdfs/data/2014-report-estimates-of-diabetes-and-its-burden-in-the-united-states.pdf",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Centers for Disease Control and Prevention (CDC). 2015. FastStats: Deaths and Mortality. www.cdc.gov/nchs/fastats/deaths.htm.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Centers for Disease Control and Prevention (CDC). 2015. FastStats: Deaths and Mortality. www.cdc.gov/nchs/fastats/deaths.htm.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Centers for Disease Control and Prevention. 2014. CDC Features. Diabetes Latest. www.cdc.gov/features/diabetesfactsheet/.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Centers for Disease Control and Prevention. 2014. CDC Features. Diabetes Latest. www.cdc.gov/features/diabetesfactsheet/.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, et al. (2015) American Association of Clinical Endocrinologists and American College of Endocrinology-Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan-2015. Endocr Pract 21 Suppl 1: 1-87.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Handelsman Y, Bloomgarden ZT, Grunberger G, Umpierrez G, Zimmerman RS, Bailey TS, et al. (2015) American Association of Clinical Endocrinologists and American College of Endocrinology-Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan-2015. Endocr Pract 21 Suppl 1: 1-87.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DEF",
      "value": "None",
      "name": "Definition",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DEF",
        "title": "Definition"
      },
      "value_obj": {
        "type": "ED",
        "value": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "GUIDE",
      "value": "Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included",
      "name": "Guidance",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "GUIDE",
        "title": "Guidance"
      },
      "value_obj": {
        "type": "ED",
        "value": "Only patients with a diagnosis of Type 1 or Type 2 diabetes should be included in the denominator of this measure; patients with a diagnosis of secondary diabetes due to another condition should not be included",
        "media_type": "text/plain"
      }
    },
    {
      "code": "TRANF",
      "value": "TBD",
      "name": "Transmission Format",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "TRANF",
        "title": "Transmission Format"
      },
      "value_obj": {
        "type": "ED",
        "value": "TBD",
        "media_type": "text/plain"
      }
    },
    {
      "code": "IPOP",
      "value": "Patients 18-75 years of age with diabetes with a visit during the measurement period",
      "name": "Initial Population",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "IPOP",
        "title": "Initial Population"
      },
      "value_obj": {
        "type": "ED",
        "value": "Patients 18-75 years of age with diabetes with a visit during the measurement period",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENOM",
      "value": "Equals Initial Population",
      "name": "Denominator",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DENOM",
        "title": "Denominator"
      },
      "value_obj": {
        "type": "ED",
        "value": "Equals Initial Population",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENEX",
      "value": "Exclude patients who were in hospice care during the measurement year",
      "name": "Denominator Exclusions",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DENEX",
        "title": "Denominator Exclusions"
      },
      "value_obj": {
        "type": "ED",
        "value": "Exclude patients who were in hospice care during the measurement year",
        "media_type": "text/plain"
      }
    },
    {
      "code": "NUMER",
      "value": "Patients with a screening for nephropathy or evidence of nephropathy during the measurement period",
      "name": "Numerator",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "NUMER",
        "title": "Numerator"
      },
      "value_obj": {
        "type": "ED",
        "value": "Patients with a screening for nephropathy or evidence of nephropathy during the measurement period",
        "media_type": "text/plain"
      }
    },
    {
      "code": "NUMEX",
      "value": "Not Applicable",
      "name": "Numerator Exclusions",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "NUMEX",
        "title": "Numerator Exclusions"
      },
      "value_obj": {
        "type": "ED",
        "value": "Not Applicable",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENEXCEP",
      "value": "None",
      "name": "Denominator Exceptions",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DENEXCEP",
        "title": "Denominator Exceptions"
      },
      "value_obj": {
        "type": "ED",
        "value": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "SDE",
      "value": "For every patient evaluated by this measure also identify payer, race, ethnicity and sex",
      "name": "Supplemental Data Elements",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "SDE",
        "title": "Supplemental Data Elements"
      },
      "value_obj": {
        "type": "ED",
        "value": "For every patient evaluated by this measure also identify payer, race, ethnicity and sex",
        "media_type": "text/plain"
