{
  "_id": "5977b702942c6d0f50004988",
  "bundle_id": "59638a8b942c6d2e17000435",
  "category": "Miscellaneous",
  "cms_id": "CMS735v0",
  "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": "Valid Encounters",
        "complexity": 1
      },
      {
        "name": "History of Clinical ASCVD Procedures",
        "complexity": 1
      },
      {
        "name": "History of Clinical ASCVD Diagnoses",
        "complexity": 1
      },
      {
        "name": "PalliativeCare",
        "complexity": 1
      },
      {
        "name": "MedsAdverse",
        "complexity": 1
      },
      {
        "name": "MedsAllergyIntolerance",
        "complexity": 1
      },
      {
        "name": "In Demographic",
        "complexity": 1
      },
      {
        "name": "Encounters During Measurement Period",
        "complexity": 1
      },
      {
        "name": "Initial Population",
        "complexity": 2
      },
      {
        "name": "ASCVD Diagnosis Before MP",
        "complexity": 1
      },
      {
        "name": "ASCVD Procedure Before MP",
        "complexity": 1
      },
      {
        "name": "Denominator 1",
        "complexity": 3
      },
      {
        "name": "Statin Active",
        "complexity": 1
      },
      {
        "name": "Statin starts before end of MP",
        "complexity": 2
      },
      {
        "name": "Statin order",
        "complexity": 1
      },
      {
        "name": "Statin order during MP",
        "complexity": 1
      },
      {
        "name": "Numerator",
        "complexity": 2
      },
      {
        "name": "LDL gte 190",
        "complexity": 1
      },
      {
        "name": "Hypercholesterolemia Diagnosis",
        "complexity": 1
      },
      {
        "name": "Denominator 2",
        "complexity": 5
      },
      {
        "name": "Pregnancy",
        "complexity": 1
      },
      {
        "name": "Breastfeed",
        "complexity": 1
      },
      {
        "name": "Rhabdo",
        "complexity": 1
      },
      {
        "name": "Denex",
        "complexity": 3
      },
      {
        "name": "ESRD",
        "complexity": 1
      },
      {
        "name": "HepA",
        "complexity": 1
      },
      {
        "name": "HepB",
        "complexity": 1
      },
      {
        "name": "Liver Disease Diagnosis",
        "complexity": 1
      },
      {
        "name": "Denexcep",
        "complexity": 7
      },
      {
        "name": "Age 40 to 75",
        "complexity": 2
      },
      {
        "name": "Diabetes Diagnosis",
        "complexity": 1
      },
      {
        "name": "LDL between 70 and 189",
        "complexity": 2
      },
      {
        "name": "LDL 70 to 189 2 years prior",
        "complexity": 1
      },
      {
        "name": "Denominator 3",
        "complexity": 8
      },
      {
        "name": "LDL in past 2 years",
        "complexity": 1
      },
      {
        "name": "Most recent LDL",
        "complexity": 1
      },
      {
        "name": "LDL lt 70",
        "complexity": 1
      },
      {
        "name": "Denexcep Den3",
        "complexity": 1
      }
    ]
  },
  "continuous_variable": false,
  "cql": [
    "library StatinTherapy version '0.0.004'\n\nusing QDM version '5.0.2'\n\nvalueset \"ONC Administrative Sex\": 'urn:oid:2.16.840.1.113762.1.4.1' \n\nvalueset \"Race\": 'urn:oid:2.16.840.1.114222.4.11.836' \n\nvalueset \"Ethnicity\": 'urn:oid:2.16.840.1.114222.4.11.837' \n\nvalueset \"Payer\": 'urn:oid:2.16.840.1.114222.4.11.3591' \n\nvalueset \"Office Visit\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.11.1005' \n\nvalueset \"Outpatient Consultation\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.11.1040' \n\nvalueset \"Preventive Care Services-Initial Office Visit, 18 and Up\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.11.1115' \n\nvalueset \"Preventive Care Services - Established Office Visit, 18 and Up\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.11.1125' \n\nvalueset \"Preventive Care Services-Individual Counseling\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1026' \n\nvalueset \"Preventive Care Services - Other\": 'urn:oid:2.16.840.1.113883.3.464.1003.101.12.1030' \n\nvalueset \"Annual Wellness Visit\": 'urn:oid:2.16.840.1.113883.3.526.2.1363' \n\nvalueset \"Outpatient Encounters for Preventive Care\": 'urn:oid:2.16.840.1.113762.1.4.1047.9' \n\nvalueset \"PCI\": 'urn:oid:2.16.840.1.113762.1.4.1045.67' \n\nvalueset \"Myocardial Infarction\": 'urn:oid:2.16.840.1.113883.3.526.3.403' \n\nvalueset \"Cerebrovascular disease, Stroke, TIA\": 'urn:oid:2.16.840.1.113762.1.4.1047.44' \n\nvalueset \"CABG Surgeries\": 'urn:oid:2.16.840.1.113883.3.666.5.694' \n\nvalueset \"Atherosclerosis and Peripheral Arterial Disease\": 'urn:oid:2.16.840.1.113762.1.4.1047.21' \n\nvalueset \"Carotid Intervention\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.204' \n\nvalueset \"Ischemic heart disease or coronary occlusion, rupture, or thrombosis\": 'urn:oid:2.16.840.1.113762.1.4.1047.46' \n\nvalueset \"Stable and Unstable Angina\": 'urn:oid:2.16.840.1.113762.1.4.1047.47' \n\nvalueset \"Palliative Care\": 'urn:oid:2.16.840.1.113883.3.600.1.1579' \n\nvalueset \"End Stage Renal Disease\": 'urn:oid:2.16.840.1.113883.3.526.3.353' \n\nvalueset \"Hepatitis A\": 'urn:oid:2.16.840.1.113883.3.464.1003.110.12.1024' \n\nvalueset \"Hepatitis B\": 'urn:oid:2.16.840.1.113883.3.67.1.101.1.269' \n\nvalueset \"Liver Disease\": 'urn:oid:2.16.840.1.113762.1.4.1047.42' \n\nvalueset \"Statin Allergen\": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.423' \n\nvalueset \"Pregnancy Dx\": 'urn:oid:2.16.840.1.113883.3.600.1.1623' \n\nvalueset \"Breastfeeding\": 'urn:oid:2.16.840.1.113762.1.4.1047.73' \n\nvalueset \"Rhabdomyolysis\": 'urn:oid:2.16.840.1.113762.1.4.1047.102' \n\nvalueset \"High intensity statin therapy\": 'urn:oid:2.16.840.1.113762.1.4.1047.97' \n\nvalueset \"Low intensity statin therapy\": 'urn:oid:2.16.840.1.113762.1.4.1047.107' \n\nvalueset \"Moderate intensity statin therapy\": 'urn:oid:2.16.840.1.113762.1.4.1047.98' \n\nvalueset \"LDL Test\": 'urn:oid:2.16.840.1.113883.3.464.1003.198.11.1029' \n\nvalueset \"Hypercholesterolemia\": 'urn:oid:2.16.840.1.113762.1.4.1047.100' \n\nvalueset \"Diabetes\": 'urn:oid:2.16.840.1.113883.3.464.1003.103.12.1001' \n\nparameter \"Measurement Period\" Interval<DateTime>\n\ncontext Patient\n\ndefine \"SDE Ethnicity\": [\"Patient Characteristic Ethnicity\": \"Ethnicity\"]\n\ndefine \"SDE Payer\": [\"Patient Characteristic Payer\": \"Payer\"]\n\ndefine \"SDE Race\": [\"Patient Characteristic Race\": \"Race\"]\n\ndefine \"SDE Sex\": [\"Patient Characteristic Sex\": \"ONC Administrative Sex\"]\n\ndefine \"Valid Encounters\": [\"Encounter, Performed\": \"Annual Wellness Visit\"]\nunion [\"Encounter, Performed\":\"Office Visit\"]\nunion [\"Encounter, Performed\":\"Outpatient Consultation\"]\nunion [\"Encounter, Performed\":\"Outpatient Encounters for Preventive Care\"]\nunion [\"Encounter, Performed\":\"Preventive Care Services - Established Office Visit, 18 and Up\"]\nunion [\"Encounter, Performed\":\"Preventive Care Services - Other\"]\nunion [\"Encounter, Performed\":\"Preventive Care Services-Individual Counseling\"]\nunion [\"Encounter, Performed\":\"Preventive Care Services-Initial Office Visit, 18 and Up\"]\n\ndefine \"History of Clinical ASCVD Procedures\": [\"Procedure, Performed\": \"PCI\"]\n union [\"Procedure, Performed\": \"CABG Surgeries\"]\n union [\"Procedure, Performed\": \"Carotid Intervention\"]\n\ndefine \"History of Clinical ASCVD Diagnoses\": [\"Diagnosis\": \"Myocardial Infarction\"]\nunion [\"Diagnosis\": \"Cerebrovascular disease, Stroke, TIA\" ]\nunion [\"Diagnosis\": \"Atherosclerosis and Peripheral Arterial Disease\" ]\nunion [\"Diagnosis\": \"Ischemic heart disease or coronary occlusion, rupture, or thrombosis\" ]\nunion [\"Diagnosis\": \"Stable and Unstable Angina\" ]\n\ndefine \"PalliativeCare\": exists ([\"Intervention, Performed\":\"Palliative Care\"] palliative \n where palliative.relevantPeriod overlaps \"Measurement Period\")\n\ndefine \"MedsAdverse\": exists ([\"Adverse Event\": \"Statin Allergen\"] adverse\n where adverse.relevantPeriod overlaps \"Measurement Period\")\n\ndefine \"MedsAllergyIntolerance\": exists ([\"Allergy/Intolerance\": \"Statin Allergen\"] allergy\n where allergy.prevalencePeriod overlaps \"Measurement Period\")\n\ndefine \"In Demographic\": AgeInYearsAt(start of \"Measurement Period\") >= 21\n\ndefine \"Encounters During Measurement Period\": \"Valid Encounters\" Encounter\nwhere Encounter.relevantPeriod during \"Measurement Period\"\n\ndefine \"Initial Population\": \"In Demographic\" and\nexists(\"Encounters During Measurement Period\")\n\ndefine \"Denominator 1\": \"Initial Population\" and\n(\"ASCVD Diagnosis Before MP\" or\n\"ASCVD Procedure Before MP\")\n\ndefine \"ASCVD Diagnosis Before MP\": exists (\"History of Clinical ASCVD Diagnoses\" diag\nwhere diag.prevalencePeriod starts before end of \"Measurement Period\")\n\ndefine \"ASCVD Procedure Before MP\": exists (\"History of Clinical ASCVD Procedures\" proc\nwhere proc.relevantPeriod starts before end of \"Measurement Period\")\n\ndefine \"Statin Active\": [\"Medication, Active\": \"Low intensity statin therapy\"]\nunion [\"Medication, Active\": \"Moderate intensity statin therapy\"]\nunion [\"Medication, Active\": \"High intensity statin therapy\"]\n\ndefine \"Statin starts before end of MP\": \"Statin Active\" statin\nwhere statin.relevantPeriod starts before end of \"Measurement Period\" and not\n (statin.relevantPeriod ends before end of \"Measurement Period\")\n\ndefine \"Statin order\": [\"Medication, Order\": \"Low intensity statin therapy\"]\nunion [\"Medication, Order\": \"Moderate intensity statin therapy\"]\nunion [\"Medication, Order\": \"High intensity statin therapy\"]\n\ndefine \"Statin order during MP\": \"Statin order\" statin\nwhere statin.authorDatetime during \"Measurement Period\"\n\ndefine \"Numerator\": exists (\"Statin order during MP\") or\nexists (\"Statin starts before end of MP\")\n\ndefine \"LDL gte 190\": exists ([\"Laboratory Test, Performed\": \"LDL Test\"] Ldl\nwhere Ldl.result >= 190'mg/dl' and \n    Ldl.relevantPeriod starts before end of \"Measurement Period\")\n\ndefine \"Hypercholesterolemia Diagnosis\": exists ([\"Diagnosis\":\"Hypercholesterolemia\"] Hyper\n where Hyper.prevalencePeriod starts before end of \"Measurement Period\")\n\ndefine \"Denominator 2\": \"Initial Population\" and\n(\"LDL gte 190\" or\n\"Hypercholesterolemia Diagnosis\") and not \n(\"ASCVD Diagnosis Before MP\" or \n\"ASCVD Procedure Before MP\")\n\ndefine \"Pregnancy\": exists ([\"Diagnosis\": \"Pregnancy Dx\"] preg\nwhere preg.prevalencePeriod overlaps \"Measurement Period\")\n\ndefine \"Breastfeed\": exists ([\"Diagnosis\": \"Breastfeeding\"] breastfeed\nwhere breastfeed.prevalencePeriod overlaps \"Measurement Period\")\n\ndefine \"Rhabdo\": exists ([\"Diagnosis\": \"Rhabdomyolysis\"] rhabdo\n where rhabdo.prevalencePeriod overlaps \"Measurement Period\")\n\ndefine \"Denex\": \"Pregnancy\" or\n\"Breastfeed\" or\n\"Rhabdo\"\n\ndefine \"ESRD\": exists (\n [\"Diagnosis\":\"End Stage Renal Disease\"] esrd\nwhere esrd.prevalencePeriod during \"Measurement Period\")\n\ndefine \"HepA\": exists (\n [\"Diagnosis\":\"Hepatitis A\"] HepA\nwhere HepA.prevalencePeriod during \"Measurement Period\")\n\ndefine \"HepB\": exists (\n [\"Diagnosis\":\"Hepatitis B\"] HepB\nwhere HepB.prevalencePeriod during \"Measurement Period\")\n\ndefine \"Liver Disease Diagnosis\": exists (\n [\"Diagnosis\":\"Liver Disease\"] Liver\nwhere Liver.prevalencePeriod during \"Measurement Period\")\n\ndefine \"Denexcep\": \"PalliativeCare\" or\n\"ESRD\" or\n\"HepA\" or\n\"HepB\" or\n\"Liver Disease Diagnosis\" or\n\"MedsAdverse\" or\n\"MedsAllergyIntolerance\"\n\ndefine \"Age 40 to 75\": AgeInYearsAt(start of \"Measurement Period\") >=40 and\n AgeInYearsAt(start of \"Measurement Period\") <=75\n\ndefine \"Diabetes Diagnosis\": exists ([\"Diagnosis\": \"Diabetes\"] diab\n where diab.prevalencePeriod starts before end of \"Measurement Period\")\n\ndefine \"Denominator 3\": \"Initial Population\" and\n\"Diabetes Diagnosis\" and\n\"LDL 70 to 189 2 years prior\" and\n\"Age 40 to 75\" and not\n\"ASCVD Diagnosis Before MP\" and not\n\"ASCVD Procedure Before MP\" and not \n\"LDL gte 190\" and not\n\"Hypercholesterolemia Diagnosis\"\n\ndefine \"LDL between 70 and 189\": [\"Laboratory Test, Performed\": \"LDL Test\"] ldl\nwhere ldl.result < 190 'mg/dL' and ldl.result >=70 'mg/dL'\n\ndefine \"LDL 70 to 189 2 years prior\": exists (\"LDL between 70 and 189\" ldl\nwhere ldl.relevantPeriod starts 2 years before end \"Measurement Period\")\n\ndefine \"LDL in past 2 years\": [\"Laboratory Test, Performed\": \"LDL Test\"] ldl\n  where ldl.relevantPeriod starts 2 years before start \"Measurement Period\"   and ldl.result is not null\n  sort by start of ldl.relevantPeriod\n\ndefine \"LDL lt 70\": exists ({\n \"Most recent LDL\" recldl\n  where recldl.result <70 'mg/dL'\n })\n\ndefine \"Most recent LDL\": Last (\"LDL in past 2 years\")\n\ndefine \"Denexcep Den3\": \"PalliativeCare\" or\n\"ESRD\" or\n\"HepA\" or\n\"HepB\" or\n\"Liver Disease Diagnosis\" or\n\"MedsAdverse\" or\n\"MedsAllergyIntolerance\" or\n\"LDL lt 70\"\n\n"
  ],
  "cql_statement_dependencies": {
    "StatinTherapy": {
      "Patient": [

