{
  "birthDatetime": "2000-12-31T03:00:00.000-05:00",
  "bundleId": "5a2ee976942c6d1fee845b69",
  "dataElements": [
    {
      "anatomicalLocationSite": null,
      "authorDatetime": "2012-05-05T04:05:00.000-04:00",
      "category": "condition",
      "dataElementCodes": [
        {
          "code": "125851000119106",
          "system": "2.16.840.1.113883.6.96"
        },
        {
          "code": "291.0",
          "system": "2.16.840.1.113883.6.103"
        },
        {
          "code": "F10.10",
          "system": "2.16.840.1.113883.6.90"
        }
      ],
      "description": "Diagnosis: Alcohol And Drug Dependence",
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.110",
      "prevalencePeriod": {
        "low": "2012-05-05T08:05:00.000+00:00",
        "high": "9999-12-31T23:59:59.990+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "qdmVersion": "5.3",
      "qrdaOid": "2.16.840.1.113883.10.20.24.3.135",
      "severity": null,
      "_type": "QDM::Diagnosis"
    },
    {
      "admissionSource": null,
      "authorDatetime": "2012-05-05T04:00:00.000-04:00",
      "category": "encounter",
      "dataElementCodes": [
        {
          "code": "99218",
          "system": "2.16.840.1.113883.6.12"
        }
      ],
      "description": "Encounter, Performed: Hospital Observation Care - Initial",
      "diagnoses": [

      ],
      "dischargeDisposition": null,
      "facilityLocations": [

      ],
      "hqmfOid": "2.16.840.1.113883.3.560.1.79",
      "lengthOfStay": {
        "value": 0,
        "unit": "days"
      },
      "negationRationale": null,
      "principalDiagnosis": null,
      "qdmStatus": "performed",
      "qdmVersion": "5.3",
      "relevantPeriod": {
        "low": "2012-05-05T08:00:00.000+00:00",
        "high": "2012-05-05T08:10:00.000+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "_type": "QDM::EncounterPerformed"
    },
    {
      "admissionSource": null,
      "authorDatetime": "2012-05-15T05:45:00.000-04:00",
      "category": "encounter",
      "dataElementCodes": [
        {
          "code": "313071005",
          "system": "2.16.840.1.113883.6.96"
        }
      ],
      "description": "Encounter, Performed: Alcohol and Drug Dependence Treatment",
      "diagnoses": [

      ],
      "dischargeDisposition": null,
      "facilityLocations": [

      ],
      "hqmfOid": "2.16.840.1.113883.3.560.1.79",
      "lengthOfStay": {
        "value": 0,
        "unit": "days"
      },
      "negationRationale": null,
      "principalDiagnosis": null,
      "qdmStatus": "performed",
      "qdmVersion": "5.3",
      "relevantPeriod": {
        "low": "2012-05-15T09:45:00.000+00:00",
        "high": "2012-05-15T10:05:00.000+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "_type": "QDM::EncounterPerformed"
    },
    {
      "admissionSource": null,
      "authorDatetime": "2012-05-20T04:15:00.000-04:00",
      "category": "encounter",
      "dataElementCodes": [
        {
          "code": "90837",
          "system": "2.16.840.1.113883.6.12"
        }
      ],
      "description": "Encounter, Performed: Psych Visit - Psychotherapy",
      "diagnoses": [

      ],
      "dischargeDisposition": null,
      "facilityLocations": [

      ],
      "hqmfOid": "2.16.840.1.113883.3.560.1.79",
      "lengthOfStay": {
        "value": 0,
        "unit": "days"
      },
      "negationRationale": null,
      "principalDiagnosis": null,
      "qdmStatus": "performed",
      "qdmVersion": "5.3",
      "relevantPeriod": {
        "low": "2012-05-20T08:15:00.000+00:00",
        "high": "2012-05-20T08:20:00.000+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "_type": "QDM::EncounterPerformed"
    },
    {
      "admissionSource": null,
      "authorDatetime": "2012-06-03T07:00:00.000-04:00",
      "category": "encounter",
      "dataElementCodes": [
        {
          "code": "90834",
          "system": "2.16.840.1.113883.6.12"
        }
      ],
      "description": "Encounter, Performed: Psych Visit - Psychotherapy",
      "diagnoses": [

      ],
      "dischargeDisposition": null,
      "facilityLocations": [

      ],
      "hqmfOid": "2.16.840.1.113883.3.560.1.79",
      "lengthOfStay": {
        "value": 0,
        "unit": "days"
      },
      "negationRationale": null,
      "principalDiagnosis": null,
      "qdmStatus": "performed",
      "qdmVersion": "5.3",
      "relevantPeriod": {
        "low": "2012-06-03T11:00:00.000+00:00",
        "high": "2012-06-03T11:10:00.000+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "_type": "QDM::EncounterPerformed"
    },
    {
      "birthDatetime": "2000-12-31T03:00:00.000-05:00",
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "21112-8",
          "display": null,
          "system": "2.16.840.1.113883.6.1",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.54",
      "qdmStatus": "birthdate",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicBirthdate"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "2186-5",
          "display": "Not Hispanic or Latino",
          "system": "2.16.840.1.113883.6.238",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.56",
      "qdmStatus": "ethnicity",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicEthnicity"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "2131-1",
          "display": "Other",
          "system": "2.16.840.1.113883.6.238",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.59",
      "qdmStatus": "race",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicRace"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "M",
          "display": "M",
          "system": "2.16.840.1.113883.5.1",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.55",
      "qdmStatus": "gender",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicSex"
    }
  ],
  "extendedData": {
    "type": null,
    "measure_ids": [
      "C3657D72-21B4-4675-820A-86C7FE293BF5",
      null
    ],
    "source_data_criteria": [
      {
        "negation": false,
        "definition": "encounter",
        "status": "performed",
        "title": "Hospital Observation Care - Initial",
        "description": "Encounter, Performed: Hospital Observation Care - Initial",
        "code_list_id": "2.16.840.1.113883.3.464.1003.101.12.1002",
        "type": "encounters",
        "id": "EncounterPerformedHospitalObservationCareInitial",
        "start_date": 1336204800000,
        "end_date": 1336205400000,
        "value": [

