MicroMD emr version 7.5

Transcription

1 MicroMD emr version 7.5 C l i n i c a l q u a l i t y m e a s u r e c a l c u l at i o n s

2 MICROMD EMR CLINICAL QUALITY MEASURES VERSION 7.5

3 TRADEMARKS Because of the nature of the material, numerous hardware and software products are mentioned by their trade names in this publication. All product names referenced herein are trademarks of their respective companies. The MICROMD design mark is a registered trademark of Henry Schein Medical Systems, Inc., and HENRY SCHEIN and the Henry Schein logo mark are registered trademarks of HS TM, Inc. COPYRIGHT This document is covered by the terms and conditions of the license agreement and/or the non-disclosure agreement, and may not be reproduced according to the terms of that agreement, or without the written consent of Henry Schein Medical Systems, Inc. August 3, Henry Schein Medical Systems, Inc. All rights reserved. Printed in the United States. Please forward all corrections, comments or suggestions to: [email protected].

4 TABLE OF CONTENTS PREFACE Welcome to MicroMD EMR... i How This Guide is Organized... i Understanding Typographical Conventions... i Cross-References... i Text You Type Using the Keyboard... i Keys You Press and Buttons You Click... i Dialog Box, Application Window Titles, and Field Names...ii Notes, Warnings, and Tips...ii INTRODUCTION About This Guide References Core Measures and Alternate Measures Non-Supported Measures About the Clinical Quality Measures Reporting Considerations REPORTING CLINICAL QUALITY MEASURES NQF 0001 / PQRI 64 Asthma Assessment (Alternate) Code Lists for Measure NQF 0002 / PQRI 66 Appropriate Testing for Children with Pharyngitis (Alternate) Code Lists for Measure NQF Initiation (a) and Engagement (b) of Alcohol and Other Drug Dependence Treatment (Alternate) Code Lists for Measure NQF Prenatal Care Screening for HIV (Alternate) Code Lists for Measure NQF 0013 Hypertension: Blood Pressure Management (Core) Code Lists for Measure NQF 0014 Prenatal Care: Anti-D Immune Globulin (Alternate) Code Lists for Measure NQF Controlling High Blood Pressure (Alternate) Code Lists for Measure NQF Weight Assessment and Counseling for Children and Adolescents (Core) Code Lists for Measure NQF 0027 / PQRI 115 Smoking cessation advising to quit, discuss cessation medications, discuss strategies for quitting (Alternate) Code Lists for Measure NQF 0028a Preventive Care and Screening: Tobacco Use Assessment (Core) MicroMD EMR Clinical Quality Measure Calculations Version 7.5 TOC.1

5 Table of Contents Code Lists for Measure NQF 0028b Preventive Care and Screening: Tobacco Use Assessment (Core) Code Lists for Measure NQF 0031 Breast Cancer Screening (Alternate) Code Lists for Measure NQF 0032 Cervical Cancer Screening (Alternate) Code Lists for Measure NQF 0033 Chlamydia Screening for Women (Alternate) Code Lists for Measure NQF Colorectal Cancer Screening (Alternate) Code Lists for Measure NQF Use of Appropriate Medications for Asthma (Alternate) Code Lists for Measure NQF Childhood Immunization Status (Core) Code Lists for Measure NQF 0041 / PQRI 110 Influenza Immunization for patients 50 and older (Alternate) Code Lists for Measure NQF 0043 / PQRI 111 Pneumonia Vaccination for Older Adults (Alternate) Code Lists for Measure NQF 0047 / PQRI 53 Asthma Pharmacology Therapy (Alternate) Code Lists for Measure NQF Low Back Pain: Use of Imaging Studies (Alternate) Code Lists for Measure NQF 0055 / PQRI 117 Diabetes: Eye Exam (Alternate) Code Lists for Measure NQF 0056 / PQRI 163 Diabetes: Foot Exam (Alternate) Code Lists for Measure NQF 0059 / PQRI 1 Diabetes: HbA1c Poor Control (Alternate) Code Lists for Measure NQF 0061 / PQRI 3 Diabetes: Blood Pressure Management (Alternate) Code Lists for Measure NQF 0062 / PQRI 119 Diabetes: Urine Screening (Alternate) Code Lists for Measure NQF 0064 / PQRI 2 Diabetes: LDL Management and Control (Alternate) Code Lists for Measure NQF 0067 / PQRI 6 Coronary Artery Disease: Oral Antiplatelet Therapy Prescribed (Alternate) Code Lists for Measure NQF 0068 / PQRI 204 Ischemic Vascular Disease: Use of Aspirin or another Antithrombotic (Alternate) Code Lists for Measure NQF 0070 / PQRI 7 Coronary Artery Disease: Beta Blocker Therapy for CAD Patients with Prior MI (Alternate) Code Lists for Measure NQF 0073 / PQRI 201 Ischemic Vascular Disease: Blood Pressure Management (Alternate) Code Lists for Measure TOC.2 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

6 Table of Contents NQF 0074 / PQRI 197 Coronary Artery Disease: Drug Therapy for Lowering LDL Cholesterol (Alternate) Code Lists for Measure NQF 0075 Ischemic Vascular Disease: Complete Lipid Panel and LDL Control (Alternate) Code Lists for Measure NQF 0081 / PQRI 5 Heart Failure: ACE Inhibitor or ARB Therapy for LVSD (Alternate) Code Lists for Measure NQF 0083 / PQRI 8 Heart Failure: Beta Blocker Therapy for LVSD (Alternate) Code Lists for Measure NQF 0084 / PQRI 200 Heart Failure: Warfarin Therapy for Patients with Atrial Fib (Alternate) Code Lists for Measure NQF 0086 / PQRI 12 Primary Open Angle Glaucoma: Optic Nerve Evaluation (Not Supported) NQF 0088 / PQRI 18 Diabetic Retinopathy Documentation of Presence of Macular Edema and Level of Severity Retinopathy (Not Supported) NQF 0089 / PQRI 19 Diabetic Retinopathy Communicating with the physician managing ongoing Diabetes care. (Not Supported) NQF 0105 / PQRI 9 Anti-Depressant medication management: A: Effective acute phase treatment B: effective continuation (Alternate) Code Lists for Measure NQF 0385 / PQRI 72 Oncology Colon Cancer: Chemo for State III Colon Cancer Patients (Non-Supported) NQF 0387 / PQRI 71 Oncology Breast Cancer: Hormonal Therapy for State IC-IIIC ER/PR Positive Breast Cancer (Not Supported) NQF 0389 / PQRI 102 Prostate Cancer: Avoidance of Overuse of Bone Scan for staging low risk cancer patients (Alternate) Code Lists for Measure NQF 0421 / PQRI 128 Adult Weight Screening and Follow-Up (Core) Code Lists for Measure NQF 0575 Diabetes: HgA1c Control <8.0% (Alternate) Code Lists for Measure MicroMD EMR Clinical Quality Measure Calculations Version 7.5 TOC.3

7 Table of Contents TOC.4 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

8 PREFACE WELCOME TO MICROMD EMR From all of us here at Henry Schein Medical Systems, Inc., thank you for selecting MicroMD EMR, the definitive Electronic Medical Records (EMR) solution. This manual is a reference to the Clinical Quality Measures supported and calculated by MicroMD EMR. This manual does not cover hardware setup, networking, or installation of the program. HOW THIS GUIDE IS ORGANIZED We have organized this guide according to the modules within MicroMD EMR. The discussion consists mainly of the new features within the modules. You can find in-depth information about the entire module in the MicroMD EMR User s Reference Manual located in the Help menu of MicroMD EMR. UNDERSTANDING TYPOGRAPHICAL CONVENTIONS Before using this manual, it is important to understand the typographical conventions used to identify and describe information. Cross-References Cross-references to chapters, sections, page numbers, headings, etc. are shown in an italic typeface. e.g., Refer to Understanding Typographical Conventions on page i. Text You Type Using the Keyboard Text that you type using the keyboard is shown in a Courier typeface. e.g., Type Anthony Smith in the Name field. Keys You Press and Buttons You Click Keys that you press on the keyboard and buttons/icons that you click with the mouse are shown in a bold sans-serif typeface. e.g., Press Enter. e.g., Click OK to continue. MicroMD EMR Clinical Quality Measure Calculations Version 7.5 i

9 Preface Dialog Box, Application Window Titles, and Field Names The titles of dialog boxes and application windows are shown in italics. Field names and selections made from dropdown menus, etc. are also shown in italics. e.g., The Print Preview dialog box appears. e.g., Select Commercial Insurance from the drop-down list. Notes, Warnings, and Tips Notes, tips and warnings are provided throughout the manual. These provide additional information that is important for you to know about the topic. NOTE A note is an important piece of information. STOP You should definitely read the information in a warning. It could help you prevent a disaster. TIP A tip table helps you with some interesting information about different ways to use the program. ii MicroMD EMR Clinical Quality Measure Calculations Version 7.5

10 INTRODUCTION CHAPTER 1 ABOUT THIS GUIDE This guide documents the Clinical Quality Measures (CQM) that are supported and calculated by MicroMD EMR version 7.5. MicroMD EMR version 7.5 was designed to comply with the requirements of the CMS EHR Incentive Program and Stage 1 Meaningful Use requirements for eligible providers. REFERENCES Additional information about HITECH Measures can be found at the sites below: The CMS EHR Incentive Program offers eligible providers opportunities for incentive payments over a multiple year period. For details on the program, visit MicroMD EMR version 7.5 has been certified under the ONC EHR Certification program as a Complete EHR Solution. Requirements for testing of HITECH Measures under the certification included testing for all core measures and menu-set measures. All additional measures are available to MicroMD EMR users for calculation and use in qualifying for the incentives offered in the CMS EHR Incentive Program. To reference the certification listing for MicroMD EMR version 7.5, please visit CORE MEASURES AND ALTERNATE MEASURES The CMS EHR Incentive Program requires each eligible provider to report three core measures and three alternate measures to demonstrate Stage 1 of Meaningful Use. There are three Required Core CQMs and three Alternate Core CQMs. Eligible providers must report on the three Required Core CQMs. If a physician reports 0 (zero) for one or more of the three Required Core CQMs, he or she must then report on up to three Alternate Core CQMs. (Some specialists, therefore, may have to report on as many as three alternate CQMs.) The three core measures are required for all providers to submit and include: NQF 0013 NQF 0028a NQF 0028b NQF 0421 Hypertension: Blood Pressure Management Preventive Care and Screening: Tobacco Use Assessment (Core) Preventive Care and Screening: Tobacco Use Assessment Adult Weight Screening and Follow-Up The three alternate core measures to submit include: NQF 0024 NQF 0038 NQF 0041 Weight Assessment and Counseling for Children and Adolescents Childhood Immunization Status Influenza Vaccine for Patients 50 years and Older The alternate measures are designed to allow providers to select measures that pertain to the specialty or patient population that they serve. Three must be reported, but providers may track as many measures as they like. MicroMD EMR Clinical Quality Measure Calculations Version

11 Chapter 1. INTRODUCTION NON-SUPPORTED MEASURES MicroMD EMR version 7.5 supports and calculates all but five of the listed Clinical Quality Measures. The five listed measures that are not supported are measurements designed to be used by ophthalmologists and oncologists. As the MicroMD EMR software is not designed for use in these specialties, these measures are not supported: NQF 0086 / PQRI 12 Primary Open Angle Glaucoma: Optic Nerve Evaluation NQF 0088 / PQRI 18 Diabetic Retinopathy Documentation of Presence of Macular Edema and Level of Severity Retinopathy NQF 0089 / PQRI 19 Diabetic Retinopathy Communicating with the physician managing ongoing Diabetes care. (Not Supported) NQF 0385 / PQRI 72 Oncology Colon Cancer: Chemo for State III Colon Cancer Patients NQF 0387 / PQRI 71 Oncology Breast Cancer: Hormonal Therapy for State IC-IIIC ER/PR Positive Breast Cancer ABOUT THE CLINICAL QUALITY MEASURES Each Clinical Quality Measure is designed to calculate the compliance with standards in delivery of healthcare. Henry Schein Medical Systems has followed the measurement documentation (as published by the NQF) in the design of the Clinical Quality Measures reporting module. Each documented measure contains the following elements: NQF Measure Number the number assigned by the National Quality Forum for this quality measurement. PQRI Measure Number the number assigned by CMS for use in the Physician Quality Reporting Initiative (PQRS - Physician Quality Reporting System). Description provides a brief description of the CQM and what it is intending to measure. Note that the descriptions are brief and may not always indicate the detailed nature of the measure. It is important to review the measure in its entirety to understand the calculation completely. Clinical Rationale provides the rationale and purpose of the measurement. Measure Calculation requires a denominator, numerator and exclusions from the calculation. Denominator describes the patients that should be included in the measurement calculation. In other words, these patients qualify to be included in the calculation. For example, if the measurement is looking for diabetic patients who have had an eye exam, the Denominator would include all diabetic patients. Numerator describes the patients in the Denominator who have satisfied the requirements of the measure. For example, if the measurement is looking for diabetic patients who had an eye exam, the numerator would only be the patients who had the eye exam. Exclusions describes patients who should not be included in the measurement (either Denominator or Numerator) because of a clinical indication in their chart. Typically these measurements are considered clinically inappropriate for patients due to their prior history or current health status. For example, a patient with his or her appendix removed would not be included in a measure testing the treatment of appendicitis. Code Lists are used extensively throughout the Clinical Quality Measures documentation. The code lists contain the approved codes that should be used to document a condition or action in the patient s chart. Note that these codes are provided by NQF in the documentation of each measure. Code lists that are referenced are: 1.2 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

12 Reporting Considerations Chapter 1. INTRODUCTION ICD-9 and ICD-10 - represent the documentation of a patient s diagnosis. CPT, HCSPS - represents services provided to the patient. LOINC - (Logical Observation Identifiers Names and Codes) represents the standard nomenclature for lab results. CVX - represents the standard nomenclature for immunization. Practices reporting the measurements that involve immunizations will need to update their immunization listing to include the CVX codes. This may involve referring to documentation provided with the immunizations or referring to the following lists provided online by Centers for Disease Control (CDC): Provides a list by vaccine type: Provides a list by tradename for the vaccine: REPORTING CONSIDERATIONS NOTE MicroMD EMR does not support the use of user-defined codes and medications in the calculation of the Clinical Quality Measures. Reporting Period - Users of MicroMD EMR version 7.5 can choose to calculate the Clinical Quality Measure reporting at any time and may specify a reporting period. This reporting period typically follows a reporting year but may be modified to include any date range. Lookback Periods These periods represent the time prior to the encounter or the end of the reporting period that are considered for the measure calculation. It is important to consider that the lookback period may be prior to the reporting period and any practice may not have collected the data required to satisfy the measure based on the lookback period requirements. While this data disparity will correct itself over time by collecting the data for the measurement in the future, the initial results may not reflect the actual compliance with the measurement. Qualifying Encounters Please note that the basis for CQM reporting is the patient encounter. Patients will only be considered in the calculations when an encounter has been created during the specified reporting period. Patient Age Calculation For most measures, the patient s age is calculated at the beginning of the reporting period. Lab Results These must be documented with numeric values only and must not use special characters (!, %, etc). Additionally, most lab results look to a LOINC code associated with the result. Note that LOINC is a recognized standard for each lab result. Settings in MicroMD EMR Manager allow you to link your existing lab results to a LOINC result. Similar Measurements Several measures are focused on certain groups of patients or types of care. The similarities in these measures may lead practices to implement the quality measures simultaneously for these patient groups: MicroMD EMR Clinical Quality Measure Calculations Version

13 Chapter 1. INTRODUCTION Asthma 0001, 0036, 0047 Cancer Screening 0031, 0032, 0034 Coronary Artery Disease 0067, 0070, 0074 Diabetes 0055, 0056, 0059, 0061, 0062, 0064, 0575 Heart Failure 0081, 0083, 0084 Hypertension 0013, 0018 Immunization Status 0038, 0111, 0041 Ischemic Vascular Disease 0068, 0073, 0075 Prenatal Screening 0012, 0014 Smoking/Tobacco Use Assessment 0027, 0028a, 0028b Weight Assessment 0024, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

14 REPORTING CLINICAL QUALITY MEASURES CHAPTER 2 NQF 0001 / PQRI 64 ASTHMA ASSESSMENT (ALTERNATE) Description: Clinical Rationale: Detail Percentage of patients aged 5 through 40 years with a diagnosis of asthma and who have been seen for at least two office visits, who were evaluated during at least one office visit within 12 months for the frequency (numeric) of daytime and nocturnal asthma symptoms. To determine whether the goals of therapy are being met, monitoring is recommended in the six areas listed below: Signs and symptoms (daytime; nocturnal awakening) of asthma Pulmonary function (spirometry; peak flow monitoring) Quality of life/functional status History of asthma exacerbations Pharmacotherapy (as-needed use of inhaled short-acting beta2- agonist, adherence to regimen of long-term-control medications) Patient-provider communication and patient satisfaction (NAEPP/NHLBI) Denominator: **Patients in Age Range: >= 5 and <=40 **who have condition of Asthma recorded in their chart-(see code list) Problem List Entry ( with a beginning date <= encounter date) or an Encounter Assessment (beginning date <= encounter date) AND **who have been seen at least two times **Date Range: during the reporting period Encounters with Encounter Levels specified. (see code list) Numerator: Exclusions: **Patients with Asthma History documented before the end of the reporting period. None. MedInfo>Histories> Asthma History Encounter Plan (QM Tab) in one encounter in the reporting period contains the following CPT code (1005F) MicroMD EMR Clinical Quality Measure Calculations Version

15 Code Lists for Measure Asthma ICD-9 Codes: (Denominator) Encounter Level Codes: (Denominator) Encounter Plan Codes: (Numerator) Detail , , , , , , , , , , , , , , 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, F NQF 0002 / PQRI 66 APPROPRIATE TESTING FOR CHILDREN WITH PHARYNGITIS (ALTERNATE) Description: Clinical Rationale: Detail The percentage of children 2-18 years of age who were diagnosed with Pharyngitis, dispensed an antibiotic and received a group A streptococcus (strep) test for the episode. This measure assesses the proportion of age-appropriate children diagnosed with pharyngitis who were prescribed an antibiotic at an outpatient visit and who received a group A streptococcus (group A strep) test. Pharyngitis occurs in all age groups, but those aged 5-18 years have the highest incidence of streptococcal infections. A physician s clinical diagnosis can be validated with an objective diagnostic (group A strep) test. This test, which is widely available to practitioners, can result in a reduction of two-thirds of antibiotic consumption of pharyngitis while maintaining significant benefits for patients. In a recent nationwide physician survey, however, 42% of physicians reported that they would start antibiotic treatment for children with pharyngitis before knowing the results of a group A strep test, and would continue treatment regardless. This measure is important because it requires initial antigen screening to ensure accurate diagnosis and promotes judicious use of antibiotics and reduction of antibiotic overuse. Denominator: **Patients in Age Range: >= 2 and <=18 **who have condition of Pharyngitis recorded in their chart- (see code list) MedInfo>Medical>Problem List Entry ( with a beginning date <= encounter date) or an Encounter with an Assessment (beginning date <= encounter date) AND **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified by ICD or CPT 2.2 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

16 Detail AND ** who were prescribed medications for Pharyngitis (see code list) on the encounter date or up to 3 days afterwards. MedInfo>Medical>Medications - Medication for Pharyngitis AND NOT **Patients who were prescribed a qualifying antibiotic <=30 days prior to the encounter. MedInfo>Medical>Medications - Medication for Pharyngitis <= 30 days before 1 days prior to encounter. Numerator: Exclusions: Code Lists for Measure ICD-9 Codes: Pharyngitis (Denominator) Encounter Level Codes: (Denominator) **Patients who received a step test for the episode. Lab Test completed for LOINC Codes (see code list) Lab Test date is <= 3 days earlier than the medication given. None , 462, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, 99456, 99281, 99282, 99283, 99284, Encounter Levels (Denominator) ICD Lab Result LOINC Codes: (Numerator) v70.0, v70.3, v70.5, v70.6, v70.8, v , , , , ,5036-9, 626-2, , , Qualifying Medications: A-Cillin 250 mg Cap, A-Cillin 500 mg Cap, Acanya 1.2 %-2.5 % Topical Gel, Achromycin 250 mg Cap, Achromycin V 125 mg/5 ml Oral Susp, Achromycin V 250 mg Cap, Achromycin V 500 mg Cap, Adoxa 100 mg Tab, Adoxa 150 mg Cap, Adoxa 50 mg Tab, Adoxa 75 mg Tab, Adoxa Pak 100 mg Tab, Adoxa Pak 150 mg Tab, Adoxa Pak 75 mg Tab, Ak-Ramycin 100 mg Cap, Ak-Ramycin 100 mg Tab, Ala-Tet 250 mg Cap, Alodox 20 mg Kit, Amcap 250 mg Cap, Amficot 250 mg Cap, amoxicillin 125 mg Chewable Tab, amoxicillin 125 mg/5 ml Oral Susp, amoxicillin 200 mg Chewable Tab, MicroMD EMR Clinical Quality Measure Calculations Version

17 amoxicillin 200 mg Dispersible Tab, amoxicillin 200 mg/5 ml Oral Susp, amoxicillin 250 mg Cap, amoxicillin 250 mg Chewable Tab, amoxicillin 250 mg/5 ml Oral Susp, amoxicillin 400 mg Chewable Tab, amoxicillin 400 mg Dispersible Tab, amoxicillin 400 mg/5 ml Oral Susp, amoxicillin 50 mg/ml Oral Susp, amoxicillin 500 mg Cap, amoxicillin 500 mg Tab, amoxicillin 600 mg Dispersible Tab, amoxicillin 875 mg Tab, amoxicillin ER 775 mg multiphase 24 hr Tab, amoxicillin-potassium clavulanate 125 mg mg Chewable Tab, amoxicillin-potassium clavulanate 125 mg mg/5 ml Oral Susp, amoxicillin-potassium clavulanate 200 mg-28.5 mg Chewable Tab, amoxicillin-potassium clavulanate 200 mg-28.5 mg/5 ml Oral Susp, amoxicillin-potassium clavulanate 250 mg-125 mg Tab, amoxicillinpotassium clavulanate 250 mg-62.5 mg Chewable Tab, amoxicillinpotassium clavulanate 250 mg-62.5 mg/5 ml Oral Susp, amoxicillinpotassium clavulanate 400 mg-57 mg Chewable Tab, amoxicillin-potassium clavulanate 400 mg-57 mg/5 ml Oral Susp, amoxicillin-potassium clavulanate 500 mg-125 mg Tab, amoxicillinpotassium clavulanate 600 mg-42.9 mg/5 ml Oral Susp, amoxicillinpotassium clavulanate 875 mg-125 mg Tab, amoxicillin-potassium clavulanate ER 1,000 mg-62.5 mg 12 hr Tab, Amoxil 125 mg Chewable Tab, Amoxil 125 mg/5 ml Oral Susp, Amoxil 200 mg Chewable Tab, Amoxil 200 mg/5 ml Oral Susp, Amoxil 250 mg Cap, Amoxil 250 mg Chewable Tab, Amoxil 250 mg/5 ml Oral Susp, Amoxil 400 mg Chewable Tab, Amoxil 400 mg/5 ml Oral Susp, Amoxil 50 mg/ml Oral Susp, Amoxil 500 mg Cap, Amoxil 500 mg Tab, Amoxil 875 mg Tab, Ampi-Co 125 mg/5 ml Oral Susp, Ampi-Co 250 mg Cap, Ampi-Co 250 mg/5 ml Oral Susp, Ampi-Co 500 mg Cap, Ampicap-S 125 mg/5 ml Oral Susp, Ampicap-S 250 mg Cap, Ampicap-S 250 mg/5 ml Oral Susp, ampicillin 1 gram IV Piggy Back, ampicillin 1 gram IV Solution, ampicillin 1 gram Solution for Injection, ampicillin 10 gram Solution for Injection, ampicillin 125 mg IV Solution, ampicillin 125 mg Solution for Injection, ampicillin 125 mg/5 ml Oral Susp, ampicillin 2 gram IV Piggy Back, ampicillin 2 gram IV Solution, ampicillin 2 gram Solution for Injection, ampicillin 250 mg Cap, ampicillin 250 mg IV Solution, ampicillin 250 mg Solution for Injection, ampicillin 250 mg/5 ml Oral Susp, ampicillin 500 mg Cap, ampicillin 500 mg IV Piggy Back, ampicillin 500 mg IV Solution, ampicillin 500 mg Solution for Injection, ampicillin-sulbactam 1.5 gram IV Piggy Back, ampicillin-sulbactam 1.5 gram IV Solution, ampicillin-sulbactam 1.5 gram Solution for Injection, ampicillinsulbactam 15 gram Solution for Injection, ampicillin-sulbactam 3 gram IV Piggy Back, ampicillin-sulbactam 3 gram IV Solution, ampicillin-sulbactam 3 gram Solution for Injection, Amplin 125 mg/5 ml Oral Susp, Amplin 250 mg Cap, Amplin 250 mg/5 ml Oral Susp, Amplin 500 mg Cap, Amplin mg/5 ml Oral Susp, Amplin mg Cap, Amplin mg/5 ml Oral Susp, Amplin mg Cap, Ancef 1 gram IV Piggy Back, Ancef 1 gram Solution for Injection, Ancef 10 gram Solution for Injection, Ancef MicroMD EMR Clinical Quality Measure Calculations Version 7.5

18 mg Solution for Injection, Ancef 5 gram Solution for Injection, Ancef 500 mg IV Piggy Back, Ancef 500 mg Solution for Injection, Ancef in dextrose (iso-osmotic) 1 gram/50 ml IV Piggy Back, Ancef in dextrose (iso-osmotic) 500 mg/50 ml IV Piggy Back, Anspor 125 mg/5 ml Oral Susp, Anspor 250 mg Cap, Anspor 250 mg/5 ml Oral Susp, Anspor 500 mg Cap, Aoracillin B 500 mg Tab, Arestin 1 mg Dental Cartridge, Arladox 100 mg Cap, Arladox 50 mg Cap, Augmentin 125 mg mg Chewable Tab, Augmentin 125 mg mg/5 ml Oral Susp, Augmentin 200 mg-28.5 mg Chewable Tab, Augmentin 200 mg-28.5 mg/5 ml Oral Susp, Augmentin 250 mg-125 mg Tab, Augmentin 250 mg-62.5 mg Chewable Tab, Augmentin 250 mg-62.5 mg/5 ml Oral Susp, Augmentin 400 mg-57 mg Chewable Tab, Augmentin 400 mg-57 mg/5 ml Oral Susp, Augmentin 500 mg-125 mg Tab, Augmentin 875 mg-125 mg Tab, Augmentin ES mg-42.9 mg/5 ml Oral Susp, Augmentin XR 1,000 mg-62.5 mg 12 hr Tab, Avelox 400 mg Tab, Avelox ABC Pack 400 mg Tab, Avelox in sodium chloride (iso-osmotic) 400 mg/250 ml IV Piggy Back, Avidoxy 100 mg Tab, azithromycin 1 gram Oral Packet, azithromycin 100 mg/5 ml Oral Susp, azithromycin 200 mg/5 ml Oral Susp, azithromycin 250 mg Cap, azithromycin 250 mg Tab, azithromycin 500 mg IV Solution, azithromycin ER 2 gram/60 ml Oral Susp, azithromycin hydrogen citrate 2.5 g IV Solution, azithromycin hydrogen citrate 500 mg IV Solution, Bactrim 200 mg-40 mg/5 ml Oral Susp, Bactrim 400 mg-80 mg Tab, Bactrim 400 mg-80 mg/5 ml IV, Bactrim DS 800 mg- 160 mg Tab, Beepen VK 125 mg/5 ml Oral Susp, Beepen VK 250 mg Tab, Beepen VK 250 mg/5 ml Oral Susp, Beepen-VK 500 mg Tab, Benzaclin 1 %-5 % Topical Gel, Benzaclin Carekit 1 %-5 % Topical Kit, Benzaclin Pump 1 %-5 % Topical Gel, Betapen VK 250 mg Tab, Betapen-VK 125 mg/5 ml Oral Susp, Betapen-VK 250 mg/5 ml Oral Susp, Betapen-VK 500 mg Tab, Bethaprim DS 800 mg-160 mg Tab, Biaxin 125 mg/5 ml Oral Susp, Biaxin mg/5 ml Oral Susp, Biaxin 250 mg Tab, Biaxin 250 mg/5 ml Oral Susp, Biaxin 500 mg Tab, Biaxin XL 500 mg 24 hr Tab, Biaxin XL Pak 500 mg 24 hr Tab, Bicillin C-R 1,200,000 unit/2 ml IM Syringe, Bicillin C-R 150,000 unit-150,000 unit/ml IM Susp, Bicillin C-R 900,000 unit-300k unit/2 ml IM Syringe, Bicillin L-A 1,200,000 unit/2 ml IM Syringe, Bicillin L-A 2,400,000 unit/4 ml IM Syringe, Bicillin L-A 300,000 unit/ml IM Susp, Bicillin L-A 600,000 unit/ml IM Syringe, Bio-Tab 100 mg Tab, Biocef 125 mg/5 ml Oral Susp, Biocef 250 mg/5 ml Oral Susp, Biocef 500 mg Cap, Biocycline 125 mg/5 ml Oral Susp, bismuth subcit K-metronidazole-tetracycline 140 mg-125 mg-125 mg Cap, Bristamycin 250 mg Tab, Brodspec 125 mg/5 ml Oral Susp, Brodspec 250 mg Cap, C-Lexin 250 mg Cap, C-Lexin 500 mg Cap, C/T/S 1 % Topical Soln, Caropen VK 250 mg Tab, Caropen-VK 125 mg/5 ml Oral Susp, Caropen-VK 250 mg/5 ml Oral Susp, Caropen-VK 500 mg Tab, Ceclor 125 mg/5 ml Oral Susp, Ceclor 187 mg/5 ml Oral Susp, Ceclor 250 mg Cap, Ceclor 250 mg/5 ml Oral Susp, Ceclor 375 mg/5 ml Oral Susp, Ceclor 500 MicroMD EMR Clinical Quality Measure Calculations Version

19 mg Cap, Ceclor CD 375 mg 12 hr Tab, Ceclor CD 500 mg 12 hr Tab, Cedax 180 mg/5 ml Oral Susp, Cedax 400 mg Cap, Cedax 90 mg/5 ml Oral Susp, cefaclor 125 mg Chewable Tab, cefaclor 125 mg/5 ml Oral Susp, cefaclor 187 mg Chewable Tab, cefaclor 187 mg/5 ml Oral Susp, cefaclor 250 mg Cap, cefaclor 250 mg Chewable Tab, cefaclor 250 mg/5 ml Oral Susp, cefaclor 375 mg Chewable Tab, cefaclor 375 mg/5 ml Oral Susp, cefaclor 500 mg Cap, cefaclor ER 375 mg 12 hr Tab, cefaclor ER 500 mg 12 hr Tab, cefadroxil 1 gram Tab, cefadroxil 125 mg/5 ml Oral Susp, cefadroxil 250 mg/5 ml Oral Susp, cefadroxil 500 mg Cap, cefadroxil 500 mg/5 ml Oral Susp, Cefanex 250 mg Cap, Cefanex 500 mg Cap, cefazolin 1 gram IV Piggy Back, cefazolin 1 gram IV Solution, cefazolin 1 gram Solution for Injection, cefazolin 10 gram Solution for Injection, cefazolin 100 gram Solution for Injection, cefazolin 20 gram Solution for Injection, cefazolin 250 mg Solution for Injection, cefazolin 300 g Solution for Injection, cefazolin 5 gram Solution for Injection, cefazolin 500 mg IV Piggy Back, cefazolin 500 mg Solution for Injection, cefazolin in 0.9 % sodium chloride 1 gram/10 ml IV Syringe, cefazolin in 0.9 % sodium chloride 2 gram/100 ml IV, cefazolin in D5W 2 gram/100 ml IV, cefazolin in dextrose (isoosmotic) 1 gram/50 ml IV Piggy Back, cefazolin in dextrose (iso-osmotic) 500 mg/50 ml IV Piggy Back, cefazolin sodium-sterile water 1 gram/10 ml IV Syringe, cefazolin sodium-sterile water 2 gram/20 ml IV Syringe, cefdinir 125 mg/5 ml Oral Susp, cefdinir 250 mg/5 ml Oral Susp, cefdinir 300 mg Cap, cefditoren pivoxil 200 mg Tab, cefditoren pivoxil 400 mg Tab, cefixime 100 mg/5 ml Oral Susp, cefixime 200 mg Tab, cefixime 200 mg/5 ml Oral Susp, cefixime 400 mg Tab, cefpodoxime 100 mg Tab, cefpodoxime 100 mg/5 ml Oral Susp, cefpodoxime 200 mg Tab, cefpodoxime 50 mg/5 ml Oral Susp, cefprozil 125 mg/5 ml Oral Susp, cefprozil 250 mg Tab, cefprozil 250 mg/5 ml Oral Susp, cefprozil 500 mg Tab, ceftibuten 180 mg/5 ml Oral Susp, ceftibuten 400 mg Cap, ceftibuten 90 mg/5 ml Oral Susp, Ceftin 125 mg Tab, Ceftin 125 mg/5 ml Oral Susp, Ceftin 250 mg Tab, Ceftin 250 mg/5 ml Oral Susp, Ceftin 500 mg Tab, ceftriaxone 1 gram IV Piggy Back, ceftriaxone 1 gram IV Solution, ceftriaxone 1 gram Solution for Injection, ceftriaxone 10 gram Solution for Injection, ceftriaxone 2 gram IV Piggy Back, ceftriaxone 2 gram IV Solution, ceftriaxone 2 gram Solution for Injection, ceftriaxone 250 mg Solution for Injection, ceftriaxone 500 mg Solution for Injection, ceftriaxone in dextrose (iso-osmotic) 1 gram/50 ml IV Piggy Back, ceftriaxone in dextrose (iso-osmotic) 2 gram/50 ml IV Piggy Back, cefuroxime axetil 125 mg Tab, cefuroxime axetil 125 mg/5 ml Oral Susp, cefuroxime axetil 250 mg Tab, cefuroxime axetil 250 mg/5 ml Oral Susp, cefuroxime axetil 500 mg Tab, cefuroxime in sterile water 1.5 gram/50 ml IV Piggy Back, cefuroxime sodium 1.5 gram IV Piggy Back, cefuroxime sodium 1.5 gram IV Solution, cefuroxime sodium 1.5 gram Solution for Injection, cefuroxime sodium 7.5 gram IV Solution, cefuroxime sodium in D5W 1.5 gram/100 ml IV Piggy Back, cefuroxime-dextrose (iso- 2.6 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

20 osmotic) 1.5 gram/50 ml IV Piggy Back, cefuroxime-dextrose (iso-osmotic) 750 mg/50 ml IV Piggy Back, Cefzil 125 mg/5 ml Oral Susp, Cefzil 250 mg Tab, Cefzil 250 mg/5 ml Oral Susp, Cefzil 500 mg Tab, Cen-Amp 125 mg/5 ml Oral Susp, Cen-Amp 250 mg Cap, Cen-Amp 250 mg/5 ml Oral Susp, Cen-Mycin 250 mg Tab, Cen-Tet 250 mg Cap, Centet mg Cap, cephalexin 125 mg Dispersible Tab, cephalexin 125 mg/5 ml Oral Susp, cephalexin 250 mg Cap, cephalexin 250 mg Dispersible Tab, cephalexin 250 mg Tab, cephalexin 250 mg/5 ml Oral Susp, cephalexin 500 mg Cap, cephalexin 500 mg Tab, cephalexin 750 mg Cap, cephalexin HCl 500 mg Tab, cephradine 125 mg/5 ml Oral Susp, cephradine 250 mg Cap, cephradine 250 mg/5 ml Oral Susp, cephradine 500 mg Cap, Cheragan 500 mg Tab, Cheragan with Tmp 800 mg-160 mg Tab, Cipro 250 mg Tab, Cipro 250 mg/5 ml Oral Susp, Cipro 500 mg Tab, Cipro 500 mg/5 ml Oral Susp, Cipro 750 mg Tab, Cipro Cystitis 100 mg Tab, Cipro in D5W 200 mg/100 ml IV Piggy Back, Cipro in D5W 400 mg/200 ml IV Piggy Back, Cipro XR 1,000 mg 24 hr Tab, Cipro XR 500 mg 24 hr Tab, ciprofloxacin 100 mg Tab, ciprofloxacin 250 mg Tab, ciprofloxacin 250 mg/5 ml Oral Susp, ciprofloxacin 500 mg Tab, ciprofloxacin 500 mg/5 ml Oral Susp, ciprofloxacin 750 mg Tab, ciprofloxacin ER 1,000 mg multiphase 24 hr Tab, ciprofloxacin ER 500 mg 24 hr Tab, ciprofloxacin ER 500 mg multiphase 24 hr Tab, ciprofloxacin in D5W 200 mg/100 ml IV Piggy Back, ciprofloxacin in D5W 400 mg/200 ml IV Piggy Back, clarithromycin 125 mg/5 ml Oral Susp, clarithromycin mg/5 ml Oral Susp, clarithromycin 250 mg Tab, clarithromycin 250 mg/5 ml Oral Susp, clarithromycin 500 mg Tab, clarithromycin ER 500 mg 24 hr Tab, Cleocin 100 mg Vaginal Suppository, Cleocin 150 mg Cap, Cleocin 150 mg/ml Injection, Cleocin 2 % Vaginal Cream, Cleocin 300 mg Cap, Cleocin 600 mg/4 ml IV, Cleocin 75 mg Cap, Cleocin 75 mg/5 ml Oral Solution, Cleocin 900 mg/6 ml IV, Cleocin in D5W 300 mg/50 ml IV Piggy Back, Cleocin in D5W 600 mg/50 ml IV Piggy Back, Cleocin in D5W 900 mg/50 ml IV Piggy Back, Cleocin T 1 % Lotion, Cleocin T 1 % Soln, Cleocin T 1 % Topical Gel, Cleocin T 1 % Topical Swab, Clinda- Derm 1 % Topical Soln, Clindagel 1 % Topical, ClindaMax 1 % Lotion, ClindaMax 1 % Topical Gel, ClindaMax 2 % Vaginal Cream, clindamycin 1 % Lotion, clindamycin 1 % Topical Foam, clindamycin 1 % Topical Gel, clindamycin 1 % Topical Soln, Clindamycin 1 % Topical Swab, clindamycin 100 mg Vaginal Suppository, clindamycin 150 mg Cap, clindamycin 150 mg/ml Injection, clindamycin 2 % Vaginal Cream, clindamycin 300 mg Cap, clindamycin 300 mg/2 ml IV, clindamycin 600 mg/4 ml IV, clindamycin 75 mg Cap, clindamycin 75 mg/5 ml Oral Solution, clindamycin 900 mg/6 ml IV, clindamycin ER 2 % Vaginal Cream, clindamycin in D5W 300 mg/50 ml IV Piggy Back, clindamycin in D5W 600 mg/50 ml IV Piggy Back, clindamycin in D5W 900 mg/50 ml IV Piggy Back, clindamycin phosphate 1 % Topical Swab, clindamycin-benzoyl peroxide 1 %-5 % Topical Gel, clindamycin-benzoyl peroxide 1.2 %-2.5 % Topical Gel, clindamycin- MicroMD EMR Clinical Quality Measure Calculations Version