      ],
      "SDE Ethnicity": [

      ],
      "SDE Payer": [

      ],
      "SDE Race": [

      ],
      "SDE Sex": [

      ],
      "Valid Encounters": [

      ],
      "History of Clinical ASCVD Procedures": [

      ],
      "History of Clinical ASCVD Diagnoses": [

      ],
      "PalliativeCare": [

      ],
      "MedsAdverse": [

      ],
      "MedsAllergyIntolerance": [

      ],
      "In Demographic": [

      ],
      "Encounters During Measurement Period": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Valid Encounters"
        }
      ],
      "Initial Population": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "In Demographic"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Encounters During Measurement Period"
        }
      ],
      "ASCVD Diagnosis Before MP": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "History of Clinical ASCVD Diagnoses"
        }
      ],
      "ASCVD Procedure Before MP": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "History of Clinical ASCVD Procedures"
        }
      ],
      "Denominator 1": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Initial Population"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Diagnosis Before MP"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Procedure Before MP"
        }
      ],
      "Statin Active": [

      ],
      "Statin starts before end of MP": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Statin Active"
        }
      ],
      "Statin order": [

      ],
      "Statin order during MP": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Statin order"
        }
      ],
      "Numerator": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Statin order during MP"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Statin starts before end of MP"
        }
      ],
      "LDL gte 190": [

      ],
      "Hypercholesterolemia Diagnosis": [

      ],
      "Denominator 2": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Initial Population"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "LDL gte 190"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Hypercholesterolemia Diagnosis"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Diagnosis Before MP"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Procedure Before MP"
        }
      ],
      "Pregnancy": [

      ],
      "Breastfeed": [

      ],
      "Rhabdo": [

      ],
      "Denex": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Pregnancy"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Breastfeed"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Rhabdo"
        }
      ],
      "ESRD": [

      ],
      "HepA": [

      ],
      "HepB": [

      ],
      "Liver Disease Diagnosis": [

      ],
      "Denexcep": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "PalliativeCare"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ESRD"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "HepA"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "HepB"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Liver Disease Diagnosis"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "MedsAdverse"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "MedsAllergyIntolerance"
        }
      ],
      "Age 40 to 75": [

      ],
      "Diabetes Diagnosis": [

      ],
      "LDL between 70 and 189": [

      ],
      "LDL 70 to 189 2 years prior": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "LDL between 70 and 189"
        }
      ],
      "Denominator 3": [
        {
          "library_name": "StatinTherapy",
          "statement_name": "Initial Population"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Diabetes Diagnosis"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "LDL 70 to 189 2 years prior"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Age 40 to 75"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Diagnosis Before MP"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "ASCVD Procedure Before MP"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "LDL gte 190"
        },
        {
          "library_name": "StatinTherapy",
          "statement_name": "Hypercholesterolemia Diagnosis"
        }
      ],
      "LDL in past 2 years": [