        ],
        "references": null,
        "field_values": {
        },
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0",
        "criteria_id": "14f747e39f55N",
        "codes": {
          "CPT": [
            "99218"
          ]
        },
        "negation_code_list_id": "",
        "coded_entry_id": "5aeb77adb848463d625b4fb5",
        "code_source": "DEFAULT"
      },
      {
        "negation": false,
        "definition": "diagnosis",
        "title": "Alcohol and Drug Dependence",
        "description": "Diagnosis: Alcohol And Drug Dependence",
        "code_list_id": "2.16.840.1.113883.3.464.1003.106.12.1001",
        "type": "conditions",
        "id": "less_thn_eql_10monthsStartsAfterStartOf_10CA30A6_60E6_4392_9212_E51191690677_8a4d92b2_3946_cdae_0139_7944acc200ce",
        "start_date": 1336205100000,
        "value": [

        ],
        "references": null,
        "field_values": {
        },
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0",
        "criteria_id": "152d15518e5wh",
        "codes": {
          "SNOMED-CT": [
            "125851000119106"
          ],
          "ICD-9-CM": [
            "291.0"
          ],
          "ICD-10-CM": [
            "F10.10"
          ]
        },
        "coded_entry_id": "5aeb77adb848463d625b4fb4",
        "code_source": "DEFAULT"
      },
      {
        "negation": false,
        "definition": "encounter",
        "status": "performed",
        "title": "Alcohol and Drug Dependence Treatment",
        "description": "Encounter, Performed: Alcohol and Drug Dependence Treatment",
        "code_list_id": "2.16.840.1.113883.3.464.1003.106.12.1005",
        "type": "encounters",
        "id": "OccurrenceAAlcoholAndDrugDependenceTreatment2",
        "start_date": 1337075100000,
        "end_date": 1337076300000,
        "value": [

        ],
        "field_values": {
        },
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0",
        "codes": {
          "SNOMED-CT": [
            "313071005"
          ]
        },
        "negation_code_list_id": "",
        "coded_entry_id": "5aeb77adb848463d625b4fb6",
        "code_source": "USER_DEFINED",
        "criteria_id": "14f746d5d5akN",
        "references": null
      },
      {
        "negation": false,
        "definition": "encounter",
        "status": "performed",
        "title": "Psych Visit - Psychotherapy",
        "description": "Encounter, Performed: Psych Visit - Psychotherapy",
        "code_list_id": "2.16.840.1.113883.3.526.3.1496",
        "type": "encounters",
        "id": "OccurrenceAPsychVisitPsychotherapy3",
        "start_date": 1337501700000,
        "end_date": 1337502000000,
        "value": [

        ],
        "field_values": {
        },
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0",
        "codes": {
          "CPT": [
            "90837"
          ]
        },
        "negation_code_list_id": "",
        "coded_entry_id": "5aeb77adb848463d625b4fb7",
        "code_source": "DEFAULT",
        "criteria_id": "14f746d5d5awU",
        "references": null
      },
      {
        "negation": false,
        "definition": "encounter",
        "status": "performed",
        "title": "Psych Visit - Psychotherapy",
        "description": "Encounter, Performed: Psych Visit - Psychotherapy",
        "code_list_id": "2.16.840.1.113883.3.526.3.1496",
        "type": "encounters",
        "id": "OccurrenceAPsychVisitPsychotherapy3",
        "start_date": 1338721200000,
        "end_date": 1338721800000,
        "value": [

        ],
        "field_values": {
        },
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0",
        "codes": {
          "CPT": [
            "90834"
          ]
        },
        "negation_code_list_id": "",
        "coded_entry_id": "5aeb77adb848463d625b4fb8",
        "code_source": "USER_DEFINED",
        "criteria_id": "14f746d5d5aPt",
        "references": null
      },
      {
        "id": "MeasurePeriod",
        "start_date": 0,
        "end_date": 0,
        "references": null,
        "hqmf_set_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "cms_id": "CMSv0"
      }
    ],
    "expected_values": [
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      },
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 1,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      },
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 2,
        "STRAT": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      },
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 3,
        "STRAT": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      },
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 4,
        "STRAT": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      },
      {
        "measure_id": "C3657D72-21B4-4675-820A-86C7FE293BF5",
        "population_index": 5,
        "STRAT": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0
      }
    ],
    "notes": "Incorrect age. Patient is diagnosed with Alcohol and Drug Dependence (Occ A) starts during encounter that takes place within 10 months of MP. Patient undergoes Alcohol and Drug Dependence (Occ A) treatment within 14 days of diagnosis. Two additional visits take place within 30 days of Occ A of alcohol and drug dependence treatment",
    "is_shared": false,
    "origin_data": [

    ],
    "test_id": null,
    "medical_record_number": "b21a07bfaa38b0ecb86f8a6cb4fb4349",
    "medical_record_assigner": "Bonnie",
    "description": null,
    "description_category": null,
    "insurance_providers": "[]"
  },
  "familyName": "IPPPopFail",
  "givenNames": [
    "2YoungDependence&TX"
  ],
  "qdmVersion": "5.3"
}