21 benzoyl peroxide ER 1 %-5 % Topical Gel, clindamycin-benzoyl peroxidehyaluronate 1 %-5 % Topical Kit, clindamycin-benzoyl peroxide-skin cleanser #5 1 %-5 % Topical Kit, clindamycin-tretinoin 1.2 % % Topical Gel, Clindesse 2 % Vaginal Cream, Clindets 1 % Topical Swab, Cofatrim Forte 800 mg-160 mg Tab, Colmox 250 mg Cap, Colmox 500 mg Cap, Comoxol 400 mg-80 mg Tab, Comoxol 800 mg-160 mg Tab, Cor Vk 250 mg/5 ml Oral Susp, Cotrim 200 mg-40 mg/5 ml Oral Susp, Cotrim 400 mg-80 mg Tab, Cotrim 400 mg-80 mg/5 ml IV, Cotrim Double-Strength 800 mg-160 mg Tab, Cotrim I.V. 400 mg-80 mg/5 ml Soln, Cyclatet 250 mg Cap, Cycline mg Cap, Cyclinex 250 mg Cap, D-Amp 500 mg Cap, D-Cillin 125 mg/5 ml Oral Susp, D-Cillin 250 mg Cap, D-Mycin 500 mg Cap, D-Sulfa 500 mg Tab, D.R. Erycin 250 mg Tab, D.R. T-Cycline 250 mg Cap, Deltamycin 250 mg Cap, Deltapen VK 250 mg Tab, Desamycin 250 mg Cap, Desamycin 500 mg Cap, dicloxacillin 250 mg Cap, dicloxacillin 500 mg Cap, dicloxacillin 62.5 mg/5 ml Oral Susp, DisperMox 200 mg Tab, DisperMox 400 mg Tab, DisperMox 600 mg Tab, Doryx 100 mg Cap, Doryx 100 mg Tab, Doryx 150 mg Tab, Doryx 75 mg Cap, Doryx 75 mg Tab, Doxi Film 100 mg Tab, Doxy 100 mg Cap, Doxy 100 mg Tab, Doxy mg IV Solution, Doxy mg IV Solution, Doxy-Caps 100 mg Cap, Doxy-Caps 50 mg Cap, Doxy-D 100 mg Cap, Doxy-D 50 mg Cap, Doxy-Lemmon 100 mg Cap, Doxy-Lemmon 100 mg Tab, Doxy- Lemmon 50 mg Cap, Doxy-Tabs 100 mg Tab, Doxychel 100 mg Cap, Doxychel 100 mg Tab, Doxychel 50 mg Cap, doxycycline 100 mg Cap, doxycycline 100 mg Tab, doxycycline 150 mg Cap, doxycycline 150 mg Tab, doxycycline 25 mg/5 ml Oral Susp, doxycycline 50 mg Cap, doxycycline 50 mg Tab, doxycycline 50 mg/5 ml Syrup, doxycycline 75 mg Cap, doxycycline 75 mg Tab, doxycycline hyclate 100 mg Cap, doxycycline hyclate 100 mg Cap, Delayed Release, doxycycline hyclate 100 mg IV Solution, doxycycline hyclate 100 mg Tab, doxycycline hyclate 100 mg Tab, Delayed Release, doxycycline hyclate 150 mg Tab, Delayed Release, doxycycline hyclate 20 mg Cap, doxycycline hyclate 20 mg Tab, doxycycline hyclate 200 mg IV Solution, doxycycline hyclate 50 mg Cap, doxycycline hyclate 75 mg Cap, Delayed Release, doxycycline hyclate 75 mg Tab, Delayed Release, doxycycline-eyelid cleansers no.2 & no.3 20 mg Kit, Doxygen 100 mg Tab, Duac 1 %-5 % Topical Gel, Duac CS 1 %-5 % Topical Kit, Duricef 1 gram Tab, Duricef 125 mg/5ml Oral Susp, Duricef 250 mg/5 ml Oral Susp, Duricef 500 mg Cap, Duricef 500 mg/5 ml Oral Susp, Dycill 250 mg Cap, Dycill 500 mg Cap, Dynacin 100 mg Cap, Dynacin 100 mg Tab, Dynacin 50 mg Cap, Dynacin 50 mg Tab, Dynacin 75 mg Cap, Dynacin 75 mg Tab, Dynapen 250 mg Cap, Dynapen 500 mg Cap, Dynapen 62.5 mg/5 ml Oral Susp, Dynasep DS 800 mg-160 mg Tab, Dynasep SS 400 mg-80 mg Tab, E- Base 500 mg Tab, E-Mycin E 200 mg/5 ml Oral Susp, E-Mycin E 400 mg/5 ml Oral Susp, E.E.S mg/5 ml Oral Susp, E.E.S mg/5 ml Susp, Recon, E.E.S. 200 mg Chewable Tab, E.E.S mg Tab, E.E.S. 2.8 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

22 mg/5 ml Oral Susp, E.E.S. Granules 200 mg/5 ml Oral Susp, ED A- Ceph 125 mg/5 ml Oral Susp, ED A-Ceph 250 mg/5 ml Oral Susp, Emtet mg Cap, Entaceph 250 mg Cap, Entamox 250 mg Cap, Ery-Tab 500 mg Tab, EryPed 100 mg/2.5 ml Oral Drops, EryPed mg/5 ml Oral Susp, EryPed 200 mg Chewable Tab, EryPed 200 mg/5 ml Oral Susp, EryPed mg/5 ml Oral Susp, Erythro-C 250 mg Cap, Erythrobon 250 mg Tab, Erythrocin 1,000 mg IV Solution, Erythrocin 500 mg IV Piggy Back, Erythrocin 500 mg IV Solution, Erythrocin Lactobionate 500 mg IV Piggy Back, Erythrocin Stearate 250 mg Tab, Erythrocin Stearate 500 mg Tab, Erythrocot 250 mg Tab, erythromycin 500 mg Tab, erythromycin 500 mg Tab, Delayed Release, erythromycin 500 mg Tab, Particles/Crystals, erythromycin estolate 125 mg Chewable Tab, erythromycin estolate 125 mg/5 ml Oral Susp, erythromycin estolate 250 mg Cap, erythromycin estolate 250 mg Chewable Tab, erythromycin estolate 250 mg/5 ml Oral Susp, erythromycin estolate 500 mg Tab, erythromycin ethylsuccinate 100 mg/2.5 ml Oral Drops, erythromycin ethylsuccinate 200 mg Chewable Tab, erythromycin ethylsuccinate 200 mg/5 ml Oral Susp, erythromycin ethylsuccinate 200 mg/5 ml Susp, Recon, erythromycin ethylsuccinate 400 mg Tab, erythromycin ethylsuccinate 400 mg/5 ml Oral Susp, erythromycin ethylsuccinate 400 mg/5 ml Susp, Recon, erythromycin gluceptate 1 gram IV Solution, erythromycin lactobionate 1,000 mg IV Solution, erythromycin lactobionate 500 mg IV Piggy Back, erythromycin lactobionate 500 mg IV Solution, erythromycin stearate 250 mg Tab, erythromycin stearate 500 mg Tab, erythromycin-sulfisoxazole 200 mg-600 mg/5 ml Oral Susp, Erythrozone 125 mg/5 ml Oral Susp, Erythrozone 250 mg/5 ml Oral Susp, Eryzole 200 mg-600 mg/5 ml Oral Susp, Ethril mg Tab, Ethril mg Tab, Evoclin 1 % Topical Foam, Factive 320 mg Tab, Floxin 20 mg/ml IV, Floxin 200 mg Tab, Floxin 300 mg Tab, Floxin 40 mg/ml IV, Floxin 400 mg Tab, Floxin I.V. in D5W 200 mg/50 ml Piggy Back, Floxin I.V. in D5W 400 mg/100 ml Piggy Back, Gantrisin 500 mg Tab, Gantrisin 500 mg/5 ml Oral Susp, Gantrisin Pediatric 500 mg/5 ml Oral Susp, gatifloxacin 10 mg/ml IV, gatifloxacin 200 mg Tab, gatifloxacin 400 mg Tab, gatifloxacin in D5W 200 mg/100 ml IV Piggy Back, gatifloxacin in D5W 400 mg/200 ml IV Piggy Back, gemifloxacin 320 mg Tab, Gulfasin 500 mg Tab, Ilosone 125 mg Chewable Tab, Ilosone 125 mg/5 ml Oral Susp, Ilosone 250 mg Cap, Ilosone 250 mg Chewable Tab, Ilosone 250 mg/5 ml Oral Susp, Ilosone 500 mg Tab, Ilotycin 1 gram IV Solution, J-Azo 500 mg Tab, J-Cillin 250 mg Cap, J-Mycin 500 mg Cap, Keflet 250 mg Tab, Keflet 500 mg Tab, Keflex 125 mg/5 ml Oral Susp, Keflex 250 mg Cap, Keflex 250 mg/5 ml Oral Susp, Keflex 500 mg Cap, Keflex 750 mg Cap, Keftab 500 mg Tab, Kefurox 1.5 gram IV Piggy Back, Kefurox 1.5 gram IV Solution, Kefurox 1.5 gram Solution for Injection, Kefurox 7.5 gram IV Solution, Kefzol 1 gram IV Solution, Kefzol 1 gram Solution for Injection, Kefzol 10 gram Solution for Injection, Kefzol 20 gram MicroMD EMR Clinical Quality Measure Calculations Version

23 Solution for Injection, Kefzol 250 mg Solution for Injection, Kefzol 500 mg Solution for Injection, Kencillin mg Cap, Kenmycin mg Tab, Kidtrim DS 800 mg-160 mg Tab, Lanacillin VK 250 mg Tab, Lanacillin VK 500 mg Tab, Larotid 125 mg/5 ml Oral Susp, Larotid 250 mg Cap, Larotid 250 mg/5 ml Oral Susp, Larotid 50 mg/ml Oral Susp, Larotid 500 mg Cap, Ledercillin VK 125 mg/5 ml Oral Susp, Ledercillin VK 250 mg Tab, Ledercillin VK 250 mg/5 ml Oral Susp, Ledercillin VK 500 mg Tab, Levaquin 250 mg/10 ml Oral Soln, Levaquin 750 mg Tab, Levaquin in D5W 250 mg/50 ml IV Piggy Back, Levaquin in D5W 500 mg/100 ml IV Piggy Back, Levaquin in D5W 750 mg/150 ml IV Piggy Back, Levaquin Leva-Pak 750 mg Tab, levofloxacin 250 mg/10 ml Oral Soln, levofloxacin 750 mg Tab, levofloxacin in D5W 250 mg/50 ml IV Piggy Back, levofloxacin in D5W 500 mg/100 ml IV Piggy Back, levofloxacin in D5W 750 mg/150 ml IV Piggy Back, lomefloxacin 400 mg Tab, Lorabid 100 mg/5 ml Oral Susp, Lorabid 200 mg Cap, Lorabid 200 mg/5 ml Oral Susp, Lorabid 400 mg Cap, loracarbef 100 mg/5 ml Oral Susp, loracarbef 200 mg Cap, loracarbef 200 mg/5 ml Oral Susp, loracarbef 400 mg Cap, M-Amp 250 mg Cap, M-Mycin 250 mg Tab, M-Tet 250 mg Cap, M-Tetra mg Cap, Marcillin 125 mg/5 ml Oral Susp, Marcillin 250 mg Cap, Marcillin 250 mg/5 ml Oral Susp, Marcillin 500 mg Cap, Marpen VK 125 mg/5 ml Oral Susp, Marpen VK 250 mg Tab, Marpen VK 250 mg/5 ml Oral Susp, Martet 250 mg Cap, Martet 500 mg Cap, Maxaquin 400 mg Tab, Minocin 100 mg Cap, Minocin 100 mg Combo Pack, Minocin 100 mg IV Solution, Minocin 50 mg Cap, Minocin 50 mg Combo Pack, Minocin 50 mg/5ml Oral Susp, minocycline 100 mg Cap, minocycline 100 mg IV Solution, minocycline 100 mg Tab, minocycline 50 mg Cap, minocycline 50 mg Tab, minocycline 50 mg/5 ml Oral Susp, minocycline 75 mg Cap, minocycline 75 mg Tab, minocycline ER 115 mg 24 hr Tab, minocycline ER 135 mg 24 hr Tab, minocycline ER 45 mg 24 hr Tab, minocycline ER 65 mg 24 hr Tab, minocycline ER 90 mg 24 hr Tab, minocycline microspheres 1 mg Dental Cartridge, minocycline-wipes 100 mg Combo Pack, minocycline-wipes 50 mg Combo Pack, Monodox 100 mg Cap, Monodox 50 mg Cap, Monodox 75 mg Cap, Mox-I mg/5 ml Oral Susp, Moxatag 775 mg 24 hr Tab, moxifloxacin 400 mg Tab, moxifloxacin in sodium chloride (iso-osm) 400 mg/250 ml IV Piggy Back, Moxilin 250 mg Cap, Moxilin 250 mg/5 ml Oral Susp, Moxilin 500 mg Cap, My-E 250 mg Tab, My-E Film 250 mg Tab, My-E Film 500 mg Tab, Nor-Tet 250 mg Cap, norfloxacin 400 mg Tab, Noroxin 400 mg Tab, Nortet 500 mg Cap, ofloxacin 20 mg/ml IV, ofloxacin 200 mg Tab, ofloxacin 300 mg Tab, ofloxacin 40 mg/ml IV, ofloxacin 400 mg Tab, ofloxacin in D5W 200 mg/50 ml IV Piggy Back, ofloxacin in D5W 400 mg/100 ml IV Piggy Back, Omnicef 125 mg/5 ml Oral Susp, Omnicef 250 mg/5 ml Oral Susp, Omnicef 300 mg Cap, Omnipen 125 mg/5 ml Oral Susp, Omnipen 250 mg Cap, Omnipen 250 mg/5 ml Oral Susp, Omnipen 500 mg Cap, Omnipen Redipak 250 mg Cap, Omnipen Redipak 500 mg Cap, Omnipen-N 1 gram IV Piggy Back, 2.10 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

24 Omnipen-N 1 gram IV Solution, Omnipen-N 1 gram Solution for Injection, Omnipen-N 10 gram Solution for Injection, Omnipen-N 125 mg Solution for Injection, Omnipen-N 2 gram IV Piggy Back, Omnipen-N 2 gram IV Solution, Omnipen-N 2 gram Solution for Injection, Omnipen-N 250 mg Solution for Injection, Omnipen-N 500 mg IV Piggy Back, Omnipen-N 500 mg Solution for Injection, Oraxyl 20 mg Cap, Panixine DisperDose 125 mg Tab, Panixine DisperDose 250 mg Tab, Panmycin 250 mg Cap, Panmycin 250 mg Tab, Panmycin 500 mg Tab, Panmycin Syrup 125 mg/5 ml Oral Susp, Pathocil 250 mg Cap, Pathocil 500 mg Cap, Pathocil 62.5 mg/5 ml Oral Susp, PC Mycin 250 mg Tab, PC Pen V K 500 mg Tab, Pc Pen VK 250 mg Tab, PC Tet 250 mg Cap, PC Tet 500 mg Cap, PCE 500 mg Tab, Pediamycin 200 mg Chewable Tab, Pediamycin 200 mg/5 ml Oral Susp, Pediamycin 400 mg/5 ml Oral Susp, Pediatrim 200 mg-40 mg/5 ml Oral Susp, Pediazole 200 mg-600 mg/5 ml Oral Susp, Pen-Vee K 125 mg/5 ml Oral Susp, Pen-Vee K 250 mg Tab, Pen-Vee K 250 mg/5 ml Oral Susp, Pen- Vee K 500 mg Tab, Penamp mg Cap, Penamp mg Cap, penicillin G benzathine 1,200,000 unit/2 ml IM Syringe, penicillin G benzathine 2,400,000 unit/4 ml IM Syringe, penicillin G benzathine 300,000 unit/ml IM Susp, penicillin G benzathine 600,000 unit/ml IM Syringe, penicillin G benzathine&procain 1,200,000 unit/2 ml IM Syringe, penicillin G benzathine&procain 150,000 unit-150,000 unit/ml IM Susp, penicillin G benzathine&procain 900,000 unit-300k unit/2 ml IM Syringe, penicillin G pot in dextrose 1 million unit/50 ml IV Piggy Back, penicillin G pot in dextrose 2 million unit/50 ml IV Piggy Back, penicillin G pot in dextrose 3 million unit/50 ml IV Piggy Back, penicillin G potassium 1 million unit Solution for Injection, penicillin G potassium 10 million unit Solution for Injection, penicillin G potassium 20 million unit Solution for Injection, penicillin G potassium 5 million unit Solution for Injection, penicillin G potassium in D5W 1 million unit/50 ml IV Piggy Back, penicillin G potassium in D5W 2 million unit/50 ml IV Piggy Back, penicillin G potassium in D5W 3 million unit/100 ml IV Piggy Back, penicillin G procaine 1,200,000 unit IM Syringe, penicillin G procaine 300,000 unit/ml IM Susp, penicillin G procaine 600,000 unit IM Syringe, penicillin G sodium 5 million unit Solution for Injection, penicillin V potassium 125 mg/5 ml Oral Susp, penicillin V potassium 250 mg Tab, penicillin V potassium 250 mg/5 ml Oral Susp, penicillin V potassium 500 mg Tab, Pensyn 500 mg Cap, Periostat 20 mg Cap, Periostat 20 mg Tab, Permapen 1,200,000 unit/2 ml IM Syringe, Pfizer-E 250 mg Tab, Pfizer-E 500 mg Tab, Pfizerpen 5 million unit Solution for Injection, Pfizerpen A 125 mg/5 ml Oral Susp, Pfizerpen A 250 mg Cap, Pfizerpen A 250 mg/5 ml Oral Susp, Pfizerpen A 500 mg Cap, Pfizerpen-AS 300,000 unit/ml IM Susp, Pfizerpen-G 20 million unit Solution for Injection, Pfizerpen-G 5 million unit Solution for Injection, Piracaps 500 mg Cap, Poly-V 100 mg Tab, Polycillin 125 mg/5 ml Oral Susp, Polycillin 250 mg Cap, Polycillin 250 mg/5 ml Oral Susp, MicroMD EMR Clinical Quality Measure Calculations Version

25 Polycillin 500 mg Cap, Polycillin Dosa-Trol 250 mg/5 ml Oral Susp, Polycillin-N 1 gram IV Piggy Back, Polycillin-N 10 gram Solution for Injection, Polycillin-N 2 gram Solution for Injection, Polycillin-N 250 mg Solution for Injection, Polycillin-N 500 mg Solution for Injection, Polymox 125 mg/5 ml Oral Susp, Polymox 250 mg Cap, Polymox 250 mg/5 ml Oral Susp, Polymox 50 mg/ml Oral Susp, Polymox 500 mg Cap, Polymyxin B Sul- Trimethoprim 0.1 %-10,000 unit/ml Eye Drops, Polytrim 0.1 %-10,000 unit/ml Eye Drops, Primsol 50 mg/5 ml Oral Soln, Principen mg/5 ml Oral Susp, Principen 125 mg/5 ml Oral Susp, Principen mg Cap, Principen mg/5 ml Oral Susp, Principen 250 mg Cap, Principen 250 mg/5 ml Oral Susp, Principen mg Cap, Principen 500 mg Cap, Proloprim 100 mg Tab, Proloprim 200 mg Tab, ProQuin XR 500 mg 24 hr Tab, Pylera 140 mg-125 mg-125 mg Cap, Q- Amp 250 mg Cap, Rancillin 250 mg Cap, Rancillin 500 mg Cap, Raniclor 125 mg Chewable Tab, Raniclor 187 mg Chewable Tab, Raniclor 250 mg Chewable Tab, Raniclor 375 mg Chewable Tab, Retet 250 mg Cap, Retet mg Cap, Robicillin VK 250 mg Tab, Robicillin VK 500 mg Tab, Robitet 250 mg Cap, Robitet 500 mg Cap, Rocephin 1 gram IV Piggy Back, Rocephin 1 gram IV Solution, Rocephin 1 gram Solution for Injection, Rocephin 10 gram Solution for Injection, Rocephin 2 gram IV Piggy Back, Rocephin 2 gram IV Solution, Rocephin 2 gram Solution for Injection, Rocephin 250 mg Solution for Injection, Rocephin 500 mg Solution for Injection, Rocephin in dextrose (iso-osmotic) 1 gram/50 ml IV Piggy Back, Rocephin in dextrose (iso-osmotic) 2 gram/50 ml IV Piggy Back, Sarocycline 250 mg Cap, Senox 250 mg Cap, Septra 200 mg-40 mg/5 ml Oral Susp, Septra 400 mg-80 mg Tab, Septra DS 800 mg-160 mg Tab, Septra I.V. 400 mg-80 mg/5 ml Soln, Sk-Ampicillin Trihydrate 125 mg/5 ml Oral Susp, Sk- Ampicillin Trihydrate 250 mg/5 ml Oral Susp, Sk-Ampicillin-N 500 mg Solution for Injection, Sk-Doxycycline Hyclate 100 mg Cap, Sk-Doxycycline Hyclate 50 mg Cap, Sk-Erythromycin 250 mg Tab, Sk-Erythromycin 500 mg Tab, Sk-Soxazole 500 mg Tab, SK-Tetracycline 125 mg/5 ml Oral Susp, SK- Tetracycline 250 mg Cap, SK-Tetracycline 500 mg Cap, SMZ-TMP DS 800 mg-160 mg Tab, Solodyn 115 mg 24 hr Tab, Solodyn 135 mg 24 hr Tab, Solodyn 45 mg 24 hr Tab, Solodyn 65 mg 24 hr Tab, Solodyn 90 mg 24 hr Tab, Soxa 500 mg Tab, sparfloxacin 200 mg Tab, Spectracef 200 mg Tab, Spectracef 400 mg Tab, Sulfagan 500 mg Tab, Sulfamar 200 mg-40 mg/5 ml Oral Susp, Sulfamethoprim 400 mg-80 mg Tab, Sulfamethoprim 400 mg-80 mg/5 ml IV, Sulfamethoprim DS 800 mg-160 mg Tab, Sulfamethoprim SS 400 mg-80 mg Tab, sulfamethoxazole-trimethoprim 200 mg-40 mg/5 ml Oral Susp, sulfamethoxazole-trimethoprim 400 mg-80 mg Tab, sulfamethoxazole-trimethoprim 400 mg-80 mg/5 ml IV, sulfamethoxazole-trimethoprim 80 mg-16 mg/ml IV Syringe, sulfamethoxazole-trimethoprim 800 mg-160 mg Tab, Sulfaprim 200 mg-40 mg/5 ml Oral Susp, Sulfaprim 400 mg-80 mg Tab, Sulfaprim DS 800 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

26 160 mg Tab, Sulfasox 500 mg Tab, Sulfatrim 200 mg-40 mg/5 ml Oral Susp, Sulfatrim 400 mg-80 mg Tab, Sulfatrim DS 800 mg-160 mg Tab, sulfisoxazole 500 mg Tab, sulfisoxazole acetyl 500 mg/5 ml Oral Susp, Sulfizin 500 mg Tab, Sulfoxaprim DS 800 mg-160 mg Tab, Sulfoxaprim SS 400 mg-80 mg Tab, Sulmeprim 200 mg-40 mg/5 ml Oral Susp, Sultrex 200 mg-40 mg/5 ml Oral Susp, Sultrim-DS 800 mg-160 mg Tab, Sumox 125 mg/5 ml Oral Susp, Sumox 250 mg Cap, Sumox 250 mg/5 ml Oral Susp, Sumycin 125 mg/5 ml Oral Susp, Sumycin mg Cap, Sumycin mg Tab, Sumycin 250 mg Cap, Sumycin 250 mg Tab, Sumycin mg Cap, Sumycin mg Tab, Sumycin 500 mg Cap, Sumycin 500 mg Tab, Sumycin Syrup 125 mg/5 ml Oral Susp, Supen 125 mg/5 ml Oral Susp, Supen 250 mg Cap, Supen 250 mg/5 ml Oral Susp, Supen 500 mg Cap, Suprax 100 mg/5 ml Oral Susp, Suprax 200 mg Tab, Suprax 200 mg/5 ml Oral Susp, Suprax 400 mg Tab, T-Vibra 100 mg Cap, Tega-Cycline 250 mg Cap, Tega-Cycline 500 mg Cap, Teline 250 mg Cap, Teline 500 mg Cap, Tequin 10 mg/ml IV, Tequin 200 mg Tab, Tequin 400 mg Tab, Tequin in D5W 200 mg/100 ml IV Piggy Back, Tequin in D5W 400 mg/200 ml IV Piggy Back, Tet-Cy 250 mg Cap, Tetra mg Cap, Tetra-Co 250 mg Cap, Tetra-Co 500 mg Cap, Tetracap 250 mg Cap, Tetraclor mg Cap, Tetraclor L 125 mg/5 ml Oral Susp, tetracycline 125 mg/5 ml Oral Susp, tetracycline 250 mg Cap, tetracycline 250 mg Tab, tetracycline 500 mg Cap, tetracycline 500 mg Tab, Tetracyn 250 mg Cap, Tetracyn 500 mg Cap, Tetracyrex 250 mg Cap, Tetralan 125 mg/5 ml Oral Susp, Tetralan 250 mg Cap, Tetralan 500 mg Cap, Tetram 250 mg Cap, Tetramax 250 mg Cap, Totacillin 125 mg/5 ml Oral Susp, Totacillin 250 mg Cap, Totacillin 250 mg/5 ml Oral Susp, Totacillin 500 mg Cap, Totacillin-N 1 gram IV Piggy Back, Totacillin-N 1 gram IV Solution, Totacillin-N 1 gram Solution for Injection, Totacillin-N 10 gram Solution for Injection, Totacillin-N 2 gram IV Piggy Back, Totacillin-N 2 gram IV Solution, Totacillin-N 2 gram Solution for Injection, Totacillin-N 250 mg Solution for Injection, Totacillin-N 500 mg IV Piggy Back, Totacillin-N 500 mg Solution for Injection, Triazole 400 mg-80 mg Tab, Triazole 800 mg-160 mg Tab, trimethoprim 100 mg Tab, trimethoprim 200 mg Tab, trimethoprim 50 mg/5 ml Oral Soln, trimethoprim-polymyxin B 0.1 %-10,000 unit/ml Eye Drops, Trimox mg/5 ml Oral Susp, Trimox 125 mg Chewable Tab, Trimox 125 mg/5 ml Oral Susp, Trimox mg/5 ml Oral Susp, Trimox 250 mg Cap, Trimox 250 mg Chewable Tab, Trimox 250 mg/5 ml Oral Susp, Trimox 50 mg/ml Oral Susp, Trimox 500 mg Cap, Trimpex 100 mg Tab, Trisulfam 200 mg-40 mg/5 ml Oral Susp, Trisuprim 200 mg-40 mg/5 ml Oral Susp, trovafloxacin 100 mg Tab, trovafloxacin 200 mg Tab, Trovan 100 mg Tab, Trovan 200 mg Tab, Tycil 250 mg/5 ml Oral Susp, Ultracef 1 gram Tab, Ultracef 125 mg/5 ml Oral Susp, Ultracef 250 mg/5 ml Oral Susp, Ultracef 500 mg Cap, Ultracef Dosa-Trol 1 gram Tab, Unasyn 1.5 gram IV Piggy Back, Unasyn 1.5 gram Solution for Injection, Unasyn 15 MicroMD EMR Clinical Quality Measure Calculations Version

27 gram Solution for Injection, Unasyn 3 gram IV Piggy Back, Unasyn 3 gram Solution for Injection, Unisul 500 mg Tab, Uroplus DS 800 mg-160 mg Tab, Uroplus SS 400 mg-80 mg Tab, V-Cillin K 125 mg/5 ml Oral Susp, V-Cillin K 250 mg/5 ml Oral Susp, V-Cillin K 500 mg Tab, V-Cillin-K 250 mg Tab, V- Sul 500 mg Tab, Vantin 100 mg Tab, Vantin 100 mg/5 ml Oral Susp, Vantin 200 mg Tab, Vantin 50 mg/5 ml Oral Susp, Vectrin 100 mg Cap, Vectrin 50 mg Cap, Veetids 125 mg/5 ml Oral Susp, Veetids mg Tab, Veetids 250 mg Tab, Veetids 250 mg/5 ml Oral Susp, Veetids 500 mg Tab, Velmatrol 500 mg Tab, Velosef 125 mg/5 ml Oral Susp, Velosef 250 mg Cap, Velosef 250 mg/5 ml Oral Susp, Velosef 500 mg Cap, Veltin 1.2 % % Topical Gel, Vibra-Tabs 100 mg Tab, Vibracin 100 mg Tab, Vibramycin 100 mg Cap, Vibramycin 100 mg IV Solution, Vibramycin 200 mg IV Solution, Vibramycin 25 mg/5 ml Oral Susp, Vibramycin 50 mg Cap, Vibramycin 50 mg/5 ml Syrup, Vibramycin Calcium 50 mg/5 ml Syrup, Wellamox 250 mg Cap, Wellamox 500 mg Cap, Wellamp 125 mg/5 ml Oral Susp, Wellamp mg Cap, Wellamp 250 mg/5 ml Oral Susp, Wellamp mg Cap, Wincillin-VK 250 mg Tab, Wincillin-VK 250 mg/5 ml Oral Susp, Wintrocin 250 mg Tab, Wyamycin E 200 mg/5 ml Oral Susp, Wyamycin E 400 mg/5 ml Oral Susp, Wyamycin S 250 mg Tab, Wyamycin S 500 mg Tab, Wycillin 1,200,000 unit IM Syringe, Wycillin 1,200,000 unit/2 ml IM Syringe, Wycillin 600,000 unit/ml IM Syringe, Wymox 125 mg/5 ml Oral Susp, Wymox 250 mg Cap, Wymox 250 mg/5 ml Oral Susp, Wymox 500 mg Cap, Zagam 200 mg Tab, Zartan 500 mg Cap, Ziana 1.2 % % Topical Gel, Zinacef 1.5 gram IV Solution, Zinacef 1.5 gram Solution for Injection, Zinacef 7.5 gram IV Solution, Zinacef in D5W 1.5 gram/100 ml IV Piggy Back, Zinacef in dextrose (isoosmotic) 750 mg/50 ml IV Piggy Back, Zinacef in Sterile Water 1.5 gram/50 ml IV Piggy Back, Zithromax 1 gram Oral Packet, Zithromax 100 mg/5 ml Oral Susp, Zithromax 200 mg/5 ml Oral Susp, Zithromax 250 mg Cap, Zithromax 250 mg Tab, Zithromax 500 mg IV Solution, Zithromax Z-Pak 250 mg Cap, Zithromax Z-Pak 250 mg Tab, Zmax 2 gram/60 ml Oral Susp, Zmax Adult-Pediatric 2 gram/60 ml Oral Susp, Zmax Pediatric 2 gram/60 ml Oral Susp 2.14 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

28 NQF INITIATION (A) AND ENGAGEMENT (B) OF ALCOHOL AND OTHER DRUG DEPENDENCE TREATMENT (ALTERNATE) Description: Clinical Rationale: The percentage of adolescent and adult patients with a new episode of alcohol and other drug (AOD) dependence who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis and who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit. There are more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition. Treatment of medical problems caused by substance use and abuse places a huge burden on the health care system. According to a report from the 2001 National Household Survey on Drug Abuse (NHSDA), an estimated 16.6 million Americans aged 12 or older in 2001 were classified with dependence on or abuse of either alcohol or illicit drugs (7.3 percent of the total population). Of these, 2.4 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.2 million were dependent on or abused illicit drugs but not alcohol, and 11.0 million were dependent on or abused alcohol but not illicit drugs.(samhsa, 2002). Denominator: **Patients in Age Range: >= 12 and <= 16 (Numerator 1,2) >=17 (Numerator 3,4) >=12 (Numerator 5,6) AND NOT **who have had a Diagnosis of Alcohol or Drug dependence <=60 days before the New Episode of Alcohol or Drug dependence (<= 1 year and >= 45 days before the end date of the reporting period.) (See code list for ICD codes) Problem List Entry ( with a beginning date <= 60 days prior to the new episode) or an Encounter Assessment <= 60 days prior to the new episode AND **who have met one of the conditions below: MicroMD EMR Clinical Quality Measure Calculations Version

29 Condition 1 ** who have had their New Episode of Alcohol or Drug dependence (see code list) **within the date range from the beginning of the reporting period and >= 45 days before the end date of the reporting period. MedInfo>Medical>Problem List Entry or Encounter with an Assessment AND **had at least 1 Encounters ED or Non-acute inpatient or Acute inpatient or Outpatient BH, outpatient BH req POS and modifier (see code list) **within the date range: within the reporting period Encounters with Level Specified or (see code list) MedInfo>Histories>Hospitalization History(see code list- ICD Codes - Alcohol or Drug Dependence) Condition 2 ** who had their New Episode as an acute inpatient or non acute inpatient (see code list) **within the date range from the beginning of the reporting period and >= 45 days before the end date of the reporting period And **who had a procedure performed for Alcohol, Drug Rehab and Detox interventions within the reporting period MedInfo>Orders>Procedure Order (Performed) (see code list for ICD codes) or MedInfo>Histories>Hospitalization History (See code list for ICD) Condition 3 **who had their New Episode as Procedure Performed of Detoxification intervention **within the date range <= 1 year and >= 45 days before the end date of the reporting period. MedInfo>Orders>Procedure Order (Completed) (see code list for ICD codes) or MedInfo>Histories>Hospitalization History (See code list CPT codes : H0008,H0014) for ICD and CPT codes)(either a qualifying CPT or ICD will satisfy this - Alcohol or Drug dependence or CPT also ICD-9 Procedure Codes) Encounter Plan (CPT codes : H0008,H0014) 2.16 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

30 Numerator: Numerator 1,3,5 are identical except for the age ranges specified in the denominator. (Patients who had follow-up within 14 days of New Episode) ** who had their New Episode as an acute inpatient or non acute inpatient (see code list) **within the date range of: <= 1 year and >= 45 days before the end date of the reporting period. **And had a Procedure Performed of Alcohol, Drug rehab and Detox interventions **within the date range of : within the reporting period MedInfo>Orders>Procedure Order (Performed) (see code list for ICD codes) or MedInfo>Histories>Hospitalization History (See code list for ICD codes ) Encounter Plan (CPT codes : H0008,H0014) OR ** who had at least 2 Procedure Performed (on different dates) of Alcohol, Drug rehab and Detox interventions **within the date range of: within 14 days of each other MedInfo>Histories>Hospitalization History (See code list(cpt codes : H0008,H0014) for ICD and CPT codes) OR **who had a BH encounter outpatient indicated by a POS code (see codes for visit types) or point of Service Modifier (see codes for visit types) **within the date range of: <= 14 days After New Episode **who have condition of Alcohol or Drug dependence recorded in their chart-(see code list) **within the date range of: <= 1 year and >= 45 days before the end date of the reporting period MedInfo>Medical>Problem List Entry or an Encounter with an Assessment MicroMD EMR Clinical Quality Measure Calculations Version