      ],
      "Most recent LDL": [

      ],
      "LDL lt 70": [

      ],
      "Denexcep Den3": [

      ]
    }
  },
  "created_at": "2017-07-25T21:24:18.149Z",
  "data_criteria": {
    "OutpatientConsultation_EncounterPerformed_9ebfeb54_36bd_40c2_a5bb_f4161353fddb": {
      "title": "Outpatient Consultation",
      "description": "Encounter, Performed: Outpatient Consultation",
      "code_list_id": "2.16.840.1.113883.3.464.1003.101.11.1040",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "OutpatientConsultation_EncounterPerformed_9ebfeb54_36bd_40c2_a5bb_f4161353fddb_source",
      "variable": false
    },
    "StatinAllergen_AdverseEvent_0642c70a_9e54_4d5a_804a_e04b123dc75e": {
      "title": "Statin Allergen",
      "description": "Adverse Event: Statin Allergen",
      "code_list_id": "2.16.840.1.113883.3.117.1.7.1.423",
      "type": "adverse_events",
      "definition": "adverse_event",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "StatinAllergen_AdverseEvent_0642c70a_9e54_4d5a_804a_e04b123dc75e_source",
      "variable": false
    },
    "StatinAllergen_Allergy_Intolerance_0642c70a_9e54_4d5a_804a_e04b123dc75e": {
      "title": "Statin Allergen",
      "description": "Allergy/Intolerance: Statin Allergen",
      "code_list_id": "2.16.840.1.113883.3.117.1.7.1.423",
      "type": "allergies_intolerances",
      "definition": "allergy_intolerance",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "StatinAllergen_Allergy_Intolerance_0642c70a_9e54_4d5a_804a_e04b123dc75e_source",
      "variable": false
    },
    "PalliativeCare_InterventionPerformed_80ca46ce_4c01_4cf8_aad4_edb8fbe47284": {
      "title": "Palliative Care",
      "description": "Intervention, Performed: Palliative Care",
      "code_list_id": "2.16.840.1.113883.3.600.1.1579",
      "type": "interventions",
      "definition": "intervention",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "PalliativeCare_InterventionPerformed_80ca46ce_4c01_4cf8_aad4_edb8fbe47284_source",
      "variable": false
    },
    "OutpatientEncountersforPreventiveCare_EncounterPerformed_150ee4c2_83cd_46ac_9fe5_ec238c453762": {
      "title": "Outpatient Encounters for Preventive Care",
      "description": "Encounter, Performed: Outpatient Encounters for Preventive Care",
      "code_list_id": "2.16.840.1.113762.1.4.1047.9",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "OutpatientEncountersforPreventiveCare_EncounterPerformed_150ee4c2_83cd_46ac_9fe5_ec238c453762_source",
      "variable": false
    },
    "Rhabdomyolysis_Diagnosis_9173182c_585b_48d4_bd4b_c93bb558816e": {
      "title": "Rhabdomyolysis",
      "description": "Diagnosis: Rhabdomyolysis",
      "code_list_id": "2.16.840.1.113762.1.4.1047.102",
      "type": "conditions",
      "definition": "diagnosis",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "Rhabdomyolysis_Diagnosis_9173182c_585b_48d4_bd4b_c93bb558816e_source",
      "variable": false
    },
    "PreventiveCareServices_EstablishedOfficeVisit18andUp_EncounterPerformed_87a31d70_68ba_40af_8490_0b31b3b09f9a": {
      "title": "Preventive Care Services - Established Office Visit, 18 and Up",
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    },
    "Ethnicity_PatientCharacteristicEthnicity_faad2452_237e_426a_899c_6d6817eb4ae9": {
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                        "value": [
                          "define ",
                          "\"LDL lt 70\"",
                          ": "
                        ]
                      },
                      {
                        "r": "408",
                        "s": [
                          {
                            "value": [
                              "exists "
                            ]
                          },
                          {
                            "r": "407",
                            "s": [
                              {
                                "value": [
                                  "("
                                ]
                              },
                              {
                                "r": "407",
                                "s": [
                                  {
                                    "value": [
                                      "{\n "
                                    ]
                                  },
                                  {
                                    "r": "406",
                                    "s": [
                                      {
                                        "s": [
                                          {
                                            "r": "400",
                                            "s": [
                                              {
                                                "r": "399",
                                                "s": [
                                                  {
                                                    "s": [
                                                      {
                                                        "value": [
                                                          "\"Most recent LDL\""
                                                        ]
                                                      }
                                                    ]
                                                  }
                                                ]
                                              },
                                              {
                                                "value": [
                                                  " ",
                                                  "recldl"
                                                ]
                                              }
                                            ]
                                          }
                                        ]
                                      },
                                      {
                                        "value": [
                                          "\n  "
                                        ]
                                      },
                                      {
                                        "r": "405",
                                        "s": [
                                          {
                                            "value": [
                                              "where "
                                            ]
                                          },
                                          {
                                            "r": "404",
                                            "s": [
                                              {
                                                "r": "402",
                                                "s": [
                                                  {
                                                    "r": "401",
                                                    "s": [
                                                      {
                                                        "value": [
                                                          "recldl"
                                                        ]
                                                      }
                                                    ]
                                                  },
                                                  {
                                                    "value": [
                                                      "."
                                                    ]
                                                  },
                                                  {
                                                    "r": "402",
                                                    "s": [
                                                      {
                                                        "value": [
                                                          "result"
                                                        ]
                                                      }
                                                    ]
                                                  }
                                                ]
                                              },
                                              {
                                                "value": [
                                                  " ",
                                                  "<"
                                                ]
                                              },
                                              {
                                                "r": "403",
                                                "s": [
                                                  {
                                                    "value": [
                                                      "70 ",
                                                      "'mg/dL'"
                                                    ]
                                                  }
                                                ]
                                              }
                                            ]
                                          }
                                        ]
                                      }
                                    ]
                                  },
                                  {
                                    "value": [
                                      "\n }"
                                    ]
                                  }
                                ]
                              },
                              {
                                "value": [
                                  ")"
                                ]
                              }
                            ]
                          }
                        ]
                      }
                    ]
                  }
                }
              ],
              "expression": {
                "localId": "408",
                "type": "Null"
              }
            },
            {
              "localId": "425",
              "name": "Denexcep Den3",
              "context": "Patient",
              "accessLevel": "Public",
              "annotation": [
                {
                  "type": "Annotation",
                  "s": {
                    "r": "425",
                    "s": [
                      {
                        "value": [
                          "define ",
                          "\"Denexcep Den3\"",
                          ": "
                        ]
                      },
                      {
                        "r": "424",
                        "s": [
                          {
                            "r": "422",
                            "s": [
                              {
                                "r": "420",
                                "s": [
                                  {
                                    "r": "418",
                                    "s": [
                                      {
                                        "r": "416",
                                        "s": [
                                          {
                                            "r": "414",
                                            "s": [
                                              {
                                                "r": "412",
                                                "s": [
                                                  {
                                                    "r": "410",
                                                    "s": [
                                                      {
                                                        "value": [
                                                          "\"PalliativeCare\""
                                                        ]
                                                      }
                                                    ]
                                                  },
                                                  {
                                                    "value": [
                                                      " or\n"
                                                    ]
                                                  },
                                                  {
                                                    "r": "411",
                                                    "s": [
                                                      {
                                                        "value": [
                                                          "\"ESRD\""
                                                        ]
                                                      }
                                                    ]
                                                  }
                                                ]
                                              },
                                              {
                                                "value": [
                                                  " or\n"
                                                ]
                                              },
                                              {
                                                "r": "413",
                                                "s": [
                                                  {
                                                    "value": [
                                                      "\"HepA\""
                                                    ]
                                                  }
                                                ]
                                              }
                                            ]
                                          },
                                          {
                                            "value": [
                                              " or\n"
                                            ]
                                          },
                                          {
                                            "r": "415",
                                            "s": [
                                              {
                                                "value": [
                                                  "\"HepB\""
                                                ]
                                              }
                                            ]
                                          }
                                        ]
                                      },
                                      {
                                        "value": [
                                          " or\n"
                                        ]
                                      },
                                      {
                                        "r": "417",
                                        "s": [
                                          {
                                            "value": [
                                              "\"Liver Disease Diagnosis\""
                                            ]
                                          }
                                        ]
                                      }
                                    ]
                                  },
                                  {
                                    "value": [
                                      " or\n"
                                    ]
                                  },
                                  {
                                    "r": "419",
                                    "s": [
                                      {
                                        "value": [
                                          "\"MedsAdverse\""
                                        ]
                                      }
                                    ]
                                  }
                                ]
                              },
                              {
                                "value": [
                                  " or\n"
                                ]
                              },
                              {
                                "r": "421",
                                "s": [
                                  {
                                    "value": [
                                      "\"MedsAllergyIntolerance\""
                                    ]
                                  }
                                ]
                              }
                            ]
                          },
                          {
                            "value": [
                              " or\n"
                            ]
                          },
                          {
                            "r": "423",
                            "s": [
                              {
                                "value": [
                                  "\"LDL lt 70\""
                                ]
                              }
                            ]
                          }
                        ]
                      }
                    ]
                  }
                }
              ],
              "expression": {
                "localId": "424",
                "type": "Null"
              }
            }
          ]
        }
      }
    }
  ],
  "elm_annotations": {
    "StatinTherapy": {
      "statements": [
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"SDE Ethnicity\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Ethnicity\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Ethnicity\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": " ]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "40"
                }
              ],
              "ref_id": "41"
            }
          ],
          "define_name": "SDE Ethnicity"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"SDE Payer\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Payer\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Payer\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": " ]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "42"
                }
              ],
              "ref_id": "43"
            }
          ],
          "define_name": "SDE Payer"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"SDE Race\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Race\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Race\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": " ]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "44"
                }
              ],
              "ref_id": "45"
            }
          ],
          "define_name": "SDE Race"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"SDE Sex\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "[\"Patient Characteristic Sex\": "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"ONC Administrative Sex\""
                            }
                          ]
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": " ]"
                        }
                      ]
                    }
                  ],
                  "node_type": "Retrieve",
                  "ref_id": "46"
                }
              ],
              "ref_id": "47"
            }
          ],
          "define_name": "SDE Sex"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Valid Encounters\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "[\"Encounter, Performed\": "
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": "\"Annual Wellness Visit\""
                                                        }
                                                      ]
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": " ]"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "48"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "\nunion "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "[\"Encounter, Performed\":"
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "children": [
                                                        {
                                                          "text": " \"Office Visit\""
                                                        }
                                                      ]
                                                    }
                                                  ]
                                                },
                                                {
                                                  "children": [
                                                    {
                                                      "text": " ]"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Retrieve",
                                              "ref_id": "49"
                                            }
                                          ],
                                          "node_type": "Union",
                                          "ref_id": "50"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "\nunion "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Encounter, Performed\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Outpatient Consultation\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "51"
                                        }
                                      ],
                                      "node_type": "Union",
                                      "ref_id": "52"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "\nunion "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "[\"Encounter, Performed\":"
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " \"Outpatient Encounters for Preventive Care\""
                                                }
                                              ]
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " ]"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "53"
                                    }
                                  ],
                                  "node_type": "Union",
                                  "ref_id": "54"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\nunion "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Encounter, Performed\":"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": " \"Preventive Care Services - Established Office Visit, 18 and Up\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "55"
                                }
                              ],
                              "node_type": "Union",
                              "ref_id": "56"
                            },
                            {
                              "children": [
                                {
                                  "text": "\nunion "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "[\"Encounter, Performed\":"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": " \"Preventive Care Services - Other\""
                                        }
                                      ]
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "text": " ]"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "57"
                            }
                          ],
                          "node_type": "Union",
                          "ref_id": "58"
                        },
                        {
                          "children": [
                            {
                              "text": "\nunion "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Encounter, Performed\":"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " \"Preventive Care Services-Individual Counseling\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "59"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "60"
                    },
                    {
                      "children": [
                        {
                          "text": "\nunion "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Encounter, Performed\":"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": " \"Preventive Care Services-Initial Office Visit, 18 and Up\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": " ]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "61"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "62"
                }
              ],
              "ref_id": "63"
            }
          ],
          "define_name": "Valid Encounters"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"History of Clinical ASCVD Procedures\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Procedure, Performed\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"PCI\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "64"
                        },
                        {
                          "children": [
                            {
                              "text": "\n union "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Procedure, Performed\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"CABG Surgeries\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "65"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "66"
                    },
                    {
                      "children": [
                        {
                          "text": "\n union "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Procedure, Performed\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Carotid Intervention\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": " ]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "67"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "68"
                }
              ],
              "ref_id": "69"
            }
          ],
          "define_name": "History of Clinical ASCVD Procedures"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"History of Clinical ASCVD Diagnoses\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Diagnosis\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Myocardial Infarction\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "70"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "\nunion "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Diagnosis\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Cerebrovascular disease, Stroke, TIA\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "71"
                                }
                              ],
                              "node_type": "Union",
                              "ref_id": "72"
                            },
                            {
                              "children": [
                                {
                                  "text": "\nunion "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "[\"Diagnosis\": "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Atherosclerosis and Peripheral Arterial Disease\""
                                        }
                                      ]
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "text": " ]"
                                    }
                                  ]
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "73"
                            }
                          ],
                          "node_type": "Union",
                          "ref_id": "74"
                        },
                        {
                          "children": [
                            {
                              "text": "\nunion "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Diagnosis\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Ischemic heart disease or coronary occlusion, rupture, or thrombosis\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "75"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "76"
                    },
                    {
                      "children": [
                        {
                          "text": "\nunion "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Diagnosis\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Stable and Unstable Angina\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": " ]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "77"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "78"
                }
              ],
              "ref_id": "79"
            }
          ],
          "define_name": "History of Clinical ASCVD Diagnoses"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"PalliativeCare\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Intervention, Performed\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Palliative Care\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "80"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "80"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " palliative"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "81"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " \n "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "palliative"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "82"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "relevantPeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "83"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "83"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "84"
                                    }
                                  ],
                                  "ref_id": "85"
                                }
                              ],
                              "ref_id": "85"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "86"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "86"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "87"
                }
              ],
              "ref_id": "88"
            }
          ],
          "define_name": "PalliativeCare"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"MedsAdverse\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Adverse Event\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Statin Allergen\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "89"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "89"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " adverse"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "90"
                                }
                              ]
                            },
                            {
                              "children": [

                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "adverse"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "91"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "relevantPeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "92"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "92"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "93"
                                    }
                                  ],
                                  "ref_id": "94"
                                }
                              ],
                              "ref_id": "94"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "95"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "95"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "96"
                }
              ],
              "ref_id": "97"
            }
          ],
          "define_name": "MedsAdverse"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"MedsAllergyIntolerance\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Allergy/Intolerance\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Statin Allergen\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "98"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "98"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " allergy"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "99"
                                }
                              ]
                            },
                            {
                              "children": [