      }
    }
  ],
  "measure_id": "40280382-5FA6-FE85-0160-0918E74D2075",
  "measure_period": {
    "type": "IVL_TS",
    "low": {
      "type": "TS",
      "value": "201201010000",
      "inclusive?": true,
      "derived?": false
    },
    "high": {
      "type": "TS",
      "value": "201212312359",
      "inclusive?": true,
      "derived?": false
    },
    "width": {
      "type": "PQ",
      "unit": "a",
      "value": "1",
      "inclusive?": true,
      "derived?": false
    }
  },
  "needs_finalize": false,
  "observations": [

  ],
  "population_criteria": {
    "IPP": {
      "conjunction?": true,
      "type": "IPP",
      "hqmf_id": "6CD39B4B-16E6-4FD4-9241-527F9F4A48D0",
      "preconditions": [
        {
          "id": 2,
          "preconditions": [
            {
              "id": 1,
              "reference": "DiabetesMedicalAttentionforNephropathy__Initial_Population__D9836559_E946_49E8_A122_0B0C13F9770B"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENOM": {
      "conjunction?": true,
      "type": "DENOM",
      "hqmf_id": "B735F4BD-DFAE-45E3-BAA9-E09BDF731B8E",
      "preconditions": [
        {
          "id": 4,
          "preconditions": [
            {
              "id": 3,
              "reference": "DiabetesMedicalAttentionforNephropathy__Denominator__D9836559_E946_49E8_A122_0B0C13F9770B"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "NUMER": {
      "conjunction?": true,
      "type": "NUMER",
      "hqmf_id": "ECFD4C68-90F8-4143-8298-21798069AE8E",
      "preconditions": [
        {
          "id": 6,
          "preconditions": [
            {
              "id": 5,
              "reference": "DiabetesMedicalAttentionforNephropathy__Numerator__D9836559_E946_49E8_A122_0B0C13F9770B"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENEX": {
      "conjunction?": true,
      "type": "DENEX",
      "hqmf_id": "F82CC93D-C1A2-4E10-A087-81D666395C48",
      "preconditions": [
        {
          "id": 8,
          "preconditions": [
            {
              "id": 7,
              "reference": "DiabetesMedicalAttentionforNephropathy__Denominator_Exclusions__D9836559_E946_49E8_A122_0B0C13F9770B"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    }
  },
  "populations": [
    {
      "IPP": "IPP",
      "DENOM": "DENOM",
      "NUMER": "NUMER",
      "DENEX": "DENEX",
      "id": "PopulationCriteria1",
      "title": "Population Criteria Section"
    }
  ],
  "populations_cql_map": {
    "IPP": [
      "Initial Population"
    ],
    "DENOM": [
      "Denominator"
    ],
    "DENEX": [
      "Denominator Exclusions"
    ],
    "NUMER": [
      "Numerator"
    ]
  },
  "publish_date": null,
  "published": null,
  "record_ids": [

  ],
  "source_data_criteria": {
    "Face_to_FaceInteraction_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e301a_source": {
      "title": "Face-to-FaceInteraction",
      "description": "Encounter, Performed: Face-to-FaceInteraction",
      "code_list_id": "2.16.840.1.113883.3.464.1003.101.12.1048",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "Face_to_FaceInteraction_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e301a_source",
      "variable": false
    },
    "DialysisServices_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300e_source": {
      "title": "DialysisServices",
      "description": "Procedure, Performed: DialysisServices",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1013",
      "type": "procedures",
      "definition": "procedure",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "DialysisServices_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300e_source",
      "variable": false
    },
    "KidneyTransplant_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300c_source": {
      "title": "KidneyTransplant",
      "description": "Procedure, Performed: KidneyTransplant",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1012",
      "type": "procedures",
      "definition": "procedure",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "KidneyTransplant_ProcedurePerformed_40280381_3d61_56a7_013e_62abf57d300c_source",
      "variable": false
    },
    "ONCAdministrativeSex_PatientCharacteristicSex_629109a3_b658_4124_b1ac_c6396879f9a1_source": {
      "title": "ONCAdministrativeSex",
      "description": "Patient Characteristic Sex: ONCAdministrativeSex",
      "code_list_id": "2.16.840.1.113762.1.4.1",
      "property": "gender",
      "type": "characteristic",
      "definition": "patient_characteristic_gender",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "ONCAdministrativeSex_PatientCharacteristicSex_629109a3_b658_4124_b1ac_c6396879f9a1_source",
      "variable": false,
      "value": {
        "type": "CD",
        "system": "Administrative Sex",
        "code": "F"
      }
    },
    "ESRDMonthlyOutpatientServices_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3011_source": {
      "title": "ESRDMonthlyOutpatientServices",
      "description": "Encounter, Performed: ESRDMonthlyOutpatientServices",
      "code_list_id": "2.16.840.1.113883.3.464.1003.109.12.1014",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "ESRDMonthlyOutpatientServices_EncounterPerformed_40280381_3d61_56a7_013e_62abf57e3011_source",
      "variable": false
    },
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