31 Numerator 2,4,6 are identical except for the age ranges specified in the denominator. (Patients who had second follow-up within 30 days of first follow-up) **who had 2 or more qualifying encounters after the New Episode (Encounters can be either Condition 1 or 2 or both) Condition 1 : **who had encounters Non-acute inpatient or Acute inpatient or Outpatient BH (see codes for visit types) **within date range : <= 30 days After First Encounter Non-acute inpatient or Acute inpatient or Outpatient BH or Encounter outpatient BH req POS (with Encounter outpatient BH req POS ) (see code list) **Within the date range: First Encounter was between the beginning of the reporting period and >= 45 days before the end date of the reporting period. Second Encounter was within 30 days of the first. AND **who had a Procedure Performed of Alcohol, Drug rehab and Detox interventions **within the reporting period MedInfo>Orders>Procedure Order (Performed) (see code list for ICD codes) or MedInfo>Histories>Hospitalization History (See code list for ICD codes) Encounter Plan (CPT codes : H0008,H0014) AND **who have a condition of Alcohol or Drug dependence recorded in their chart (see code list) Problem List Entry ( with a beginning date <= encounter date) or an Encounter Assessment (beginning date <= encounter date) 2.18 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

32 Condition 2 : **who have had Encounter outpatient BH req POS And Encounter point of Service Modifier (see codes for visit types) **within date range: less than or equal to 30 days After first encounter AND **who have Encounter Non-acute inpatient or Acute inpatient or Outpatient BH or Encounter outpatient BH req POS AND Encounter point of Service Modifier (see code list) Within date range: <= 14 days After Diagnosis of Alcohol or Drug dependence (see code list) Problem List Entry or an Encounter Assessment Exclusions: None. Code Lists for Measure Alcohol or Drug Dependence ICD 291, 291.0, 291.1, 291.2, 291.3, 291.4, 291.5, 291.8, , , , 291.9, 292, 292.0, 292.1, , , 292.2, 292.8, , , , , , , 292.9, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 535.3, , , Encounter Level - ED 99281, 99282, 99283, 99284, Encounter Level Acute Inpatient Encounter Level Non- Acute Inpatient Encounter Level - Outpatient BH 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, , 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, , 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 98960, 98961, 98962, 99078, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, MicroMD EMR Clinical Quality Measure Calculations Version

33 Encounter Level Outpatient BH req POS Codes: Encounter POS Modifier Codes Alcohol, Drug Rehab and Detox Interventions Detoxification intervention - ICD Procedure Detoxification intervention CPT Codes : 99403, 99404, 99408, 99409, 99411, 99412, , 90802, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90845, 90847, 90849, 90853, 90857, 90862, 90875, 90876, 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, , 05, 07, 09, 11, 12, 13, 14, 15, 20, 22, 33, 49, 50, 52, 53, 57, 71, , 94.63, 94.64, 94.66, 94.67, , 94.65, H0008,H0014 NQF PRENATAL CARE SCREENING FOR HIV (ALTERNATE) Field Description: Clinical Rationale: Description Percentage of patients, regardless of age, who gave birth during a 12-month period who were screened for HIV infection during the first or second prenatal visit. While the number of perinatally transmitted cases of HIV has decreased, perinatal transmission still accounts for the majority of new cases of HIV in children. Benefits of knowing a woman s HIV status early on in pregnancy have been well documented and allow the health care provider to initiate treatment early on in the pregnancy, thereby decreasing the risk of transmission of HIV to the child. Denominator: **Patients with Gender: Female **with a diagnosis of Delivery/Live Births (see code list) **within the reporting period MedInfo>Medical>Hospitalization History AND **who have had a procedure performed - Delivery of Live Births (see code list) **within the reporting period MedInfo>Medical>Hospitalization History 2.20 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

34 Field Numerator: Description AND **who have condition of Pregnancy recorded in their chart (see code list) **within the date range of: And begin date is <= 10 months prior to (procedure of) delivery date(above) Encounter with an Assessment **Patients who have a completed lab order for HIV Testing (see code list) **within the date range: within 30 days of 1st or 2nd prenatal visit Lab Test completed for LOINC Codes Lab Result for LOINC Codes 1st Prenatal Visit is calculated as: **Patient Chart contains pregnancy codes ( see code list) ** And begin date is <= 10 months prior to (procedure of) delivery date(above) Encounter Assessment 2nd Prenatal Visit is calculated as: **Patient Chart contains pregnancy codes ( see code list) **And begin date is <= 10 months prior to (procedure of) delivery date(above) And begin date is > 1st Visit Date Encounter Assessment Exclusions: **Patients with Active or Inactive Diagnoses HIV indicated in the chart (see code list) **with a begin date <= 10 months prior to delivery date Encounter Assessment MedInfo>Medical>Problem List MicroMD EMR Clinical Quality Measure Calculations Version

35 Code Lists for Measure Delivery/Live Births ICD-9 Codes: (Denominator) Delivery/Live Births (CPT Codes) Pregnancy ICD-9 Codes v22.0, v22.1, v22.2 Lab Result (LOINC) HIV Testing , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 59409, 59410, 59425, 59426, 59510, 59514, 59515, 59610, 59612, 59614, 59618, 59620, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 2.22 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

36 HIV ICD , , , , , , , , , , , , , , ,9664-4, , , , , , , , , V08 NQF 0013 HYPERTENSION: BLOOD PRESSURE MANAGEMENT (CORE) Description: Clinical Rationale: Percentage of patient visits for patients aged 18 years and older with a diagnosis of hypertension who have been seen for at least 2 office visits, with blood pressure (BP) recorded. Effective management of blood pressure in patients with hypertension can help prevent cardiovascular events, including myocardial infarction, stroke, and the development of heart failure. Denominator: **Patients in Age Range: 18 yrs and older **who have condition of Hypertension recorded in their chart-(see code list) MedInfo>Medical>Problem List Entry or an Encounter with an Assessment **who have been seen at least 2 times during the reporting period (see code list) Encounters with Encounter Levels specified. Numerator: Exclusions: **Patients whose vital signs are recorded in at least one encounter **Vital Signs are recorded on the same date as the encounter(s) MedInfo>Medical>Vital Signs(both Diastolic and Systolic BP measurements are required) None. Code Lists for Measure Hypertension ICD-9 Codes: (Denominator) Encounter Level Codes: (Denominator) 401.0, 401.1, 401.9, , , , , , , , , , , , , , , , , , , , , , , , Codes included in the encounter: (Outpatient E&M) 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, MicroMD EMR Clinical Quality Measure Calculations Version

37 Codes included in the encounter: (Nursing Facility) 99304, 99305, 99306, 99307, 99308, 99309, NQF 0014 PRENATAL CARE: ANTI-D IMMUNE GLOBULIN (ALTERNATE) Description: Clinical Rationale: Percentage of D (Rh) negative, unsensitized patients, regardless of age, who gave birth during a 12-month period who received anti-d immune globulin at weeks gestation. Rh sensitization is a serious complication of pregnancy that places the lives of both mother and child at risk. This complication can be avoided through the prophylactic administration of anti-d immune globulin. Antibody tests can be repeated in an unsensitized, D-negative patient at weeks gestation. She should also receive anti-d immune globulin prophylactically at that time. In addition, any unsensitzed, D-negative patient should receive anti-d immune globulin if she has one of the following conditions or procedures: Ectopic gestation Abortion (either threatened, spontaneous, or induced) Procedure associated with possible fetal-to-maternal bleeding, such as chorionic villus sampling (CVS) or amniocentesis Condition associated with fetal-maternal hemorrhage (eg, abdominal trauma, abruptio placentae) Delivery of a D-positive newborn (AAP/ACOG) (Level A) The USPSTF recommends the repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at weeks gestation, unless the biological father is known to be Rh (D)-negative. (USPSTF) (B Recommendation). Denominator: **Patients with Gender: Female **with a diagnosis of Delivery/Live Births (see code list) **within the reporting period Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List MedInfo>Medical>Hospitalization History 2.24 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

38 AND **who have had a procedure performed - Delivery of Live Births (see code list) **within the reporting period Diagnostic Test MedInfo>Orders>Procedure Orders (Performed) MedInfo>Orders>Nursing Care Orders (Performed) NOTE MedInfo>Histories>Surgical History MedInfo>Medical>Hospitalization History MedInfo>Histories>Surgical Procedures Reporting will look at the CPTcodes or Procedure names AND **who have Prenatal Visit recorded in their chart (see code list) **within the date range of: And begin date is >= 10 months prior to (procedure of) delivery date(above) and is prior to or on (procedure of) delivery date(above) MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Medical>Hospitalization History MedInfo>Histories>Medical History AND **who have an active diagnosis of D (Rh) negative (see code list) **prior to the end of reporting period MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Medical>Hospitalization History MedInfo>Histories>Medical History MicroMD EMR Clinical Quality Measure Calculations Version

39 AND Patient has an Active Diagnosis for Primagravida (see code list) **within the reporting period MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Medical>Hospitalization History MedInfo>Histories>Medical History **and Lab Test Result (with appropriate LOINC Values) is Negative **and Lab Test Date is >= 10 months prior to (procedure of) delivery date(above) and is prior to or on (procedure of) delivery date(above) MedInfo>Medical>Lab Result OR Patient has an Active Diagnosis for Multigravida (see code list) **within the reporting period MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Medical>Hospitalization History MedInfo>Histories>Medical History **and Lab Test Result (with appropriate LOINC Values) is Negative for Mother **and Lab Test Result (with appropriate LOINC Values) is Negative for Child(ren) **and Lab Test Date is >= 10 months prior to (procedure of) delivery date(above) and is prior to or on (procedure of) delivery date(above) MedInfo>Medical>Lab Result NOTE The presence of multiple test results during the pregnancy will assume that mother and child were both tested. Numerator: **Patients who were administered Anti-D immune globulin between 26 and 30 weeks. **within date range: Dates >=10 and <=14 weeks prior to delivery. MedInfo>Medical>Medications (see code list) MedInfo>Orders>Nursing Orders (performed) for Medication (see code list) Exclusions: None MicroMD EMR Clinical Quality Measure Calculations Version 7.5

40 Code Lists for Measure Delivery/Live Births ICD-9 Codes: (Denominator) Delivery/Live Births (CPT Codes) Delivery/Live Births - Procedure , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 59409, 59410, 59425, 59426, 59510, 59514, 59515, 59610, 59612, 59614, 59618, 59620, Episiotomy Prenatal Visit ICD-9 Codes v22.0, v22.1, v22.2 Lab Codes (LOINC) for Rh Status (Mother): , , , , , , MicroMD EMR Clinical Quality Measure Calculations Version

41 Lab Codes (LOINC) for Rh Status (Child): Primagravida ICD-9 Codes Multigravida ICD-9 Codes v , , , , , , V22.0,659.53, D Rh Negative ICD-9 Codes , Medications Anti-D Immune Globulin BayRho-D 300 mcg IM Syringe, BayRho-D 50 mcg IM Syringe, Gamulin Rh 300 mcg IM Syringe, HyperRHO S/D 300 mcg IM Syringe, HyperRHO S/D 50 mcg IM Syringe, HypRho-D (Human) 300 mcg IM Syringe, Hyprho- D 300 mcg IM Syringe, Hyprho-D 50 mcg IM Syringe, MicRhoGam 50 mcg IM Syringe, MicRhoGam Ultra-Filtered 50 mcg IM Syringe, MicRhoGam Ultra-Filtered Plus 50 mcg IM Syringe, Mini-Gamulin Rh 50 mcg IM Syringe, rho(d) immune globulin 300 mcg IM Syringe, rho(d) immune globulin 300 mcg/2 ml Syringe, rho(d) immune globulin 5,000 unit Solution for Injection, rho(d) immune globulin 50 mcg IM Syringe, rho(d) immune globulin 600 unit Solution for Injection, rho(d) immune globulin-maltose 2,500 unit/2.2 ml Injection, rho(d) immune globulinmaltose 5,000 unit/4.4 ml Injection, RhoGam (Human) 300 mcg IM Syringe, RhoGam Ultra-Filtered 300 mcg IM Syringe, RhoGam Ultra- Filtered Plus 300 mcg IM Syringe, Rhophylac 300 mcg/2 ml Syringe, WinRho SD 600 unit Solution for Injection, WinRho SDF 2,500 unit/2.2 ml Injection, WinRho SDF 5,000 unit Solution for Injection, WinRho SDF 5,000 unit/4.4 ml Injection, WinRho SDF 600 unit Solution for Injection NQF CONTROLLING HIGH BLOOD PRESSURE (ALTERNATE) Description: Clinical Rationale: The percentage of patients years of age who had a diagnosis of hypertension and whose BP was adequately controlled during the measurement year. This measure assesses the percentage of patients demonstrating adequate control of systolic and diastolic blood pressure levels. Over 50 million Americans warrant treatment for high blood pressure, according to the NHANES survey (JNC ). Financially, hypertension and associated disorders and heath complications, such as coronary heart disease and congestive heart failure, cost the U.S. economy more than $100 billion each year. The United States Preventive Services Task Force (USPSTF) recommends that clinicians screen adults 18 and older for high blood pressure (2007). This guideline is further endorsed by research studies and clinical trials that have demonstrated decline in costly health outcomes as a direct result of improved blood pressure control. This measure is important in efforts to promote blood pressure control and improve quality of life MicroMD EMR Clinical Quality Measure Calculations Version 7.5

42 Denominator: **Patients in Age Range: >= 18 and <=85 **who have condition of Hypertension recorded in their chart-(see code list) MedInfo>Medical>Problem List Entry ( with a beginning date <= 6 months after the start of the reporting period) or an Encounter with an Assessment (encounter date <= 6 months after the start of the reporting period) AND **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified. AND NOT **Patients who have an active diagnosis of ESRD or Procedures indicative of ESRD (see code list) **within the reporting period MedInfo>Medical>Problem List Entry (ICD) Encounter with an Assessment (ICD) MedInfo>Medical>Hospitalization History (CPT) MedInfo>Histories>Medical History (CPT) MedInfo>Histories>Surgical Procedures (CPT) OR **Patients who have an active Pregnancy (see code list) **within the reporting period MedInfo>Medical>Problem List Entry Encounter with an Assessment Numerator: Exclusions: **Patients whose vital were recorded and met Systolic (<140) and Diastolic (<90) measurements on the most recent encounter. None. Code Lists for Measure Hypertension ICD-9 Codes: 401, 401.0, 401.1, Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, MicroMD EMR Clinical Quality Measure Calculations Version

43 Pregnancy ICD-9 Codes See Measure 0024 ESRD ICD-9 Codes 38.95, 39.27, 39.42, 39.43, 39.53, 39.93, 39.94, 39.95, 54.98, 55.6, 55.61, 55.69, 585.5, 585.6, V42.0, V45.1, V45.11, V45.12, V56, V56.0, V56.1, V56.2, V56.3, V56.31, V56.32, V56.8 Procedures indicative of ESRD 36145, 36147, 36148, 36800, 36810, 36815, 36818, 36819, 36820, 36821, 36831, 36832, 36833, 50300, 50320, 50340, 50360, 50365, 50370, 50380, 90920, 90921, 90924, 90925, 90935, 90937, 90940, 90945, 90947, 90957, 90958, 90959, 90960, 90961, 90962, 90965, 90966, 90969, 90970, 90989, 90993, 90997, 90999, 99512, G0257, G0308, G0309, G0310, G0311, G0312, G0313, G0314, G0315, G0316, G0317, G0318, G0319, G0322, G0323, G0326, G0327, G0392, G0393, S9339 NQF WEIGHT ASSESSMENT AND COUNSELING FOR CHILDREN AND ADOLESCENTS (CORE) Description: Clinical Rationale: The percentage of patients 2-17 years of age who had an outpatient visit with a PCP or OB/GYN and who had evidence of BMI percentile documentation, counseling for nutrition and counseling for physical activity during the measurement year. This measure assesses the percentage of age-appropriate patients who had an outpatient visit with a PCP or OB/GYN and who had evidence of a BMI percentile assessment, counseling for nutrition or counseling for physical activity. The prevalence of overweight and obesity has increased sharply for children over the last 30 years: from 5.0% to 13.9% for those aged 2 5 years; from 6.5% to 18.8% for those aged 6 11 years; and from 5.0% to 17.4% for those aged years. This increasing prevalence has had significant economic ramifications, with economic costs correlated to obesity and related comorbidities estimated at over $70 billion or 7% of the national health care budget. To address this problem and its long-term implications effectively, promotion of routine physical activity and healthy eating and lifestyle changes are essential (CDC 2007). This measure is important in efforts to improve long-term health outcomes and quality of life MicroMD EMR Clinical Quality Measure Calculations Version 7.5

44 Denominator: **Patients in Age Range: >= 2 and <=17 (Numerator 1,2,3) >=2 and <=10 (Numerator 4,5,6) >=11 and <=17 (Numerator 7,8,9) **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified. AND NOT **Patients who are pregnant. (see code list) Encounter Assessments : Patients with an encounter assessment during the reporting period -OR- MedInfo>Medical>Problem List = Active Pregnancy during the reporting period (See List Below) Numerator: Numerator 1,4,7 are identical except for the age ranges covered. (BMI was Documented) ** Vital Signs Recorded: Height and Weight to calculate BMI ** within the reporting period MedInfo>Medical>Vital Signs OR ** Plan, Order or Referral with associated diagnosis codes (see code list) ** within the reporting period Encounter Plan MedInfo>Orders>Procedure Order MedInfo>Orders>Referral Order Numerator 2,5,8 are identical except for the age ranges covered. (Nutritional counseling was ordered) ** Plan, Order or Referral with associated procedure codes (see code list) ** within the reporting period Encounter Plan MedInfo>Orders>Procedure Order MedInfo>Orders>Referral Order MicroMD EMR Clinical Quality Measure Calculations Version

45 Numerator 3,6,9 are identical except for the age ranges covered. (Physical Activity was ordered) ** Plan, Order or Referral with associated procedure codes (see code list) ** within the reporting period Encounter Plan MedInfo>Orders>Procedure Order MedInfo>Orders>Referral Order OR ** Plan, Order or Referral with associated diagnosis codes (see code list) ** within the reporting period Encounter Plan MedInfo>Orders>Procedure Order MedInfo>Orders>Referral Order Exclusions: None. Code Lists for Measure Vital Signs Recorded (Numerator 1) ICD-9 Codes: V85.5, V85.51, V85.52, V85.53, V85.54 Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Plan Codes: (Nutritional Counseling) Nutritional Counseling ICD- 9 Codes: Exercise Plan Codes: S9470 G0270 G0271 S9449 S9452, 97802, 97803, V65.3 S9451 Exercise ICD-9 Codes V65.41 Pregnancy ICD-9 Codes V26.81 v28.3 v28.81 v28.82 v72.4 v72.40 v72.41 v MicroMD EMR Clinical Quality Measure Calculations Version 7.5

46 NQF 0027 / PQRI 115 SMOKING CESSATION ADVISING TO QUIT, DISCUSS CESSATION MEDICATIONS, DISCUSS STRATEGIES FOR QUITTING (ALTERNATE) Description: Clinical Rationale: Detail The percentage of patients 18 years of age and older who were current smokers or tobacco users, who were seen by a practitioner during the measurement year and who received advice to quit smoking or tobacco use or whose practitioner recommended or discussed smoking or tobacco use cessation medications, methods or strategies. This measure assesses different facets of providing medical assistance with smoking cessation or tobacco use. Smoking is the leading preventable cause of premature death in the United States and is identified as a causal factor in more than 25 diseases and health problems (USDHHS 2004). In 2003, based on evidence that cessation strategies are effective in improving health outcomes, the USPSTF recommended that clinicians screen adults for tobacco use and provide tobacco cessation interventions. Interventions to control smoking are also strategically important because of the financial burden: approximately $167 billion in annual health-related economic losses, when considered with other tobacco use causes. This measure facilitates efforts to implement recommended clinical practices and guidelines and subsequently reduce mortality rates and health problems related to smoking and tobacco use. Denominator: **Patients in Age Range: >=18 **who have been seen at least 1 time up to 2 years prior to the end of the reporting period (see code list) Encounters with Encounter Levels specified. Numerator: Numerator1: Calculate Patients who smoke MedInfo>Histories>Habits> Smoking Status is one of: (Current Every Day Smoker or Current Some Day Smoker) MicroMD EMR Clinical Quality Measure Calculations Version

47 Detail Numerator2: Calculate Smoking Patients who were advised to quit via Tobacco Use Cessation counseling or medication MedInfo>Histories>Habits> Smoking Status is one of: (Current Every Day Smoker or Current Some Day Smoker) AND Encounter Plan (see CPT Code list) **Date Range: up to 1 year prior to the beginning of the reporting period period OR Referral with CPT Codes (see code list) **Date Range: up to 1 year prior to the beginning of the reporting Exclusions: None. Code Lists for Measure Tobacco Use Cessation Counseling CPT: 99406, 99407, ZA045, Z5049, Z6357,Z9537,Z6356 Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, NQF 0028A PREVENTIVE CARE AND SCREENING: TOBACCO USE ASSESSMENT (CORE) Description: Clinical Rationale: Detail Percentage of patients aged 18 years or older who have been seen for at least 2 office visits, who were queried about tobacco use one or more times within 24 months. Tobacco use is one of the leading causes of many preventable diseases, however, not all individuals are screened for tobacco use. Denominator: **Patients in Age Range: >=18 **who have been seen at least 2 times during the reporting period (see code list) Encounters with Encounter Levels specified MicroMD EMR Clinical Quality Measure Calculations Version 7.5

48 Numerator: Exclusions: Detail Patients have had their smoking status documented. MedInfo>Histories>Habits>Category: Smoking Status and Status Dropdown: is selected as one of the following Current Every Day Smoker Current Some Day Smoker Former Smoker Never Smoker Smoker, current status unknown Unknown if ever smoked NOTE Report will check the MedInfo Reviewed log (to see if the entire Habits category was reviewed <= 24 months before the Encounter) None. Code Lists for Measure Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 96150, 96152, 97003, 97004, 99411, 99412, 99420, 99429, 99385, 99386,99387, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 90845, NQF 0028B PREVENTIVE CARE AND SCREENING: TOBACCO USE ASSESSMENT (CORE) Description: Clinical Rationale: Percentage of patients aged 18 years and older identified as tobacco users within the past 24 months and have been seen for at least 2 office visits, who received cessation intervention. The USPSTF strongly recommends that clinicians screen all adults for tobacco use and provide tobacco cessation interventions for those who use tobacco products. Denominator: **Patients in Age Range: >=18 **who have been seen at least 2 times during the reporting period (see code list) Encounters with Encounter Levels specified. MicroMD EMR Clinical Quality Measure Calculations Version

49 AND **Patients have had their smoking status documented. MedInfo>Histories>Habits>Category: Smoking Status and Status Dropdown is selected as one of the following: Current Every Day Smoker Current Some Day Smoker Smoker, current status unknown Numerator: Exclusions: **Tobacco use cessation counseling was ordered (see code list) **within date range: up to 24 months before encounter Encounter Plan CPT Codes OR **Smoking cessation agents were active or ordered(see Code list) **within date range: up to 24 months prior to the encounter MedInfo>Medical>Medications to see if medication was active within 24 months prior to the encounter. None. Code Lists for Measure Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,96150,96152, 97003, 97004, 99411, 99412,99420, 99429, 99385, 99386, 99387, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 90845, Encounter Plan Codes: Tobacco Cessation CPTs 99406, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

50 Smoking Cessation Agents (Medications) Commit 2 mg Buccal Lozenge, Commit 4 mg Buccal Lozenge, Habitrol 14 mg/24 hr daily Patch, Habitrol 21 mg/24 hr daily Patch, Habitrol 7 mg/24 hr daily Patch, Nicoderm 14 mg/24 hr daily Patch, Nicoderm 21 mg/24 hr daily Patch, Nicoderm 7 mg/24 hr daily Patch, Nicoderm CQ 14 mg/24 hr daily Patch, Nicoderm CQ 21 mg/24 hr daily Patch, Nicoderm CQ 7 mg/24 hr daily Patch, Nicorelief 2 mg Gum, Nicorelief 4 mg Gum, Nicorette 2 mg Buccal Lozenge, Nicorette 2 mg Gum, Nicorette 4 mg Buccal Lozenge, Nicorette 4 mg Gum, Nicorette DS 4 mg Gum, Nicorette Refill 2 mg Gum, Nicorette Refill 4 mg Gum, Nicorette Starter Kit 2 mg Gum, Nicorette Starter Kit 4 mg Gum, nicotine (polacrilex) 2 mg Buccal Lozenge, nicotine (polacrilex) 2 mg Gum, nicotine (polacrilex) 4 mg Buccal Lozenge, nicotine (polacrilex) 4 mg Gum, nicotine 14 mg/24 hr daily Patch, nicotine 21 mg/24 hr daily Patch, nicotine 7 mg/24 hr daily Patch, NTS Step 1 21 mg/24 hr Transderm 24 hr Patch, NTS Step 2 14 mg/24 hr Transderm 24 hr Patch, NTS Step 3 7 mg/24 hr Transderm 24 hr Patch, Stop Smoking Aid 2 mg Buccal Lozenge, Stop Smoking Aid 2 mg Gum, Stop Smoking Aid 4 mg Buccal Lozenge, Stop Smoking Aid 4 mg Gum, Thrive Nicotine 2 mg Gum, Thrive Nicotine 4 mg Gum NQF 0031 BREAST CANCER SCREENING (ALTERNATE) Description: Clinical Rationale: The percentage of women years of age who had a mammogram to screen for breast cancer. This measure assesses the percentage of women in a specific age demographic who had a mammogram to screen for breast cancer. Breast cancer is the most common cancer diagnosed in women in the United States and is the second leading cause of death from cancer. Awareness of the importance of early detection serves as a significant preventive measure in improving correlated health outcomes. Among women with undetected breast cancer, mammography correctly identifies breast cancer 83% 95% of the time (IOM, 2004). Additionally, mammography screening has been shown to reduce mortality by 20% 30% (IOM 2004). This measure facilitates efforts toward early detection of breast cancer and acceleration of treatment upon diagnosis. Denominator: **Patients in Age Range: >= 40 and <=69 **Patient Gender is Female **who have been seen at least 1 time up to 2 years prior to the end of the reporting period (see code list) Encounters with Encounter Levels specified. MicroMD EMR Clinical Quality Measure Calculations Version

51 AND NOT **Patients who have had either a bilateral mastectomy (see code list) or more than one instance of unilateral mastectomy (see code list) MedInfo>Orders>Procedure Order (Performed) CPT code MedInfo>Histories>Medical History- Diagnosis code (see code lists) MedInfo>Histories>Hospitalization History - CPT Code or Diagnosis code (see code lists) MedInfo>Histories>Surgical Procedures>Medical > CPT Code or Diagnosis code (in before or after operation fields) (see code lists) Numerator: Exclusions: **Patients whose chart provides documentation that Mammography has been performed (see CPT, HCPCS and ICD code list) **Date Range: up to 2 years prior to the end of the reporting period Encounter Plan (Procedure Order, Referral Order) MedInfo> Medical> Diagnostic Test Result None. MedInfo >Health Maintenance>Screening and Prevention Code Lists for Measure Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Mammography Screening Codes (CPT, HCPCS) Mammography Screening Codes (ICD-9) in Encounter Plan Bilateral Mastectomy 76090, 76091, 76092, 77055, 77056, 77057, G0202, G0204, G , 87.37, V76.11, V ,85.44,85.46,85.48,Z08DA, Z08DC,Z0A37,Z5200, Z0D57, Z7102,Z109A, Z85C8, Z9621,Z9623, Z980B, Z9945,ZA017, Z1F68, Z2405,Z2473, Z27DE, Z2DD2, 19180, 19200, 19220, 19240, 19303, 19304, 19305, 19306, 19307\ Unilateral Mastectomy 85.41,85.43,85.45,85.47, 19180, 19200, 19220, 19240, 19303, 19304, 19305, 19306, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

52 NQF 0032 CERVICAL CANCER SCREENING (ALTERNATE) Description: Clinical Rationale: The percentage of women years of age who received one or more Pap tests to screen for cervical cancer. (NOTE The expectation is that since this measure has a look back period of 3 years, the screening should begin at 21, but will not be measured until 23) This measure assesses the percentage of women in a specific age demographic who receive appropriate screening for cervical cancer. The American Cancer Society predicted that in 2009, nearly 11,270 women would be newly diagnosed with cervical cancer and 4,070 women would die of cervical cancer. The financial burden is also noteworthy: treatment for cervical cancer cost about $2 billion in 2004 (CDC). The American Cancer Society reported that screening can save lives, stating that the overall five-year survival rate for cervical cancer is nearly 71%, with a survival rate of 92% for detection in the earliest stage (2010). This evidence is corroborated by the fact that from , the mortality rate from cervical cancer declined by 74% because of screening. This measure facilitates efforts toward early detection of cervical cancer and acceleration of treatment upon diagnosis. Denominator: **Patients in Age Range: >= 23 and <=63 **Patient Gender is Female **who have been seen at least 1 time up to 2 years prior to the end of the reporting period (see code list) Encounters with Encounter Levels specified. AND NOT **Patients who have had a Hysterectomy (see code list) MedInfo>Orders>Procedure Order Performed Hysterectomy (CPT) MedInfo>Histories>Surgical History (Procedure Name) MedInfo>Histories>Medical History (ICD) MedInfo>Histories>Hospitalization History (CPT or ICD) MedInfo>Histories>Surgical Procedures ( CPT or ICD) Numerator: **Patients who have had appropriate Cervical Cancer Screening(see code list) **Date Range: Up to 3 years prior to the end of the reporting period Encounter Plan that has been performed Lab Result with LOINC Codes has been performed MedInfo>Health Maintenance>Screening and Prevention Exclusions: None. MicroMD EMR Clinical Quality Measure Calculations Version

53 Code Lists for Measure Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Screening Codes (CPT) 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88155, 88164, 88165, 88166, 88167, 88174, / G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091 Hysterectomy - ICD , 68.4, 68.41, 68.49, 68.5, 68.51, 68.59, 68.6, 68.61, 68.69, 68.7, 68.71, 68.79, 68.8, V67.01, V76.47, V88.01, V88.03 Hysterectomy - CPT 51925, 56308, 58150, 58152, 58200, 58210, 58240, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58285, 58290, 58291, 58292, 58293, 58294, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573, 58951, 58953, 58954, 58956, Hysterectomy - Procedure Lab Result (LOINC) for Pap Test Hysterectomy, Hysterectomy-Total, Hysterectomy-Radical, Uterus Removal , , , , , , , , , NQF 0033 CHLAMYDIA SCREENING FOR WOMEN (ALTERNATE) Description: Clinical Rationale: The percentage of women years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement year. This measure assesses appropriate screening for chlamydia among women in a specific age demographic. Chlamydia is one of the most frequently occurring sexually-transmitted diseases in the United States, resulting in over 2.8 million new cases each year. Women are particularly susceptible and account for over 80% of new cases, according to the U.S. National Health and Nutrition Examination Survey. Additionally, heath care costs attributable to chlamydia and its complications exceed $3.5 billion per year in the U.S.. Early detection and treatment have proven to be effective in preventing and managing chlamydia. Several studies have shown that screening reduces overall disease prevalence by 4.2% and is strongly correlated with a reduced incidence of pelvic inflammatory disease (PID). This measure facilitates efforts toward early screening and treatment to improve health outcomes for infected women and prevent the spread of disease MicroMD EMR Clinical Quality Measure Calculations Version 7.5

54 Denominator: Patient Age >= 15 and <= 23 (Numerator 1) Patient Age >=15 and <= 19 (Numerator 2) Patient Age >= 20 and <=23 (Numerator 3) Patient Gender Female **Patient has had at least one encounter (see code lists) Date Range: within the reporting period. AND **Sexual Activity is Documented by using one of the following: (see code list) **Date Range: Within the Reporting Period MedInfo>Orders>Procedure Order performed indicative of sexual activity Encounter Plan MedInfo>Lab Test result for Pregnancy Test MedInfo>Lab Test result for Sexually Active Woman OR **IUD is being used and is documented in the chart (see code list) **Date Range prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment OR **Patient has been counseled about Contraception (see code list) **Date Range Within Reporting Period Encounter Plan OR **Patient has been prescribed contraceptives (see code list) **Date Range Before the end of the reporting period OR **Pregnancy is documented in the patient chart (see code list) **Date Range Within Reporting Period Encounter Assessment MicroMD EMR Clinical Quality Measure Calculations Version

55 OR **Patient s chart has a diagnosis of Sexually Active Woman **Date Range: Prior to the end of the reporting period Encounter Assessment MedInfo>Medical>Problem List Numerator: Numerator 1 (Patient Age >= 15 and <= 23 ) : Numerator 2 (Patient Age >=15 and <= 19) Numerator 3 (Patient Age >= 20 and <=23) Exclusions: Lab Result for Chlamydia Screening (within the reporting period) (see code list CPT and LOINC) **If a Pregnancy test was performed AND a medication was prescribed or a follow-up test was performed <= 7 days afterwards **Date Range: within reporting period MedInfo>Medical>Lab Result for Pregnancy Test (see code list CPT) AND MedInfo>Medications prescribed : Retinoid (see code list) OR Diagnostic Test Result performed (see code list) Code Lists for Measure Encounter Level 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Pregnancy Test CPT 81025, 84702, Lab Tests indicative of sexually active women Lab Results (LOINC) indicative of sexually active women 86592, 86593, 87164, 87166, 87590, 87591, 87592, 87620, 87621, 87622, 87660, 87800, 87801, 87808, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,1832-5, , , , , , , , 2.42 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

56 Procedures indicative of sexually active women Sexually Active woman ICD , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 557-9, 560-3, , , , , , , , , , 660-1, 688-2, 690-8, 691-6, 692-4, 693-2, 698-1, , , 11976, 11977, 57022, 57170, 58300, 58301, 58600, 58605, 58611, 58615, 58970, 58974, 58976, 59000, 59001, 59012, 59015, 59020, 59025, 59030, 59050, 59051, 59070, 59072, 59074, 59076, 59100, 59120, 59121, 59130, 59135, 59136, 59140, 59150, 59151, 59160, 59200, 59300, 59320, 59325, 59350, 59400, 59409, 59410, 59412, 59414, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620, 59622, 59812, 59820, 59821, 59830, 59840, 59841, , 59855, 59856, 59857, 59866, 59870, 59871, 59897, 59898, 59899, 76801, 76805, 76811, 76813, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76826, 76827, 76828, 76941, 76945, 76946, 80055, 81025, 82105, 82106, 82143, 82731, 83632, 83661, 83662, 83663, 83664, 84163, 84702, 84703, 84704, 86592, 86593, 86631, 86632, 87110, 87164, 87166, 87270, 87320, 87490, 87491, 87492, 87590, 87591, 87592, 87620, 87621, 87622, 87660, 87800, 87801, 87808, 87810, 87850, 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88155, 88164, 88165, 88166, 88167, 88174, 88175, 88235, 88267, G0101, G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, H1000, H1001, H1003, H1004, H1005, P3000, P3001, Q0091, S0180, S0199, S4981, S , , , , , , 079.4, , , , , , 091, 091.0, 091.1, 091.2, 091.3, 091.4, 091.5, , , , 091.6, , , , 091.7, 091.8, , , , 091.9, 092, 092.0, 092.9, 093, 093.0, 093.1, 093.2, , , , , , 093.8, , , , 093.9, 094, 094.0, 094.1, 094.2, 094.3, 094.8, , , MicroMD EMR Clinical Quality Measure Calculations Version

57 Device Applied IUD ICD , V25.02, V , , , , , , 094.9, 095, 095.0, 095.1, 095.2, 095.3, 095.4, 095.5, 095.6, 095.7, 095.8, 095.9, 096, 097, 097.0, 097.1, 097.9, 098.0, , , , , , , 098.2, , , , , , , 098.4, , , , , , 098.5, , , , , , 098.6, 098.7, 098.8, , , , , , , , 099, 099.0, 099.1, 099.2, 099.3, 099.4, , , , 099.5, , , , , , , , , 099.8, 099.9, 131, 131.0, , , , , , 131.8, 131.9, , 614, 614.0, 614.1, 614.2, 614.3, 614.4, 614.5, 614.6, 614.7, 614.8, 614.9, 615, 615.0, 615.1, 615.9, 616, 616.0, 616.1, , , 616.2, 616.3, 616.4, 616.5, , , 616.8, , , 616.9, 622.3, 623.4, 626.7, 628, 628.0, 628.1, 628.2, 628.3, 628.4, 628.8, Chlamydia Screening CPT 86631, 86632, 87110, 87270, 87320, 87490, 87491, 87492, Lab Results (LOINC) Chlamydia Screening , , , , , , , , , , , , , , , , , , , , , , , , Contraceptives Alesse (21) 0.1 mg-20 mcg Tab, Alesse mg-20 mcg Tab, Aviane 0.1 mg-20 mcg Tab, Demulen 1/35 (21) 1 mg-35 mcg Tab, Demulen 1/35 (28) 1 mg-35 mcg Tab, Demulen 1/50 (21) 1 mg-50 mcg Tab, Demulen 1/50 (28) 1 mg-50 mcg Tab, drospirenone-ethinyl estradiol 3 mg-0.03 mg Tab, Estinyl 0.02 mg Tab, Estinyl 0.05 mg Tab, Estinyl 0.5 mg Tab, ethinyl estradiol 0.02 mg Tab, ethinyl estradiol 0.05 mg Tab, ethinyl estradiol 0.5 mg Tab, ethynodiol diac-eth estradiol 1 mg-35 mcg Tab, ethynodiol diaceth estradiol 1 mg-50 mcg Tab, etonogestrel 68 mg Subdermal Implant, etonogestrel-ethinyl estradiol 0.12 mg mg/24 hr Vaginal Ring, Femhrt 1/5 1 mg-5 mcg Tab, Femhrt Low Dose 0.5 mg-2.5 mcg Tab, Feminone 0.05 mg Tab, Genora 1/35 (21) 1 mg-35 mcg Tab, Genora 1/35 (28) 1 mg-35 mcg Tab, Gynex 1/35E (21) 1 mg-35 mcg Tab, Gynex 1/35E (28) 1 mg-35 mcg Tab, IMPLANON 68 mg Subdermal Implant, Junel 1.5/30 (21) 1.5 mg-30 mcg Tab, Junel 1/20 (21) 1 mg-20 mcg Tab, Kelnor 1/35 (28) 1 mg-35 mcg Tab, Lessina 0.1 mg-20 mcg Tab, Levlite mg-20 mcg Tab, Levlite mg-20 mcg Tab, levonorgestrel-ethinyl estradiol 0.1 mg-20 mcg Tab, levonorgestrel-ethinyl estradiol 90 mcg-20 mcg Tab, Loestrin 1.5/30 (21) 1.5 mg-30 mcg Tab, Loestrin 1/20 (21) 1 mg-20 mcg Tab, Lutera (28) 0.1 mg-20 mcg Tab, Lybrel 90 mcg-20 mcg Tab, Microgestin 1.5/30 (21) 1.5 mg-30 mcg Tab, Microgestin 1/20 (21) 1 mg- 20 mcg Tab, N.E.E. 1/35 (21) 1 mg-35 mcg Tab, N.E.E. 1/35 (28) 1 mg-35 mcg Tab, Necon 1/35 (21) 1 mg-35 mcg Tab, Necon 1/35 (28) 1 mg-35 mcg Tab, Nelova 1/35 (21) 1 mg-35 mcg Tab, Nelova 1/35 (28) 1 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