                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "allergy"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "100"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "101"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "101"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "102"
                                    }
                                  ],
                                  "ref_id": "103"
                                }
                              ],
                              "ref_id": "103"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "104"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "104"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "105"
                }
              ],
              "ref_id": "106"
            }
          ],
          "define_name": "MedsAllergyIntolerance"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"In Demographic\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "AgeInYearsAt("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": " start of "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "107"
                            }
                          ],
                          "node_type": "Start",
                          "ref_id": "108"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "CalculateAgeAt",
                      "ref_id": "109"
                    },
                    {
                      "children": [
                        {
                          "text": " &gt;= 21"
                        }
                      ]
                    }
                  ],
                  "node_type": "GreaterOrEqual",
                  "ref_id": "111"
                }
              ],
              "ref_id": "112"
            }
          ],
          "define_name": "In Demographic"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Encounters During Measurement Period\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Valid Encounters\""
                                        }
                                      ]
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "113"
                            },
                            {
                              "children": [
                                {
                                  "text": " Encounter"
                                }
                              ]
                            }
                          ],
                          "ref_id": "114"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "Encounter"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "115"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "relevantPeriod"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "116"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "116"
                            },
                            {
                              "children": [
                                {
                                  "text": " during "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "117"
                            }
                          ],
                          "ref_id": "118"
                        }
                      ],
                      "ref_id": "118"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "119"
                }
              ],
              "ref_id": "120"
            }
          ],
          "define_name": "Encounters During Measurement Period"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Initial Population\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"In Demographic\""
                            }
                          ]
                        }
                      ],
                      "node_type": "ExpressionRef",
                      "ref_id": "121"
                    },
                    {
                      "children": [
                        {
                          "text": " and\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "exists"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": " ("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " \"Encounters During Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "122"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "122"
                        }
                      ],
                      "node_type": "Exists",
                      "ref_id": "123"
                    }
                  ],
                  "node_type": "And",
                  "ref_id": "124"
                }
              ],
              "ref_id": "125"
            }
          ],
          "define_name": "Initial Population"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"ASCVD Diagnosis Before MP\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " \"History of Clinical ASCVD Diagnoses\""
                                                }
                                              ]
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "127"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " diag"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "128"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "diag"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "129"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "130"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "130"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " starts before "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "end of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Measurement Period\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ParameterRef",
                                          "ref_id": "131"
                                        }
                                      ],
                                      "node_type": "End",
                                      "ref_id": "132"
                                    }
                                  ],
                                  "ref_id": "133"
                                }
                              ],
                              "ref_id": "133"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "134"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "134"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "135"
                }
              ],
              "ref_id": "136"
            }
          ],
          "define_name": "ASCVD Diagnosis Before MP"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"ASCVD Procedure Before MP\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " \"History of Clinical ASCVD Procedures\""
                                                }
                                              ]
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "138"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " proc"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "139"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "proc"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "140"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "relevantPeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "141"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "141"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " starts before "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "end of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Measurement Period\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ParameterRef",
                                          "ref_id": "142"
                                        }
                                      ],
                                      "node_type": "End",
                                      "ref_id": "143"
                                    }
                                  ],
                                  "ref_id": "144"
                                }
                              ],
                              "ref_id": "144"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "145"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "145"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "146"
                }
              ],
              "ref_id": "147"
            }
          ],
          "define_name": "ASCVD Procedure Before MP"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denominator 1\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Initial Population\""
                            }
                          ]
                        }
                      ],
                      "node_type": "ExpressionRef",
                      "ref_id": "126"
                    },
                    {
                      "children": [
                        {
                          "text": " and\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " \"ASCVD Diagnosis Before MP\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "137"
                            },
                            {
                              "children": [
                                {
                                  "text": " or\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"ASCVD Procedure Before MP\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "148"
                            }
                          ],
                          "node_type": "Or",
                          "ref_id": "149"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Or",
                      "ref_id": "149"
                    }
                  ],
                  "node_type": "And",
                  "ref_id": "150"
                }
              ],
              "ref_id": "151"
            }
          ],
          "define_name": "Denominator 1"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Statin Active\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Medication, Active\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Low intensity statin therapy\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "152"
                        },
                        {
                          "children": [
                            {
                              "text": "\nunion "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Medication, Active\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Moderate intensity statin therapy\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "153"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "154"
                    },
                    {
                      "children": [
                        {
                          "text": "\nunion "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Medication, Active\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"High intensity statin therapy\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": " ]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "155"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "156"
                }
              ],
              "ref_id": "157"
            }
          ],
          "define_name": "Statin Active"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Statin starts before end of MP\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Statin Active\""
                                        }
                                      ]
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "158"
                            },
                            {
                              "children": [
                                {
                                  "text": " statin"
                                }
                              ]
                            }
                          ],
                          "ref_id": "159"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "statin"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "160"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "relevantPeriod"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "161"
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "161"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " starts before "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "end of "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "162"
                                    }
                                  ],
                                  "node_type": "End",
                                  "ref_id": "163"
                                }
                              ],
                              "node_type": "Before",
                              "ref_id": "164"
                            },
                            {
                              "children": [
                                {
                                  "text": " and "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "not\n "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "("
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " statin"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "165"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "relevantPeriod"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Property",
                                              "ref_id": "166"
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "166"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " ends before "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "end of "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Measurement Period\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ParameterRef",
                                              "ref_id": "167"
                                            }
                                          ],
                                          "node_type": "End",
                                          "ref_id": "168"
                                        }
                                      ],
                                      "node_type": "Before",
                                      "ref_id": "169"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " )"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Before",
                                  "ref_id": "169"
                                }
                              ],
                              "node_type": "Not",
                              "ref_id": "170"
                            }
                          ],
                          "ref_id": "171"
                        }
                      ],
                      "ref_id": "171"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "172"
                }
              ],
              "ref_id": "173"
            }
          ],
          "define_name": "Statin starts before end of MP"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Statin order\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Medication, Order\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Low intensity statin therapy\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "174"
                        },
                        {
                          "children": [
                            {
                              "text": "\nunion "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "[\"Medication, Order\": "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Moderate intensity statin therapy\""
                                    }
                                  ]
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": " ]"
                                }
                              ]
                            }
                          ],
                          "node_type": "Retrieve",
                          "ref_id": "175"
                        }
                      ],
                      "node_type": "Union",
                      "ref_id": "176"
                    },
                    {
                      "children": [
                        {
                          "text": "\nunion "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "[\"Medication, Order\": "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"High intensity statin therapy\""
                                }
                              ]
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "text": " ]"
                            }
                          ]
                        }
                      ],
                      "node_type": "Retrieve",
                      "ref_id": "177"
                    }
                  ],
                  "node_type": "Union",
                  "ref_id": "178"
                }
              ],
              "ref_id": "179"
            }
          ],
          "define_name": "Statin order"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Statin order during MP\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Statin order\""
                                        }
                                      ]
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "180"
                            },
                            {
                              "children": [
                                {
                                  "text": " statin"
                                }
                              ]
                            }
                          ],
                          "ref_id": "181"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "statin"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "182"
                                },
                                {
                                  "children": [
                                    {
                                      "text": "."
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "authorDatetime"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "183"
                                }
                              ],
                              "node_type": "Property",
                              "ref_id": "183"
                            },
                            {
                              "children": [
                                {
                                  "text": " during "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Measurement Period\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ParameterRef",
                              "ref_id": "184"
                            }
                          ],
                          "ref_id": "185"
                        }
                      ],
                      "ref_id": "185"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "186"
                }
              ],
              "ref_id": "187"
            }
          ],
          "define_name": "Statin order during MP"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Numerator\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "exists "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " \"Statin order during MP\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "188"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "188"
                        }
                      ],
                      "node_type": "Exists",
                      "ref_id": "189"
                    },
                    {
                      "children": [
                        {
                          "text": " or\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "exists "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " \"Statin starts before end of MP\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "190"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "190"
                        }
                      ],
                      "node_type": "Exists",
                      "ref_id": "191"
                    }
                  ],
                  "node_type": "Or",
                  "ref_id": "192"
                }
              ],
              "ref_id": "193"
            }
          ],
          "define_name": "Numerator"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"LDL gte 190\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Laboratory Test, Performed\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"LDL Test\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "194"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "194"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " Ldl"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "195"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "Ldl"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "196"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "result"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Property",
                                              "ref_id": "197"
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "197"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " &gt;= "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "190'mg/dl'"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Quantity",
                                          "ref_id": "198"
                                        }
                                      ],
                                      "node_type": "GreaterOrEqual",
                                      "ref_id": "199"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " and \n    "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "Ldl"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "200"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "relevantPeriod"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "Property",
                                              "ref_id": "201"
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "201"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " starts before "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "end of "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Measurement Period\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ParameterRef",
                                              "ref_id": "202"
                                            }
                                          ],
                                          "node_type": "End",
                                          "ref_id": "203"
                                        }
                                      ],
                                      "node_type": "Before",
                                      "ref_id": "204"
                                    }
                                  ],
                                  "ref_id": "205"
                                }
                              ],
                              "ref_id": "205"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "206"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "206"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "207"
                }
              ],
              "ref_id": "208"
            }
          ],
          "define_name": "LDL gte 190"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Hypercholesterolemia Diagnosis\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Diagnosis\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Hypercholesterolemia\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "209"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "209"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " Hyper"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "210"
                                }
                              ]
                            },
                            {
                              "children": [

                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "Hyper"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "211"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "212"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "212"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " starts before "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "end of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Measurement Period\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ParameterRef",
                                          "ref_id": "213"
                                        }
                                      ],
                                      "node_type": "End",
                                      "ref_id": "214"
                                    }
                                  ],
                                  "ref_id": "215"
                                }
                              ],
                              "ref_id": "215"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "216"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "216"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "217"
                }
              ],
              "ref_id": "218"
            }
          ],
          "define_name": "Hypercholesterolemia Diagnosis"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denominator 2\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Initial Population\""
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "219"
                        },
                        {
                          "children": [
                            {
                              "text": " and\n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": " \"LDL gte 190\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "220"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " or\n"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Hypercholesterolemia Diagnosis\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "221"
                                }
                              ],
                              "node_type": "Or",
                              "ref_id": "222"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "Or",
                          "ref_id": "222"
                        }
                      ],
                      "node_type": "And",
                      "ref_id": "223"
                    },
                    {
                      "children": [
                        {
                          "text": " and "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "not \n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": " \"ASCVD Diagnosis Before MP\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "224"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " or \n"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"ASCVD Procedure Before MP\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "225"
                                }
                              ],
                              "node_type": "Or",
                              "ref_id": "226"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "Or",
                          "ref_id": "226"
                        }
                      ],
                      "node_type": "Not",
                      "ref_id": "227"
                    }
                  ],
                  "node_type": "And",
                  "ref_id": "228"
                }
              ],
              "ref_id": "229"
            }
          ],
          "define_name": "Denominator 2"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Pregnancy\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Diagnosis\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Pregnancy Dx\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "230"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "230"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " preg"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "231"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "preg"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "232"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "233"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "233"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "234"
                                    }
                                  ],
                                  "ref_id": "235"
                                }
                              ],
                              "ref_id": "235"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "236"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "236"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "237"
                }
              ],
              "ref_id": "238"
            }
          ],
          "define_name": "Pregnancy"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Breastfeed\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Diagnosis\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Breastfeeding\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "239"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "239"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " breastfeed"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "240"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "breastfeed"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "241"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "242"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "242"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "243"
                                    }
                                  ],
                                  "ref_id": "244"
                                }
                              ],
                              "ref_id": "244"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "245"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "245"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "246"
                }
              ],
              "ref_id": "247"
            }
          ],
          "define_name": "Breastfeed"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Rhabdo\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " [\"Diagnosis\": "
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Rhabdomyolysis\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "248"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "248"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " rhabdo"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "249"
                                }
                              ]
                            },
                            {
                              "children": [

                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "rhabdo"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "250"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "251"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "251"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " overlaps "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "252"
                                    }
                                  ],
                                  "ref_id": "253"
                                }
                              ],
                              "ref_id": "253"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "254"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "254"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "255"
                }
              ],
              "ref_id": "256"
            }
          ],
          "define_name": "Rhabdo"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denex\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Pregnancy\""
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "257"
                        },
                        {
                          "children": [
                            {
                              "text": " or\n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Breastfeed\""
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "258"
                        }
                      ],
                      "node_type": "Or",
                      "ref_id": "259"
                    },
                    {
                      "children": [
                        {
                          "text": " or\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"Rhabdo\""
                            }
                          ]
                        }
                      ],
                      "node_type": "ExpressionRef",
                      "ref_id": "260"
                    }
                  ],
                  "node_type": "Or",
                  "ref_id": "261"
                }
              ],
              "ref_id": "262"
            }
          ],
          "define_name": "Denex"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"ESRD\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "(\n "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Diagnosis\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"End Stage Renal Disease\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "263"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "263"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " esrd"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "264"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "esrd"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "265"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "266"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "266"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " during "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "267"
                                    }
                                  ],
                                  "ref_id": "268"
                                }
                              ],
                              "ref_id": "268"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "269"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "269"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "270"
                }
              ],
              "ref_id": "271"
            }
          ],
          "define_name": "ESRD"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"HepA\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "(\n "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Diagnosis\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Hepatitis A\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "272"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "272"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " HepA"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "273"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "HepA"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "274"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "275"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "275"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " during "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "276"
                                    }
                                  ],
                                  "ref_id": "277"
                                }
                              ],
                              "ref_id": "277"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "278"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "278"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "279"
                }
              ],
              "ref_id": "280"
            }
          ],
          "define_name": "HepA"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"HepB\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "(\n "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Diagnosis\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Hepatitis B\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "281"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "281"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " HepB"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "282"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "HepB"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "283"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "284"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "284"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " during "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "285"
                                    }
                                  ],
                                  "ref_id": "286"
                                }
                              ],
                              "ref_id": "286"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "287"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "287"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "288"
                }
              ],
              "ref_id": "289"
            }
          ],
          "define_name": "HepB"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Liver Disease Diagnosis\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "(\n "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "[\"Diagnosis\":"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": " \"Liver Disease\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " ]"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Retrieve",
                                          "ref_id": "290"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "290"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " Liver"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "291"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "Liver"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "292"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "293"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "293"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " during "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "294"
                                    }
                                  ],
                                  "ref_id": "295"
                                }
                              ],
                              "ref_id": "295"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "296"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "296"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "297"
                }
              ],
              "ref_id": "298"
            }
          ],
          "define_name": "Liver Disease Diagnosis"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denexcep\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"PalliativeCare\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ExpressionRef",
                                          "ref_id": "299"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " or\n"
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"ESRD\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ExpressionRef",
                                          "ref_id": "300"
                                        }
                                      ],
                                      "node_type": "Or",
                                      "ref_id": "301"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " or\n"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"HepA\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "302"
                                    }
                                  ],
                                  "node_type": "Or",
                                  "ref_id": "303"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " or\n"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"HepB\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "304"
                                }
                              ],
                              "node_type": "Or",
                              "ref_id": "305"
                            },
                            {
                              "children": [
                                {
                                  "text": " or\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"Liver Disease Diagnosis\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "306"
                            }
                          ],
                          "node_type": "Or",
                          "ref_id": "307"
                        },
                        {
                          "children": [
                            {
                              "text": " or\n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"MedsAdverse\""
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "308"
                        }
                      ],
                      "node_type": "Or",
                      "ref_id": "309"
                    },
                    {
                      "children": [
                        {
                          "text": " or\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"MedsAllergyIntolerance\""
                            }
                          ]
                        }
                      ],
                      "node_type": "ExpressionRef",
                      "ref_id": "310"
                    }
                  ],
                  "node_type": "Or",
                  "ref_id": "311"
                }
              ],
              "ref_id": "312"
            }
          ],
          "define_name": "Denexcep"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Age 40 to 75\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "AgeInYearsAt("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " start of "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Measurement Period\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ParameterRef",
                                  "ref_id": "313"
                                }
                              ],
                              "node_type": "Start",
                              "ref_id": "314"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "CalculateAgeAt",
                          "ref_id": "315"
                        },
                        {
                          "children": [
                            {
                              "text": " &gt;=40"
                            }
                          ]
                        }
                      ],
                      "node_type": "GreaterOrEqual",
                      "ref_id": "317"
                    },
                    {
                      "children": [
                        {
                          "text": " and\n "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "AgeInYearsAt("
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " start of "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Measurement Period\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ParameterRef",
                                  "ref_id": "318"
                                }
                              ],
                              "node_type": "Start",
                              "ref_id": "319"
                            },
                            {
                              "children": [
                                {
                                  "text": " )"
                                }
                              ]
                            }
                          ],
                          "node_type": "CalculateAgeAt",
                          "ref_id": "320"
                        },
                        {
                          "children": [
                            {
                              "text": " &lt;=75"
                            }
                          ]
                        }
                      ],
                      "node_type": "LessOrEqual",
                      "ref_id": "322"
                    }
                  ],
                  "node_type": "And",
                  "ref_id": "323"
                }
              ],
              "ref_id": "324"
            }
          ],
          "define_name": "Age 40 to 75"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Diabetes Diagnosis\": "
                    }
                  ]
                },
                {
                  "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": "325"
                                        }
                                      ],
                                      "node_type": "Retrieve",
                                      "ref_id": "325"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " diab"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "326"
                                }
                              ]
                            },
                            {
                              "children": [

                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": " where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "diab"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "327"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "prevalencePeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "328"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "328"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " starts before "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "end of "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"Measurement Period\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ParameterRef",
                                          "ref_id": "329"
                                        }
                                      ],
                                      "node_type": "End",
                                      "ref_id": "330"
                                    }
                                  ],
                                  "ref_id": "331"
                                }
                              ],
                              "ref_id": "331"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "332"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "332"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "333"
                }
              ],
              "ref_id": "334"
            }
          ],
          "define_name": "Diabetes Diagnosis"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"LDL between 70 and 189\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Laboratory Test, Performed\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"LDL Test\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ]"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Retrieve",
                                  "ref_id": "338"
                                }
                              ],
                              "node_type": "Retrieve",
                              "ref_id": "338"
                            },
                            {
                              "children": [
                                {
                                  "text": " ldl"
                                }
                              ]
                            }
                          ],
                          "ref_id": "339"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "text": "\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "ldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "340"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "result"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "341"
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "341"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " &lt; "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "190 'mg/dL'"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Quantity",
                                  "ref_id": "342"
                                }
                              ],
                              "node_type": "Less",
                              "ref_id": "343"
                            },
                            {
                              "children": [
                                {
                                  "text": " and "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "ldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "344"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "result"
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "345"
                                    }
                                  ],
                                  "node_type": "Property",
                                  "ref_id": "345"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " &gt;="
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": " 70 'mg/dL'"
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "Quantity",
                                  "ref_id": "346"
                                }
                              ],
                              "node_type": "GreaterOrEqual",
                              "ref_id": "347"
                            }
                          ],
                          "ref_id": "348"
                        }
                      ],
                      "ref_id": "348"
                    }
                  ],
                  "node_type": "Query",
                  "ref_id": "349"
                }
              ],
              "ref_id": "350"
            }
          ],
          "define_name": "LDL between 70 and 189"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"LDL 70 to 189 2 years prior\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " \"LDL between 70 and 189\""
                                                }
                                              ]
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "351"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ldl"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "352"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "text": "\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "where "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "ldl"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "353"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": "."
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "relevantPeriod"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Property",
                                          "ref_id": "354"
                                        }
                                      ],
                                      "node_type": "Property",
                                      "ref_id": "354"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "starts "
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "2 years"
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "Quantity",
                                          "ref_id": "356"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " before end"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "357"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Measurement Period\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ParameterRef",
                                      "ref_id": "355"
                                    }
                                  ],
                                  "ref_id": "357"
                                }
                              ],
                              "ref_id": "357"
                            }
                          ],
                          "node_type": "Query",
                          "ref_id": "358"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "node_type": "Query",
                      "ref_id": "358"
                    }
                  ],
                  "node_type": "Exists",
                  "ref_id": "359"
                }
              ],
              "ref_id": "360"
            }
          ],
          "define_name": "LDL 70 to 189 2 years prior"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denominator 3\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Initial Population\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ExpressionRef",
                                              "ref_id": "335"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " and\n"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Diabetes Diagnosis\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "node_type": "ExpressionRef",
                                              "ref_id": "336"
                                            }
                                          ],
                                          "node_type": "And",
                                          "ref_id": "337"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " and\n"
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"LDL 70 to 189 2 years prior\""
                                                }
                                              ]
                                            }
                                          ],
                                          "node_type": "ExpressionRef",
                                          "ref_id": "361"
                                        }
                                      ],
                                      "node_type": "And",
                                      "ref_id": "362"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " and\n"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"Age 40 to 75\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "363"
                                    }
                                  ],
                                  "node_type": "And",
                                  "ref_id": "364"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " and "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "not\n"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"ASCVD Diagnosis Before MP\""
                                            }
                                          ]
                                        }
                                      ],
                                      "node_type": "ExpressionRef",
                                      "ref_id": "365"
                                    }
                                  ],
                                  "node_type": "Not",
                                  "ref_id": "366"
                                }
                              ],
                              "node_type": "And",
                              "ref_id": "367"
                            },
                            {
                              "children": [
                                {
                                  "text": " and "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "not\n"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"ASCVD Procedure Before MP\""
                                        }
                                      ]
                                    }
                                  ],
                                  "node_type": "ExpressionRef",
                                  "ref_id": "368"
                                }
                              ],
                              "node_type": "Not",
                              "ref_id": "369"
                            }
                          ],
                          "node_type": "And",
                          "ref_id": "370"
                        },
                        {
                          "children": [
                            {
                              "text": " and "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "not \n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"LDL gte 190\""
                                    }
                                  ]
                                }
                              ],
                              "node_type": "ExpressionRef",
                              "ref_id": "371"
                            }
                          ],
                          "node_type": "Not",
                          "ref_id": "372"
                        }
                      ],
                      "node_type": "And",
                      "ref_id": "373"
                    },
                    {
                      "children": [
                        {
                          "text": " and "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "not\n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"Hypercholesterolemia Diagnosis\""
                                }
                              ]
                            }
                          ],
                          "node_type": "ExpressionRef",
                          "ref_id": "374"
                        }
                      ],
                      "node_type": "Not",
                      "ref_id": "375"
                    }
                  ],
                  "node_type": "And",
                  "ref_id": "376"
                }
              ],
              "ref_id": "377"
            }
          ],
          "define_name": "Denominator 3"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"LDL in past 2 years\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "[\"Laboratory Test, Performed\": "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"LDL Test\""
                                            }
                                          ]
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " ]"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "378"
                                }
                              ],
                              "ref_id": "378"
                            },
                            {
                              "children": [
                                {
                                  "text": " ldl"
                                }
                              ]
                            }
                          ],
                          "ref_id": "379"
                        }
                      ]
                    },
                    {
                      "children": [

                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": " where "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "ldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "380"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "relevantPeriod"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "381"
                                    }
                                  ],
                                  "ref_id": "381"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "starts "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "2 years"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "383"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " before start"
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "384"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Measurement Period\""
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "382"
                                }
                              ],
                              "ref_id": "384"
                            },
                            {
                              "children": [
                                {
                                  "text": "   and "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "ldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "385"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "result"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "386"
                                    }
                                  ],
                                  "ref_id": "386"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " is not null"
                                    }
                                  ]
                                }
                              ],
                              "ref_id": "387"
                            }
                          ],
                          "ref_id": "388"
                        }
                      ],
                      "ref_id": "388"
                    },
                    {
                      "children": [

                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": " sort by "
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "start of "
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "ldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "389"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": "."
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "relevantPeriod"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "390"
                                    }
                                  ],
                                  "ref_id": "390"
                                }
                              ],
                              "ref_id": "391"
                            }
                          ],
                          "ref_id": "392"
                        }
                      ],
                      "ref_id": "393"
                    }
                  ],
                  "node_type": "Null",
                  "ref_id": "394"
                }
              ],
              "ref_id": "395"
            }
          ],
          "define_name": "LDL in past 2 years"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Most recent LDL\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "Last ("
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": " \"LDL in past 2 years\""
                            }
                          ]
                        }
                      ],
                      "ref_id": "396"
                    },
                    {
                      "children": [
                        {
                          "text": " )"
                        }
                      ]
                    }
                  ],
                  "node_type": "Null",
                  "ref_id": "397"
                }
              ],
              "ref_id": "398"
            }
          ],
          "define_name": "Most recent LDL"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"LDL lt 70\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "text": "exists "
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "("
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "{\n "
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"Most recent LDL\""
                                                    }
                                                  ]
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "399"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " recldl"
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "400"
                                    }
                                  ]
                                },
                                {
                                  "children": [