58 mcg Tab, Norcept-E 1/35 (21) 1 mg-35 mcg Tab, Norcept-E 1/35 (28) 1 mg-35 mcg Tab, norelgestrom-ethinyl estradiol 150 mcg-20 mcg/24 hr Weekly TDerm Patch, Norethin 1/35E (21) 1 mg-35 mcg Tab, Norethin 1/35E (28) 1 mg-35 mcg Tab, norethindrone acetate-ethinyl estradiol 0.5 mg-2.5 mcg Tab, norethindrone acetate-ethinyl estradiol 1 mg-20 mcg Tab, norethindrone acetate-ethinyl estradiol 1 mg-5 mcg Tab, norethindrone acetate-ethinyl estradiol 1.5 mg-30 mcg Tab, norethindrone-ethinyl estradiol 1 mg-35 mcg Tab, norethindrone-ethinyl estradiol 1 mg-50 mcg Tab, norethindrone-mestranol 1 mg-80 mcg Tab, norgestrel-ethinyl estradiol 0.5 mg-50 mcg Tab, Norinyl 1+35 (21) 1 mg-35 mcg Tab, Norinyl 1+35 (28) 1 mg-35 mcg Tab, Nortrel 1/35 (21) 1 mg-35 mcg Tab, Nortrel 1/35 (28) 1 mg-35 mcg Tab, NuvaRing 0.12 mg mg/24 hr Vaginal, Ocella 3 mg-0.03 mg Tab, Ogestrel (28) 0.5 mg-50 mcg Tab, Ortho Evra 150 mcg-20 mcg/24 hr Transderm Patch, Ortho-Novum 1/35 (21) 1 mg-35 mcg Tab, Ortho-Novum 1/35 (28) 1 mg-35 mcg Tab, Ortho-Novum 1/80 (21) 1 mg-80 mcg Tab, Ortho-Novum 1/80 (28) 1 mg-80 mcg Tab, Ovcon- 50 (21) 1 mg-50 mcg Tab, Ovcon-50 (28) 1 mg-50 mcg Tab, Ovral (21) 0.5 mg-50 mcg Tab, Ovral (28) 0.5 mg-50 mcg Tab, Ovral (4) 0.5 mg-50 mcg Tab, Sronyx 0.1 mg-20 mcg Tab, Yasmin 28 3 mg-0.03 mg Tab, Zarah 3 mg-0.03 mg Tab, Zovia 1/35E (21) 1 mg-35 mcg Tab, Zovia 1/35E (28) 1 mg-35 mcg Tab, Zovia 1/50E (21) 1 mg-50 mcg Tab, Zovia 1/50E (28) 1 mg-50 mcg Tab Pregnancy ICD-9 V26.81, V28, V28.3, V28.81, V28.82, V72.4, V72.40, V72.41, V72.42 Lab Results (LOINC) Pregnancy Test Patient Education Contraception Plan Codes Medications - Retinoid , , , , , , , , , , , , , , , , , ZA1A6, Z1830, Z09CC, Z1AB2 Accutane 10 mg Cap, Accutane 20 mg Cap, Accutane 40 mg Cap, Amnesteem 10 mg Cap, Amnesteem 20 mg Cap, Amnesteem 40 mg Cap, Claravis 10 mg Cap, Claravis 20 mg Cap, Claravis 30 mg Cap, Claravis 40 mg Cap, isotretinoin 10 mg Cap, isotretinoin 20 mg Cap, isotretinoin 30 mg Cap, isotretinoin 40 mg Cap, Sotret 10 mg Cap, Sotret 20 mg Cap, Sotret 30 mg Cap, Sotret 40 mg Cap NQF COLORECTAL CANCER SCREENING (ALTERNATE) Description: The percentage of adults years of age who had appropriate screening for colorectal cancer. MicroMD EMR Clinical Quality Measure Calculations Version

59 Clinical Rationale: This measure assesses the percentage of patients in a specific age demographic who receive appropriate screening for colorectal cancer. Colorectal cancer is the third leading cause of cancer-related deaths in the United States for both men and women, and was expected to be the primary cause of 49,920 deaths in In 2009, there were 106,100 new cases of colon cancer and 40,870 new cases of rectal cancer. Screening decreases mortality rates by detecting cancerous formations in the early and most curable stage; as a result, the mortality rate has been dropping for more than 20 years because of early identification of polyps for removal prior to disease onset, as well as other colorectal cancers. Screening is also fiscally responsible, with studies showing cost-savings of $40,000 per life-year gained. This measure facilitates efforts toward early detection of colorectal cancer and acceleration of treatment upon diagnosis. Denominator: **Patients in Age Range: >= 50 and <=74 **who have been seen at least 1 time up to 2 years prior to the end of the reporting period (see code list) Encounters with Encounter Levels specified. AND NOT **Patient had Total Colectomy (see code list) **Date Range (performed prior to the end of the reporting period) Encounter Plan with CPT Code (see code list) MedInfo>Orders>Procedure Order (Performed) MedInfo>Histories>Surgical History (Procedure name) MedInfo>Histories>Hospitalization History MedInfo>Histories>Surgical Procedures with CPT Codes or ICD codes(before and after operation) NOTE Reporting will be looking at CPT codes or ICD codes or Procedure Names related to Total Colectomy 2.46 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

60 Numerator: **Patient has had screening performed either Colonoscopy up to 10 years prior to the end of the reporting period Flexible Sigmoidoscopy up to five years prior to the end of the reporting period list) Encounter Plan (Performed) MedInfo>Orders>Procedure Order Performed (CPT /HCPCS) MedInfo>Histories>Surgical Procedures (see code list) MedInfo>Medical>Diagnostic Test Result with CPT codes (see code MedInfo>Health Maintenance>Screening and Prevention OR **Patient has had Fecal Occult Blood Testing (FOBT) **Date Range Within the reporting period Encounter Plan (Performed) MedInfo>Orders>Procedure Order Performed (CPT /HCPCS) MedInfo>Medical>Diagnostic Test Result with CPT codes (see code list) MedInfo>Health Maintenance>Screening and Prevention MedInfo>Medical>Lab Results Exclusions: **Patient has diagnosis of Colorectal Cancer (see code list) MedInfo>Medical>Problem List (Active, Inactive or Resolved prior to the end of the reporting period) Encounter Assessments (prior to the end of the reporting period) Code Lists for Measure Encounter Level Codes 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Colonoscopy CPT Codes 44388, 44389, 44390, 44391, 44392, 44393, 44394, 44397, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, 45385, 45386, 45387, 45391, 45392, G0105, G0121 MicroMD EMR Clinical Quality Measure Calculations Version

61 Flexible Sigmoidoscopy CPT Codes FOBT CPT 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45339, 45340, 45341, 45342, 45345, G , 82274, G0328, G0394 FOBT Lab Result (LOINC) , , , , , , , , , , Total colectomy CPT 44150, 44151, 44152, 44153, 44155, 44156, 44157, 44158, 44210, 44211, Total colectomy ICD 45.8, 45.81, 45.82, Total colectomy - Procedure Colectomy Colorectal Cancer ICD 153, 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 197.5, V10.05 NQF USE OF APPROPRIATE MEDICATIONS FOR ASTHMA (ALTERNATE) Description: Clinical Rationale: The percentage of patients 5-50 years of age during the measurement year who were identified as having persistent asthma and were appropriately prescribed medication during the measurement year. Report three age stratifications (5-11 years, years, and total). This measure assesses the appropriate and timely use of medications for long-term control of asthma symptoms and offers meaningful and actionable information to health care providers and consumers. Asthma is the most common chronic childhood disease, affecting an estimated 6.2 million children and resulting in more than 6.5 million office visits, 500,000 hospitalizations, 1.51 million nonemergency outpatient department visits and 1.81 million ER visits for children and adults. In 1998, over $10 billion was spent on related medical expenditures in the United States. The financial and disease burden can be alleviated if patients have appropriate medications and medical management. This measure facilitates efforts toward effective disease management and prevention of traumatic outcomes. Denominator: **Patients in Age Range: >= 4 and <= 10 (Numerator 1) >=11 and <= 49 (Numerator 2) >= 4 and <=49 (Numerator 3) AND one of the conditions below are true: 2.48 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

62 Condition 1 ** who have been seen at least 1 time in the ED or had Acute Inpatient Encounter (see code list) **Date Range: during the reporting period. Encounter with Level of ED or Acute Inpatient MedInfo>Histories>Hospitalization History(see code list- ICD Codes - Asthma ) AND **who have condition of Active Asthma recorded in their chart-(see code list) **Date Range: during the reporting period. MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Histories>Hospitalization History NOTE Reporting will be looking at begin date of problem list prior to end of reporting period. MicroMD EMR Clinical Quality Measure Calculations Version

63 Condition 2 ** who have been seen at least 4times as an Outpatient (see code list) **Date Range: during the reporting period. Encounter with Level of Outpatient AND **who have condition of Active Asthma recorded in their chart-(see code list) **Date Range: during the reporting period. MedInfo>Medical>Problem List Entry Encounter with an Assessment MedInfo>Histories>Hospitalization History NOTE Reporting will be looking at begin date of problem list prior to end of reporting period. AND ** at least 2 counts of following medications have been prescribed for this patient **Date Range: prior to the end of the reporting period. MedInfo>Medical>Medications - Antiasthmatic Combinations, Antibody Inhibitors, Inhaled Corticosteroids, Inhaled steroid combinations, Leukotriene Inhibitors, Long Acting Inhaled Beta 2 agonist, Mast Cell stabilizer, Methylxanthines, Short Acting Beta 2 agonist (see code list) **Condition 3 ** at least 4 counts of following medications have been prescribed for this patient **Date Range: prior to the end of the reporting period. MedInfo>Medical>Medications - Antiasthmatic Combinations, Antibody Inhibitors, Inhaled Corticosteroids, Inhaled steroid combinations, Leukotriene Inhibitors, Long Acting Inhaled Beta 2 agonist, Mast Cell stabilizer, Methylxanthines, Short Acting Beta 2 agonist (see code list) 2.50 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

64 Numerator: **Patients who received at least one of the following medications **Date Range: during the reporting period. MedInfo>Medical>Medications - Antiasthmatic Combinations, Antibody Inhibitors, Inhaled Corticosteroids, Leukotriene Inhibitors, Mast Cell stabilizer, Methylxanthines (see code list) Exclusions: Numerator 1 Patient Age >= 4 and <= 10 Numerator 2 Patient Age >=11 and <= 49 Numerator 3 Patient Age >= 4 and <=49 ** Patients have an active diagnosis of COPD, Cystic Fibrosis, emphysema or Acute Respiratory Failure (see code list) ** Within Date Range: during the reporting period Encounter Assessment MedInfo>Medical>Problem List NOTE Reporting will be looking at begin date of problem list prior to end of reporting period. Code Lists for Measure Asthma ICD-9 Codes: 493, 493.0, , , , 493.1, , , , 493.2, , , , 493.8, , , 493.9, , , Encounter Level Codes: ED 99281, 99282, 99283, 99284, Encounter Level Codes: Outpatient Encounter Level Codes: Inpatient Exclusion Respiratory Failure ICD 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, , 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, Exclusion COPD ICD 491.2, , , 492.0, 493.2, , , , 496, Exclusion Cystic Fibrosis 277.0, , , , , Exclusion - Emphysema 492, 492.8, 518.1, Medications Antiasthmatic Air-Tabs GG 200 mg-200 mg Tab, Asma 150 mg-90 mg/15 ml Syrup, MicroMD EMR Clinical Quality Measure Calculations Version

65 Combinations Asma-Liquid 150 mg-90 mg/15 ml, Asmalan 150 mg-90 mg/15 ml Oral Liquid, Asmalan 200 mg-200 mg Tab, Bi-Filin G 200 mg-300 mg Tab, Broncap 150 mg-200 mg Tab, Bronchial 150 mg-90 mg Cap, Broncodur 150 mg-200 mg/15 ml Oral Soln, Broncomar GG 150 mg-90 mg/15 ml Elixir, Broncomar mg-30 mg-150 mg/15 ml Elixir, Bronkaid Dual Action 24 mg-100 mg-100 mg Tab, Bronkesin 150 mg-90 mg/15 ml Oral Liquid, Bronkospas-G 200 mg-200 mg Tab, Cerylin 150 mg-90 mg Cap, Cerylin 150 mg-90 mg/15 ml Oral Liquid, COPD 200 mg-200 mg Tab, D-G Liquid 300 mg-300 mg/15 ml, DG mg-200 mg Tab, Dialixir 150 mg-90 mg/15 ml, Difil G Forte 300 mg-300 mg/15 ml Oral Liquid, Difil-G 200 mg-200 mg Tab, Difil-G 200 mg-300 mg Tab, Difil-G mg-400 mg Tab, Dilex-G 200 mg-200 mg Tab, Dilex-G 300 mg-300 mg/15 ml Oral Liquid, DILEX-G mg-400 mg Tab, Dilex-T 150 mg-90 mg/15 ml Oral Liquid, Dilor-G 200 mg-200 mg Tab, Dilor-G 300 mg-300 mg/15 ml Oral Liquid, Dy-G 300 mg-300 mg/15 ml Oral Liquid, Dyflex 200 mg-100 mg Tab, Dyflex-G 200 mg-200 mg Tab, Dyline-GG 200 mg-200 mg Tab, Dyline-GG 300 mg-300 mg/15 ml Oral Liquid, Dyphar-GG 200 mg-200 mg Tab, Dyphyl-G 200 mg-200 mg Tab, Dyphylline GG ES 200 mg-300 mg Tab, Dyphylline-GG 200 mg-200 mg Tab, dyphylline-guaifenesin 200 mg-100 mg Cap, dyphylline-guaifenesin 200 mg-100 mg Tab, dyphyllineguaifenesin 200 mg-200 mg Tab, dyphylline-guaifenesin 200 mg-300 mg Tab, dyphylline-guaifenesin 200 mg-400 mg Tab, dyphylline-guaifenesin 300 mg-300 mg/15 ml Oral Liquid, Dyphysin 300 mg-300 mg/15 ml Oral Liquid, Elixophyllin GG 100 mg-100 mg/15 ml Oral Liquid, Elixophyllin-KI 80 mg-130 mg/15 ml, Emfaseem 200 mg-100 mg Cap, Glyceryl-T 150 mg- 90 mg Cap, Glyceryl-T 150 mg-90 mg/15 ml Elixir, Glyceryl-T 150 mg-90 mg/15 ml Oral Liquid, H-Quib 150 mg-90 mg Cap, Lanophyllin 150 mg-90 mg Cap, Lufyllin-GG 200 mg-200 mg Tab, Neothylline-GG 200 mg-200 mg Tab, Nuphyl-GG 200 mg-200 mg Tab, Nuphyll-GG 200 mg-200 mg Tab, Panfil-G 200 mg-100 mg Cap, Panfil-G 200 mg-200 mg Tab, Parbron 150 mg-90 mg Cap, Q-B 150 mg-90 mg Cap, Quelan 150 mg-90 mg/15 ml Elixir, Quelan 150 mg-90 mg/15 ml Oral Liquid, Quiagen 150 mg-90 mg Cap, Quiatex 150 mg-90 mg/15 ml Elixir, Quibron 150 mg-90 mg Cap, Quibron 150 mg-90 mg/15 ml Oral Liquid, Quibron mg-180 mg Cap, Slo-Phyllin GG 150 mg-90 mg Cap, Slo-Phyllin GG 150 mg-90 mg/15 ml Syrup, Sterabron 150 mg-90 mg Cap, Theo-Col 150 mg-90 mg Cap, Theo-Col 150 mg-90 mg/15 ml Elixir, Theo-G 150 mg-90 mg Cap, Theo- Guaia 150 mg-90 mg/15 ml Oral Liquid, Theobron 200 mg-200 mg Tab, Theocolate 150 mg-90 mg/15 ml Oral Liquid, Theolate 150 mg-90 mg Cap, Theolate 150 mg-90 mg/15 ml Elixir, Theolate 150 mg-90 mg/15 ml Syrup, Theolate 300 mg-180 mg Cap, Theomar GG 150 mg-90 mg/15 ml Oral Liquid, theophylline-ephedrine-gg 100 mg-24 mg-100 mg Tab, theophylline-guaifenesin 100 mg-100 mg/15 ml Oral Liquid, theophyllineguaifenesin 150 mg-200 mg Tab, theophylline-guaifenesin 150 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

66 Medications Antibody Inhibitors Medications Inhaled Corticosteroids mg/15 ml Oral Soln, theophylline-guaifenesin 150 mg-90 mg Cap, theophylline-guaifenesin 150 mg-90 mg/15 ml Elixir, theophyllineguaifenesin 150 mg-90 mg/15 ml Oral Liquid, theophylline-guaifenesin 150 mg-90 mg/15 ml Syrup, theophylline-guaifenesin 300 mg-180 mg Cap, theophylline-potassium iodide 80 mg-130 mg/15 ml Elixir, theophyllinepseudoephed-gg 150 mg-30 mg-150 mg/15 ml Elixir, Thylline-GG 200 mg-200 mg Tab, Uni-Bronchial 150 mg-90 mg Cap omalizumab 150 mg Sub-Q Soln, omalizumab 75 mg Sub-Q Soln, Xolair 150 mg Sub-Q Soln, Xolair 75 mg Sub-Q Soln Advair Diskus 100 mcg-50 mcg/dose for Inhalation, Advair Diskus 250 mcg- 50 mcg/dose for Inhalation, Aerobid 250 mcg/actuation Aerosol Inhaler, Aerobid-M 250 mcg/actuation Aerosol Inhaler, Asmanex Twisthaler 110 mcg (30 doses) Breath Activated, Asmanex Twisthaler 110 mcg (7 doses) Breath Activated, Asmanex Twisthaler 220 mcg (120 doses) Breath Activated, Asmanex Twisthaler 220 mcg (14 doses) Breath Activated, Asmanex Twisthaler 220 mcg (30 doses) Breath Activated, Asmanex Twisthaler 220 mcg (60 doses) Breath Activated, Brondil 100 mg-100 mg/15 ml Oral Liquid, budesonide 0.25 mg/2 ml Neb Suspension, budesonide 0.5 mg/2 ml Neb Suspension, budesonide 1 mg/2 ml Neb Suspension, budesonide 200 mcg/inhalation Breath Activated Powder Aerosol, budesonide 32 mcg/actuation Nasal Spray, budesonide 32 mcg/actuation Nasal Spray, Aerosol, budesonide ER 3 mg 24 hr Cap, Difil-G 100 mg-100 mg/15 ml Oral Liquid, Dyfilin-GG 100 mg-100 mg/15 ml Elixir, dyphylline-guaifenesin 100 mg-100 mg/15 ml Elixir, dyphyllineguaifenesin 100 mg-100 mg/15 ml Oral Liquid, Entocort EC 3 mg 24 hr Cap, Flonase 50 mcg/actuation Nasal Spray, Flovent 110 mcg/actuation Aerosol Inhaler, Flovent 220 mcg/actuation Aerosol Inhaler, Flovent 44 mcg/actuation Aerosol Inhaler, Flovent Diskus 100 mcg/actuation for Inhalation, Flovent Diskus 250 mcg/actuation for Inhalation, Flovent Diskus 50 mcg/actuation for Inhalation, Flovent HFA 110 mcg/actuation Aerosol Inhaler, Flovent HFA 220 mcg/actuation Aerosol Inhaler, Flovent HFA 44 mcg/actuation Aerosol Inhaler, Flovent Rotadisk 100 mcg/actuation for Inhalation, Flovent Rotadisk 250 mcg/actuation for Inhalation, Flovent Rotadisk 50 mcg/actuation for Inhalation, flunisolide 25 mcg (0.025 %) Nasal Spray, flunisolide 250 mcg/actuation Aerosol Inhaler, flunisolide 29 mcg (0.025 %) Nasal Spray, flunisolide-menthol 250 mcg/actuation Aerosol Inhaler, fluticasone 100 mcg/actuation Disk Device for Inhalation, fluticasone 110 mcg/actuation Aerosol Inhaler, fluticasone 220 mcg/actuation Aerosol Inhaler, fluticasone 250 mcg/actuation Disk Device for Inhalation, fluticasone 44 mcg/actuation Aerosol Inhaler, fluticasone 50 mcg/actuation Disk Device for Inhalation, fluticasone 50 mcg/actuation Nasal Spray, Susp, fluticasone furoate 27.5 mcg/actuation Nasal Spray, Susp, fluticasone-salmeterol 100 mcg-50 mcg/dose Disk Device for Inhalation, fluticasone-salmeterol 250 mcg-50 mcg/dose Disk Device for MicroMD EMR Clinical Quality Measure Calculations Version

67 Medications Inhaled steroid combinations Medications Leukotriene Inhibitors Medications Long Acting Inhaled Beta 2 agonist Medications Mast Cell stabilizer Inhalation, Lufyllin-GG 100 mg-100 mg/15 ml Elixir, mometasone 110 mcg (30 doses) Breath Activated Powder Aerosol, mometasone 110 mcg (7 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (120 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (14 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (30 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (60 doses) Breath Activated Powder Aerosol, mometasone 50 mcg/actuation Nasal Spray, Nasalide 25 mcg (0.025 %) Spray Aerosol, Nasarel 25 mcg (0.025 %) Nasal Spray, Nasarel 29 mcg (0.025 %) Nasal Spray, Nasonex 50 mcg/actuation Spray, Pulmicort 0.25 mg/2 ml Neb Suspension, Pulmicort 0.5 mg/2 ml Neb Suspension, Pulmicort 1 mg/2 ml Neb Suspension, Pulmicort Turbuhaler 200 mcg/inhalation Breath Activated, Rhinocort 32 mcg/actuation Nasal Spray, Rhinocort Aqua 32 mcg/actuation Nasal Spray, Tri-Nasal 50 mcg Spray, triamcinolone acetonide 50 mcg Nasal Spray, Veramyst 27.5 mcg/actuation Nasal Spray Advair Diskus 100 mcg-50 mcg/dose for Inhalation, fluticasone-salmeterol 100 mcg-50 mcg/dose Disk Device for Inhalation Accolate 10 mg Tab, Accolate 20 mg Tab, montelukast 10 mg Tab, montelukast 4 mg Chewable Tab, montelukast 4 mg Oral Granules in Packet, montelukast 5 mg Chewable Tab, Singulair 10 mg Tab, Singulair 4 mg Chewable Tab, Singulair 4 mg Oral Granules in Packet, Singulair 5 mg Chewable Tab, zafirlukast 10 mg Tab, zafirlukast 20 mg Tab, zileuton 600 mg Tab, zileuton ER 600 mg multiphase 12 hr Tab, Zyflo 600 mg Tab, Zyflo CR 600 mg 12 hr Tab Advair Diskus 100 mcg-50 mcg/dose for Inhalation, Advair Diskus 250 mcg- 50 mcg/dose for Inhalation, fluticasone-salmeterol 100 mcg-50 mcg/dose Disk Device for Inhalation, fluticasone-salmeterol 250 mcg-50 mcg/dose Disk Device for Inhalation, Foradil Aerolizer 12 mcg inhalation Caps, formoterol fumarate 12 mcg Caps with inhalation device, formoterol fumarate 20 mcg/2 ml Neb Solution, Perforomist 20 mcg/2 ml Neb Solution, salmeterol (refill) 21 mcg/actuation Aerosol Inhaler, salmeterol 21 mcg/actuation Aerosol Inhaler, Serevent 21 mcg/actuation Aerosol Inhaler, Serevent Refill 21 mcg/actuation Aerosol Inhaler Children's Nasalcrom 5.2 mg/actuation (4 %) Spray, Crolom 4 % Eye Drops, cromolyn 100 mg/5 ml Oral Soln, cromolyn 20 mg/2 ml Neb Solution, cromolyn 4 % Eye Drops, cromolyn 5.2 mg/actuation (4 %) Nasal Spray, cromolyn 800 mcg/actuation Aerosol Inhaler, Gastrocrom 100 mg/5 ml Oral Soln, Intal mcg/actuation Aerosol Inhaler, Intal 20 mg/2 ml Neb Solution, Intal mcg/actuation Aerosol Inhaler, Intal 800 mcg/actuation Aerosol Inhaler, Nasal Allergy Control 5.2 mg/actuation (4 %) Spray, Nasal Allergy Symptom Control 5.2 mg/actuation (4 %) Spray, Nasalcrom 5.2 mg/actuation (4 %) Spray, Opticrom 4 % Eye Drops 2.54 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

68 Medications Methylxanthines Aerolate mg 12 hr Cap, Aerolate III TD 65 mg 12 hr Cap, Aerolate Jr 130 mg 12 hr Cap, Aerolate Sr 260 mg 12 hr Cap, Air-Tabs GG 200 mg- 200 mg Tab, Aminophyllin 100 mg Tab, Aminophyllin 200 mg Tab, aminophylline 100 mg Tab, aminophylline 105 mg/5 ml Oral Liquid, aminophylline 200 mg Tab, aminophylline 250 mg Rectal Suppository, aminophylline 250 mg/10 ml IV, aminophylline 250 mg/10 ml IV Syringe, aminophylline 500 mg Rectal Suppository, aminophylline 500 mg/20 ml IV, Aminophylline Df 105 mg/5 ml Oral Liquid, aminophylline in 0.9 % sodium chloride 1 mg/ml IV, aminophylline in 0.9 % sodium chloride 2 mg/ml IV, Aquaphyllin 80 mg/15 ml Syrup, Asma 150 mg-90 mg/15 ml Syrup, Asma- Liquid 150 mg-90 mg/15 ml, Asmalan 150 mg-90 mg/15 ml Oral Liquid, Asmalan 200 mg-200 mg Tab, Asmalix 80 mg/15 ml, Bi-Filin G 200 mg- 300 mg Tab, Broncap 150 mg-200 mg Tab, Bronchial 150 mg-90 mg Cap, Broncodur 150 mg-200 mg/15 ml Oral Soln, Broncomar GG 150 mg-90 mg/15 ml Elixir, Broncomar mg-30 mg-150 mg/15 ml Elixir, Brondil 100 mg-100 mg/15 ml Oral Liquid, Bronkaid Dual Action 24 mg-100 mg- 100 mg Tab, Bronkesin 150 mg-90 mg/15 ml Oral Liquid, Bronkodyl 80 mg/15 ml Elixir, Bronkodyl Sr 300 mg 12 hr Cap, Bronkospas-G 200 mg- 200 mg Tab, Cerylin 150 mg-90 mg Cap, Cerylin 150 mg-90 mg/15 ml Oral Liquid, Constant-T 200 mg 12 hr Tab, Constant-T 300 mg 12 hr Tab, COPD 200 mg-200 mg Tab, D-G Liquid 300 mg-300 mg/15 ml, DG mg-200 mg Tab, Dialixir 150 mg-90 mg/15 ml, Difil G Forte 300 mg- 300 mg/15 ml Oral Liquid, Difil-G 100 mg-100 mg/15 ml Oral Liquid, Difil- G 200 mg-200 mg Tab, Difil-G 200 mg-300 mg Tab, Difil-G mg- 400 mg Tab, Dilex-G mg-200 mg/5 ml Syrup, Dilex-G 200 mg-200 mg Tab, Dilex-G 300 mg-300 mg/15 ml Oral Liquid, DILEX-G mg- 400 mg Tab, Dilex-T 150 mg-90 mg/15 ml Oral Liquid, Dilor 160 mg/15 ml Elixir, Dilor 200 mg Tab, Dilor 250 mg/ml IM, Dilor 400 mg Tab, Dilor-G 200 mg-200 mg Tab, Dilor-G 300 mg-300 mg/15 ml Oral Liquid, Dy-G 300 mg-300 mg/15 ml Oral Liquid, Dyfilin-GG 100 mg-100 mg/15 ml Elixir, Dyflex 200 mg-100 mg Tab, Dyflex mg Tab, Dyflex mg Tab, Dyflex-G 200 mg-200 mg Tab, Dyline-GG 200 mg-200 mg Tab, Dyline- GG 300 mg-300 mg/15 ml Oral Liquid, Dylix 100 mg/15 ml, Dyphar-GG 200 mg-200 mg Tab, Dyphyl-G 100 mg-50 mg/5 ml Syrup, Dyphyl-G 200 mg-200 mg Tab, dyphylline 100 mg/15 ml Elixir, dyphylline 160 mg/15 ml Elixir, dyphylline 200 mg Tab, dyphylline 250 mg/ml IM, dyphylline 400 mg Tab, Dyphylline GG ES 200 mg-300 mg Tab, Dyphylline-GG 200 mg-200 mg Tab, dyphylline-guaifenesin 100 mg-100 mg/15 ml Elixir, dyphyllineguaifenesin 100 mg-100 mg/15 ml Oral Liquid, dyphylline-guaifenesin 100 mg-200 mg/5 ml Syrup, dyphylline-guaifenesin 100 mg-50 mg/5 ml Syrup, dyphylline-guaifenesin 200 mg-100 mg Cap, dyphylline-guaifenesin 200 mg-100 mg Tab, dyphylline-guaifenesin 200 mg-200 mg Tab, dyphyllineguaifenesin 200 mg-300 mg Tab, dyphylline-guaifenesin 200 mg-400 mg Tab, dyphylline-guaifenesin 300 mg-300 mg/15 ml Oral Liquid, Dyphysin MicroMD EMR Clinical Quality Measure Calculations Version

69 300 mg-300 mg/15 ml Oral Liquid, Ed-Bron G 100 mg-150 mg/5 ml Oral Liquid, Elixophyllin 200 mg 12 hr Cap, Elixophyllin 250 mg 12 hr Cap, Elixophyllin 80 mg/15 ml, Elixophyllin GG 100 mg-100 mg/15 ml Oral Liquid, Elixophyllin Sr 125 mg 12 hr Cap, Elixophyllin Sr 250 mg 12 hr Cap, Elixophyllin-KI 80 mg-130 mg/15 ml, Emfaseem 200 mg-100 mg Cap, Glyceryl-T 150 mg-90 mg Cap, Glyceryl-T 150 mg-90 mg/15 ml Elixir, Glyceryl-T 150 mg-90 mg/15 ml Oral Liquid, H-Quib 150 mg-90 mg Cap, Jay-Phyl 100 mg-50 mg/5 ml Syrup, Lanophyllin 150 mg-90 mg Cap, Lanophyllin 250 mg/10 ml IV, Lanophyllin 80 mg/15 ml Elixir, Liquophylline 80 mg/15 ml Elixir, Lixolin 80 mg/15 ml, Lodrane mg 12 hr Cap, Lodrane mg 12 hr Cap, Lufyllin 100 mg/15 ml Elixir, Lufyllin 200 mg Tab, Lufyllin 250 mg/ml IM, Lufyllin 400 mg Tab, Lufyllin mg Tab, Lufyllin-GG 100 mg-100 mg/15 ml Elixir, Lufyllin-GG 200 mg-200 mg Tab, MYCI BRON-G 100 mg-150 mg/5 ml Oral Liquid, Neothylline 200 mg Tab, Neothylline 250 mg/ml IM, Neothylline 400 mg Tab, Neothylline-GG 200 mg-200 mg Tab, Norophylline 80 mg/15 ml Elixir, Nuphyl-GG 200 mg- 200 mg Tab, Nuphyll-GG 200 mg-200 mg Tab, Panamin 100 mg Tab, Panamin 200 mg Tab, Panfil-G 100 mg-50 mg/5 ml Syrup, Panfil-G 200 mg-100 mg Cap, Panfil-G 200 mg-200 mg Tab, Parbron 150 mg-90 mg Cap, Q-B 150 mg-90 mg Cap, Quelan 150 mg-90 mg/15 ml Elixir, Quelan 150 mg-90 mg/15 ml Oral Liquid, Quiagen 150 mg-90 mg Cap, Quiatex 150 mg-90 mg/15 ml Elixir, Quibron 150 mg-90 mg Cap, Quibron 150 mg- 90 mg/15 ml Oral Liquid, Quibron mg-180 mg Cap, Quibron-T 300 mg Tab, Quibron-T/SR 300 mg 12 hr Tab, Respbid 250 mg 12 hr Tab, Respbid 500 mg 12 hr Tab, Slo-Bid mg 12 hr Cap, Slo-Bid mg 12 hr Cap, Slo-Bid mg 12 hr Cap, Slo-Bid mg 12 hr Cap, Slo-Bid mg 12 hr Cap, Slo-Bid Gyrocaps 100 mg, Slo-Bid Gyrocaps 125 mg, Slo-Bid Gyrocaps 200 mg, Slo-Bid Gyrocaps 300 mg, Slo- Bid Gyrocaps 50 mg, Slo-Bid Gyrocaps 75 mg, Slo-Phyllin 100 mg Tab, Slo- Phyllin 125 mg 12 hr Cap, Slo-Phyllin 200 mg Tab, Slo-Phyllin 250 mg 12 hr Cap, Slo-Phyllin 60 mg 12 hr Cap, Slo-Phyllin mg/15 ml Syrup, Slo-Phyllin 80 mg/15 ml Syrup, Slo-Phyllin GG 150 mg-90 mg Cap, Slo- Phyllin GG 150 mg-90 mg/15 ml Syrup, Somophyllin 105 mg/5 ml Oral Liquid, Somophyllin-CRT 100 mg 12 hr Cap, Somophyllin-CRT 200 mg 12 hr Cap, Somophyllin-CRT 250 mg 12 hr Cap, Somophyllin-CRT 300 mg 12 hr Cap, Somophyllin-CRT 50 mg 12 hr Cap, Somophyllin-Df 105 mg/5 ml Oral Liquid, Somophylline 105 mg/5 ml Oral Liquid, Sterabron 150 mg-90 mg Cap, Sustaire 100 mg 12 hr Tab, Sustaire 300 mg 12 hr Tab, T-Phyl 200 mg 12 hr Tab, Theo 80 mg/15 ml Elixir, Theo Liquid 80 mg/15 ml Elixir, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo-Col 150 mg-90 mg Cap, Theo-Col 150 mg-90 mg/15 ml Elixir, Theo-Dilate 300 mg 12 hr Tab, Theo-Dur 100 mg 12 hr Tab, Theo-Dur 200 mg 12 hr Tab, Theo-Dur 300 mg 12 hr Tab, Theo-Dur 450 mg 12 hr Tab, Theo-G 150 mg-90 mg Cap, Theo-Guaia MicroMD EMR Clinical Quality Measure Calculations Version 7.5