                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": " where "
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "recldl"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "401"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": "."
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "result"
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "402"
                                            }
                                          ],
                                          "ref_id": "402"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " &lt;"
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": " 70 'mg/dL'"
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "403"
                                        }
                                      ],
                                      "ref_id": "404"
                                    }
                                  ],
                                  "ref_id": "405"
                                }
                              ],
                              "ref_id": "406"
                            },
                            {
                              "children": [
                                {
                                  "text": "\n }"
                                }
                              ]
                            }
                          ],
                          "ref_id": "407"
                        },
                        {
                          "children": [
                            {
                              "text": " )"
                            }
                          ]
                        }
                      ],
                      "ref_id": "407"
                    }
                  ],
                  "node_type": "Null",
                  "ref_id": "408"
                }
              ],
              "ref_id": "409"
            }
          ],
          "define_name": "LDL lt 70"
        },
        {
          "children": [
            {
              "children": [
                {
                  "children": [
                    {
                      "text": " define \"Denexcep Den3\": "
                    }
                  ]
                },
                {
                  "children": [
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"PalliativeCare\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "410"
                                            },
                                            {
                                              "children": [
                                                {
                                                  "text": " or\n"
                                                }
                                              ]
                                            },
                                            {
                                              "children": [
                                                {
                                                  "children": [
                                                    {
                                                      "text": "\"ESRD\""
                                                    }
                                                  ]
                                                }
                                              ],
                                              "ref_id": "411"
                                            }
                                          ],
                                          "ref_id": "412"
                                        },
                                        {
                                          "children": [
                                            {
                                              "text": " or\n"
                                            }
                                          ]
                                        },
                                        {
                                          "children": [
                                            {
                                              "children": [
                                                {
                                                  "text": "\"HepA\""
                                                }
                                              ]
                                            }
                                          ],
                                          "ref_id": "413"
                                        }
                                      ],
                                      "ref_id": "414"
                                    },
                                    {
                                      "children": [
                                        {
                                          "text": " or\n"
                                        }
                                      ]
                                    },
                                    {
                                      "children": [
                                        {
                                          "children": [
                                            {
                                              "text": "\"HepB\""
                                            }
                                          ]
                                        }
                                      ],
                                      "ref_id": "415"
                                    }
                                  ],
                                  "ref_id": "416"
                                },
                                {
                                  "children": [
                                    {
                                      "text": " or\n"
                                    }
                                  ]
                                },
                                {
                                  "children": [
                                    {
                                      "children": [
                                        {
                                          "text": "\"Liver Disease Diagnosis\""
                                        }
                                      ]
                                    }
                                  ],
                                  "ref_id": "417"
                                }
                              ],
                              "ref_id": "418"
                            },
                            {
                              "children": [
                                {
                                  "text": " or\n"
                                }
                              ]
                            },
                            {
                              "children": [
                                {
                                  "children": [
                                    {
                                      "text": "\"MedsAdverse\""
                                    }
                                  ]
                                }
                              ],
                              "ref_id": "419"
                            }
                          ],
                          "ref_id": "420"
                        },
                        {
                          "children": [
                            {
                              "text": " or\n"
                            }
                          ]
                        },
                        {
                          "children": [
                            {
                              "children": [
                                {
                                  "text": "\"MedsAllergyIntolerance\""
                                }
                              ]
                            }
                          ],
                          "ref_id": "421"
                        }
                      ],
                      "ref_id": "422"
                    },
                    {
                      "children": [
                        {
                          "text": " or\n"
                        }
                      ]
                    },
                    {
                      "children": [
                        {
                          "children": [
                            {
                              "text": "\"LDL lt 70\""
                            }
                          ]
                        }
                      ],
                      "ref_id": "423"
                    }
                  ],
                  "node_type": "Null",
                  "ref_id": "424"
                }
              ],
              "ref_id": "425"
            }
          ],
          "define_name": "Denexcep Den3"
        }
      ],
      "identifier": {
        "id": "StatinTherapy",
        "version": "0.0.004"
      }
    }
  },
  "episode_ids": null,
  "episode_of_care": false,
  "hqmf_id": "40280582-5BB1-1AEA-015B-FDFA9AB70B54",
  "hqmf_set_id": "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
  "hqmf_version_number": 0,
  "id": "5977b702942c6d0f50004988",
  "main_cql_library": "StatinTherapy",
  "measure_attributes": [
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      "value": "735",
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    {
      "code": "COPY",
      "value": "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Quality Insights, Inc. disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT [R]) or other coding contained in the specifications.\n\nCPT (R) contained in the Measure specifications is copyright 2007-2016 American Medical Association. \n\nLOINC (R) copyright 2004-2016 [2.56] Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms (R) (SNOMED CT [R]) copyright 2004-2016 [2016-09] International Health Terminology Standards Development Organization. All Rights Reserved.\n\nDue to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].",
      "name": "Copyright",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "COPY",
        "title": "Copyright"
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      "value_obj": {
        "type": "ED",
        "value": "Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Quality Insights, Inc. disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT [R]) or other coding contained in the specifications.\n\nCPT (R) contained in the Measure specifications is copyright 2007-2016 American Medical Association. \n\nLOINC (R) copyright 2004-2016 [2.56] Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms (R) (SNOMED CT [R]) copyright 2004-2016 [2016-09] International Health Terminology Standards Development Organization. All Rights Reserved.\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": "DISC",
      "value": "These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.\n\nTHE MEASURES AND SPECIFICATIONS ARE PROVIDED \"AS IS\" WITHOUT WARRANTY OF ANY KIND.",
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        "code": "PROPOR",
        "title": "Proportion"
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      "name": "Measure Type",
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        "code": "PROCESS",
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      "code": "STRAT",
      "value": "None",
      "name": "Stratification",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "STRAT",
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    {
      "code": "MSRADJ",
      "value": "None",
      "name": "Risk Adjustment",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "MSRADJ",
        "title": "Risk Adjustment"
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        "value": "None",
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    {
      "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": "\"Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 7 deaths in the United States in 2011. In 2011, stroke caused approximately 1 of every 20 deaths in the United States and the estimated annual costs for CVD and stroke were $320.1 billion, including $195.6 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $124.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group\" (Mozaffarian et al., 2015).\n\nData collected between 2009 and 2012 indicates that more than 100 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 31 million had levels 240 mg/dL or more (Mozaffarian et al., 2015). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C, and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015).  \n\nIn 2013, guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (see Stone et al., 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: a Report of the American College of Cardiology [ACC]/American Heart Association [AHA] Task Force on Practice Guidelines). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The ACC/AHA Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of Atherosclerotic Cardiovascular Disease (ASCVD) in adult men and women (21 years of age or older). The document concludes the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C >= 190 mg/dL, or with diabetes and LDL-C 70-189 mg/dL (Stone et al., 2013).\n\nHowever, one study that surveyed U.S. cardiovascular practices participating in the PINNACLE registry, found that 32.4 percent of patients with an indication for statins under the 2013 ACC/AHA cholesterol guidelines were not currently receiving them (Maddox et al., 2014). Although, systematic evidence review found that statins are safe drugs with low incidence of conditions or diseases attributable to statin use (Law et al., 2006). Overall, the Statin Safety Expert Panel that participated in an NLA Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweighs any potential harm related to the drug (Jacobson, 2014).",
      "name": "Rationale",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "RAT",
        "title": "Rationale"
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      "value_obj": {
        "type": "ED",
        "value": "\"Cardiovascular disease (CVD) is the leading cause of death in the United States, causing approximately 1 of every 7 deaths in the United States in 2011. In 2011, stroke caused approximately 1 of every 20 deaths in the United States and the estimated annual costs for CVD and stroke were $320.1 billion, including $195.6 billion in direct costs (hospital services, physicians and other professionals, prescribed medications, home health care, and other medical durables) and $124.5 billion in indirect costs from lost future productivity (cardiovascular and stroke premature deaths). CVD costs more than any other diagnostic group\" (Mozaffarian et al., 2015).\n\nData collected between 2009 and 2012 indicates that more than 100 million U.S. adults, 20 years or older, had total cholesterol levels equal to 200 mg/dL or more, while almost 31 million had levels 240 mg/dL or more (Mozaffarian et al., 2015). Elevated blood cholesterol is a major risk factor for CVD and statin therapy has been associated with a reduced risk of CVD. Numerous randomized trials have demonstrated that treatment with a statin reduces LDL-C, and reduces the risk of major cardiovascular events by approximately 20 percent (Ference, 2015).  \n\nIn 2013, guidelines on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults were published (see Stone et al., 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: a Report of the American College of Cardiology [ACC]/American Heart Association [AHA] Task Force on Practice Guidelines). This guideline was published by an Expert Panel, which synthesized evidence from randomized controlled trials to identify people most likely to benefit from cholesterol-lowering therapy. The ACC/AHA Guideline recommendations are intended to provide a strong evidence-based foundation for the treatment of blood cholesterol for the primary and secondary prevention and treatment of Atherosclerotic Cardiovascular Disease (ASCVD) in adult men and women (21 years of age or older). The document concludes the addition of statin therapy reduces the risk of ASCVD among high-risk individuals, defined as follows: individuals with clinical ASCVD, with LDL-C >= 190 mg/dL, or with diabetes and LDL-C 70-189 mg/dL (Stone et al., 2013).\n\nHowever, one study that surveyed U.S. cardiovascular practices participating in the PINNACLE registry, found that 32.4 percent of patients with an indication for statins under the 2013 ACC/AHA cholesterol guidelines were not currently receiving them (Maddox et al., 2014). Although, systematic evidence review found that statins are safe drugs with low incidence of conditions or diseases attributable to statin use (Law et al., 2006). Overall, the Statin Safety Expert Panel that participated in an NLA Statin Safety Task Force meeting in October 2013 reaffirms the general safety of statin therapy. The panel members concluded that for most patients requiring statin therapy, the potential benefits of statin therapy outweigh the potential risks. In general terms, the benefits of statins to prevent non-fatal myocardial infarction, revascularization, stroke, and CVD mortality, far outweighs any potential harm related to the drug (Jacobson, 2014).",
        "media_type": "text/plain"
      }
    },
    {
      "code": "CRS",
      "value": "This electronic clinical quality measure is intended to align with the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol (Stone et al. 2013), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations.\n\nRecommendations for Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment:\nSecondary Prevention:\n1. High-intensity statin therapy should be initiated or continued as first-line therapy in women and men <=75 years of age who have clinical ASCVD, unless contraindicated. (Level of Evidence A), (ACC/AHA, 2013)\n\n2. In individuals with clinical ASCVD in whom high-intensity statin therapy would otherwise be used, when high-intensity statin therapy is contraindicated or when characteristics predisposing to statin-associated adverse effects are present, moderate-intensity statin should be used as the second option, if tolerated. (Level of Evidence A), (ACC/AHA, 2013) \n\nPrimary Prevention in Individuals >= 21 Years of Age With LDL-C >=190 mg/dL:\n2. Adults >=21 years of age with primary LDL-C >=190 mg/dL should be treated with statin therapy. (10-year ASCVD risk estimation is not required.) (Level of Evidence B), (ACC/AHA, 2013)\n\nPrimary Prevention in Individuals With Diabetes and LDL-C 70-189 mg/dL:\n1. Moderate-intensity statin therapy should be initiated or continued for adults 40-75 years of age with diabetes. (Level of Evidence A),(ACC/AHA, 2013)",
      "name": "Clinical Recommendation Statement",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "CRS",
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      "value_obj": {
        "type": "ED",
        "value": "This electronic clinical quality measure is intended to align with the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol (Stone et al. 2013), which indicates the use of statins as the first line of cholesterol-lowering medication therapy to lower the risk of ASCVD among at-risk populations.\n\nRecommendations for Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults - Statin Treatment:\nSecondary Prevention:\n1. High-intensity statin therapy should be initiated or continued as first-line therapy in women and men <=75 years of age who have clinical ASCVD, unless contraindicated. (Level of Evidence A), (ACC/AHA, 2013)\n\n2. In individuals with clinical ASCVD in whom high-intensity statin therapy would otherwise be used, when high-intensity statin therapy is contraindicated or when characteristics predisposing to statin-associated adverse effects are present, moderate-intensity statin should be used as the second option, if tolerated. (Level of Evidence A), (ACC/AHA, 2013) \n\nPrimary Prevention in Individuals >= 21 Years of Age With LDL-C >=190 mg/dL:\n2. Adults >=21 years of age with primary LDL-C >=190 mg/dL should be treated with statin therapy. (10-year ASCVD risk estimation is not required.) (Level of Evidence B), (ACC/AHA, 2013)\n\nPrimary Prevention in Individuals With Diabetes and LDL-C 70-189 mg/dL:\n1. Moderate-intensity statin therapy should be initiated or continued for adults 40-75 years of age with diabetes. (Level of Evidence A),(ACC/AHA, 2013)",
        "media_type": "text/plain"
      }
    },
    {
      "code": "IDUR",
      "value": "Higher score indicates better quality.",
      "name": "Improvement Notation",
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        "code": "IDUR",
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      "value_obj": {
        "type": "ED",
        "value": "Higher score indicates better quality.",
        "media_type": "text/plain"
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    {
      "code": "REF",
      "value": "Banach, M., Rizzo, M., Toth, P., et al. (2015). Statin intolerance- an attempt at a\nunified definition. Position paper from an International Lipid Expert Panel. Archives of Medical Science : AMS, 11(1), 1-23. http://doi.org/10.5114/aoms.2015.49807",
      "name": "Reference",
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        "code": "REF",
        "title": "Reference"
      },
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        "type": "ED",
        "value": "Banach, M., Rizzo, M., Toth, P., et al. (2015). Statin intolerance- an attempt at a\nunified definition. Position paper from an International Lipid Expert Panel. Archives of Medical Science : AMS, 11(1), 1-23. http://doi.org/10.5114/aoms.2015.49807",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Ference, B.A. (2015). Statins and the Risk of Developing New-Onset Type 2 Diabetes: Expert Analysis. J Am Coll Cardiol, Mar 10, 2015.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
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        "value": "Ference, B.A. (2015). Statins and the Risk of Developing New-Onset Type 2 Diabetes: Expert Analysis. J Am Coll Cardiol, Mar 10, 2015.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Jacobson, T. A. (2014). Executive Summary: NLA Task Force on Statin Safety - 2014 update. Journal of Clinical Lipidology, 8, S1-S4.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Jacobson, T. A. (2014). Executive Summary: NLA Task Force on Statin Safety - 2014 update. Journal of Clinical Lipidology, 8, S1-S4.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Law, M., & Rudnicka, A.R. (2006). Statin Safety: A Systematic Review. Report of the National Lipid Association's Statin Safety Task Force. The American Journal of Cardiology, 97 (8), S52-S60. doi:10.1016/j.amjcard.2005.12.010",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Law, M., & Rudnicka, A.R. (2006). Statin Safety: A Systematic Review. Report of the National Lipid Association's Statin Safety Task Force. The American Journal of Cardiology, 97 (8), S52-S60. doi:10.1016/j.amjcard.2005.12.010",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Maddox, T.M., Borden, W.B., Tang, F. et al. (2014). \"Implications of the 2013 ACC/AHA cholesterol guidelines for adults in contemporary cardiovascular practice: insights from the NCDR Pinnacle registry.\" Journal of American College of Cardiology, 64(21), 2183-2192. doi:10.1016/j.acc.2014.08.041.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Maddox, T.M., Borden, W.B., Tang, F. et al. (2014). \"Implications of the 2013 ACC/AHA cholesterol guidelines for adults in contemporary cardiovascular practice: insights from the NCDR Pinnacle registry.\" Journal of American College of Cardiology, 64(21), 2183-2192. doi:10.1016/j.acc.2014.08.041.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Mozaffarian, D., Benjamin, E.J., Go, A.S., et al. (2015). \"Heart disease and stroke statistics-2015 update: a report from the American Heart Association.\" Circulation, 131, e29-e322. doi:10.1161/CIR.0000000000000152",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Mozaffarian, D., Benjamin, E.J., Go, A.S., et al. (2015). \"Heart disease and stroke statistics-2015 update: a report from the American Heart Association.\" Circulation, 131, e29-e322. doi:10.1161/CIR.0000000000000152",
        "media_type": "text/plain"
      }
    },
    {
      "code": "REF",
      "value": "Stone, N.J., J. Robinson, A.H. Lichtenstein, C.N. Bairey Merz, C.B. Blum, R.H. Eckel, A.C. Goldberg, D. Gordon, D. Levy, D.M. Lloyd-Jones, P. McBride, J.S. Schwartz, S.T. Shero, S.C. Smith Jr., K. Watson, and P.W.F. Wilson. \"2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.\" Full Panel Report Supplement. Circulation, vol. 129, no. 25, Suppl. 2, June 24, 2014, pp. S1-S45. Available at http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a/suppl/DC1.",
      "name": "Reference",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "REF",
        "title": "Reference"
      },
      "value_obj": {
        "type": "ED",
        "value": "Stone, N.J., J. Robinson, A.H. Lichtenstein, C.N. Bairey Merz, C.B. Blum, R.H. Eckel, A.C. Goldberg, D. Gordon, D. Levy, D.M. Lloyd-Jones, P. McBride, J.S. Schwartz, S.T. Shero, S.C. Smith Jr., K. Watson, and P.W.F. Wilson. \"2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.\" Full Panel Report Supplement. Circulation, vol. 129, no. 25, Suppl. 2, June 24, 2014, pp. S1-S45. Available at http://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a/suppl/DC1.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DEF",
      "value": "Clinical atherosclerotic cardiovascular disease (ASCVD) includes: \n*  Acute coronary syndromes \n*  History of myocardial infarction \n*  Stable or unstable angina \n*  Coronary or other arterial revascularization \n*  Stroke or transient ischemic attack (TIA) \n*  Peripheral arterial disease of atherosclerotic origin \n\nLipoprotein density cholesterol (LDL-C) result: \n* A fasting or direct LDL-C laboratory test performed and test result documented in the medical record. \n\nStatin therapy:   \n* Administration of one or more of a group of medications that are used to lower plasma lipoprotein levels in the treatment of hyperlipoproteinemia. \n\nStatin Medication Therapy List (NOTE: List does NOT include dosage):\n\n[Generic name] (Brand or trade name) and (-) Medication type, if applicable:\n[Atorvastatin] (Lipitor) - Statin\n[Fluvastatin] (Lescol XL or Lescol) - Statin\n[Lovastatin (Mevinolin)](Mevacor or Altoprev) -Statin\n[Pitavastatin]Livalo\n[Pravastatin Sodium] (Pravachol) - Statin\n[Rosuvastatin Calcium] (Crestor) - Statin\n[Simvastatin] (Zocor) - Statin\n[Amlodipine Besylate/Atorvastatin Calcium] (Caduet) - Combination\n[Ezetimibe/Simvastatin] (Vytorin) - Combination\n[Ezetimibe/Atorvastatin] (Liptruzet) - Combination\n\nSome patients may not be appropriate to prescribe or use statin therapy (see\nexceptions and exclusions for a complete list). \n\n\"Statin intolerance is the inability to tolerate a dose of statin required to reduce a person's CV risk sufficiently from their baseline risk and could result from different statin related side effects including: muscle symptoms, headache, sleep disorders, dyspepsia, nausea, rash, alopecia, erectile dysfunction, gynecomastia, and/or arthritis\" (Banach, et al., 2015).\n\nPatients that experience symptoms such as these may prefer not to take or continue statin therapy and therefore may be exempt from the denominator.",
      "name": "Definition",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DEF",
        "title": "Definition"
      },
      "value_obj": {
        "type": "ED",
        "value": "Clinical atherosclerotic cardiovascular disease (ASCVD) includes: \n*  Acute coronary syndromes \n*  History of myocardial infarction \n*  Stable or unstable angina \n*  Coronary or other arterial revascularization \n*  Stroke or transient ischemic attack (TIA) \n*  Peripheral arterial disease of atherosclerotic origin \n\nLipoprotein density cholesterol (LDL-C) result: \n* A fasting or direct LDL-C laboratory test performed and test result documented in the medical record. \n\nStatin therapy:   \n* Administration of one or more of a group of medications that are used to lower plasma lipoprotein levels in the treatment of hyperlipoproteinemia. \n\nStatin Medication Therapy List (NOTE: List does NOT include dosage):\n\n[Generic name] (Brand or trade name) and (-) Medication type, if applicable:\n[Atorvastatin] (Lipitor) - Statin\n[Fluvastatin] (Lescol XL or Lescol) - Statin\n[Lovastatin (Mevinolin)](Mevacor or Altoprev) -Statin\n[Pitavastatin]Livalo\n[Pravastatin Sodium] (Pravachol) - Statin\n[Rosuvastatin Calcium] (Crestor) - Statin\n[Simvastatin] (Zocor) - Statin\n[Amlodipine Besylate/Atorvastatin Calcium] (Caduet) - Combination\n[Ezetimibe/Simvastatin] (Vytorin) - Combination\n[Ezetimibe/Atorvastatin] (Liptruzet) - Combination\n\nSome patients may not be appropriate to prescribe or use statin therapy (see\nexceptions and exclusions for a complete list). \n\n\"Statin intolerance is the inability to tolerate a dose of statin required to reduce a person's CV risk sufficiently from their baseline risk and could result from different statin related side effects including: muscle symptoms, headache, sleep disorders, dyspepsia, nausea, rash, alopecia, erectile dysfunction, gynecomastia, and/or arthritis\" (Banach, et al., 2015).\n\nPatients that experience symptoms such as these may prefer not to take or continue statin therapy and therefore may be exempt from the denominator.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "GUIDE",
      "value": "Numerator instructions and guidance:\n-Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.\n-ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).\n-Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.\n-Statin medication \"samples\" provided to patients can be documented as \"current statin therapy\" if documented in the medication list in health/medical record.\n-Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure. \n-Adherence to statin therapy is not calculated in this measure.\n\n\nDenominator Guidance: \nThe denominator covers three distinct populations. Use the following process to prevent counting patients more than once.\n\nDenominator Population 1:  \nPatients aged >= 21 years at the beginning of the measurement period with clinical ASCVD\n\n-If YES, meets Denominator Population 1 risk category\t\t \n-If NO, screen for next risk category\n\nDenominator Population 2: \nPatients aged >= 21 years at the beginning of the measurement period who have ever had a fasting or direct laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia\n\n-If YES, meets Denominator Population 2 risk category\t\t \n-If NO, screen for next risk category\n\nDenominator Population 3:\nPatients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and with a LDL-C result of 70 -189 mg/dL recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period\n\n-If YES, meets Denominator Population 3 risk category\n-If NO, patient does NOT meet Denominator criteria and is NOT eligible for measure inclusion\n\nDenominator Guidance for Encounter:\n-In order for the patient to be included in the denominator, the patient must have ONE denominator-eligible visit, defined as follows:\n\n--Outpatient encounter visit type\n--Encounter, performed: initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit\n\n\nLDL-C Laboratory test result options:\nThe measure can be reported for all patients with a documented fasting or direct LDL-C level recorded as follows:\n\nTo meet Denominator Population 1: \nThere is no LDL-C result required.\n\nTo meet Denominator Population 2:\nIf a patient has ANY previous fasting or direct laboratory result of LDL-C >= 190 mg/dL, report the highest value >= 190 mg/dL.\n\nTo meet Denominator Population 3: \nIf a patient has more than one LDL-C result during the measurement period or during the two years before the start of the measurement period, report the highest level recorded during either time. The Denominator Exception, \"Patients with diabetes who have the most recent fasting or direct LDL-C laboratory test result < 70 mg/dL and are not taking statin therapy\" applies only to Denominator Population 3.\n\nIntensity of statin therapy in primary and secondary prevention:\n\nThe expert panel of the 2013 ACC/AHA Guidelines (Stone et al. 2013) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.\n\nLifestyle modification coaching:\nA healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.",