70 mg-90 mg/15 ml Oral Liquid, Theo-Lix 80 mg/15 ml, Theo-Sav 100 mg 12 hr Tab, Theo-Sav 200 mg 12 hr Tab, Theo-Sav 300 mg 12 hr Tab, Theo-X 100 mg 12 hr Tab, Theo-X 200 mg 12 hr Tab, Theo-X 300 mg 12 hr Tab, Theobid 260 mg 12 hr Cap, Theobid Duracap 260 mg, Theobid Jr 130 mg 12 hr Cap, Theobron 200 mg-200 mg Tab, Theobron Sr 125 mg 12 hr Cap, Theobron Sr 250 mg 12 hr Cap, TheoCap 125 mg, TheoCap 200 mg, TheoCap 300 mg, Theochron 100 mg 12 hr Tab, Theochron 200 mg 12 hr Tab, Theochron 300 mg 12 hr Tab, Theochron 450 mg 12 hr Tab, Theoclear La mg 12 hr Cap, Theoclear La mg 12 hr Cap, Theoclear La mg 12 hr Cap, Theoclear mg Tab, Theoclear mg Tab, Theoclear mg Tab, Theoclear mg/15 ml Syrup, Theocolate 150 mg-90 mg/15 ml Oral Liquid, Theolair 125 mg Tab, Theolair 250 mg Tab, Theolair 80 mg/15 ml Oral Soln, Theolair-SR 200 mg 12 hr Tab, Theolair-SR 250 mg 12 hr Tab, Theolair-SR 300 mg 12 hr Tab, Theolair-SR 500 mg 12 hr Tab, Theolate 150 mg-90 mg Cap, Theolate 150 mg-90 mg/15 ml Elixir, Theolate 150 mg-90 mg/15 ml Syrup, Theolate 300 mg-180 mg Cap, Theolixir 80 mg/15 ml, Theomar GG 150 mg-90 mg/15 ml Oral Liquid, Theophyl 100 mg Chewable Tab, Theophyl mg Tab, Theophyl-Sr 125 mg 12 hr Cap, Theophyl-Sr 250 mg 12 hr Cap, theophylline 100 mg Chewable Tab, theophylline 100 mg Tab, theophylline 125 mg Tab, theophylline 200 mg Tab, theophylline 225 mg Tab, theophylline 250 mg Tab, theophylline 300 mg Tab, theophylline 80 mg/15 ml Elixir, theophylline 80 mg/15 ml Oral Soln, theophylline 80 mg/15 ml Syrup, theophylline ER 100 mg 12 hr Cap, theophylline ER 100 mg 12 hr Tab, theophylline ER 100 mg 24 hr Cap, theophylline ER 125 mg 12 hr Cap, theophylline ER 130 mg 12 hr Cap, theophylline ER 200 mg 12 hr Cap, theophylline ER 200 mg 12 hr Tab, theophylline ER 200 mg 24 hr Cap, theophylline ER 250 mg 12 hr Cap, theophylline ER 250 mg 12 hr Tab, theophylline ER 260 mg 12 hr Cap, theophylline ER 300 mg 12 hr Cap, theophylline ER 300 mg 12 hr Tab, theophylline ER 300 mg 24 hr Cap, theophylline ER 400 mg 24 hr Cap, theophylline ER 400 mg 24 hr Tab, theophylline ER 400 mg Tab, theophylline ER 450 mg 12 hr Tab, theophylline ER 50 mg 12 hr Cap, theophylline ER 500 mg 12 hr Tab, theophylline ER 60 mg 12 hr Cap, theophylline ER 600 mg 24 hr Tab, theophylline ER 600 mg Tab, theophylline ER 65 mg 12 hr Cap, theophylline ER 75 mg 12 hr Cap, theophylline in D5W 200 mg/100 ml IV, theophylline in D5W 200 mg/50 ml IV, theophylline in D5W 400 mg/100 ml IV, theophylline in D5W 400 mg/250 ml IV, theophylline in D5W 400 mg/500 ml IV, theophylline in D5W 400 mg/l IV, theophylline in D5W 800 mg/250 ml IV, theophylline in D5W 800 mg/500 ml IV, theophylline in D5W 800 mg/l IV, theophylline-ephed-phenobarb 130 mg-24 mg-8 mg Tab, theophylline-ephedrine-gg 100 mg-24 mg-100 mg Tab, theophyllineguaifenesin 100 mg-100 mg/15 ml Oral Liquid, theophylline-guaifenesin 100 mg-150 mg/5 ml Oral Liquid, theophylline-guaifenesin 150 mg-200 MicroMD EMR Clinical Quality Measure Calculations Version

71 Medications Short Acting Beta 2 agonist mg Tab, theophylline-guaifenesin 150 mg-200 mg/15 ml Oral Soln, theophylline-guaifenesin 150 mg-90 mg Cap, theophylline-guaifenesin 150 mg-90 mg/15 ml Elixir, theophylline-guaifenesin 150 mg-90 mg/15 ml Oral Liquid, theophylline-guaifenesin 150 mg-90 mg/15 ml Syrup, theophyllineguaifenesin 300 mg-180 mg Cap, theophylline-potassium iodide 80 mg- 130 mg/15 ml Elixir, theophylline-pseudoephed-gg 150 mg-30 mg-150 mg/15 ml Elixir, Theorex 80 mg/15 ml Elixir, Theospan-Sr 130 mg 12 hr Cap, Theospan-Sr 260 mg 12 hr Cap, Theospan-Sr 65 mg 12 hr Cap, Theostat 100 mg Tab, Theostat 200 mg Tab, Theostat mg/15 ml Syrup, Theovent 125 mg 12 hr Cap, Theovent 250 mg 12 hr Cap, Thylline 200 mg Tab, Thylline 400 mg Tab, Thylline-GG 200 mg-200 mg Tab, Truphylline 250 mg Rectal Suppository, Truphylline 500 mg Rectal Suppository, Truxophyllin 80 mg/15 ml Elixir, Uni-Bronchial 150 mg-90 mg Cap, Uni-Dur 400 mg 24 hr Tab, Uni-Dur 600 mg 24 hr Tab, Uniphyl 400 mg Tab, Uniphyl 600 mg Tab AccuNeb 0.63 mg/3 ml Neb Solution, AccuNeb 1.25 mg/3 ml Neb Solution, Airet 2.5 mg/3 ml (0.083 %) Neb Solution, albuterol (refill) 90 mcg/actuation Aerosol Inhaler, albuterol 90 mcg/actuation Aerosol Inhaler, albuterol sulfate 0.63 mg/3 ml Neb Solution, albuterol sulfate 1.25 mg/3 ml Neb Solution, albuterol sulfate 2 mg Tab, albuterol sulfate 2 mg/5 ml Syrup, albuterol sulfate 2.5 mg/0.5 ml Neb Solution, albuterol sulfate 2.5 mg/3 ml (0.083 %) Neb Solution, albuterol sulfate 200 mcg Caps with inhalation device, albuterol sulfate 200 mcg Capsules for Inhalation, albuterol sulfate 4 mg Tab, albuterol sulfate 5 mg/ml (0.5 %) Neb Solution, albuterol sulfate ER 4 mg 12 hour tab, albuterol sulfate ER 4 mg 12 hr Tab, albuterol sulfate ER 4 mg multiphase 12 hr Tab, albuterol sulfate ER 4 mg Tab, albuterol sulfate ER 8 mg 12 hour tab, albuterol sulfate ER 8 mg Tab, albuterol sulfate HFA 90 mcg/actuation Aerosol Inhaler, Combivent 18 mcg-103 mcg/actuation Aerosol Inhaler, DuoNeb 0.5 mg-3 mg(2.5 mg base)/3 ml Neb Solution, ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 ml Neb Solution, ipratropium-albuterol 18 mcg-103 mcg/actuation Aerosol Inhaler, levalbuterol 0.31 mg/3 ml Neb Solution, levalbuterol 0.63 mg/3 ml Neb Solution, levalbuterol 1.25 mg/0.5 ml Neb Solution, levalbuterol 1.25 mg/3 ml Neb Solution, levalbuterol HFA 45 mcg/actuation Aerosol Inhaler, ProAir HFA 90 mcg/actuation Aerosol Inhaler, Proventil (Refill) 90 mcg/actuation Aerosol Inhaler, Proventil 2 mg Tab, Proventil 2 mg/5 ml Syrup, Proventil 2.5 mg/3 ml (0.083 %) Neb Solution, Proventil 4 mg 12 hr Tab, Proventil 4 mg Tab, Proventil 5 mg/ml (0.5 %) Neb Solution, Proventil 90 mcg/actuation Aerosol Inhaler, Proventil HFA 90 mcg/actuation Aerosol Inhaler, Respirol 90 mcg/actuation Aerosol Inhaler, Ventolin 2 mg Tab, Ventolin 2 mg/5 ml Syrup, Ventolin 2.5 mg/3 ml (0.083 %) Neb Solution, Ventolin 4 mg Tab, Ventolin 5 mg/ml (0.5 %) Neb Solution, Ventolin 90 mcg/actuation Aerosol Inhaler, Ventolin HFA 90 mcg/actuation Aerosol Inhaler, Ventolin Refill 90 mcg/actuation Aerosol 2.58 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

72 Inhaler, Ventolin Rotacaps 200 mcg for Inhalation, Ventolin Rotahaler with Rotacaps 200 mcg for inhalation, Volmax 4 mg 12 hr Tab, Volmax 4 mg Tab, Volmax 8 mg Tab, Vospire ER 4 mg 12 hr Tab, Vospire ER 8 mg 12 hr Tab, Xopenex 0.31 mg/3 ml Neb Solution, Xopenex 0.63 mg/3 ml Neb Solution, Xopenex 1.25 mg/3 ml Neb Solution, Xopenex HFA 45 mcg/actuation Aerosol Inhaler NQF CHILDHOOD IMMUNIZATION STATUS (CORE) Description: Clinical Rationale: The percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV); one measles, mumps and rubella (MMR); two H influenza type B (HiB); three hepatitis B (Hep B), one chicken pox (VZV); four pneumococcal conjugate (PCV); two hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. The measure calculates a rate for each vaccine and two separate combination rates. This measure monitors the appropriate and timely use of vaccines for children prior to their second birthday. Pediatric vaccines are responsible for preventing 10.5 million diseases per birth cohort in the U.S. and are a cost-effective preventive measure. For every dollar spent on immunizations, as many as $29 can be saved in direct and indirect costs. With the development and use of vaccines, the prevalence of some infectious diseases has dramatically reduced; since the beginning of the 20th century, there has been a 99% decline in vaccine-preventable disease morbidity. Despite the established guidelines and well-known benefits of vaccination, however, in 2007, 22.5% of children months of age had not received the recommended immunizations. General clinical consensus notes that if immunization practices ceased, most infectious diseases currently prevented by vaccinations would reemerge as serious health threats. This measure facilitates efforts toward infectious disease prevention among a vulnerable subgroup of the population. Denominator: **Patients in Age Range: >= 1 and <=2 **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified. MicroMD EMR Clinical Quality Measure Calculations Version

73 Numerator: Numerator 1 **Patients who received 4 or more DTaP Immunizations (see code list) **Within Date Range >=42 days and < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 2 **Patients who received 3 or more IPV Immunizations (see code list) **Within Date Range >=42 days and < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 3 Either **Patients who received 1 or more MMR Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan(CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 3 - OR **Patients who received 1 or more Rubella Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had Rubella and it is documented as resolved before the end of the reporting period(see code list) MedInfo>Medical>Problem List (Status marked as Resolved) AND **Patient received 1 or more Measles Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had Measles and it is documented as resolved before the end of the reporting period (see code list) MedInfo>Medical>Problem List (Status marked as Resolved) 2.60 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

74 AND **Patient received 1 or more Mumps Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had Mumps and it is documented as resolved before the end of the reporting period (see code list) MedInfo>Medical>Problem List (Status marked as Resolved) Numerator 4 **Patients who received 2 or more HiB Immunizations (see code list) **Within Date Range >=42 days and < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 5 **Patients who received 3 or more Hepatitis B Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had Hepatitis B before the end of the reporting period (see code list) Encounter Assessment - (see ICD Code List) MedInfo>Medical>Problem List Numerator 6 **Patients who received 1 or more VZV or Varicella Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had VZV and it is documented as resolved before the end of the reporting period (see code list) MedInfo>Medical>Problem List (Status marked as Resolved) MicroMD EMR Clinical Quality Measure Calculations Version

75 Numerator 7 **Patients who received 4 or more Pneumococcal Immunizations (see code list) Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) **Within Date Range >=42 days and < 2 years after patient s date of birth. Numerator 8 **Patients who received 2 or more Hepatitis A Immunizations (see code list) **Within Date Range < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) OR **Patient has had Hepatitis A and it is documented as resolved before the end of the reporting period (see code list) MedInfo>Medical>Problem List (Status marked as Resolved) Numerator 9 **Patients who received 2 or more Rotavirus Immunizations (see code list) **Within Date Range >=42 days and < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 10 **Patients who received 2 or more Influenza Immunizations (see code list) **Within Date Range >=180 days and < 2 years after patient s date of birth. Encounter Plan (CPT codes) MedInfo>Health Maintenance>Immunizations (CVX / CPT codes) Numerator 11 = Those patients who satisfied Numerators Numerator 12 = Those patients who satisfied Numerators MicroMD EMR Clinical Quality Measure Calculations Version 7.5

76 Exclusions: Exclusion from Numerator 1 : **Patient had documentation of Encephalopathy or Progressive Neurologic Disorder documented in their chart (see code list) **Date Range: Documented to have begun prior to the end of reporting period Encounter Assessment MedInfo>Medical>Problem List MedInfo>Histories>Medical History OR **Patient has a Medication Allergy of DTaP Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 2: **Patient has a Medication Allergy of IPV or Neomycin or Streptomycin or Polymyxin or IPOL or Poliovirus Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 3: **Patient has a documented History of Cancer of Lymphoreticular or Histiocytic Tissue, HIV disease, Multiple Myeloma, Leukemia or Immunodeficiency **Date Range: Documented to have begun prior to the end of reporting period Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patient has a Medication Allergy of MMR, Mumps, Measles or Rubella Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 4: **Patient has a Medication Allergy of HiB Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies MicroMD EMR Clinical Quality Measure Calculations Version

77 Exclusion from Numerator 5: **Patient has a Medication Allergy of Hepatitis B Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies OR **Patient has a Non-Medication Allergy of Baker s Yeast (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies (use allergy with a description that includes yeast ) Exclusion from Numerator 6: **Patient has a documented History of Cancer of Lymphoreticular or Histiocytic Tissue, HIV disease, Multiple Myeloma, Leukemia or Immunodeficiency **Date Range: Documented to have begun prior to the end of reporting period Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patient has a Medication Allergy of VZV or Varicella Immunization (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 7: **Patient has a Medication Allergy of Pneumococcal Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 8: **Patient has a Medication Allergy of Hepatitis A Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 9: **Patient has a Medication Allergy of Rotavirus Vaccine (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies 2.64 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

78 Exclusion from Numerator 10: **Patient has a documented History of Cancer of Lymphoreticular or Histiocytic Tissue, HIV disease, Multiple Myeloma, Leukemia or Immunodeficiency **Date Range: Documented to have begun prior to the end of reporting period Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patient has a Medication Allergy of Influenza Immunization (See code list) **Date Range: Prior to the end of reporting period MedInfo>Medical>Allergies Exclusion from Numerator 11 = Those patients who were excluded from Exclusion from Numerator 12 = Those patients who were excluded from Code Lists for Measure Encounter Level Codes 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Immunization CVX for DTaP 110,120,20,50 Immunization CVX for IPV 10,120 Immunization CVX for MMR 03,94 Immunization CVX for Rubella Immunization CVX for Measles Immunization CVX for Mumps MicroMD EMR Clinical Quality Measure Calculations Version

79 Immunization CVX for HiB 46,47,48,49,50,51,120 Immunization CVX for Hepatitis B Immunization CVX for VZV 21,94 Immunization CVX for Pneumococcal Immunization CVX for Hepatitis A Immunization CVX for Rotavirus Immunization CVX for Influenza 08,110,44,51 100, , ,15 DTaP Vaccine - CPT 90698, 90700, 90721, IPV Vaccine CPT 90713, MMR Vaccine CPT 90707, Rubella Vaccine CPT Measles Vaccine - CPT Mumps Vaccine CPT HiB Vaccine CPT 90645, 90646, 90647, 90648, Hepatitis B Vaccine CPT 90723, 90740, 90744, 90747, VZV or Varicella Vaccine CPT Pneumococcal Vaccine - CPT Hepatitis A Vaccine - CPT , , Rotavirus Vaccine - CPT 90680, Influenza Vaccine - CPT 90655, 90657, 90661, Encephalopathy ICD Progressive Neurologic Disorder ICD Cancer of Lymphoreticular or Histiocytic Tissue - ICD HIV Disease - ICD ,202, , v MicroMD EMR Clinical Quality Measure Calculations Version 7.5

80 Multiple Myeloma ICD 203 Leukemia ICD 200, 202, 204, 205, 206, 207, 208 Immunodeficiency - ICD 279 DtaP Vaccine for Allergy IPV Vaccine for Allergy MMR Vaccine for Allergy Acel-Imune 7.5 Lf unit-40 mcg-5 Lf/0.5mL IM, Acel-Imune 9 Lf unit-40 mcg- 5 Lf/0.5 ml IM Soln, Adacel (Adolescent & Adult) 2 Lf-(5-3-5mcg)-5 Lf/0.5 ml IM Susp, BOOSTRIX 2.5 Lf unit-8 mcg-5 Lf/0.5 ml IM Susp, BOOSTRIX 2.5 Lf unit-8 mcg-5 Lf/0.5 ml IM Syringe, Certiva 15 Lf unit-40 mcg-6 Lf/0.5 ml IM Susp, Daptacel (Pediatric) (PF) 15 Lf unit-10 mcg-5 Lf/0.5 ml IM Susp, diph,pertus(acel),tet ped (PF) 15 Lf unit-10 mcg-5 Lf/0.5 ml IM Susp, diph,pertus(acel),tet ped (PF) 25 Lf unit-58 mcg-10 Lf/0.5mL IM Susp, diph,pertus(acel),tet ped (PF) 6.7 Lf unit-46.8 mcg-5/0.5 ml IM Susp, diph,pertus(acel),tet,polio(pf) 25 Lf-58 mcg-10 Lf/0.5 ml IM Susp, diph,pertus(acel),tet,polio(pf) 25 Lf-58 mcg-10 Lf/0.5 ml IM Syringe, diph,pertus(acel),tetanus pedi 15 Lf unit-40 mcg-6 Lf/0.5 ml IM Susp, diph,pertus(acel),tetanus pedi 25 Lf unit-58 mcg-10 Lf/0.5mL IM Syring, diphth, pertus(acell), tetanus 7.5 Lf unit-40 mcg-5 Lf/0.5mL Inject IM, diphth, pertus(acell), tetanus 9 Lf unit-40 mcg-5 Lf/0.5 ml IM, diphth,pertus(ac)tetanus vac(pf) 2 Lf-(5-3-5mcg)-5 Lf/0.5 ml IM Susp, diphth,pertus(ac)tetanus vac(pf) 2.5 Lf unit-8 mcg-5 Lf/0.5 ml IM Susp, diphth,pertus(ac)tetanus vac(pf) 2.5 Lf unit-8 mcg-5 Lf/0.5 ml IM Syr, diphtheria,pertussis,tetanus 12.5 Lf unit-4 Lf unit-5 Lf u Inject IM, diphtheria,pertussis,tetanus 6.7 Lf unit-4 Lf unit-5 Lf u Inject IM, Diptheria- Tetanus-Pertuss Vacc 6.7 Lf unit-4 Lf unit-5 Lf u Inject IM, DP(a)T-polio-hib conj-tet (PF) 15 Lf unit-20 mcg-5 Lf /0.5mL IM Kit, DTP Toxoids Adsorbed 6.7 LFunit-4 LFunit-5 LFunit IM, hep B-DP(acell)T-polio vacc-pf 10mcg- 25Lf-25mcg-10Lf IM Susp, hep B-DP(acell)T-polio vacc-pf 10mcg- 25Lf-25mcg-10Lf IM Syring, hep B-DP(acell)T-polio vaccine 10mcg-25Lf-25mcg-10Lf IM Syring, Infanrix (PF) 25 Lf unit-58 mcg-10 Lf/0.5mL IM Susp, Infanrix 25 Lf unit-58 mcg-10 Lf/0.5mL IM Syringe, Kinrix 25 Lf-58 mcg-10 Lf/0.5 ml IM Susp, Kinrix 25 Lf-58 mcg-10 Lf/0.5 ml IM Syringe, Pediarix (PF) 10mcg-25Lf-25mcg-10Lf IM Susp, Pediarix (PF) 10mcg-25Lf-25mcg-10Lf IM Syringe, Pediarix 10mcg-25Lf-25mcg-10Lf IM Syringe, Pentacel 15 Lf unit-20 mcg-5 Lf /0.5mL IM Kit, Tri-Immunol LFunit IM, Tripedia (PF) 6.7 Lf unit mcg-5/0.5 ml IM Susp IPOL 40 unit-8 unit-32 unit/0.5 ml Susp for Injection, IPOL 40 unit-8 unit- 32 unit/0.5 ml Syringe, poliovirus vaccine 40 unit-8 unit-32 unit/0.5 ml Inj Syringe, poliovirus vaccine 40 unit-8 unit-32 unit/0.5 ml Susp for Injection M-M-R II (PF) 1,000-12,500 TCID50/0.5 ml Sub-Q Susp, measles,mumps&rubella vaccin(pf) 1,000-12,500 TCID50/0.5 ml Sub-Q Susp, measles,mumps,rub,varicel (PF) 10exp TCID50/0.5mL Sub-Q, ProQuad 10exp TCID50/0.5mL Sub-Q MicroMD EMR Clinical Quality Measure Calculations Version

81 Measles Vaccine for Allergy Rubella Vaccine for Allergy HiB Vaccine for Allergy Hepatitis B Vaccine for Allergy Pneumococcal Vaccine for Allergy Hepatitis A Vaccine for Allergy Rotavirus Vaccine for Allergy Attenuvax (PF) 1,000 TCID50/0.5 ml Sub-Q Susp, M-M-R II (PF) 1,000-12,500 TCID50/0.5 ml Sub-Q Susp, measles vaccine,live,attenuated (PF) 1,000 TCID50/0.5 ml Sub-Q Susp, measles,mumps&rubella vaccin(pf) 1,000-12,500 TCID50/0.5 ml Sub-Q Susp, measles,mumps,rub,varicel (PF) 10exp TCID50/0.5mL Sub-Q, ProQuad 10exp TCID50/0.5mL Sub-Q Meruvax II (PF) 1,000 TCID50/0.5 ml Sub-Q Susp, rubella vaccine (PF) 1,000 TCID50/0.5 ml Sub-Q Susp ActHIB 10 mcg/0.5 ml IM, haemophilus B polysaccharid conj-tetanus tox (PF) 10 mcg/0.5 ml IM, Hiberix 10 mcg/0.5 ml IM Engerix-B 10 mcg/0.5 ml IM Susp, Engerix-B 10 mcg/0.5 ml IM Syringe, Engerix-B 20 mcg/ml IM Susp, Engerix-B 20 mcg/ml IM Syringe, hepatitis A & B virus vaccine 720 Elisa unit-20 mcg/ml IM Susp, hepatitis B virus vaccine recomb (PF) 40 mcg/ml IM Susp, hepatitis B virus vaccine recomb (PF) 5 mcg/0.5 ml IM Susp, hepatitis B virus vaccine recomb 10 mcg/0.5 ml IM Susp, hepatitis B virus vaccine recomb 10 mcg/0.5 ml IM Syringe, hepatitis B virus vaccine recomb 10 mcg/ml IM Susp, hepatitis B virus vaccine recomb 10 mcg/ml IM Syringe, hepatitis B virus vaccine recomb 20 mcg/ml IM Susp, hepatitis B virus vaccine recomb 20 mcg/ml IM Syringe, hepatitis B virus vaccine recomb 40 mcg/ml IM, hepatitis B virus vaccine recomb 5 mcg/0.5 ml IM Susp, hepatitis B virus vaccine recomb 5 mcg/0.5 ml IM Syringe, Recombivax HB (PF) 40 mcg/ml IM Susp, Recombivax HB (PF) 5 mcg/0.5 ml IM Susp, Recombivax HB 10 mcg/ml IM Susp, Recombivax HB 10 mcg/ml IM Syringe, Recombivax HB 40 mcg/ml IM, Recombivax HB 5 mcg/0.5 ml IM Susp, Recombivax HB 5 mcg/0.5ml IM Syringe, Twinrix 720 Elisa unit-20 mcg/ml IM Susp pneumococcal 23-valps vaccine 25 mcg/0.5 ml Injection, pneumococcal 23- valps vaccine 25 mcg/0.5 ml Syringe, Pneumovax mcg/0.5 ml Injection, Pneumovax mcg/0.5 ml Syringe, Pnu-Imune 25 mcg/0.5ml Injection, Pnu-Imune 25 mcg/0.5ml Syringe Havrix (PF) 1,440 Elisa unit/ml IM Susp, Havrix (PF) 1,440 Elisa unit/ml IM Syringe, Havrix (PF) 720 Elisa unit/0.5 ml IM Susp, Havrix (PF) 720 Elisa unit/0.5 ml IM Syringe, hepatitis A & B virus vaccine (PF) 720 Elisa unit-20 mcg/ml IM Syringe, hepatitis A virus vaccine (PF) 1,440 Elisa unit/ml IM Susp, hepatitis A virus vaccine (PF) 1,440 Elisa unit/ml IM Syringe, hepatitis A virus vaccine (PF) 720 Elisa unit/0.5 ml IM Susp, hepatitis A virus vaccine (PF) 720 Elisa unit/0.5 ml IM Syringe, Twinrix (PF) 720 Elisa unit-20 mcg/ml IM Syringe Rotarix 10exp6 CCID50/mL Oral Susp, RotaTeq Vaccine 2 ml Oral Susp, rotavirus vac,live att, strain G1P[8] 10exp6 CCID50/mL Oral Susp, rotavirus vaccine live, penta valent 2 ml Oral Susp 2.68 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

82 Influenza Vaccine for Allergy Rubella ICD 056 Measles ICD 055 Mumps ICD 055 Hepatitis B ICD 070.2, 070.3, V02.61 VZV ICD 052, 053 Hepatitis A ICD 070.0, flu vaccine tr-vl split (PF) 22.5 mcg/0.25 ml IM Syrng, Fluzone Pedi (PF) 22.5 mcg/0.25 ml IM Syringe, influenza A (H1N1) vaccine 2009 (PF) 15 mcg/0.5 ml IM Syringe, influenza A (H1N1) vaccine 2009 (PF) 7.5 mcg/0.25 ml IM Syringe, influenza A(H1N1)vaccine 2009 live 10exp FFU/0.2 ml Nasal Spray NQF 0041 / PQRI 110 INFLUENZA IMMUNIZATION FOR PATIENTS 50 AND OLDER (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 50 years and older who received an influenza immunization during the flu season (October through April). Influenza vaccination has shown to decrease hospitalizations for influenza, especially for those with risk factors, however annual influenza vaccination rates remain low. Denominator: **Patients in Age Range: >= 49 Numerator: **Who also had qualifying encounters between 58 days before the beginning of the reporting period and 122 days after the beginning of the reporting period. (see code list) At least 1 Outpatient, Preventive, Nursing Facility or Nursing Discharge **Patients who received the influenza vaccine during the flu season Encounter Plan to indicate influenza vaccine (see code list of CPT) MedInfo>Health Maintenance>Immunizations (see code list of CVX / CPT) NOTE in both cases, the dates on the immunization and the encounter will need to be between 58 days before the beginning of the reporting period and 122 days after the beginning of the reporting period. MicroMD EMR Clinical Quality Measure Calculations Version

83 Exclusions: Code Lists for Measure Encounter Levels - Outpatient Encounter Levels - Preventive Encounter Levels Preventive Group Counseling Encounter Levels Prevention Individual Counseling Encounter Levels Nursing Facility Encounter Levels Nursing Discharge Encounter Levels Preventive Med Other Services Influenza Vaccine CPT Codes Influenza Vaccine CVX Codes **Patient has a Non-Medication Allergy of Eggs (description of Non- Medication Allergy contains egg but not eggplant ) **Date Range: Prior to or on the day of the encounter MedInfo>Medical>Allergies>Non-Medication Allergy OR **Patient has a Medication Allergy of Influenza Immunization (See code list) **Date Range: Prior to or on the day of the encounter MedInfo>Medical>Allergies 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99387, 99396, , , 99402, 99403, , 99305, 99306, 99307, 99308, 99309, , ,90658,90660,90661,90662,90663,90664,90666, 90667, ,16,111,125,126,127,128 and MicroMD EMR Clinical Quality Measure Calculations Version 7.5

84 NQF 0043 / PQRI 111 PNEUMONIA VACCINATION FOR OLDER ADULTS (ALTERNATE) Description: Clinical Rationale: The percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine. This measure monitors the appropriate and timely use of vaccines among age-appropriate older adults. Each year, 20% of Americans contract influenza (flu) (CDC 2009). Rates of infection are highest among children and immunosuppressed patients, while mortality is highest among adults over 64 years, children under 2 years and persons with chronic medical conditions (CDC 2008). More than 200,000 people are hospitalized for flurelated complications each year; 63% are 65 or older (CDC 2009; Thompson et al. 2004). The health impact of influenza on older adults is substantial and flu short vaccines are the most effective way to prevent severe illness complications and death. This measure facilitates efforts toward infectious disease prevention among a vulnerable subgroup of the population. Denominator: **Patients in Age Range: >= 64 **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified. Numerator: Exclusions: **Patients who received a Pneumococcal Vaccine **Date Range: Prior to the end of reporting period Encounter Plan to indicate Pneumococcal vaccine (see code list of CPT) MedInfo>Health Maintenance> Immunizations with appropriate CVX / CPT Codes (see code list) None. Code Lists for Measure Encounter Level - Outpatient Pneumococcal Vaccine - CVX 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, , 133, 33 MicroMD EMR Clinical Quality Measure Calculations Version

85 Pneumococcal Vaccine - CPT 90669, 90670, NQF 0047 / PQRI 53 ASTHMA PHARMACOLOGY THERAPY (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 5 through 40 years with a diagnosis of mild, moderate, or severe persistent asthma who were prescribed either the preferred long-term control medication (inhaled corticosteroid) or an acceptable alternative treatment. Although current guidelines recommend inhaled corticosteroids as the preferred pharmacological treatment for persistent asthma, other long-term control medications are acceptable alternatives. Long Acting-inhaled Beta2 Agonists (LABA) are recommended in combination with Inhaled Corticosteroids. Denominator: **Patients in Age Range: >= 5 and <=40 **who have condition of Asthma recorded in their chart-(see code list) **Date Range: beginning prior to the end of the reporting period. MedInfo>Medical>Problem List Entry Encounter with an Assessment **who have been seen at least 2 times during the reporting period (see code list) Encounters with Encounter Level Specified Numerator: Exclusions: **Patients who were prescribed a preferred long-term control medication or an acceptable alternative treatment (see code list) **Date Range: during the reporting period MedInfo>Medical>Medications **Patients with documented Allergy to corticosteroid, inhaled or alternative asthma medications (see code list) **Date Range: begin date <= encounter date MedInfo>Allergies>Drug Allergy Or **Patient had a Medication Intolerance event to corticosteroid, inhaled or alternative asthma medications **Date Range: Prior to or on encounter date MedInfo>Medical>Medications>Long Term Medications where there is a termination date in the date range and a reason for termination MicroMD EMR Clinical Quality Measure Calculations Version 7.5

86 Code Lists for Measure Asthma ICD-9 Codes: , , , , , , , , , , , , , Encounter Level Codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, Medications Corticosteroid, Inhaled or Alternative Asthma Medication Accolate 10 mg Tab, Accolate 20 mg Tab, AccuNeb 0.63 mg/3 ml Neb Solution, AccuNeb 1.25 mg/3 ml Neb Solution, Advair Diskus 100 mcg-50 mcg/dose for Inhalation, Advair Diskus 250 mcg-50 mcg/dose for Inhalation, Aerobid 250 mcg/actuation Aerosol Inhaler, Aerobid-M 250 mcg/actuation Aerosol Inhaler, Airet 2.5 mg/3 ml (0.083 %) Neb Solution, albuterol sulfate 0.63 mg/3 ml Neb Solution, albuterol sulfate 1.25 mg/3 ml Neb Solution, albuterol sulfate 2.5 mg/0.5 ml Neb Solution, albuterol sulfate 2.5 mg/3 ml (0.083 %) Neb Solution, albuterol sulfate 200 mcg Caps with inhalation device, albuterol sulfate 200 mcg Capsules for Inhalation, albuterol sulfate 5 mg/ml (0.5 %) Neb Solution, albuterol sulfate HFA 90 mcg/actuation Aerosol Inhaler, Asmanex Twisthaler 220 mcg (120 doses) Breath Activated, Asmanex Twisthaler 220 mcg (14 doses) Breath Activated, Asmanex Twisthaler 220 mcg (30 doses) Breath Activated, Asmanex Twisthaler 220 mcg (60 doses) Breath Activated, Beta-2 1 % Soln for Inhalation, Bisorine 1 % Soln for Inhalation, Brethaire 0.2 mg/actuation Aerosol Inhaler, Bronkosol 1 % Soln for Inhalation, budesonide 0.25 mg/2 ml Neb Suspension, budesonide 0.5 mg/2 ml Neb Suspension, Choledyl SA 400 mg Tab, Choledyl SA 600 mg Tab, Combivent 18 mcg-103 mcg/actuation Aerosol Inhaler, Constant-T 200 mg 12 hr Tab, Constant-T 300 mg 12 hr Tab, cromolyn 20 mg/2 ml Neb Solution, Dey-Dose (isoetharine) 1 % Soln for Inhalation, Flovent 44 mcg/actuation Aerosol Inhaler, Flovent Diskus 100 mcg/actuation for Inhalation, Flovent Diskus 250 mcg/actuation for Inhalation, Flovent Diskus 50 mcg/actuation for Inhalation, Flovent HFA 110 mcg/actuation Aerosol Inhaler, Flovent HFA 220 mcg/actuation Aerosol Inhaler, Flovent HFA 44 mcg/actuation Aerosol Inhaler, flunisolide 250 mcg/actuation Aerosol Inhaler, flunisolide-menthol 250 mcg/actuation Aerosol Inhaler, fluticasone 100 mcg/actuation Disk Device for Inhalation, fluticasone 110 mcg/actuation Aerosol Inhaler, fluticasone 220 mcg/actuation Aerosol Inhaler, fluticasone 250 mcg/actuation Disk Device for Inhalation, fluticasone 44 mcg/actuation Aerosol Inhaler, fluticasone 50 mcg/actuation Disk Device for Inhalation, fluticasone-salmeterol 100 mcg-50 mcg/dose Disk Device for Inhalation, fluticasone-salmeterol 250 mcg-50 mcg/dose Disk Device for Inhalation, Foradil Aerolizer 12 mcg inhalation Caps, formoterol fumarate 12 mcg Caps with inhalation device, Intal 20 mg/2 ml Neb Solution, ipratropium-albuterol 18 mcg-103 mcg/actuation Aerosol Inhaler, Iprenol 0.5 % Soln for Inhalation, Iprenol 131 mcg/actuation Aerosol Inhaler, Iso Meters 131 mcg/actuation Aerosol Inhaler, isoetharine 1 % Soln for Inhalation, Isoetharine Dispos-A-Med 1 % Soln for Inhalation, isoproterenol MicroMD EMR Clinical Quality Measure Calculations Version

87 (refill) 131 mcg/actuation Aerosol Inhaler, isoproterenol 0.5 % Soln for Inhalation, isoproterenol 131 mcg/actuation Aerosol Inhaler, Isuprel 0.5 % Soln for Inhalation, Isuprel Mistometer 131 mcg/actuation Aerosol Inhaler, Isuprel Mistometer Refill 131 mcg/actuation Aerosol Inhaler, levalbuterol 0.31 mg/3 ml Neb Solution, levalbuterol 0.63 mg/3 ml Neb Solution, levalbuterol 1.25 mg/0.5 ml Neb Solution, levalbuterol 1.25 mg/3 ml Neb Solution, levalbuterol HFA 45 mcg/actuation Aerosol Inhaler, mometasone 220 mcg (120 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (14 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (30 doses) Breath Activated Powder Aerosol, mometasone 220 mcg (60 doses) Breath Activated Powder Aerosol, montelukast 10 mg Tab, montelukast 4 mg Chewable Tab, montelukast 4 mg Oral Granules in Packet, montelukast 5 mg Chewable Tab, Norisodrine 131 mcg/actuation Aerosol Inhaler, oxtriphylline ER 400 mg Tab, oxtriphylline ER 600 mg Tab, ProAir HFA 90 mcg/actuation Aerosol Inhaler, Proventil 2.5 mg/3 ml (0.083 %) Neb Solution, Proventil 5 mg/ml (0.5 %) Neb Solution, Proventil HFA 90 mcg/actuation Aerosol Inhaler, Pulmicort 0.25 mg/2 ml Neb Suspension, Pulmicort 0.5 mg/2 ml Neb Suspension, Quibron-T 300 mg Tab, Quibron-T/SR 300 mg 12 hr Tab, Singulair 10 mg Tab, Singulair 4 mg Chewable Tab, Singulair 4 mg Oral Granules in Packet, Singulair 5 mg Chewable Tab, Sustaire 300 mg 12 hr Tab, T-Phyl 200 mg 12 hr Tab, terbutaline 0.2 mg/actuation Aerosol Inhaler, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo mg 24 hr Cap, Theo-Dilate 300 mg 12 hr Tab, Theo-Dur 200 mg 12 hr Tab, Theo-Dur 300 mg 12 hr Tab, Theo-Sav 200 mg 12 hr Tab, Theo-Sav 300 mg 12 hr Tab, Theo-X 200 mg 12 hr Tab, Theo-X 300 mg 12 hr Tab, Theochron 200 mg 12 hr Tab, Theochron 300 mg 12 hr Tab, Theolair-SR 200 mg 12 hr Tab, Theolair-SR 300 mg 12 hr Tab, theophylline 300 mg Tab, theophylline ER 100 mg 24 hr Cap, theophylline ER 200 mg 12 hr Tab, theophylline ER 200 mg 24 hr Cap, theophylline ER 300 mg 12 hr Tab, theophylline ER 300 mg 24 hr Cap, theophylline ER 400 mg 24 hr Cap, theophylline ER 400 mg 24 hr Tab, theophylline ER 400 mg Tab, theophylline ER 600 mg Tab, Uni-Dur 400 mg 24 hr Tab, Uniphyl 400 mg Tab, Uniphyl 600 mg Tab, Vapo-Iso 131 mcg/actuation Aerosol Inhaler, Ventolin 2.5 mg/3 ml (0.083 %) Neb Solution, Ventolin 5 mg/ml (0.5 %) Neb Solution, Ventolin HFA 90 mcg/actuation Aerosol Inhaler, Ventolin Rotacaps 200 mcg for Inhalation, Ventolin Rotahaler with Rotacaps 200 mcg for inhalation, Xopenex 0.31 mg/3 ml Neb Solution, Xopenex 0.63 mg/3 ml Neb Solution, Xopenex 1.25 mg/3 ml Neb Solution, Xopenex HFA 45 mcg/actuation Aerosol Inhaler, zafirlukast 10 mg Tab, zafirlukast 20 mg Tab, zileuton 600 mg Tab, Zyflo 600 mg Tab 2.74 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