      "name": "Guidance",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "GUIDE",
        "title": "Guidance"
      },
      "value_obj": {
        "type": "ED",
        "value": "Numerator instructions and guidance:\n-Current statin therapy use must be documented in the patient's current medication list or ordered during the measurement period.\n-ONLY statin therapy meets the measure Numerator criteria (NOT other cholesterol lowering medications).\n-Prescription or order does NOT need to be linked to an encounter or visit; it may be called to the pharmacy.\n-Statin medication \"samples\" provided to patients can be documented as \"current statin therapy\" if documented in the medication list in health/medical record.\n-Patients who meet the denominator criteria for inclusion, but are not prescribed or using statin therapy, will NOT meet performance for this measure. \n-Adherence to statin therapy is not calculated in this measure.\n\n\nDenominator Guidance: \nThe denominator covers three distinct populations. Use the following process to prevent counting patients more than once.\n\nDenominator Population 1:  \nPatients aged >= 21 years at the beginning of the measurement period with clinical ASCVD\n\n-If YES, meets Denominator Population 1 risk category\t\t \n-If NO, screen for next risk category\n\nDenominator Population 2: \nPatients aged >= 21 years at the beginning of the measurement period who have ever had a fasting or direct laboratory test result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia\n\n-If YES, meets Denominator Population 2 risk category\t\t \n-If NO, screen for next risk category\n\nDenominator Population 3:\nPatients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and with a LDL-C result of 70 -189 mg/dL recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period\n\n-If YES, meets Denominator Population 3 risk category\n-If NO, patient does NOT meet Denominator criteria and is NOT eligible for measure inclusion\n\nDenominator Guidance for Encounter:\n-In order for the patient to be included in the denominator, the patient must have ONE denominator-eligible visit, defined as follows:\n\n--Outpatient encounter visit type\n--Encounter, performed: initial or established office visit, face-to-face interaction, preventive care services, or annual wellness visit\n\n\nLDL-C Laboratory test result options:\nThe measure can be reported for all patients with a documented fasting or direct LDL-C level recorded as follows:\n\nTo meet Denominator Population 1: \nThere is no LDL-C result required.\n\nTo meet Denominator Population 2:\nIf a patient has ANY previous fasting or direct laboratory result of LDL-C >= 190 mg/dL, report the highest value >= 190 mg/dL.\n\nTo meet Denominator Population 3: \nIf a patient has more than one LDL-C result during the measurement period or during the two years before the start of the measurement period, report the highest level recorded during either time. The Denominator Exception, \"Patients with diabetes who have the most recent fasting or direct LDL-C laboratory test result < 70 mg/dL and are not taking statin therapy\" applies only to Denominator Population 3.\n\nIntensity of statin therapy in primary and secondary prevention:\n\nThe expert panel of the 2013 ACC/AHA Guidelines (Stone et al. 2013) defines recommended intensity of statin therapy on the basis of the average expected LDL-C response to specific statin and dose. Although intensity of statin therapy is important in managing cholesterol, this measure assesses prescription of ANY statin therapy, irrespective of intensity. Assessment of appropriate intensity and dosage documentation added too much complexity to allow inclusion of statin therapy intensity in the measure at this time.\n\nLifestyle modification coaching:\nA healthy lifestyle is important for the prevention of cardiovascular disease. However, lifestyle modification monitoring and documentation added too much complexity to allow its inclusion in the measure at this time.",
        "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": "All patients aged 21 years and older at the beginning of the measurement period with a patient encounter 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": "All patients aged 21 years and older at the beginning of the measurement period with a patient encounter during the measurement period.",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENOM",
      "value": "All patients who meet one or more of the following criteria (considered at \"high risk\" for cardiovascular events, under ACC/AHA guidelines):\n\n1)  Patients aged >= 21 years at the beginning of the measurement period with clinical ASCVD diagnosis \n\n2)  Patients aged >= 21 years at the beginning of the measurement period who have ever had a fasting or direct laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia \n\n3)  Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and with an LDL-C result of 70-189 mg/dL recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period",
      "name": "Denominator",
      "code_obj": {
        "type": "CD",
        "system": "2.16.840.1.113883.5.4",
        "code": "DENOM",
        "title": "Denominator"
      },
      "value_obj": {
        "type": "ED",
        "value": "All patients who meet one or more of the following criteria (considered at \"high risk\" for cardiovascular events, under ACC/AHA guidelines):\n\n1)  Patients aged >= 21 years at the beginning of the measurement period with clinical ASCVD diagnosis \n\n2)  Patients aged >= 21 years at the beginning of the measurement period who have ever had a fasting or direct laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia \n\n3)  Patients aged 40 to 75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes and with an LDL-C result of 70-189 mg/dL recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENEX",
      "value": "Patients who have a diagnosis of pregnancy\nPatients who are breastfeeding\nPatients who have a diagnosis of rhabdomyolysis",
      "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": "Patients who have a diagnosis of pregnancy\nPatients who are breastfeeding\nPatients who have a diagnosis of rhabdomyolysis",
        "media_type": "text/plain"
      }
    },
    {
      "code": "NUMER",
      "value": "Patients who are actively using or who receive an order (prescription) for statin therapy at any point 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 who are actively using or who receive an order (prescription) for statin therapy at any point during the measurement period",
        "media_type": "text/plain"
      }
    },
    {
      "code": "NUMEX",
      "value": "None",
      "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": "None",
        "media_type": "text/plain"
      }
    },
    {
      "code": "DENEXCEP",
      "value": "Patients with adverse effect, allergy, or intolerance to statin medication\nPatients who are receiving palliative care\nPatients with active liver disease or hepatic disease or insufficiency\nPatients with end-stage renal disease (ESRD)\nPatients with diabetes who have the most recent fasting or direct LDL-C laboratory test result < 70 mg/dL and are not taking statin therapy",
      "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": "Patients with adverse effect, allergy, or intolerance to statin medication\nPatients who are receiving palliative care\nPatients with active liver disease or hepatic disease or insufficiency\nPatients with end-stage renal disease (ESRD)\nPatients with diabetes who have the most recent fasting or direct LDL-C laboratory test result < 70 mg/dL and are not taking statin therapy",
        "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": "40280582-5BB1-1AEA-015B-FDFA9AB70B54",
  "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": "D75B1F50-E58A-4A79-BB5C-C4EBEB160F96",
      "preconditions": [
        {
          "id": 2,
          "preconditions": [
            {
              "id": 1,
              "reference": "StatinTherapy__Initial_Population__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENOM": {
      "conjunction?": true,
      "type": "DENOM",
      "hqmf_id": "FB196C50-2308-4064-88B7-C77746E76B36",
      "preconditions": [
        {
          "id": 4,
          "preconditions": [
            {
              "id": 3,
              "reference": "StatinTherapy__Denominator_1__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "NUMER": {
      "conjunction?": true,
      "type": "NUMER",
      "hqmf_id": "41010063-398D-47A2-BB73-27FE326CBACA",
      "preconditions": [
        {
          "id": 6,
          "preconditions": [
            {
              "id": 5,
              "reference": "StatinTherapy__Numerator__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENEXCEP": {
      "conjunction?": true,
      "type": "DENEXCEP",
      "hqmf_id": "2D4B2B28-EC6D-4874-9D56-992B46646DC3",
      "preconditions": [
        {
          "id": 8,
          "preconditions": [
            {
              "id": 7,
              "reference": "StatinTherapy__Denexcep__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    },
    "DENEX": {
      "conjunction?": true,
      "type": "DENEX",
      "hqmf_id": "E29D10A8-7867-472D-9407-02AF1DDA78DD",
      "preconditions": [
        {
          "id": 10,
          "preconditions": [
            {
              "id": 9,
              "reference": "StatinTherapy__Denex__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    },
    "IPP_1": {
      "conjunction?": true,
      "type": "IPP",
      "hqmf_id": "295F05AE-22D4-451F-94C6-67DA6123C409",
      "preconditions": [
        {
          "id": 12,
          "preconditions": [
            {
              "id": 11,
              "reference": "StatinTherapy__Initial_Population__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENOM_1": {
      "conjunction?": true,
      "type": "DENOM",
      "hqmf_id": "0D665008-2079-41E4-8CD5-B0E372CFD029",
      "preconditions": [
        {
          "id": 14,
          "preconditions": [
            {
              "id": 13,
              "reference": "StatinTherapy__Denominator_2__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "NUMER_1": {
      "conjunction?": true,
      "type": "NUMER",
      "hqmf_id": "5AED46FE-4EE3-42D2-B7F4-81B8E1B9959A",
      "preconditions": [
        {
          "id": 16,
          "preconditions": [
            {
              "id": 15,
              "reference": "StatinTherapy__Numerator__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENEXCEP_1": {
      "conjunction?": true,
      "type": "DENEXCEP",
      "hqmf_id": "02C31BA7-C0A1-451D-80EB-4BBC232BAE8F",
      "preconditions": [
        {
          "id": 18,
          "preconditions": [
            {
              "id": 17,
              "reference": "StatinTherapy__Denexcep__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    },
    "DENEX_1": {
      "conjunction?": true,
      "type": "DENEX",
      "hqmf_id": "99615B52-7B7D-42D8-BDA6-780CCA24F042",
      "preconditions": [
        {
          "id": 20,
          "preconditions": [
            {
              "id": 19,
              "reference": "StatinTherapy__Denex__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    },
    "IPP_2": {
      "conjunction?": true,
      "type": "IPP",
      "hqmf_id": "77B3C349-BC4E-40FA-9E73-DEAA9B32067E",
      "preconditions": [
        {
          "id": 22,
          "preconditions": [
            {
              "id": 21,
              "reference": "StatinTherapy__Initial_Population__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENOM_2": {
      "conjunction?": true,
      "type": "DENOM",
      "hqmf_id": "ED665D4E-AEA4-4D19-BEB9-5715D2EE4BC8",
      "preconditions": [
        {
          "id": 24,
          "preconditions": [
            {
              "id": 23,
              "reference": "StatinTherapy__Denominator_3__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "NUMER_2": {
      "conjunction?": true,
      "type": "NUMER",
      "hqmf_id": "97A5259A-ADD5-4BCA-928C-3CD1DF357DC8",
      "preconditions": [
        {
          "id": 26,
          "preconditions": [
            {
              "id": 25,
              "reference": "StatinTherapy__Numerator__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "allTrue"
        }
      ]
    },
    "DENEXCEP_2": {
      "conjunction?": true,
      "type": "DENEXCEP",
      "hqmf_id": "F2F08981-F7CA-44DA-987E-E0C218B52642",
      "preconditions": [
        {
          "id": 28,
          "preconditions": [
            {
              "id": 27,
              "reference": "StatinTherapy__Denexcep_Den3__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    },
    "DENEX_2": {
      "conjunction?": true,
      "type": "DENEX",
      "hqmf_id": "8B6D8852-8068-4A4C-BFB5-794A7E212C2A",
      "preconditions": [
        {
          "id": 30,
          "preconditions": [
            {
              "id": 29,
              "reference": "StatinTherapy__Denex__0DD23DE8_B8C2_4F65_9A98_BC46744532E1"
            }
          ],
          "conjunction_code": "atLeastOneTrue"
        }
      ]
    }
  },
  "populations": [
    {
      "IPP": "IPP",
      "DENOM": "DENOM",
      "NUMER": "NUMER",
      "DENEXCEP": "DENEXCEP",
      "DENEX": "DENEX",
      "id": "PopulationCriteria1",
      "title": "Population Criteria Section"
    },
    {
      "IPP": "IPP_1",
      "DENOM": "DENOM_1",
      "NUMER": "NUMER_1",
      "DENEXCEP": "DENEXCEP_1",
      "DENEX": "DENEX_1",
      "id": "PopulationCriteria2",
      "title": "Population Criteria Section"
    },
    {
      "IPP": "IPP_2",
      "DENOM": "DENOM_2",
      "NUMER": "NUMER_2",
      "DENEXCEP": "DENEXCEP_2",
      "DENEX": "DENEX_2",
      "id": "PopulationCriteria3",
      "title": "Population Criteria Section"
    }
  ],
  "populations_cql_map": {
    "IPP": [
      "Initial Population",
      "Initial Population",
      "Initial Population"
    ],
    "DENOM": [
      "Denominator 1",
      "Denominator 2",
      "Denominator 3"
    ],
    "DENEX": [
      "Denex",
      "Denex",
      "Denex"
    ],
    "DENEXCEP": [
      "Denexcep",
      "Denexcep",
      "Denexcep Den3"
    ],
    "NUMER": [
      "Numerator",
      "Numerator",
      "Numerator"
    ]
  },
  "publish_date": null,
  "published": null,
  "record_ids": [

  ],
  "source_data_criteria": {
    "OutpatientConsultation_EncounterPerformed_9ebfeb54_36bd_40c2_a5bb_f4161353fddb_source": {
      "title": "Outpatient Consultation",
      "description": "Encounter, Performed: Outpatient Consultation",
      "code_list_id": "2.16.840.1.113883.3.464.1003.101.11.1040",
      "type": "encounters",
      "definition": "encounter",
      "status": "performed",
      "hard_status": false,
      "negation": false,
      "source_data_criteria": "OutpatientConsultation_EncounterPerformed_9ebfeb54_36bd_40c2_a5bb_f4161353fddb_source",
      "variable": false
    },
    "StatinAllergen_AdverseEvent_0642c70a_9e54_4d5a_804a_e04b123dc75e_source": {
      "title": "Statin Allergen",
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