88 NQF LOW BACK PAIN: USE OF IMAGING STUDIES (ALTERNATE) Description: Clinical Rationale: The percentage of patients with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of diagnosis. This measure assesses the percentage of patients in a specific age demographic who did not receive an imaging study (i.e., x-ray, MRI, CT scan) in the 28 days following a new episode of low back pain. Low back pain is the second most frequently listed reason for physician office visits. It is a common cause of lost productivity and absenteeism from work in the United States. The general consensus from literature reviews indicates that nearly half of American adults will experience low back pain in a year, and about two-thirds will suffer from it in their lifetime. Low back pain is particularly prevalent among men and women between 30 and 50 years of age, and most likely results from aging and an inactive lifestyle. Low back pain has a significant financial impact, costing an average of $8,000 per claim (Atlas, Devo 2001). This measure facilitates efforts toward improved musculoskeletal condition and individual quality of life. Denominator: **Patients in Age Range: >= 18 and <=49 **who have First Diagnosis of Low Back Pain during their First Encounter in the reporting period(see code list) Encounter with an Assessment NOTE Reporting will be looking at ICD codes for Encounter Assessment and CPT codes for Encounter Level AND NOT **Patients with an Active Diagnosis of Cancer, Trauma, IV drug abuse or Neurological Impairment (see code list) **Date Range: date at least 2 years prior to the end of the reporting period MedInfo>Medical>Problem List OR **Patients who had a diagnosis of Low back pain before the FIRST diagnosis of the active low back pain episode during the measurement period. Numerator: **Patients who did NOT have an imaging study (see code list) **Date Range: within 28 days of the First Diagnosis of Low Back Pain Encounter Plan (performed) MedInfo>Medical>Lab Result MedInfo>Medical>Diagnostic Test Result MicroMD EMR Clinical Quality Measure Calculations Version

89 Exclusions: None. Code Lists for Measure Low Back Pain ICD-9 Codes: 724.6, 721.3, , , , , 724, , 724.2, 724.3, 724.5, 724.7, , , , 738.5, 739.3, 739.4, 846.0, 846.1, 846.2, 846.3, 846.8, Encounter Level Codes: Ortho/Chiropractor 98925, 98926, 98927, 98928, 98929, 98940, 98941, Encounter Level Codes: ED 99281, 99282, 99283, 99284, Encounter Plan Codes: Imaging Studies 72010, 72020, 72052, 72100, 72110, 72114, 72120, 72131, 72132, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72158, 72200, 72202, Cancer ICD 140.0, 140.1, 140.3, 140.4, 140.5, 140.6, 140.8, 140.9, 141, 141.0, 141.1, 141.2, 141.3, 141.4, 141.5, 141.6, 141.8, 141.9, 142, 142.0, 142.1, 142.2, 142.8, 142.9, 143, 143.0, 143.1, 143.8, 143.9, 144, 144.0, 144.1, 144.8, 144.9, 145, 145.0, 145.1, 145.2, 145.3, 145.4, 145.5, 145.6, 145.8, 145.9, 146, 146.0, 146.1, 146.2, 146.3, 146.4, 146.5, 146.6, 146.7, 146.8, 146.9, 147, 147.0, 147.1, 147.2, 147.3, 147.8, 147.9, 148, 148.0, 148.1, 148.2, 148.3, 148.8, 148.9, 149, 149.0, 149.1, 149.8, 149.9, 150, 150.0, 150.1, 150.2, 150.3, 150.4, 150.5, 150.8, 150.9, 151, 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9, 152, 152.0, 152.1, 152.2, 152.3, 152.8, 152.9, 153, 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154, 154.0, 154.1, 154.2, 154.3, 154.8, 155, 155.0, 155.1, 155.2, 156, 156.0, 156.1, 156.2, 156.8, 156.9, 157, 157.0, 157.1, 157.2, 157.3, 157.4, 157.8, 157.9, 158, 158.0, 158.8, 158.9, 159, 159.0, 159.1, 159.8, 159.9, 160, 160.0, 160.1, 160.2, 160.3, 160.4, 160.5, 160.8, 160.9, 161, 161.0, 161.1, 161.2, 161.3, 161.8, 161.9, 162, 162.0, 162.2, 162.3, 162.4, 162.5, 162.8, 162.9, 163, 163.0, 163.1, 163.8, 163.9, 164, 164.0, 164.1, 164.2, 164.3, 164.8, 164.9, 165, 165.0, 165.8, 165.9, 170, 170.0, 170.1, 170.2, 170.3, 170.4, 170.5, 170.6, 170.7, 170.8, 170.9, 171, 171.0, 171.2, 171.3, 171.4, 171.5, 171.6, 171.7, 171.8, 171.9, 172, 172.0, 172.1, 172.2, 172.3, 172.4, 172.5, 172.6, 172.7, 172.8, 172.9, 173, 173.0, 173.1, 173.2, 173.3, 173.4, 173.5, 173.6, 173.7, 173.8, 173.9, 174, 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.8, 174.9, 175, 175.0, 175.9, 176, 176.0, 176.1, 176.2, 176.3, 176.4, 176.5, 176.8, 176.9, 179, 180, 180.0, 180.1, 180.8, 180.9, 181, 182, 182.0, 182.1, 182.8, 183, 183.0, 183.2, 183.3, 183.4, 183.5, 183.8, 183.9, 184, 184.0, 184.1, 184.2, 184.3, 184.4, 184.8, 184.9, 185, 186, 186.0, 186.9, 187, 187.1, 187.2, 187.3, 187.4, 187.5, 187.6, 187.7, 187.8, 187.9, 188, 2.76 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

90 188.0, 188.1, 188.2, 188.3, 188.4, 188.5, 188.6, 188.7, 188.8, 188.9, 189, 189.0, 189.1, 189.2, 189.3, 189.4, 189.8, 189.9, 190, 190.0, 190.1, 190.2, 190.3, 190.4, 190.5, 190.6, 190.7, 190.8, 190.9, 191, 191.0, 191.1, 191.2, 191.3, 191.4, 191.5, 191.6, 191.7, 191.8, 191.9, 192, 192.0, 192.1, 192.2, 192.3, 192.8, 192.9, 193, 194, 194.0, 194.1, 194.3, 194.4, 194.5, 194.6, 194.8, 194.9, 195, 195.0, 195.1, 195.2, 195.3, 195.4, 195.5, 195.8, 196, 196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9, 197, 197.0, 197.1, 197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198, 198.0, 198.1, 198.2, 198.3, 198.4, 198.5, 198.6, 198.7, 198.8, , , , 199, 199.0, 199.1, 199.2, 200, 200.0, , , , , , , , , , 200.1, , , , , , , , , , 200.2, , , , , , , , , , 200.3, , , , , , , , , , 200.4, , , , , , , , , , 200.5, , , , , , , , , , 200.6, , , , , , , , , , 200.7, , , , , , , , , , 200.8, , , , , , , , , , 201, 201.0, , , , , , , , , , 201.1, , , , , , , , , , 201.2, , , , , , , , , , 201.4, , , , , , , , , , 201.5, , , , , , , , , , 201.6, , , , , , , , , , 201.7, , , , , , , , , , 201.9, , , , , , , , , , 202, 202.0, , , , , , , , , , 202.1, , , , , , , , , , 202.2, , , , , , , , , , 202.3, , , , , , , , , , 202.4, , , , , , , , , , 202.5, , , , , , , , , , 202.6, , , , , , , , , , 202.7, , , , , , , , , , 202.8, , , , , , , , , , 202.9, , , , , , , , , , 203, 203.0, , , , 203.1, , , , 203.8, , , , 204, 204.0, , , , 204.1, , , , 204.2, , , , 204.8, , , , 204.9, MicroMD EMR Clinical Quality Measure Calculations Version

91 204.90, , , 205, 205.0, , , , 205.1, , , , 205.2, , , , 205.3, , , , 205.8, , , , 205.9, , , , 206, 206.0, , , , 206.1, , , , 206.2, , , , 206.8, , , , 206.9, , , , 207, 207.0, , , , 207.1, , , , 207.2, , , , 207.8, , , , 208, 208.0, , , , 208.1, , , , 208.2, , , , 208.8, , , , 208.9, , , , 209, 209.0, , , , , 209.1, , , , , , , , , 209.2, , , , , , , , , , 209.3, , , , , , , , 209.4, , , , , 209.5, , , , , , , , , 209.6, , , , , , , , , , 209.7, , , , , , , , 230, 230.0, 230.1, 230.2, 230.3, 230.4, 230.5, 230.6, 230.7, 230.8, 230.9, 231, 231.0, 231.1, 231.2, 231.8, 231.9, 232, 232.0, 232.1, 232.2, 232.3, 232.4, 232.5, 232.6, 232.7, 232.8, 232.9, 233, 233.0, 233.1, 233.2, 233.3, , , , , 233.4, 233.5, 233.6, 233.7, 233.9, 234, 234.0, 234.8, 234.9, 235, 235.0, 235.1, 235.2, 235.3, 235.4, 235.5, 235.6, 235.7, 235.8, 235.9, 236, 236.0, 236.1, 236.2, 236.3, 236.4, 236.5, 236.6, 236.7, 236.9, , , , 237, 237.0, 237.1, 237.2, 237.3, 237.4, 237.5, 237.6, 237.7, , , , 237.9, 238, 238.0, 238.1, 238.2, 238.3, 238.4, 238.5, 238.6, 238.7, , , , , , , , , 238.8, 238.9, 239, 239.0, 239.1, 239.2, 239.3, 239.4, 239.5, 239.6, 239.7, 239.8, 239.9, V10, V10.0, V10.00, V10.01, V10.02, V10.03, V10.04, V10.05, V10.06, V10.07, V10.09, V10.1, V10.11, V10.12, V10.2, V10.20, V10.21, V10.22, V10.29, V10.3, V10.4, V10.40, V10.41, V10.42, V10.43, V10.44, V10.45, V10.46, V10.47, V10.48, V10.49, V10.5, V10.50, V10.51, V10.52, V10.53, V10.59, V10.6, V10.60, V10.61, V10.62, V10.63, V10.69, V10.7, V10.71, V10.72, V10.79, V10.8, V10.81, V10.82, V10.83, V10.84, V10.85, V10.86, V10.87, V10.88, V10.89, V10.9 Trauma ICD 800, 800.0, , , , , , , , , 800.1, , , , , , , , , 800.2, , , , , , , , , 800.3, , , , , , , , , 800.4, , , , , , , , , 800.5, , , , , , , , , 800.6, , , , , , , , , 800.7, , , , , , , , , 800.8, , , , , , , , 2.78 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

92 800.89, 800.9, , , , , , , , , 801, 801.0, , , , , , , , , 801.1, , , , , , , , , 801.2, , , , , , , , , 801.3, , , , , , , , , 801.4, , , , , , , , , 801.5, , , , , , , , , 801.6, , , , , , , , , 801.7, , , , , , , , , 801.8, , , , , , , , , 801.9, , , , , , , , , 802, 802.0, 802.1, 802.2, , , , , , , , , , , 802.3, , , , , , , , , , , 802.4, 802.5, 802.6, 802.7, 802.8, 802.9, 803, 803.0, , , , , , , , , 803.1, , , , , , , , , 803.2, , , , , , , , , 803.3, , , , , , , , , 803.4, , , , , , , , , 803.5, , , , , , , , , 803.6, , , , , , , , , 803.7, , , , , , , , , 803.8, , , , , , , , , 803.9, , , , , , , , , 804, 804.0, , , , , , , , , 804.1, , , , , , , , , 804.2, , , , , , , , , 804.3, , , , , , , , , 804.4, , , , , , , , , 804.5, , , , , , , , , 804.6, , , , , , , , , 804.7, , , , , , , , , 804.8, , , , , , , , , 804.9, , , , , , , , , 805, 805.0, , , , , , , , , , 805.1, , , , , , , , , , 805.2, 805.3, 805.4, 805.5, 805.6, 805.7, 805.8, 805.9, 806, 806.0, , , , , , , , , , , 806.1, , , , , , , , , , , 806.2, , , , , , , , , , , 806.3, , , , , , , , , , , 806.4, 806.5, 806.6, , , , , 806.7, MicroMD EMR Clinical Quality Measure Calculations Version

93 806.70, , , , 806.8, 806.9, 807, 807.0, , , , , , , , , , , 807.1, , , , , , , , , , , 807.2, 807.3, 807.4, 807.5, 807.6, 808, 808.0, 808.1, 808.2, 808.3, 808.4, , , , , 808.5, , , , , 808.8, 808.9, 809, 809.0, 809.1, 810, 810.0, , , , , 810.1, , , , , 811, 811.0, , , , , , 811.1, , , , , , 812, 812.0, , , , , , 812.1, , , , , , 812.2, , , 812.3, , , 812.4, , , , , , , 812.5, , , , , , , 813, 813.0, , , , , , , , , , 813.1, , , , , , , , , , 813.2, , , , , 813.3, , , , , 813.4, , , , , , , 813.5, , , , , , 813.8, , , , , 813.9, , , , , 814, 814.0, , , , , , , , , , , 814.1, , , , , , , , , , , 815, 815.0, , , , , , , 815.1, , , , , , , 816, 816.0, , , , , 816.1, , , , , 817, 817.0, 817.1, 818, 818.0, 818.1, 819, 819.0, 819.1, 820, 820.0, , , , , , 820.1, , , , , , 820.2, , , , 820.3, , , , 820.8, 820.9, 821, 821.0, , , 821.1, , , 821.2, , , , , , 821.3, , , , , , 822, 822.0, 822.1, 823, 823.0, , , , 823.1, , , , 823.2, , , , 823.3, , , , 823.4, , , , 823.8, , , , 823.9, , , , 824, 824.0, 824.1, 824.2, 824.3, 824.4, 824.5, 824.6, 824.7, 824.8, 824.9, 825, 825.0, 825.1, 825.2, , , , , , , , 825.3, , , , , , , , 826, 826.0, 826.1, 827, 827.0, 827.1, 828, 828.0, 828.1, 829, 829.0, 829.1, 830, 830.0, 830.1, 831, 831.0, , , , , , , 831.1, , , , , , , 832, 832.0, , , , , , , 832.1, , , , , , , 833, 833.0, , , , , , , , 833.1, , , , , , , , 834, 834.0, , , , 834.1, , , , 835, 835.0, , , , , 835.1, 2.80 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

94 835.10, , , , 836, 836.0, 836.1, 836.2, 836.3, 836.4, 836.5, , , , , , , 836.6, , , , , , , 837, 837.0, 837.1, 838, 838.0, , , , , , , , , 838.1, , , , , , , , , 839, 839.0, , , , , , , , , , 839.1, , , , , , , , , , 839.2, , , 839.3, , , 839.4, , , , , 839.5, , , , , 839.6, , , 839.7, , , 839.8, 839.9, 850, 850.0, 850.1, , , 850.2, 850.3, 850.4, 850.5, 850.9, 851, 851.0, , , , , , , , , 851.1, , , , , , , , , 851.2, , , , , , , , , 851.3, , , , , , , , , 851.4, , , , , , , , , 851.5, , , , , , , , , 851.6, , , , , , , , , 851.7, , , , , , , , , 851.8, , , , , , , , , 851.9, , , , , , , , , 852, 852.0, , , , , , , , , 852.1, , , , , , , , , 852.2, , , , , , , , , 852.3, , , , , , , , , 852.4, , , , , , , , , 852.5, , , , , , , , , 853, 853.0, , , , , , , , , 853.1, , , , , , , , , 854, 854.0, , , , , , , , , 854.1, , , , , , , , , 860, 860.0, 860.1, 860.2, 860.3, 860.4, 860.5, 861, 861.0, , , , , 861.1, , , , , 861.2, , , , 861.3, , , , 862, 862.0, 862.1, 862.2, , , , 862.3, , , , 862.8, 862.9, 863, 863.0, 863.1, 863.2, , , , 863.3, , , , 863.4, , , , , , , , , 863.5, , , , , , , , , 863.8, , , , , , , , 863.9, , , , , , , , 864, 864.0, , , , , , , , 864.1, , , , , , , , 865, 865.0, , , , , , , 865.1, , , , , , , 866, MicroMD EMR Clinical Quality Measure Calculations Version

95 866.0, , , , , 866.1, , , , , 867, 867.0, 867.1, 867.2, 867.3, 867.4, 867.5, 867.6, 867.7, 867.8, 867.9, 868, 868.0, , , , , , , 868.1, , , , , , , 869, 869.0, 869.1, 905, 905.0, 905.1, 905.2, 905.3, 905.4, 905.5, 905.6, 905.7, 905.8, 905.9, 906, 906.0, 906.1, 906.2, 906.3, 906.4, 906.5, 906.6, 906.7, 906.8, 906.9, 907, 907.0, 907.1, 907.2, 907.3, 907.4, 907.5, 907.9, 908, 908.0, 908.1, 908.2, 908.3, 908.4, 908.5, 908.6, 908.9, 909, 909.0, 909.1, 909.2, 909.3, 909.4, 909.5, 909.9, , , 929, 929.0, 929.9, 952, 952.0, , , , , , , , , , 952.1, , , , , , , , , , , 952.2, 952.3, 952.4, 952.8, 952.9, 958, 958.0, 958.1, 958.2, 958.3, 958.4, 958.5, 958.6, 958.7, 958.8, 958.9, , , , , , 959, 959.0, , , 959.1, , , , , , 959.2, 959.3, 959.4, 959.5, 959.6, 959.7, 959.8, IV drug abuse ICD 304.0, , , , , 304.1, , , , , 304.2, , , , , 304.4, , , , , 305.4, , , , , 305.5, , , , , 305.6, , , , , 305.7, , , , Neurological Impairment - ICD , NQF 0055 / PQRI 117 DIABETES: EYE EXAM (ALTERNATE) Description: The percentage of patients years of age with diabetes (type 1 or type 2) who had a retinal or dilated eye exam or a negative retinal exam (no evidence of retinopathy) by an eye care professional MicroMD EMR Clinical Quality Measure Calculations Version 7.5

96 Clinical Rationale: This measure evaluates the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who had an eye (retinal) exam performed. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including glaucoma and blindness. Diabetic retinopathy is the most common diabetic eye disease and causes 21,000 4,000 new cases of blindness annually. The consensus among established clinical guidelines is that patients with both types of diabetes should have an initial dilated and comprehensive eye exam soon after diagnosis (ADA 2009). Guidelines also recommend consultation with an ophthalmologist for treatment options if a patient has any level of macular edema or diabetic retinopathy (proliferative and nonproliferative). This measure facilitates the prevention and long-term management of retinal-based complications for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications MicroMD EMR Clinical Quality Measure Calculations Version

97 **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) OR **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. Numerator: **Patients who have had a retinal or dilated eye exam or negative retinal exam by an eye care professional. (see code list) **Date Range: within the reporting period Encounter Plan (CPT Code) Procedure Order (Performed) (CPT or ICD code) OR **Patient had the eye exam (listed above) and Patients problem list does not indicate diabetic retinopathy **Date Range: during the 1 year prior to the beginning of the reporting period MicroMD EMR Clinical Quality Measure Calculations Version 7.5

98 OR **Patient s Screening and Prevention has indicated that the eye exam was completed **Date Range: within the reporting period MedInfo>Health Maintenance>Screening and Prevention OR **Patient s Screening and Prevention has indicated that the eye exam was completed **Date Range: during the 1 year prior to the beginning of the reporting period. AND MedInfo>Health Maintenance>Screening and Prevention **Patients problem list does not indicate Diabetic Retinopathy (see code list) Exclusions: **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period OR MedInfo>Medical>Problem List Encounter Assessment **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications Code Lists for Measure Encounter Level Acute Inpatient or ED Encounter Level Non-Acute Inpatient 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, , 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, MicroMD EMR Clinical Quality Measure Calculations Version

99 Encounter Level - Opthamological services 92002, 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, Encounter Outpatient CPT 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Outpatient ICD V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 Eye Exam CPT/HCPCS 2022F, X0620, S0621, S0625, S3000, 67028, 67030, 67031, 67036, 67038, 67039, 67040, 67041, 67042, 67043, 67101, 67105, 67107, 67108, 67110, 67112, 67113, 67121, 67141, 67145, 67208, 67210, 67218, 67220, 67221, 67227, 67228, 92002, 92004, 92012, 92014, 92018, 92019, 92225, 92226, 92230, 92235, 92240, 92250, Eye Exam - ICD v Diabetic Retinopathy - ICD Steroid Induced Diabetes ICD Polycystic Ovaries ICD , 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, Gestational Diabetes - ICD 648.8, , , , , Medications Indicative of Diabetes acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg- 500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide MicroMD EMR Clinical Quality Measure Calculations Version 7.5

100 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizide-metformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg- 500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg- 500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburidemetformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub- Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin MicroMD EMR Clinical Quality Measure Calculations Version

101 glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub- Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg-1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi- Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub- Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

102 500 mg Tab, pioglitazone-metformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazone-glimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazoneglimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazone-glimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg- 500 mg Tab, rosiglitazone-metformin 2 mg-1,000 mg Tab, rosiglitazonemetformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg-500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg- 1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , NQF 0056 / PQRI 163 DIABETES: FOOT EXAM (ALTERNATE) Description: The percentage of patients aged years with diabetes (type 1 or type 2) who had a foot exam (visual inspection, sensory exam with monofilament, or pulse exam). MicroMD EMR Clinical Quality Measure Calculations Version

103 Clinical Rationale: This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who had a foot exam performed. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor circulation, nerve damage or neuropathy in the feet and eventual amputation. Nearly 60% 70% of diabetics suffer from mild or severe nervous system damage. The consensus among established clinical guidelines is that patients with both types of diabetes should have a foot exam soon after diagnosis and annually thereafter (ADA 2009). Comprehensive foot care programs can lower amputation rates by 45% 85%. This measure facilitates the prevention and long-term management of lower extremity-based complications for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications 2.90 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

104 **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) or **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. Numerator: Exclusions: **Patients who had a Foot Exam (See Code List) **Date Range: during the reporting period Encounter Plan MedInfo>Orders>Procedure Orders (Performed) MedInfo>Health Maintenance> Screening and Prevention **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period OR MedInfo>Medical>Problem List Encounter Assessment MicroMD EMR Clinical Quality Measure Calculations Version

105 **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications Code Lists for Measure Encounter Level Acute Inpatient or ED Encounter Level Non-Acute Inpatient Encounter Level - Othamological services 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, , 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, , 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, Encounter Outpatient CPT 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Outpatient ICD V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 Foot Exam: HCPCS 2028F Polycystic Ovaries ICD Steroid Induced Diabetes ICD 249, 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, Gestational Diabetes - ICD 648.8, , , , , Medications Indicative of Diabetes acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, 2.92 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

106 Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg- 500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizide-metformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg- 500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg- 500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburidemetformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I MicroMD EMR Clinical Quality Measure Calculations Version

107 Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub- Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub- Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg-1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric 2.94 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

108 retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi- Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub- Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg- 500 mg Tab, pioglitazone-metformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazone-glimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazoneglimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazone-glimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg- 500 mg Tab, rosiglitazone-metformin 2 mg-1,000 mg Tab, rosiglitazonemetformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg-500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg- 1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , MicroMD EMR Clinical Quality Measure Calculations Version

109 250.33, 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , NQF 0059 / PQRI 1 DIABETES: HBA1C POOR CONTROL (ALTERNATE) Field Description: Clinical Rationale: Description The percentage of patients years of age with diabetes (type 1 or type 2) who had HbA1c >9.0%. This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who demonstrate poor blood sugar control with an HbA1c level higher than 9 percent. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor blood sugar control. Studies have shown that improved glycemic control is correlated with a 40%decline in the development of associated microvascular complications (i.e., eye, kidney and nerve diseases) (ADA 2009). Clinical guidelines recommend regular HbA1c testing to facilitate patients ability to improve and sustain acceptable levels (ADA 2009). This measure facilitates the prevention and long-term management of high blood sugar levels for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications 2.96 MicroMD EMR Clinical Quality Measure Calculations Version 7.5

110 Field Description **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) or **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. Numerator: **Patients whose HbA1c is > 9.0 Lab Test completed for CPT/LOINC Codes (see code list) NOTE Most recent lab result within the reporting period will be used. NOTE Lab result values should be entered without any special characters, for example 9.1% should be entered as 9.1 to be counted. Exclusions: **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period OR MedInfo>Medical>Problem List Encounter Assessment MicroMD EMR Clinical Quality Measure Calculations Version

111 Field Description **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications Code Lists for Measure Encounter Level Acute Inpatient or ED Encounter Level Non- Acute Inpatient Encounter Level - Opthamological services Encounter Outpatient CPT Encounter Outpatient ICD HbA1c CPT 83036, , 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, ,99305,99306,99307,99308,99309,99310, 99315,99316, ,99325,99326,99327,99328,99334,99335, 99336, , 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 HbA1c LOINC , , Steroid Induced Diabetes ICD Polycystic Ovaries ICD Gestational Diabetes - ICD Medications Indicative of Diabetes 249, 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, , , , , , acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET MicroMD EMR Clinical Quality Measure Calculations Version 7.5

112 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg-500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizide-metformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg-500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg-500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburide-metformin 1.25 mg-250 mg Tab, glyburidemetformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 MicroMD EMR Clinical Quality Measure Calculations Version

113 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prtinsulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub-Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub-Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beefpork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub- Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub- Q Inj, Janumet 50 mg-1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub- Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER MicroMD EMR Clinical Quality Measure Calculations Version 7.5

114 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi-Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub-Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg-500 mg Tab, pioglitazonemetformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazoneglimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazone-glimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazone-glimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg- 500 mg Tab, rosiglitazone-metformin 2 mg-1,000 mg Tab, rosiglitazonemetformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg-500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg-1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , MicroMD EMR Clinical Quality Measure Calculations Version

115 362.07, , 648.0, , , , , NQF 0061 / PQRI 3 DIABETES: BLOOD PRESSURE MANAGEMENT (ALTERNATE) Field Description Description: The percentage of patients years of age with diabetes (type 1 or type 2) who had BP <140/90 mmhg. Clinical Rationale: This measure evaluates the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who sustain adequate blood pressure control. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor blood pressure control and subsequent cardiovascular disease of varying severity. Maintaining a healthy blood pressure has been shown to reduce complications due to diabetes, with a 10 mm Hg reduction in systolic blood pressure lowering the risk of complications by 12% It also reduces the chance of cardiovascular disease among patient with diabetes by up to 50% and reduces the chance of other related complications (eye, kidney, nerve) by more than 25% This measure facilitates long-term management of blood pressure levels for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) MicroMD EMR Clinical Quality Measure Calculations Version 7.5

116 Field Numerator: Exclusions: Code Lists for Measure Encounter Level Acute Inpatient or ED Description OR **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. **Patients whose Blood Pressure is controlled **Date Range: within the reporting period MedInfo>Medical>Vital Signs (Systolic value <140 and Diastolic value <90) NOTE Vital signs recorded during the most recent encounter within the reporting period will be used. **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment OR **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, MicroMD EMR Clinical Quality Measure Calculations Version

117 Encounter Level Non- Acute Inpatient Encounter Level - Opthamological services Encounter Outpatient CPT ,99305,99306,99307,99308,99309,99310, 99315,99316, ,99325,99326,99327,99328,99334,99335, 99336, , 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Outpatient ICD V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 Polycystic Ovaries ICD Gestational Diabetes - ICD 648.8, , , , , Steroid Induced Diabetes ICD Medications Indicative of Diabetes 249, 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg-500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizidemetformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg-500 mg Tab, Glucamide 100 mg Tab, Glucamide MicroMD EMR Clinical Quality Measure Calculations Version 7.5

118 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg-500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburidemetformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub-Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub-Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub- Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin MicroMD EMR Clinical Quality Measure Calculations Version

119 protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg- 1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi- Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub-Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg- 500 mg Tab, pioglitazone-metformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin MicroMD EMR Clinical Quality Measure Calculations Version 7.5

120 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazone-glimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazone-glimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazone-glimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg-500 mg Tab, rosiglitazonemetformin 2 mg-1,000 mg Tab, rosiglitazone-metformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg- 500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg-1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , MicroMD EMR Clinical Quality Measure Calculations Version

121 NQF 0062 / PQRI 119 DIABETES: URINE SCREENING (ALTERNATE) Description: Clinical Rationale: The percentage of patients years of age with diabetes (type 1 or type 2) who had a nephropathy screening test or evidence of nephropathy This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who are susceptible to developing kidney disease as a comorbidity. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin (NIDDK 2007). It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death (NIDDK 2007). Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including end-stage kidney disease. Diabetes is the primary cause of kidney failure, accounting for 44% of newly diagnosed cases in 2005 (NIDDK 2007). Clinical guidelines recommend regular testing to evaluate urine albumin excretions and serum creatinine and the estimated glomerular filtration rate derived from serum creatinine, in addition to comparing measurements when screening for chronic kidney disease (ADA 2009; ACCE 2007). This measure facilitates the prevention and long-term management of kidney disease for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications MicroMD EMR Clinical Quality Measure Calculations Version 7.5

122 Numerator: **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) OR **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. **Patient Chart has indications of Nephropathy (see code list) **Date Range: before the end of the reporting period MedInfo>Medical>Problem List Encounter Assessments OR **Patient Chart has indications that procedures that are related to nephropathy were performed (see code list for ICD/CPT/HCPCS) **Date Range: during the reporting period. Encounter Plan MedInfo>Orders>Procedure Order performed MedInfo>Histories>Surgical Procedures MicroMD EMR Clinical Quality Measure Calculations Version

123 Exclusions: OR **Procedure Order or Surgical Procedure contains procedures that are nephropathy-related based on ICD Code (see code list) **Date Range: during the reporting period. MedInfo>Orders>Procedure Order performed MedInfo>Histories>Surgical Procedures OR **Patient has had a Lab Result for Urine Microalbumin or Nephropathy Screening (see code lists for CPT/LOINC) **Date Range: during the reporting period. MedInfo>Medical>Lab Result OR **Patient Medications List contains an Ace Inhibitor or an ARB. (see code list) **Date Range: Prescribed before the end of the reporting period **Patients with an active diagnosis of polycystic ovaries Code Lists for Measure Encounter Level Acute Inpatient or ED **Date Range : OR MedInfo>Medical>Problem List Encounter Assessment before the end of the reporting period **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, Encounter Level Non ,99305,99306,99307,99308,99309,99310, 99315,99316, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

124 Acute Inpatient 99324,99325,99326,99327,99328,99334,99335, 99336,99337 Encounter Level - Opthamological services Encounter Outpatient CPT 92002, 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Outpatient ICD V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 Urine Microalbumin CPT 81000,81002, 81003, Urine Microalbumin LOINC Nephropathy Screening - CPT Nephropathy Screening LOINC Nephropathy-related CPT/HCPCS , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 36800, 36810, 36815, 36818, , 36831, 36832, 36833, 50300, 50320, 50340, 50360, 50365, 50370, 50380, 90920, 90921, 90924, 90925, 90935, 90937, 90940, 90945, 90947, 90957, 90958, 90959, 90960, 90961, 90962, 90965, 90966, 90969, 90970, 90989, 90993, 90997, 90999, 99512,G0257, G0314, G0315, G0316, G0317, G0318, G0319, G0322, G0323, G0326, G0327, G0392, G0393, S9339 Nephropathy ICD 250.4, , , , , 403, 403.0, , , 403.1, , , 403.9, , , 404, 404.0, , , , , 404.1, , , , , 404.9, , , , , , , , 580, 580.0, 580.4, 580.8, , , 580.9, 581, 581.0, 581.1, 581.2, 581.3, 581.8, , , 581.9, 582, 582.0, 582.1, 582.2, 582.4, 582.8, , , 582.9, 583, 583.0, 583.1, 583.2, 583.4, 583.6, 583.7, 583.8, , , 583.9, 584, 584.5, 584.6, 584.7, 584.8, 584.9, 585, 585.1, 585.2, 585.3, 585.4, 585.5, 585.6, 585.9, 586, 587, 588, 588.0, 588.1, 588.8, , , 588.9, 753.0, 753.1, , , , , , , , , , 791.0, V42.0, V45.1, V45.11, V45.12, V56, V56.0, V56.1, V56.2, V56.3, V56.31, MicroMD EMR Clinical Quality Measure Calculations Version

125 Polycystic Ovaries ICD V56.32, V56.8 Gestational Diabetes - ICD 648.8, , , , , Steroid Induced Diabetes ICD Medications - Ace Inhibitor and ARB 249, 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, Accupril 10 mg Tab, Accupril 20 mg Tab, Accupril 40 mg Tab, Accupril 5 mg Tab, Accuretic 10 mg-12.5 mg Tab, Accuretic 20 mg-12.5 mg Tab, Accuretic 20 mg-25 mg Tab, Aceon 2 mg Tab, Aceon 4 mg Tab, Aceon 8 mg Tab, Altace 1.25 mg Cap, Altace 1.25 mg Tab, Altace 10 mg Cap, Altace 10 mg Tab, Altace 2.5 mg Cap, Altace 2.5 mg Tab, Altace 5 mg Cap, Altace 5 mg Tab, amlodipine-olmesartan 10 mg-20 mg Tab, amlodipine-olmesartan 10 mg-40 mg Tab, amlodipine-olmesartan 5 mg-20 mg Tab, amlodipineolmesartan 5 mg-40 mg Tab, amlodipine-valsartan 10 mg-160 mg Tab, amlodipine-valsartan 10 mg-320 mg Tab, amlodipine-valsartan 5 mg-160 mg Tab, amlodipine-valsartan 5 mg-320 mg Tab, amlodipine-valsartanhydrochlorothiazide 10 mg-160 mg-12.5 mg Tab, amlodipine-valsartanhydrochlorothiazide 10 mg-160 mg-25 mg Tab, amlodipine-valsartanhydrochlorothiazide 10 mg-320 mg-25 mg Tab, amlodipine-valsartanhydrochlorothiazide 5 mg-160 mg-12.5 mg Tab, amlodipine-valsartanhydrochlorothiazide 5 mg-160 mg-25 mg Tab, Atacand 16 mg Tab, Atacand 32 mg Tab, Atacand 4 mg Tab, Atacand 8 mg Tab, Atacand HCT 16 mg mg Tab, Atacand HCT 32 mg-12.5 mg Tab, Atacand HCT 32 mg-25 mg Tab, Avalide 150 mg-12.5 mg Tab, Avalide 300 mg-12.5 mg Tab, Avalide 300 mg-25 mg Tab, Avapro 150 mg Tab, Avapro 300 mg Tab, Avapro 75 mg Tab, Azor 10 mg-20 mg Tab, Azor 10 mg-40 mg Tab, Azor 5 mg-20 mg Tab, Azor 5 mg-40 mg Tab, Benicar 20 mg Tab, Benicar 40 mg Tab, Benicar 5 mg Tab, Benicar HCT 20 mg-12.5 mg Tab, Benicar HCT 40 mg-12.5 mg Tab, Benicar HCT 40 mg-25 mg Tab, candesartan 16 mg Tab, candesartan 32 mg Tab, candesartan 4 mg Tab, candesartan 8 mg Tab, candesartanhydrochlorothiazide 16 mg-12.5 mg Tab, candesartan-hydrochlorothiazide 32 mg-12.5 mg Tab, candesartan-hydrochlorothiazide 32 mg-25 mg Tab, Capoten 100 mg Tab, Capoten 12.5 mg Tab, Capoten 25 mg Tab, Capoten 50 mg Tab, Capozide 25 mg-15 mg Tab, Capozide 25 mg-25 mg Tab, Capozide 50 mg-15 mg Tab, Capozide 50 mg-25 mg Tab, captopril 100 mg Tab, captopril 12.5 mg Tab, captopril 25 mg Tab, captopril 50 mg Tab, captopril-hydrochlorothiazide 25 mg-15 mg Tab, captoprilhydrochlorothiazide 25 mg-25 mg Tab, captopril-hydrochlorothiazide 50 mg- 15 mg Tab, captopril-hydrochlorothiazide 50 mg-25 mg Tab, Diovan 160 mg Cap, Diovan 160 mg Tab, Diovan 320 mg Tab, Diovan 40 mg Tab, Diovan 80 mg Cap, Diovan 80 mg Tab, Diovan HCT 160 mg-12.5 mg Tab, Diovan HCT 160 mg-25 mg Tab, Diovan HCT 320 mg-12.5 mg Tab, Diovan HCT MicroMD EMR Clinical Quality Measure Calculations Version 7.5

126 mg-25 mg Tab, Diovan HCT 80 mg-12.5 mg Tab, enalapril maleate 10 mg Tab, enalapril maleate 2.5 mg Tab, enalapril maleate 20 mg Tab, enalapril maleate 5 mg Tab, enalapril maleate-felodipine ER 5 mg-2.5 mg Tab, enalapril maleate-felodipine ER 5 mg-5 mg Tab, enalapril-diltiazem ER 5 mg- 180 mg 24 hr Tab, enalapril-hydrochlorothiazide 10 mg-25 mg Tab, enalapril-hydrochlorothiazide 5 mg-12.5 mg Tab, eprosartan 400 mg Tab, eprosartan 600 mg Tab, eprosartan-hydrochlorothiazide 600 mg-12.5 mg Tab, eprosartan-hydrochlorothiazide 600 mg-25 mg Tab, Exforge 10 mg-160 mg Tab, Exforge 10 mg-320 mg Tab, Exforge 5 mg-160 mg Tab, Exforge 5 mg-320 mg Tab, Exforge HCT 10 mg-160 mg-12.5 mg Tab, Exforge HCT 10 mg-160 mg-25 mg Tab, Exforge HCT 10 mg-320 mg-25 mg Tab, Exforge HCT 5 mg-160 mg-12.5 mg Tab, Exforge HCT 5 mg-160 mg-25 mg Tab, fosinopril 10 mg Tab, fosinopril 20 mg Tab, fosinopril 40 mg Tab, fosinoprilhydrochlorothiazide 10 mg-12.5 mg Tab, fosinopril-hydrochlorothiazide 20 mg-12.5 mg Tab, irbesartan 150 mg Tab, irbesartan 300 mg Tab, irbesartan 75 mg Tab, irbesartan-hydrochlorothiazide 150 mg-12.5 mg Tab, irbesartanhydrochlorothiazide 300 mg-12.5 mg Tab, irbesartan-hydrochlorothiazide 300 mg-25 mg Tab, Lexxel 5 mg-2.5 mg Tab, Lexxel 5 mg-5 mg Tab, lisinopril 10 mg Tab, lisinopril 2.5 mg Tab, lisinopril 20 mg Tab, lisinopril 30 mg Tab, lisinopril 40 mg Tab, lisinopril 5 mg Tab, lisinoprilhydrochlorothiazide 10 mg-12.5 mg Tab, lisinopril-hydrochlorothiazide 20 mg-12.5 mg Tab, lisinopril-hydrochlorothiazide 20 mg-25 mg Tab, Mavik 1 mg Tab, Mavik 2 mg Tab, Micardis 20 mg Tab, Micardis 40 mg Tab, Micardis 80 mg Tab, Micardis HCT 40 mg-12.5 mg Tab, Micardis HCT 80 mg-12.5 mg Tab, Micardis HCT 80 mg-25 mg Tab, moexipril 15 mg Tab, moexipril 7.5 mg Tab, moexipril-hydrochlorothiazide 15 mg-12.5 mg Tab, moexiprilhydrochlorothiazide 15 mg-25 mg Tab, moexipril-hydrochlorothiazide 7.5 mg-12.5 mg Tab, Monopril 10 mg Tab, Monopril 20 mg Tab, Monopril 40 mg Tab, Monopril HCT 10 mg-12.5 mg Tab, Monopril HCT 20 mg-12.5 mg Tab, olmesartan 20 mg Tab, olmesartan 40 mg Tab, olmesartan 5 mg Tab, olmesartan-hydrochlorothiazide 20 mg-12.5 mg Tab, olmesartanhydrochlorothiazide 40 mg-12.5 mg Tab, olmesartan-hydrochlorothiazide 40 mg-25 mg Tab, perindopril erbumine 2 mg Tab, perindopril erbumine 4 mg Tab, perindopril erbumine 8 mg Tab, Prinivil 10 mg Tab, Prinivil 2.5 mg Tab, Prinivil 20 mg Tab, Prinivil 40 mg Tab, Prinivil 5 mg Tab, Prinzide 10 mg mg Tab, Prinzide 20 mg-12.5 mg Tab, Prinzide 20 mg-25 mg Tab, quinapril 10 mg Tab, quinapril 20 mg Tab, quinapril 40 mg Tab, quinapril 5 mg Tab, quinapril-hydrochlorothiazide 10 mg-12.5 mg Tab, quinaprilhydrochlorothiazide 20 mg-12.5 mg Tab, quinapril-hydrochlorothiazide 20 mg-25 mg Tab, Quinaretic 10 mg-12.5 mg Tab, Quinaretic 20 mg-12.5 mg Tab, Quinaretic 20 mg-25 mg Tab, ramipril 1.25 mg Cap, ramipril 1.25 mg Tab, ramipril 10 mg Cap, ramipril 10 mg Tab, ramipril 2.5 mg Cap, ramipril 2.5 mg Tab, ramipril 5 mg Cap, ramipril 5 mg Tab, Teczem 5 mg-180 mg 24 hr Tab, telmisartan 20 mg Tab, telmisartan 40 mg Tab, telmisartan 80 mg MicroMD EMR Clinical Quality Measure Calculations Version

127 Medications Indicative of Diabetes Tab, telmisartan-amlodipine 40 mg-10 mg Tab, telmisartan-amlodipine 40 mg-5 mg Tab, telmisartan-amlodipine 80 mg-10 mg Tab, telmisartanamlodipine 80 mg-5 mg Tab, telmisartan-hydrochlorothiazide 40 mg-12.5 mg Tab, telmisartan-hydrochlorothiazide 80 mg-12.5 mg Tab, telmisartanhydrochlorothiazide 80 mg-25 mg Tab, Teveten 400 mg Tab, Teveten 600 mg Tab, Teveten HCT 600 mg-12.5 mg Tab, Teveten HCT 600 mg-25 mg Tab, trandolapril 1 mg Tab, trandolapril 2 mg Tab, Twynsta 40 mg-10 mg Tab, Twynsta 40 mg-5 mg Tab, Twynsta 80 mg-10 mg Tab, Twynsta 80 mg- 5 mg Tab, Uniretic 15 mg-12.5 mg Tab, Uniretic 15 mg-25 mg Tab, Uniretic 7.5 mg-12.5 mg Tab, Univasc 15 mg Tab, Univasc 7.5 mg Tab, valsartan 160 mg Cap, valsartan 160 mg Tab, valsartan 320 mg Tab, valsartan 40 mg Tab, valsartan 80 mg Cap, valsartan 80 mg Tab, valsartanhydrochlorothiazide 160 mg-12.5 mg Tab, valsartan-hydrochlorothiazide 160 mg-25 mg Tab, valsartan-hydrochlorothiazide 320 mg-12.5 mg Tab, valsartan-hydrochlorothiazide 320 mg-25 mg Tab, valsartanhydrochlorothiazide 80 mg-12.5 mg Tab, Vaseretic 10 mg-25 mg Tab, Vaseretic 5 mg-12.5 mg Tab, Vasotec 10 mg Tab, Vasotec 2.5 mg Tab, Vasotec 20 mg Tab, Vasotec 5 mg Tab, Zestoretic 10 mg-12.5 mg Tab, Zestoretic 20 mg-12.5 mg Tab, Zestoretic 20 mg-25 mg Tab, Zestril 10 mg Tab, Zestril 2.5 mg Tab, Zestril 20 mg Tab, Zestril 30 mg Tab, Zestril 40 mg Tab, Zestril 5 mg Tab acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg-500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizidemetformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

128 glipizide-metformin 5 mg-500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg-500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburidemetformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub-Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub-Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub- Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, MicroMD EMR Clinical Quality Measure Calculations Version

129 insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg- 1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi- Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub-Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg- 500 mg Tab, pioglitazone-metformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide MicroMD EMR Clinical Quality Measure Calculations Version 7.5

130 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazone-glimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazone-glimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazone-glimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg-500 mg Tab, rosiglitazonemetformin 2 mg-1,000 mg Tab, rosiglitazone-metformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg- 500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg-1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , NQF 0064 / PQRI 2 DIABETES: LDL MANAGEMENT AND CONTROL (ALTERNATE) Description: The percentage of patients years of age with diabetes (type 1 or type 2) who had LDL-C <100mg/dL. MicroMD EMR Clinical Quality Measure Calculations Version

131 Clinical Rationale: This measure assesses the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who demonstrate poor low-density lipoprotein (LDL) cholesterol levels. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor cholesterol, specifically LDL. Clinical guidelines recommend lifestyle modifications that include reducing intake of saturated fat, trans fat and cholesterol; weight loss; and increased physical activity (ADA 2009). Statin therapy is suggested for eligible patients whose levels are consistently and significantly higher (ADA 2009). This measure facilitates long-term management of LDL cholesterol levels for patients diagnosed with diabetes. Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications MicroMD EMR Clinical Quality Measure Calculations Version 7.5

132 Numerator: Exclusions: **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) OR **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. **Numerator (1) Indicates that the LDL test was performed (see code list) **Date Range: within the reporting period MedInfo>Medical>Lab Result **Numerator (2) Considers the results of the completed tests MedInfo>Medical>Lab Result must be < 100 NOTE Most recent lab result within the reporting period will be used. NOTE Lab result values should be entered without any special characters, for example 9.1% should be entered as 9.1 to be counted. **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period OR MedInfo>Medical>Problem List Encounter Assessment MicroMD EMR Clinical Quality Measure Calculations Version

133 **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND ** Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications Code Lists for Measure Encounter Level Acute Inpatient or ED Encounter Level Non- Acute Inpatient Encounter Level - Opthamological services Encounter Outpatient CPT Encounter Outpatient ICD 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, ,99305,99306,99307,99308,99309,99310, 99315,99316, ,99325,99326,99327,99328,99334,99335, 99336, , 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 LDL CPT 80061, 83700, 83701, 83704, LDL LOINC , , , , , , , , Polycystic Ovaries ICD Gestational Diabetes - ICD Steroid Induced Diabetes ICD Medications Indicative of Diabetes 648.8, , , , , , 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , , 249.7, , , 249.8, , , 249.9, , , 251.8, acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg- 500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

134 Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg-500 mg Tab, AVANDAMET 4 mg- 1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizide-metformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg-500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg-500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburide-metformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg- 500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub-Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin MicroMD EMR Clinical Quality Measure Calculations Version

135 II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prtinsulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub-Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub-Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub- Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg- 1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente MicroMD EMR Clinical Quality Measure Calculations Version 7.5

136 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi-Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub-Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazone-glimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg-500 mg Tab, pioglitazonemetformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazone-glimepiride 4 mg- 1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazone-glimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazoneglimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg-500 mg Tab, rosiglitazone-metformin 2 mg-1,000 mg Tab, rosiglitazone-metformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg-500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptin-metformin 50 mg-1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , MicroMD EMR Clinical Quality Measure Calculations Version

137 NQF 0067 / PQRI 6 CORONARY ARTERY DISEASE: ORAL ANTIPLATELET THERAPY PRESCRIBED (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed oral antiplatelet therapy. Oral antiplatelet therapy is recommended for all patients with coronary artery disease. By limiting the ability of clots to form in the arteries, antiplatelet agents have proven benefits in reducing the risk of non-fatal myocardial infarction, nonfatal stroke and death. Denominator: **Patients in Age Range: >= 18 **Who had qualifying encounters (see code list) **Date Range: within the reporting period At least 2 Encounters - Outpatient, Nursing Facility NOTE The reporting will be looking at count of total encounters. It can be a combination of Outpatient and Nursing Facility Encounters. OR At least 1 Inpatient Discharge Encounter AND **who have condition of Coronary Artery Disease includes MI recorded in their chart-(see code list) **Date Range: prior to the encounter date Encounter Assessment MedInfo>Medical>Problem List MedInfo>Histories>Medical History OR **who have had cardiac surgery (see code list) **Date Range: Prior to the encounter Encounter Plan MedInfo>Orders> Orders (Performed) MedInfo>Histories>Surgical Procedures MedInfo>Histories>Hospitalization History MedInfo>Histories>Surgical History NOTE Reporting will look at the Procedure names in Surgical History Numerator: **Patients who were prescribed antiplatelet therapy. (see code list) **Date Range: prior to the end of the reporting period MicroMD EMR Clinical Quality Measure Calculations Version 7.5

138 Exclusions: **Patients who have a documented allergy to Antiplatelet therapy **Date Range: prior to or on the date of the encounter MedInfo>Medical>Allergies Medication Allergy. OR **Patient has documentation of Bleeding Coagulation Disorders in their chart (see code list) **Date Range prior to the end of the reporting period Encounter Assessment MedInfo>Medical>Problem List Code Lists for Measure Encounter Level Outpatient Encounter Level Nursing Facility Encounter Level Inpatient Discharge OR Medication Intolerance (Medication allergy termination date<=encounter date) (see measure above) 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99305, 99306, 99307, 99308, 99309, , CAD-includes MI ICD , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 411.0, 411.1, , , 412, 413.0, 413.1, 413.9, , , , , , , , , 414.8, 414.9, V45.81, V45.82 Cardiac Surgery - CPT 33140, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 92980, 92981, 92982, 92984, 92995, Cardiac Surgery - Procedure Bleeding Coagulation Disorder - ICD Coronary Artery Bypass Graft (CABG) 286.0, 286.1, 286.2, 286.3, 286.4, 286.5, 286.6, 286.7, 286.9, 287.0, 287.1, 287.3, , , , , 287.4, , , 287.5, 287.8, 287.9, , , , MicroMD EMR Clinical Quality Measure Calculations Version

139 Medications Anti- Platelet Therapy AA & C 400 mg-32 mg Tab, Acuprin 81 mg Tab, Added Strength Headache Relief 250 mg-250 mg-65 mg Tab, Added Strength Pain Reliever 250 mg-250 mg-65 mg Tab, Adult Analgesic 400 mg-32 mg Tab, Adult Aspirin 81 mg Chewable Tab, Adult Aspirin 81 mg Tab, Adult Aspirin EC Low Strength 81 mg Tab, Delayed Release, Adult Low Dose Aspirin 81 mg Tab, Adult Low Dose Aspirin 81 mg Tab, Delayed Release, Adult Low Strength 81 mg Tab, Adult Strength Analgesic 400 mg-32 mg Tab, Adult Strength Pain Relief 400 mg-32 mg Tab, Adult Strength Pain Reliever 400 mg-32 mg Tab, Aggrenox 200 mg-25 mg 12 hr Cap, Amiprin 800 mg Tab, Anacin 400 mg-32 mg Tab, Anacin Maximum Strength 500 mg-32 mg Tab, Analgesic 325 mg Tab, Analgesic 400 mg-32 mg Tab, Analgesic Adult Strength 400 mg-32 mg Tab, Anaprin 400 mg- 32 mg Tab, Andylate 325 mg Tab, Apprin 325 mg Tab, Arthritis Foundation 500 mg Tab, Delayed Release, Arthritis Pain Formula 325 mg Tab, Arthritis Pain Formula 500 mg Tab, Arthritis Pain Formula Max St 500 mg Tab, Arthritis Pain Relief (ASA-aaffeine) 400 mg-32 mg Tab, Arthritis Pain Relief (Aspirin) 325 mg Tab, Delayed Release, Arthritis Pain Relief (Aspirin) 500 mg Tab, Arthritis Pain Relief (Aspirin) 500 mg Tab, Delayed Release, Arthritis Relief 325 mg Tab, Arthrotrin 325 mg Tab, Arthrotrin 325 mg Tab, Delayed Release, As-Caff 400 mg-32 mg Tab, ASA-acetaminophen-salicylate-caffeine 210 mg-115 mg-65 mg- 16 mg Tab, Ascriptin 325 mg Tab, Ascriptin 325 mg Tab, Delayed Release, Ascriptin 81 mg Tab, Delayed Release, Ascriptin A/D 325 mg Tab, Ascriptin AP 325 mg Tab, Ascriptin Extra Strength 500 mg Tab, Ascriptin MS 500 mg Tab, Aspercin 325 mg Tab, Aspir mg Tab, Aspir mg Tab, Aspir-Low 81 mg Tab, Aspir-Lox 325 mg Tab, Aspir-Lox AD 325 mg Tab, Aspir-Mox (with aluminum) 325 mg Tab, Aspir-Mox 325 mg Tab, Aspir-Mox IB 325 mg Tab, Aspir-Trin 325 mg Tab, Aspir-Trin 650 mg Tab, Aspircaf 400 mg-32 mg Tab, aspirin 1,200 mg Rectal Suppository, aspirin 120 mg Rectal Suppository, aspirin 125 mg Rectal Suppository, aspirin 130 mg Rectal Suppository, aspirin 162 mg Tab, Delayed Release, aspirin 200 mg Rectal Suppository, aspirin 300 mg Rectal Suppository, aspirin 325 mg Tab, aspirin 325 mg Tab, Delayed Release, aspirin mg Tab, Delayed Release, aspirin 500 mg Tab, aspirin 500 mg Tab, Delayed Release, aspirin 60 mg Rectal Suppository, aspirin 600 mg Rectal Suppository, aspirin 650 mg Tab, Delayed Release, aspirin 81 mg Cap, Delayed Release, aspirin 81 mg Chewable Tab, aspirin 81 mg Tab, aspirin 81 mg Tab, Delayed Release, aspirin 975 mg Tab, Delayed Release, Aspirin AD/Antacid 325 mg Tab, Aspirin Child 81 mg Chewable Tab, Aspirin Childrens 81 mg Chewable Tab, Aspirin Compound 400 mg-32 mg Tab, Aspirin Enseal 325 mg Tab, Delayed Release, Aspirin Enseal 650 mg Tab, Delayed Release, aspirin ER 650 mg Tab, aspirin ER 800 mg Tab, Aspirin Extra Strength 500 mg Tab, Aspirin For Children 81 mg Chewable Tab, Aspirin Lite-Coat 325 mg Tab, Aspirin Low Dose 81 mg Tab, Delayed Release, Aspirin Low-Strength 81 mg Chewable Tab, Aspirin Low- Strength 81 mg Tab, Delayed Release, Aspirin Maximum Strength 500 mg Tab, Aspirin Maximum Strength 500 mg Tab, Delayed Release, Aspirin Plus 400 mg- 32 mg Tab, Aspirin Plus Antacid 325 mg Tab, Aspirin Tri Buffered 500 mg Tab, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

140 aspirin, buffered 325 mg Tab, aspirin, buffered 325 mg Tab, Delayed Release, aspirin, buffered 500 mg Tab, aspirin, buffered 81 mg Tab, aspirin, buffered 81 mg Tab, Delayed Release, aspirin-acetaminophen-caffeine 240 mg-125 mg-32 mg Tab, aspirin-acetaminophen-caffeine 250 mg-250 mg-65 mg Tab, aspirincaffeine 400 mg-32 mg Tab, aspirin-caffeine 500 mg-32 mg Tab, Aspirin-For- Arthritis 325 mg Tab, Delayed Release, aspirin-salicylamide-caffeine 325 mg-95 mg-16 mg Tab, Aspirina 500 mg Tab, Aspralum 325 mg Tab, Aspralum E.B. 325 mg Tab, Aspridrox 325 mg Tab, Asprimox 325 mg Tab, Asprimox E/P 325 mg Tab, Asprimox ID 325 mg Tab, Asprimox ID 500 mg Tab, Baby Aspirin 81 mg Chewable Tab, Bayer 8-Hour 650 mg Tab, Bayer Arthritis Pain Regimen 500 mg Tab, Bayer Aspirin 325 mg Tab, Bayer Aspirin 500 mg Tab, Bayer Aspirin Maximum 500 mg Tab, Bayer Childrens Aspirin 81 mg Chewable Tab, Bayer Plus 325 mg Tab, Bayer Plus 500 mg Tab, Bayer Plus Extra Strength 500 mg Tab, Bayer Therapy 325 mg Tab, BC 325 mg-95 mg-16 mg Tab, BC Headache 325 mg-95 mg-16 mg Tab, Biocin 400 mg-32 mg Tab, Bioteric 325 mg Tab, Buffered Aspirin 325 mg Tab, Bufferin 325 mg Tab, Bufferin 500 mg Tab, Bufferin 81 mg Tab, Bufferin Arthritis Strength 500 mg Tab, Bufferin Extra Strength 500 mg Tab, Bufferin Tri-Buffered 325 mg Tab, Buffex 325 mg Tab, Buffex Sani-Pak 325 mg Tab, Bufpirin 325 mg Tab, Butalbital Compound 50 mg-325 mg-40 mg Cap, Butalbital Compound 50 mg-325 mg-40 mg Tab, butalbital-aspirin-caffeine 50 mg-325 mg-40 mg Cap, butalbital-aspirin-caffeine 50 mg-325 mg-40 mg Tab, Cama 500 mg Tab, Child Aspirin 81 mg Chewable Tab, Children's Aspirin 81 mg Chewable Tab, Children's Chewable Aspirin 81 mg Tab, clopidogrel 75 mg Tab, Coat-A-Prin 325 mg Tab, Coat-A-Prin 500 mg Tab, Coprin 325 mg Tab, Coprin 500 mg Tab, Cosprin 325 mg Tab, Cosprin 650 mg Tab, Dasprin 975 mg Tab, Dewitt's Aspirin 325 mg Tab, Dewitt's Children's Aspirin 81 mg Chewable Tab, dipyridamole-aspirin ER 200 mg-25 mg multiphase 12 hr Cap, E.C. Prin 325 mg Tab, Easprin 975 mg Tab, EC Aspirin 325 mg Tab, Delayed Release, Eco mg Tab, Eco mg Tab, Ecofair 325 mg Tab, Ecotrin 325 mg Tab, Ecotrin Low Strength 81 mg Tab, Ecotrin Maximum Strength 500 mg Tab, Ectasa-Orange 325 mg Tab, Empirin 325 mg Tab, Encoprin 325 mg Tab, Encoprin 500 mg Tab, Encoprin Extra Strength 500 mg Tab, Entab mg Tab, Entaprin 975 mg Tab, Entercote 325 mg Tab, Enteric Coated Aspirin 325 mg Tab, Delayed Release, Enteric Coated Aspirin 500 mg Tab, Delayed Release, Enteric Coated Aspirin 81 mg Tab, Delayed Release, Enterin 325 mg Tab, Enterin 500 mg Tab, Entrogesic 325 mg Tab, Ex-Pain 250 mg-250 mg-65 mg Tab, Excedrin Extra Strength 250 mg-250 mg-65 mg Tab, Excedrin Menstrual Complete 250 mg-250 mg-65 mg Tab, Excedrin Migraine 250 mg-250 mg-65 mg Tab, Extra Strength Bayer 500 mg Tab, Extraprin 250 mg-250 mg-65 mg Tab, Farbital 50 mg-325 mg-40 mg Cap, Farbital 50 mg-325 mg-40 mg Tab, Fast Acting Pain Relief 400 mg-32 mg Tab, Fembutal 50 mg-325 mg-40 mg Tab, Fiorgen 50 mg-325 mg-40 mg Cap, Fiorinal 50 mg-325 mg-40 mg Cap, Fiorinal 50 mg-325 mg-40 mg Tab, Fiormor 50 mg-325 mg-40 mg Cap, Fiormor 50 mg-325 mg-40 mg Tab, Fiortal 50 mg-325 mg-40 mg Cap, Fiortal 50 mg-325 mg-40 mg Tab, Fortabs 50 mg- MicroMD EMR Clinical Quality Measure Calculations Version

141 325 mg-40 mg Tab, Gelpirin 125 mg-240 mg-32 mg Tab, Genaced 250 mg-250 mg-65 mg Tab, Genacote 325 mg Tab, Genacote 500 mg Tab, Gennin 325 mg Tab, Gennin-FC 325 mg Tab, Genprin 325 mg Tab, Gensan 400 mg-32 mg Tab, Halfprin 162 mg Tab, Halfprin 81 mg Tab, Headache Formula 250 mg-250 mg- 65 mg Tab, Headache Formula Added Str 250 mg-250 mg-65 mg Tab, Headache Relief 250 mg-250 mg-65 mg Tab, Hipirin mg Tab, Idenal 50 mg-325 mg- 40 mg Cap, Idenal 50 mg-325 mg-40 mg Tab, Isobutal 50 mg-325 mg-40 mg Tab, Isolin 50 mg-325 mg-40 mg Tab, Isollyl 50 mg-325 mg-40 mg Cap, Isollyl 50 mg-325 mg-40 mg Tab, Kiddies Aspirin 81 mg Chewable Tab, Lanorinal 50 mg-325 mg-40 mg Cap, Lanorinal 50 mg-325 mg-40 mg Tab, Lite Coat Aspirin 325 mg Tab, Litecoat Aspirin 325 mg Tab, Delayed Release, Lo-Dose Aspirin 81 mg Tab, Delayed Release, Low-Dose Aspirin 81 mg Tab, Magnaprin 325 mg Tab, Majorcin 400 mg-32 mg Tab, Maprin A/D 325 mg Tab, Measurin 650 mg Tab, Megaprin 975 mg Tab, Migraine Formula 250 mg-250 mg-65 mg Tab, Migraine Pain Reliever 250 mg-250 mg-65 mg Tab, Migraine Relief 250 mg-250 mg-65 mg Tab, Minitabs 81 mg Tab, Ninoprin 81 mg Tab, Non-Irritating Aspirin 325 mg Tab, Norwich Aspirin 325 mg Tab, Norwich Aspirin 325 mg Tab, Delayed Release, Norwich Aspirin 500 mg Tab, Norwich Aspirin 500 mg Tab, Delayed Release, Or-Prin 800 mg Tab, P-A-C 400 mg-32 mg Tab, P-A-C Analgesic 400 mg-32 mg Tab, Pain Relief 400 mg-32 mg Tab, Pain Relief Extra Strength 250 mg-250 mg-65 mg Tab, Pain Relief Fast Acting 400 mg-32 mg Tab, Pain Relief Plus 250 mg-250 mg-65 mg Tab, Pain Reliever 250 mg-250 mg-65 mg Tab, Pain Reliever 400 mg-32 mg Tab, Pain Reliever Added Strength 250 mg-250 mg-65 mg Tab, Pain Reliever Extra Strength 250 mg-250 mg-65 mg Tab, Pain Reliever Plus 250 mg-250 mg-65 mg Tab, Pain Reliver Super Strength 500 mg Tab, Pain- Off 250 mg-250 mg-65 mg Tab, Painaid Extra Strength Formula 250 mg-250 mg-65 mg Tab, Pamprin Max 250 mg-250 mg-65 mg Tab, Plavix 75 mg Tab, Q- Acin 400 mg-32 mg Tab, Quality Aspirin 325 mg Tab, Regriprin 81 mg Tab, Ridiprin 325 mg Tab, Salagen 325 mg Tab, Saleto 210 mg-115 mg-65 mg-16 mg Tab, Sloprin 800 mg Tab, Special Buffered Aspirin 325 mg Tab, St Joseph Aspirin 81 mg Chewable Tab, St. Joseph Aspirin 325 mg Tab, St. Joseph Aspirin 81 mg Tab, Delayed Release, St. Joseph Aspirin Children 81 mg Chewable Tab, St. Joseph Low-Dose Aspirin 81 mg Chewable Tab, Super Pain Relief 250 mg- 250 mg-65 mg Tab, Super Strength Pain Reliever 250 mg-250 mg-65 mg Tab, Sureprin mg Tab, Tasprin 325 mg Tab, Tasprin 81 mg Tab, Tenstan 50 mg-325 mg-40 mg Tab, Tri-Buff Aspirin 325 mg Tab, Tri-Buffered Aspirin 325 mg Tab, Tri-Buffered Bufferin 325 mg Tab, Tri-Buffered Bufferin 500 mg Tab, Trinprin 650 mg Tab, Trinprin 800 mg Tab, Uni-Ann 400 mg-32 mg Tab, Uni-As Plus 325 mg Tab, Uni-As Plus A/F 325 mg Tab, Uni-Asplus 325 mg Tab, Uni- Asplus A/F 325 mg Tab, Uni-Buff 325 mg Tab, Uni-Case 250 mg-250 mg-65 mg Tab, Uni-Tren 325 mg Tab, Valomag 325 mg Tab, Valomag Extra Strength 325 mg Tab, Valumag W/Aspirin Buffered 325 mg Tab, Vibutal 50 mg-325 mg-40 mg Tab, X-Str Pain Reliever 250 mg-250 mg-65 mg Tab, YSP Aspirin 81 mg Cap, Zero-Order Release Aspirin 800 mg Tab, Zorprin 800 mg Tab MicroMD EMR Clinical Quality Measure Calculations Version 7.5

142 NQF 0068 / PQRI 204 ISCHEMIC VASCULAR DISEASE: USE OF ASPIRIN OR ANOTHER ANTITHROMBOTIC (ALTERNATE) Description: Clinical Rationale: The percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1 November 1 of the year prior to the measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year and who had documentation of use of aspirin or another antithrombotic during the measurement year This measure assesses the percentage of patients in a specific age demographic who were diagnosed with ischemic vascular disease (IVD) and demonstrated the utilization of aspirin or another antithrombotic to prevent coronary heart disease (CHD). IVD and related conditions had an estimated cost burden of $393.5 billion in 2005 (AHA 2005). The disease burden is also noteworthy, with CHD being an underlying or contributing cause of death for 451,300 people, accounting for 1 of every 5 deaths in the United States in 2004 (AHA 2008). The National Commission on Prevention Priorities (NCPP) determined that aspirin therapy is the most highly utilized and most effective clinical preventable service in preventing CHD (Maciosek 2006). Studies support this statement: aspirin therapy is shown to have directly reduced the odds of cardiovascular events among men by 14% and among women by 12% (Berger 2006). Additionally, aspirin use reduced the number of strokes by 20% and the number of myocardial infarctions and other vascular events by 30% (Weisman 2002). This measure facilitates long-term management of IVD through aspirin or another antithrombotic to prevent CHD. Denominator: **Patients in Age Range: >= 17 **who have condition of Acute Myocardial Infarction or Ischemic Vascular Disease recorded in their chart-(see code list) **Date Range: prior to the encounter date MedInfo>Medical>Problem List Encounter Assessment Medical History OR **Patient has had a CABG or PTCA (see code list) **Date Range: months prior to the end of the reporting period MedInfo>Histories>Surgical History MedInfo>Histories>Surgical Procedures NOTE Reporting will look at the CPT codes or Procedure names related to the surgery MicroMD EMR Clinical Quality Measure Calculations Version

143 AND **Patient has had a CABG or PTCA (see code list) **Date Range: date admitted is months prior to the end of the reporting period MedInfo>Histories>Hospitalization History NOTE Reporting will look at the CPT codes or ICD codes related to the surgery or diagnosis of Acute Myocardial Infarction or Ischemic Vascular Disease AND **Who have had At least 1 encounters **Date Range: within the reporting period Numerator: Exclusions: **Patients who were prescribed oral antiplatelet therapy. (see code list) **Date Range: within the reporting period. None Code Lists for Measure Acute MI - ICD , , , , , , , , , Ischemic Vascular Disease - ICD , 411.0, 411.1, , , 413.0, 413.1, 413.9, , , , , , , , , 414.2, 414.8, 414.9, 429.2, 433.0, , , , , , , , , , , , , , , , , 440.1, , , , , , , 440.4, 444.0, 444.1, , , , , 444.9, , , 445.8, CABG - CPT 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, S2205, S2206, S2207, S2208, S2209 PTCA - CPT 33140, 92980, 92982, CABG-ICD 36.1, 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19, 36.2 PTCA -ICD 00.66, 36.06, 36.07, CABG - Procedure PTCA - Procedure Coronary Artery Bypass Graft (CABG) Percutaneous Transluminal Coronary Angioplasty (PTCA) MicroMD EMR Clinical Quality Measure Calculations Version 7.5

144 Medications Oral Antiplatelet Therapy Acuprin 81 mg Tab, Adult Aspirin 81 mg Chewable Tab, Adult Aspirin 81 mg Tab, Adult Aspirin EC Low Strength 81 mg Tab, Delayed Release, Adult Low Dose Aspirin 81 mg Tab, Adult Low Dose Aspirin 81 mg Tab, Delayed Release, Adult Low Strength 81 mg Tab, Aggrenox 200 mg-25 mg 12 hr Cap, Amiprin 800 mg Tab, Analgesic 325 mg Tab, Andylate 325 mg Tab, Apprin 325 mg Tab, Arthritis Foundation 500 mg Tab, Delayed Release, Arthritis Pain Formula 325 mg Tab, Arthritis Pain Formula 500 mg Tab, Arthritis Pain Formula Max St 500 mg Tab, Arthritis Pain Relief (Aspirin) 325 mg Tab, Delayed Release, Arthritis Pain Relief (Aspirin) 500 mg Tab, Arthritis Pain Relief (Aspirin) 500 mg Tab, Delayed Release, Arthritis Relief 325 mg Tab, Arthrotrin 325 mg Tab, Arthrotrin 325 mg Tab, Delayed Release, Ascriptin 325 mg Tab, Ascriptin 325 mg Tab, Delayed Release, Ascriptin 81 mg Tab, Delayed Release, Ascriptin A/D 325 mg Tab, Ascriptin AP 325 mg Tab, Ascriptin Extra Strength 500 mg Tab, Ascriptin MS 500 mg Tab, Aspercin 325 mg Tab, Aspergum 227 mg Gum, Aspir mg Tab, Aspir mg Tab, Aspir-Low 81 mg Tab, Aspir-Lox 325 mg Tab, Aspir-Lox AD 325 mg Tab, Aspir-Mox (with aluminum) 325 mg Tab, Aspir-Mox 325 mg Tab, Aspir-Mox IB 325 mg Tab, Aspir-Trin 325 mg Tab, Aspir-Trin 650 mg Tab, aspirin 162 mg Tab, Delayed Release, aspirin 227 mg Gum, aspirin 325 mg Tab, aspirin 325 mg Tab, Delayed Release, aspirin mg Tab, Delayed Release, aspirin 500 mg Tab, aspirin 500 mg Tab, Delayed Release, aspirin 650 mg Packet, aspirin 650 mg Tab, Delayed Release, aspirin 81 mg Cap, Delayed Release, aspirin 81 mg Chewable Tab, aspirin 81 mg Tab, aspirin 81 mg Tab, Delayed Release, aspirin 975 mg Tab, Delayed Release, Aspirin AD/Antacid 325 mg Tab, Aspirin Child 81 mg Chewable Tab, Aspirin Childrens 81 mg Chewable Tab, Aspirin Enseal 325 mg Tab, Delayed Release, Aspirin Enseal 650 mg Tab, Delayed Release, aspirin ER 650 mg Tab, aspirin ER 800 mg Tab, Aspirin Extra Strength 500 mg Tab, Aspirin For Children 81 mg Chewable Tab, Aspirin Lite-Coat 325 mg Tab, Aspirin Low Dose 81 mg Tab, Delayed Release, Aspirin Low-Strength 81 mg Chewable Tab, Aspirin Low- Strength 81 mg Tab, Delayed Release, Aspirin Maximum Strength 500 mg Tab, Aspirin Maximum Strength 500 mg Tab, Delayed Release, Aspirin Plus Antacid 325 mg Tab, Aspirin Tri Buffered 500 mg Tab, aspirin, buffered 325 mg Tab, aspirin, buffered 325 mg Tab, Delayed Release, aspirin, buffered 500 mg Tab, aspirin, buffered 81 mg Tab, aspirin, buffered 81 mg Tab, Delayed Release, Aspirin-For-Arthritis 325 mg Tab, Delayed Release, Aspirina 500 mg Tab, Aspralum 325 mg Tab, Aspralum E.B. 325 mg Tab, Aspridrox 325 mg Tab, Asprimox 325 mg Tab, Asprimox E/P 325 mg Tab, Asprimox ID 325 mg Tab, Asprimox ID 500 mg Tab, Baby Aspirin 81 mg Chewable Tab, Bayer 8-Hour 650 mg Tab, Bayer Arthritis Pain Regimen 500 mg Tab, Bayer Aspirin 325 mg Tab, Bayer Aspirin 500 mg Tab, Bayer Aspirin Maximum 500 mg Tab, Bayer Childrens Aspirin 81 mg Chewable Tab, Bayer Plus 325 mg Tab, Bayer Plus 500 mg Tab, Bayer Plus Extra Strength 500 mg Tab, Bayer Therapy 325 mg Tab, Bioteric 325 mg Tab, Buffered Aspirin 325 mg Tab, Bufferin 325 mg Tab, Bufferin 500 mg Tab, Bufferin 81 mg Tab, Bufferin Arthritis Strength 500 mg Tab, Bufferin Extra Strength 500 mg Tab, Bufferin Tri-Buffered 325 mg Tab, Buffex 325 mg Tab, Buffex Sani-Pak 325 mg Tab, Bufpirin 325 mg Tab, Cama MicroMD EMR Clinical Quality Measure Calculations Version

145 500 mg Tab, Child Aspirin 81 mg Chewable Tab, Children's Aspirin 81 mg Chewable Tab, Children's Chewable Aspirin 81 mg Tab, clopidogrel 300 mg Tab, clopidogrel 75 mg Tab, Coat-A-Prin 325 mg Tab, Coat-A-Prin 500 mg Tab, Coprin 325 mg Tab, Coprin 500 mg Tab, Cosprin 325 mg Tab, Cosprin 650 mg Tab, Dasprin 975 mg Tab, Dewitt's Aspirin 325 mg Tab, Dewitt's Children's Aspirin 81 mg Chewable Tab, dipyridamole-aspirin ER 200 mg-25 mg multiphase 12 hr Cap, E.C. Prin 325 mg Tab, Easprin 975 mg Tab, EC Aspirin 325 mg Tab, Delayed Release, Eco mg Tab, Eco mg Tab, Ecofair 325 mg Tab, Ecotrin 325 mg Tab, Ecotrin Low Strength 81 mg Tab, Ecotrin Maximum Strength 500 mg Tab, Ectasa-Orange 325 mg Tab, Effient 10 mg Tab, Effient 5 mg Tab, Empirin 325 mg Tab, Encoprin 325 mg Tab, Encoprin 500 mg Tab, Encoprin Extra Strength 500 mg Tab, Entab mg Tab, Entaprin 975 mg Tab, Entercote 325 mg Tab, Enteric Coated Aspirin 325 mg Tab, Delayed Release, Enteric Coated Aspirin 500 mg Tab, Delayed Release, Enteric Coated Aspirin 81 mg Tab, Delayed Release, Enterin 325 mg Tab, Enterin 500 mg Tab, Entrogesic 325 mg Tab, Extra Strength Bayer 500 mg Tab, Genacote 325 mg Tab, Genacote 500 mg Tab, Gennin 325 mg Tab, Gennin-FC 325 mg Tab, Genprin 325 mg Tab, Halfprin 162 mg Tab, Halfprin 81 mg Tab, Hipirin mg Tab, Kiddies Aspirin 81 mg Chewable Tab, Lite Coat Aspirin 325 mg Tab, Litecoat Aspirin 325 mg Tab, Delayed Release, Lo-Dose Aspirin 81 mg Tab, Delayed Release, Low-Dose Aspirin 81 mg Tab, Magnaprin 325 mg Tab, Maprin A/D 325 mg Tab, Measurin 650 mg Tab, Megaprin 975 mg Tab, Minitabs 81 mg Tab, Ninoprin 81 mg Tab, Non-Irritating Aspirin 325 mg Tab, Norwich Aspirin 325 mg Tab, Norwich Aspirin 325 mg Tab, Delayed Release, Norwich Aspirin 500 mg Tab, Norwich Aspirin 500 mg Tab, Delayed Release, Or-Prin 800 mg Tab, Pain Reliver Super Strength 500 mg Tab, Plavix 300 mg Tab, Plavix 75 mg Tab, prasugrel 10 mg Tab, prasugrel 5 mg Tab, Quality Aspirin 325 mg Tab, Regriprin 81 mg Tab, Ridiprin 325 mg Tab, Salagen 325 mg Tab, Sloprin 800 mg Tab, Special Buffered Aspirin 325 mg Tab, St Joseph Aspirin 81 mg Chewable Tab, St. Joseph Aspirin 325 mg Tab, St. Joseph Aspirin 81 mg Tab, Delayed Release, St. Joseph Aspirin Children 81 mg Chewable Tab, St. Joseph Low-Dose Aspirin 81 mg Chewable Tab, Stanback Analgesic 650 mg Oral Packet, Stanback Headache Powder 650 mg Oral Packet, Sureprin mg Tab, Tasprin 325 mg Tab, Tasprin 81 mg Tab, Ticlid 250 mg Tab, ticlopidine 250 mg Tab, Tri-Buff Aspirin 325 mg Tab, Tri-Buffered Aspirin 325 mg Tab, Tri- Buffered Bufferin 325 mg Tab, Tri-Buffered Bufferin 500 mg Tab, Trinprin 650 mg Tab, Trinprin 800 mg Tab, Uni-As Plus 325 mg Tab, Uni-As Plus A/F 325 mg Tab, Uni-Asplus 325 mg Tab, Uni-Asplus A/F 325 mg Tab, Uni-Buff 325 mg Tab, Uni-Tren 325 mg Tab, Valomag 325 mg Tab, Valomag Extra Strength 325 mg Tab, Valumag W/Aspirin Buffered 325 mg Tab, YSP Aspirin 81 mg Cap, Zero-Order Release Aspirin 800 mg Tab, Zorprin 800 mg Tab MicroMD EMR Clinical Quality Measure Calculations Version 7.5

146 NQF 0070 / PQRI 7 CORONARY ARTERY DISEASE: BETA BLOCKER THERAPY FOR CAD PATIENTS WITH PRIOR MI (ALTERNATE) Field Description: Clinical Rationale: Description Percentage of patients aged 18 years and older with a diagnosis of CAD and prior MI who were prescribed beta-blocker therapy. In the absence of contraindications, beta-blocker therapy has been shown to reduce the risk of a recurrent MI and decrease mortality for those patients with a prior MI. Denominator: **Patients in Age Range: >= 17 **who have at least 2 outpatient encounters (see code list) OR **who have at least 2 nursing facility encounters (see code list) OR **who have at least 1 inpatient discharge encounters (see code list) OR **Date Range: during the reporting period And **who have condition of Coronary Artery Disease, no MI recorded in their chart-(see code list) **Date Range: prior to the encounter date Encounter Assessment MedInfo>Medical>Problem List OR **who have had cardiac surgery performed (see code list) **Date Range prior to the encounter date Encounter Plan (performed) MedInfo>Histories>Surgical History MedInfo>Histories>Hospitalization History MedInfo>Orders>Orders (completed) MedInfo>Histories>Surgical Procedure NOTE Reporting will look at the CPT codes or Procedure names related to the surgery AND **who have condition of Resolved of MI documented in their chart(see code list) **Date Range: prior to the encounter date Encounter Assessment MedInfo>Medical>Problem List MedInfo>Histories>Medical History MicroMD EMR Clinical Quality Measure Calculations Version

147 Field Numerator: Exclusions: Description **Patients who were prescribed beta blocker therapy (see code list) **Date Range: prior to the end of the reporting period **Patients with conditions of Arrhythmia, Hypotension, Asthma, Bradycardia, Atresia and Stenosis of Aorta (see code list) **Date Range: prior to encounter date and current status is active with status date <= encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patients with condition Atrioventricular block (see code list) **Date Range: prior to encounter date and current status is active with status date <= encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List **And do not have a pacemaker which includes : **Patients with condition Cardiac Pacer in Situ (see code list) **Date Range: prior to encounter date and current status is active with status date <= encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patient has a documented Medication Allergy to Beta Blockers (see code list) **Date Range: prior to the encounter date OR MedInfo>Medical>Allergies Medication Intolerance event to Beta Blockers (Medication termination code is not null and begin date <= encounter date) (see code list) OR **Patient Heart Rate < 50 bpm (at least 2 consecutive counts ) **Date Range: prior to or during the encounter date MedInfo>Medical>Vital Signs (pulse) MicroMD EMR Clinical Quality Measure Calculations Version 7.5

148 Code Lists for Measure Encounter Level Outpatient Encounter Level Nursing Facility Encounter Level Inpatient Discharge Coronary Artery Disease excludes MI - ICD 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99305, 99306, 99307, 99308, 99309, , , 411.1, , , 413.0, 413.1, 413.9, , , , , , , , , 414.8, 414.9, V45.81, V45.82 Myocardial Infarction ICD , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 412 Arryhythmia ICD , Hypotension - ICD 458.0, 458.1, , , 458.8, Asthma - ICD , , , , , , , , , , , , , Bradycardia ICD , , Atresia and Stenosis of Aorta ICD 440.0, Atrioventricular Block ICD 426.0, , Cardiac Pacer in Situ ICD V45.01 Cardiac Surgery - CPT 33140, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 92980, 92981, 92982, 92984, 92995, Cardiac Surgery - Procedure Medications Beta Blocker Therapy Coronary Artery Bypass Graft (CABG) atenolol 100 mg Tab, atenolol 25 mg Tab, atenolol 5 mg/10 ml IV, atenolol 50 mg Tab, atenolol-chlorthalidone 100 mg-25 mg Tab, atenololchlorthalidone 50 mg-25 mg Tab, Betachron 120 mg 24 hr Cap, Betachron 160 mg 24 hr Cap, Betachron 60 mg 24 hr Cap, Betachron 80 mg 24 hr Cap, betaxolol 10 mg Tab, betaxolol 20 mg Tab, bisoprolol fumarate 10 mg Tab, bisoprolol fumarate 5 mg Tab, bisoprolol-hydrochlorothiazide 10 mg mg Tab, bisoprolol-hydrochlorothiazide 2.5 mg-6.25 mg Tab, bisoprolol-hydrochlorothiazide 5 mg-6.25 mg Tab, Blocadren 10 mg Tab, Blocadren 20 mg Tab, Blocadren 5 mg Tab, carvedilol 12.5 mg Tab, MicroMD EMR Clinical Quality Measure Calculations Version

149 carvedilol 25 mg Tab, carvedilol mg Tab, carvedilol 6.25 mg Tab, Coreg 12.5 mg Tab, Coreg 25 mg Tab, Coreg mg Tab, Coreg 6.25 mg Tab, Corgard 120 mg Tab, Corgard 160 mg Tab, Corgard 20 mg Tab, Corgard 40 mg Tab, Corgard 80 mg Tab, Corzide 40 mg-5 mg Tab, Corzide 80 mg-5 mg Tab, Inderal 1 mg/ml IV, Inderal 10 mg Tab, Inderal 20 mg Tab, Inderal 40 mg Tab, Inderal 60 mg Tab, Inderal 80 mg Tab, Inderal 90 mg Tab, Inderal LA 120 mg 24 hr Cap, Inderal LA 160 mg 24 hr Cap, Inderal LA 60 mg 24 hr Cap, Inderal LA 80 mg 24 hr Cap, Inderide 40 mg- 25 mg Tab, Inderide 80 mg-25 mg Tab, Inderide-40/25 40 mg-25 mg Tab, Inderide-80/25 80 mg-25 mg Tab, InnoPran XL 120 mg 24 hr Cap, InnoPran XL 80 mg 24 hr Cap, Kerlone 10 mg Tab, Kerlone 20 mg Tab, labetalol 100 mg Tab, labetalol 200 mg Tab, labetalol 25 mg/5 ml (5 mg/ml) IV Syringe, labetalol 300 mg Tab, labetalol 5 mg/ml IV, labetalol 5 mg/ml IV Syringe, Levatol 20 mg Tab, Lopressor 100 mg Tab, Lopressor 5 mg/5 ml IV, Lopressor 5 mg/5 ml IV Syringe, Lopressor 50 mg Tab, Lopressor HCT 100 mg-25 mg Tab, Lopressor HCT 100 mg-50 mg Tab, Lopressor HCT 50 mg-25 mg Tab, Lorol 40 mg Tab, metoprolol 5 mg/5 ml IV, metoprolol 5 mg/5 ml IV Cartridge, metoprolol 5 mg/5 ml IV Syringe, metoprolol succinate ER 100 mg 24 hr Tab, metoprolol succinate ER 200 mg 24 hr Tab, metoprolol succinate ER 25 mg 24 hr Tab, metoprolol succinate ER 50 mg 24 hr Tab, metoprolol tartrate 100 mg Tab, metoprolol tartrate 25 mg Tab, metoprolol tartrate 50 mg Tab, metoprololhydrochlorothiazide 100 mg-25 mg Tab, metoprolol-hydrochlorothiazide 100 mg-50 mg Tab, metoprolol-hydrochlorothiazide 50 mg-25 mg Tab, nadolol 120 mg Tab, nadolol 160 mg Tab, nadolol 20 mg Tab, nadolol 40 mg Tab, nadolol 80 mg Tab, nadolol-bendroflumethiazide 40 mg-5 mg Tab, nadolol-bendroflumethiazide 80 mg-5 mg Tab, Normodyne 100 mg Tab, Normodyne 200 mg Tab, Normodyne 300 mg Tab, Normodyne 5 mg/ml IV, Normodyne 5 mg/ml IV Syringe, penbutolol 20 mg Tab, pindolol 10 mg Tab, pindolol 5 mg Tab, Procard 10 mg Tab, Procard 20 mg Tab, Procard 40 mg Tab, Pronol 10 mg Tab, Pronol 20 mg Tab, Pronol 40 mg Tab, Pronol 80 mg Tab, propranolol 1 mg/ml IV, propranolol 1 mg/ml IV Syringe, propranolol 10 mg Tab, propranolol 20 mg Tab, propranolol 20 mg/5 ml Oral Soln, propranolol 40 mg Tab, propranolol 40 mg/5 ml Oral Soln, propranolol 60 mg Tab, propranolol 80 mg Tab, propranolol 80 mg/ml Oral Drops, propranolol 90 mg Tab, propranolol ER 120 mg 24 hr Cap, propranolol ER 120 mg 24 hr Cap extended release, propranolol ER 160 mg 24 hr Cap extended release, propranolol ER 60 mg 24 hr Cap extended release, propranolol ER 80 mg 24 hr Cap, propranolol ER 80 mg 24 hr Cap extended release, propranolol-hydrochlorothiazide 40 mg-25 mg Tab, propranolol-hydrochlorothiazide 80 mg-25 mg Tab, Senormin 50 mg Tab, Tenoretic mg-25 mg Tab, Tenoretic mg-25 mg Tab, Tenormin 100 mg Tab, Tenormin 25 mg Tab, Tenormin 5 mg/10 ml IV, Tenormin 50 mg Tab, Tenormin Calendar Pak 50 mg Tab, timolol 10 mg MicroMD EMR Clinical Quality Measure Calculations Version 7.5

150 Tab, timolol 20 mg Tab, timolol 5 mg Tab, Toprol XL 100 mg 24 hr Tab, Toprol XL 200 mg 24 hr Tab, Toprol XL 25 mg 24 hr Tab, Toprol XL 50 mg 24 hr Tab, Trandate 100 mg Tab, Trandate 200 mg Tab, Trandate 300 mg Tab, Trandate 5 mg/ml IV, Trandate 5 mg/ml IV Syringe, Visken 10 mg Tab, Visken 5 mg Tab, Zebeta 10 mg Tab, Zebeta 5 mg Tab, Ziac 10 mg mg Tab, Ziac 2.5 mg-6.25 mg Tab, Ziac 5 mg-6.25 mg Tab NQF 0073 / PQRI 201 ISCHEMIC VASCULAR DISEASE: BLOOD PRESSURE MANAGEMENT (ALTERNATE) Description: Clinical Rationale: The percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1 November 1 of the year prior to the measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year and whose most recent blood pressure is in control (<140/90 mmhg). This measure evaluates the percentage of patients in a specific age demographic who had a diagnosis of IVD and demonstrated adequate blood pressure management. IVD and related conditions had an estimated cost burden of $393.5 billion in 2005 (AHA 2005). Hypertension is a risk factor for IVD and cerebrovascular disease (CVD). Fifty million or more Americans have high blood pressure that warrants treatment, according to the NHANES survey (JNC-7, 2003). Additionally, high blood pressure and its complications cost the U.S. economy more than $100 billion each year (NHLBI, 2004). The USPSTF recommends that clinicians screen adults 18 and older for high blood pressure (2007). Better control of blood pressure has been shown to result in a significant reduction of the probability of undesirable and costly outcomes. This measure facilitates the long-term management of blood pressure levels for patients with IVD. MicroMD EMR Clinical Quality Measure Calculations Version

151 Denominator: **Patients in Age Range: >= 17 **who have condition of Acute Myocardial Infarction or Ischemic Vascular Disease recorded in their chart-(see code list) **Date Range: prior to the encounter date MedInfo>Medical>Problem List Encounter Assessment Medical History OR **Patient has had a CABG or PTCA (see code list) **Date Range: months prior to the end of the reporting period MedInfo>Histories>Surgical History MedInfo>Histories>Surgical Procedures NOTE Reporting will look at the CPT codes or Procedure names related to the surgery AND **Patient has had a CABG or PTCA (see code list) **Date Range: date admitted is months prior to the end of the reporting period MedInfo>Histories>Hospitalization History NOTE Reporting will look at the CPT codes or ICD codes related to the surgery or diagnosis of Acute Myocardial Infarction or Ischemic Vascular Disease AND **Who have had At least 1 encounters **Date Range: within the reporting period Numerator: Exclusions: **Patients whose blood pressure is documented during an acute inpatient or outpatient encounter (see code list) and is below recommendations: (Systolic <140 and Diastolic <90) **Date Range: in the reporting period NOTE Latest Vital Signs will be used for this measurement. None MicroMD EMR Clinical Quality Measure Calculations Version 7.5

152 Code Lists for Measure Encounter Level Outpatient Encounter Level Acute Inpatient 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, , 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, CABG CPT S2205, S2206, S2207, S2208, S2209, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, CABG-ICD 36.1, 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19, 36.2 CABG - Procedure Coronary Artery Bypass Graft (CABG) PTCA - CPT 33140, 92980, 92982, PTCA-ICD 00.66, 36.06, 36.07, PTCA - Procedure Ischemic Vascular Disease - ICD Percutaneous Transluminal Coronary Angioplasty (PTCA) , 411.0, 411.1, , , 413.0, 413.1, 413.9, , , , , , , , , 414.2, 414.8, 414.9, 429.2, 433.0, , , , , , , , , , , , , , , , , 440.1, , , , , , , 440.4, 444.0, 444.1, , , , , 444.9, , , 445.8, Acute MI ICD , , , , , , , , , NQF 0074 / PQRI 197 CORONARY ARTERY DISEASE: DRUG THERAPY FOR LOWERING LDL CHOLESTEROL (ALTERNATE) Description: Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed a lipid-lowering therapy (based on current ACC/AHA guidelines). MicroMD EMR Clinical Quality Measure Calculations Version

153 Clinical Rationale: Studies have demonstrated that active treatment with lipid-lowering therapy is associated with stabilization and regression of coronary atherosclerotic plaques and decreased incidence of clinical events. Recent clinical trials have further documented that LDL-lowering agents can decrease the risk of adverse ischemic events in patients with established CAD. Denominator: **Patients in Age Range: >= 18 **who have been seen at least 2 times (see code list) **Date Range: During the reporting period Encounters with Encounter Levels Outpatient or Nursing Facility AND **who have condition of Coronary Artery Disease includes MI recorded in their chart-(see code list) **Date Range: prior to the encounter date MedInfo>Medical>Problem List Entry Encounter Assessment OR **who have had Cardiac Surgery (see code list) **Date Range: Prior to the encounter Encounter Plan (performed) MedInfo>Histories>Surgical History MedInfo>Histories>Surgical Procedures MedInfo>Orders>Orders (completed) NOTE Reporting will look at the CPT codes or Procedure names related to the surgery. Numerator: **Patients who were prescribed Lipid Lowering Therapy (see code list) **Date Range: Prior to the end of the reporting period MedInfo>Medical>Medications Exclusions: **Patients whose last Lab Test Result for LDL <130 mg/dl (see code list) **Date Range: <= 1 year prior to the encounter OR **Patient has had a Medication Allergy to Lipid Lowering therapy (see code list) **Date Range: prior to encounter MicroMD EMR Clinical Quality Measure Calculations Version 7.5

154 Code Lists for Measure Encounter Level Outpatient Encounter Level Nursing Facility Coronary Artery Disease includes MI - ICD 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99305, 99306, 99307, 99308, 99309, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 411.0, 411.1, , , 412, 413.0, 413.1, 413.9, , , , , , , , , 414.8, 414.9, V45.81, V45.82 Cardiac Surgery - CPT 33140, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 92980, 92981, 92982, 92984, 92995, Cardiac Surgery - Procedure Coronary Artery Bypass Graft (CABG) Lab Result LDL (LOINC) , , , , , , , , ,2090-9, ,2092-5, , , , ,3046-0, , , , , Medications Lipid Lowering Therapy Advicor 1,000 mg-20 mg 24 hr Tab, Advicor 500 mg-20 mg 24 hr Tab, Advicor 750 mg-20 mg 24 hr Tab, Altoprev 60 mg 24 hr Tab, amlodipineatorvastatin 10 mg-10 mg Tab, amlodipine-atorvastatin 10 mg-20 mg Tab, amlodipine-atorvastatin 10 mg-40 mg Tab, amlodipine-atorvastatin 10 mg- 80 mg Tab, amlodipine-atorvastatin 2.5 mg-10 mg Tab, amlodipineatorvastatin 2.5 mg-20 mg Tab, amlodipine-atorvastatin 2.5 mg-40 mg Tab, amlodipine-atorvastatin 5 mg-10 mg Tab, amlodipine-atorvastatin 5 mg-20 mg Tab, amlodipine-atorvastatin 5 mg-40 mg Tab, amlodipineatorvastatin 5 mg-80 mg Tab, Antara 130 mg Cap, Antara 43 mg Cap, atorvastatin 10 mg Tab, atorvastatin 20 mg Tab, atorvastatin 40 mg Tab, atorvastatin 80 mg Tab, Atromid-S 500 mg Cap, B-3 Niacin 100 mg Tab, B- 3 Niacin ER 500 mg Tab, B mg Tab, B3-500-GR 500 mg Tab, Caduet 10 mg-10 mg Tab, Caduet 10 mg-20 mg Tab, Caduet 10 mg-40 mg Tab, Caduet 10 mg-80 mg Tab, Caduet 2.5 mg-10 mg Tab, Caduet 2.5 mg- 20 mg Tab, Caduet 2.5 mg-40 mg Tab, Caduet 5 mg-10 mg Tab, Caduet 5 mg-20 mg Tab, Caduet 5 mg-40 mg Tab, Caduet 5 mg-80 mg Tab, Cholestyramine Light 4 gram Oral Powder, Cholestyramine Light 4 gram Packet, Cholestyramine Susp Light 4 gram Packet, cholestyramineaspartame 4 gram Oral Powder, cholestyramine-aspartame 4 gram Packet, cholestyramine-sucrose 4 gram Oral Powder, cholestyramine-sucrose 4 gram Packet, clofibrate 500 mg Cap, colesevelam 625 mg Tab, Crestor 10 MicroMD EMR Clinical Quality Measure Calculations Version

155 mg Tab, Crestor 20 mg Tab, Crestor 40 mg Tab, Crestor 5 mg Tab, Endur- Acin 500 mg Tab, ezetimibe 10 mg Tab, ezetimibe-simvastatin 10 mg-10 mg Tab, ezetimibe-simvastatin 10 mg-20 mg Tab, ezetimibe-simvastatin 10 mg-40 mg Tab, ezetimibe-simvastatin 10 mg-80 mg Tab, fenofibrate 160 mg Tab, fenofibrate 54 mg Tab, fenofibrate micronized 130 mg Cap, fenofibrate micronized 134 mg Cap, fenofibrate micronized 160 mg Tab, fenofibrate micronized 200 mg Cap, fenofibrate micronized 43 mg Cap, fenofibrate micronized 67 mg Cap, fenofibrate nanocrystallized 145 mg Tab, fenofibrate nanocrystallized 160 mg Tab, fenofibrate nanocrystallized 48 mg Tab, fenofibrate nanocrystallized 50 mg Tab, fluvastatin 20 mg Cap, fluvastatin 40 mg Cap, fluvastatin ER 80 mg 24 hr Tab, Gemcor 600 mg Tab, gemfibrozil 600 mg Tab, inositol niacinate 500 mg Cap, Lescol 20 mg Cap, Lescol 40 mg Cap, Lescol XL 80 mg 24 hr Tab, Lipitor 10 mg Tab, Lipitor 20 mg Tab, Lipitor 40 mg Tab, Lipitor 80 mg Tab, LoCholest 4 gram Oral Packet, LoCholest 4 gram Oral Powder, LoCholest Light 4 gram Oral Packet, Lofibra 134 mg Cap, Lofibra 160 mg Tab, Lofibra 200 mg Cap, Lofibra 54 mg Tab, Lofibra 67 mg Cap, Lopid 600 mg Tab, lovastatin 10 mg Tab, lovastatin 20 mg Tab, lovastatin 40 mg Tab, lovastatin ER 60 mg 24 hr Tab, Mevacor 10 mg Tab, Mevacor 20 mg Tab, Mevacor 40 mg Tab, Na mg Cap, Nb3 500 mg Tab, Nia-Bid 400 mg Cap, Niac 400 mg Cap, Niacels 400 mg Cap, niacin 100 mg Tab, niacin 250 mg Tab, niacin 50 mg Tab, niacin 500 mg Tab, niacin ER 1,000 mg Tab, niacin ER 125 mg Cap, niacin ER 250 mg Cap, niacin ER 400 mg Cap, niacin ER 500 mg Cap, niacin ER 500 mg Tab, niacin ER 750 mg Tab, niacin-lovastatin ER 1,000 mg-20 mg multiphase 24 hr Tab, niacin-lovastatin ER 500 mg-20 mg multiphase 24 hr Tab, niacin-lovastatin ER 750 mg-20 mg multiphase 24 hr Tab, Niacin-Time 500 mg Tab, Niacinol 500 mg Cap, Niacor 500 mg Tab, Niacor B3 500 mg Tab, NiaDelay 500 mg Tab, Niaplus 400 mg Cap, Niatab 500 mg, Nico mg Cap, Nico-Span 400 mg Cap, Nicobid 125 mg Cap, Nicobid 250 mg Cap, Nicobid 500 mg Cap, Nicocap 400 mg, Nicolar 500 mg Tab, Nicotinic Acid 100 mg Tab, Nicotinic Acid 250 mg Cap, Nicotinic Acid 500 mg Cap, Nicotym 400 mg Cap, Prevalite 4 gram Oral Packet, Prevalite 4 gram Oral Powder, Questran 4 gram Oral Powder, Questran 4 gram Packet, Questran Light 4 gram Oral Powder, Questran Light 4 gram Packet, Ridicin 100 mg Tab, Ridicin 50 mg Tab, rosuvastatin 10 mg Tab, rosuvastatin 20 mg Tab, rosuvastatin 40 mg Tab, rosuvastatin 5 mg Tab, simvastatin 10 mg Tab, simvastatin 20 mg Tab, simvastatin 40 mg Tab, simvastatin 5 mg Tab, simvastatin 80 mg Tab, Slo-Niacin 500 mg Tab, Slo-Niacin 750 mg Tab, Tega Span mg Cap, Tega Span mg Cap, Tega Span mg Cap, Tega-Span 400 mg Cap, Tricor 134 mg Cap, Tricor 145 mg Tab, Tricor 160 mg Tab, Tricor 200 mg Cap, Tricor 48 mg Tab, Tricor 67 mg Cap, Triglide 160 mg Tab, Triglide 50 mg Tab, Vytorin mg-10 mg Tab, Vytorin mg-20 mg Tab, Vytorin mg-40 mg Tab, Vytorin mg-80 mg Tab, WelChol MicroMD EMR Clinical Quality Measure Calculations Version 7.5

156 mg Tab, Zetia 10 mg Tab, Zocor 10 mg Tab, Zocor 20 mg Tab, Zocor 40 mg Tab, Zocor 5 mg Tab, Zocor 80 mg Tab NQF 0075 ISCHEMIC VASCULAR DISEASE: COMPLETE LIPID PANEL AND LDL CONTROL (ALTERNATE) Field Description: Clinical Rationale: Description The percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from January 1 November 1 of the year prior to the measurement year, or who had a diagnosis of ischemic vascular disease (IVD) during the measurement year and the year prior to the measurement year and who had a complete lipid profile performed during the measurement year and whose LDL- C was <100 mg/dl. This measure evaluates the percentage of patients in a specific age demographic who had a diagnosis of IVD and demonstrated adequate LDL cholesterol management. IVD and related conditions had an estimated cost burden of $393.5 billion in 2005 (AHA 2005). From and from , adults 20 and older demonstrated lower age-adjusted total serum cholesterol levels (Carroll 2005), but there is significant room for improvement. Literature reviews and clinical guidelines advise that individuals with coronary artery disease can reduce their risk of subsequent morbidity and premature mortality by managing their cholesterol level through limitations on dietary fat and cholesterol, or in certain cases, through cholesterol lowering medications. A 10% decline in total cholesterol levels (population-wide) can result in a nearly 30% reduction in the incidence of CHD (CDC 2000). This measure facilitates the long-term management of LDL cholesterol levels for patients with IVD MicroMD EMR Clinical Quality Measure Calculations Version

157 Field Description Denominator: **Patients in Age Range: >= 17 **who have condition of Acute Myocardial Infarction or Ischemic Vascular Disease recorded in their chart-(see code list) **Date Range: prior to the encounter date MedInfo>Medical>Problem List Encounter Assessment Medical History OR **Patient has had a CABG or PTCA (see code list) **Date Range: months prior to the end of the reporting period MedInfo>Histories>Surgical History MedInfo>Histories>Surgical Procedures NOTE Reporting will look at the CPT codes or Procedure names related to the surgery AND **Patient has had a CABG or PTCA (see code list) **Date Range: date admitted is months prior to the end of the reporting period MedInfo>Histories>Hospitalization History NOTE Reporting will look at the CPT codes or ICD codes related to the surgery or diagnosis of Acute Myocardial Infarction or Ischemic Vascular Disease AND **Who have had At least 1 encounters **Date Range: within the reporting period Numerator: Numerator 1 **Patients who had an LDL Test or combination of HDL, Total Cholesterol and Triglycerides (see code list) **Date Range: within the reporting period MedInfo>Medical>Lab Result MicroMD EMR Clinical Quality Measure Calculations Version 7.5

158 Field Exclusions: Description Numerator 2 **Most Recent LDL Test Result <100 **Date Range: within the reporting period OR ** Most Recent Lab Result for Triglycerides <400 and ** Most Recent Lab Result for Total Cholesterol (-) Most Recent Lab Result for HDL (-) Most Recent Lab Result for Triglycerides (*/* 5) = <100 **Date Range: None within the reporting period Code Lists for Measure Acute MI ICD , , , , , , , , , Ischemic Vascular Disease ICD , 411.0, 411.1, , , 413.0, 413.1, 413.9, , , , , , , , , 414.2, 414.8, 414.9, 429.2, 433.0, , , , , , , , , , , , , , , , , 440.1, , , , , , , 440.4, 444.0, 444.1, , , , , 444.9, , , 445.8, CABG CPT 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, S2205, S2206, S2207, S2208, S2209 CABG ICD 36.1, 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19, 36.2 CABG - Procedure Coronary Artery Bypass Graft (CABG) PTCA CPT 33140, 92980, 92982, PTCA ICD 00.66, 36.06, 36.07, PTCA - Procedure Percutaneous Transluminal Coronary Angioplasty (PTCA) LDL CPT 80061, 83700, 83701, 83704, LDL LOINC , , , , , , , , Total Cholesterol CPT Total Cholesterol - LOINC , Triglycerides CPT MicroMD EMR Clinical Quality Measure Calculations Version

159 Triglycerides LOINC , , , HDL CPT HDL- LOINC , , NQF 0081 / PQRI 5 HEART FAILURE: ACE INHIBITOR OR ARB THERAPY FOR LVSD (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 18 years and older with a diagnosis of heart failure and LVSD (LVEF < 40%) who were prescribed ACE inhibitor or ARB therapy. LVSD: Left Ventricular Systolic Dysfunction LVEF: Left Ventricular Ejection Fraction In the absence of contraindications, ACE Inhibitors or ARBs are recommended for all patients with symptoms of heart failure and reduced left ventricular systolic function, as measured by left ventricular ejection fraction (LVEF). Both drugs have been shown to decrease mortality and hospitalizations. Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD). Denominator: **Patients in Age Range: >= 18 **who have condition of Heart Failure recorded in their chart-(see code list) **Date Range: prior to or on the encounter date MedInfo>Medical>Problem List MedInfo>Histories>Medical History Encounter with an Assessment AND **who have at least 1 encounters (see code list) **Date Range: within the reporting period Encounter Levels Inpatient Discharge (CPT codes) MedInfo>Histories>Hospitalization History (ICD codes of Heart Failure) OR **who have at least 2 encounters (see code list) **Date Range: within the reporting period Encounter Levels Outpatient or Nursing Facility MicroMD EMR Clinical Quality Measure Calculations Version 7.5

160 AND **have had a LVF assessment (see code list) with result <40 **Date Range: before or during encounter MedInfo> Medical> Diagnostic Test Numerator: Exclusions: **Patients who have been prescribed an Ace Inhibitor or ARB **Date Range: within the reporting period MedInfo>Medical>Medications **Patients who have a Medication Allergy to Ace Inhibitor or ARB documented (see code list) **Date Range: prior to or on the encounter date MedInfo>Medical>Allergies OR Medication Intolerance event to ACE Inhibitor or ARB (Medication termination code is not null and begin date <= encounter date) (see code list) MedInfo>Medical>Medications>Long term medication has been terminated with a reason Code Lists for Measure Encounter Level Outpatient OR **Patients who have an active diagnosis of Active Pregnancy, Deficiencies of circulating enzymes, Non-Rheumatic Mitral (valve) disease, Chronic Kidney Disease with and without hypertension, Hypertensive renal disease with renal failure, Atherosclerosis of renal artery, renal failure and ESRD, Acute renal failure, Atresia and Stenosis of aorta. (see code list) **Date Range: prior to or on the encounter date Encounter Assessment MedInfo>Medical>Problem List MedInfo>Histories>Hospitalization History MedInfo>Histories>Medical History 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, Encounter Level Nursing 99304, 99305, 99306, 99307, 99308, 99309, MicroMD EMR Clinical Quality Measure Calculations Version

161 Facility Encounter Level Inpatient Discharge 99238, Heart Failure - ICD , , , , , , , , , 428.0, 428.1, , , , , , , , , , , , , LVF Assessment Diagnostic Test - CPT 78414, 78451, 78452, 78453, 78454, 78468, 78472, 78473, 78481, 78483, 78494, 78496, 93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93350, 93351, 93352, Active Pregnancy - ICD , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , MicroMD EMR Clinical Quality Measure Calculations Version 7.5

162 Deficiencies of circulating enzymes - ICD Disease of Aortic and Mitral Valves - ICD Atherosclerosis of Renal Artery ICD , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , V22.2, V23.0, V23.1, V23.2, V23.3, V23.4, V23.41, V23.49, V23.5, V23.7, V , 395.2, 396.0, 396.2, Renal failure and ESRD , 584.6, 584.7, 584.8, 584.9, 585.5, 585.6, 586, MicroMD EMR Clinical Quality Measure Calculations Version

163 ICD Acute Renal Failure ICD 584.5, 584.6, 584.7, 584.8, Atresia and Stenosis of Aorta ICD Hypertensive renal disease with renal failure ICD Non-rheumatic Mitral (valve) disease - ICD Chronic Kidney Disease with and without Hypertension - ICD Medications ACE Inhibitor or ARB 440.0, , , , , , , , , , , , , , , , , Accupril 10 mg Tab, Accupril 20 mg Tab, Accupril 40 mg Tab, Accupril 5 mg Tab, Accuretic 10 mg-12.5 mg Tab, Accuretic 20 mg-12.5 mg Tab, Accuretic 20 mg-25 mg Tab, Aceon 2 mg Tab, Aceon 4 mg Tab, Aceon 8 mg Tab, Altace 1.25 mg Cap, Altace 10 mg Cap, Altace 2.5 mg Cap, Altace 5 mg Cap, Atacand 16 mg Tab, Atacand 32 mg Tab, Atacand 4 mg Tab, Atacand 8 mg Tab, Atacand HCT 16 mg-12.5 mg Tab, Atacand HCT 32 mg mg Tab, Avalide 150 mg-12.5 mg Tab, Avalide 300 mg-12.5 mg Tab, Avalide 300 mg-25 mg Tab, Avapro 150 mg Tab, Avapro 300 mg Tab, Avapro 75 mg Tab, Benicar 20 mg Tab, Benicar 40 mg Tab, Benicar 5 mg Tab, Benicar HCT 20 mg-12.5 mg Tab, Benicar HCT 40 mg-12.5 mg Tab, Benicar HCT 40 mg-25 mg Tab, candesartan 16 mg Tab, candesartan 32 mg Tab, candesartan 4 mg Tab, candesartan 8 mg Tab, candesartanhydrochlorothiazide 16 mg-12.5 mg Tab, candesartan-hydrochlorothiazide 32 mg-12.5 mg Tab, Capoten 100 mg Tab, Capoten 12.5 mg Tab, Capoten 25 mg Tab, Capoten 50 mg Tab, Capozide 25 mg-15 mg Tab, Capozide 25 mg-25 mg Tab, Capozide 50 mg-15 mg Tab, Capozide 50 mg-25 mg Tab, captopril 100 mg Tab, captopril 12.5 mg Tab, captopril 25 mg Tab, captopril 50 mg Tab, captopril-hydrochlorothiazide 25 mg-15 mg Tab, captopril-hydrochlorothiazide 25 mg-25 mg Tab, captoprilhydrochlorothiazide 50 mg-15 mg Tab, captopril-hydrochlorothiazide 50 mg-25 mg Tab, Diovan 160 mg Cap, Diovan 160 mg Tab, Diovan 320 mg Tab, Diovan 40 mg Tab, Diovan 80 mg Cap, Diovan 80 mg Tab, Diovan HCT 160 mg-12.5 mg Tab, Diovan HCT 160 mg-25 mg Tab, Diovan HCT 80 mg-12.5 mg Tab, enalapril maleate 10 mg Tab, enalapril maleate 2.5 mg Tab, enalapril maleate 20 mg Tab, enalapril maleate 5 mg Tab, enalapril maleate-felodipine ER 5 mg-5 mg Tab, enalapril-hydrochlorothiazide 10 mg-25 mg Tab, enalapril-hydrochlorothiazide 5 mg-12.5 mg Tab, enalaprilat 1.25 mg/ml IV, enalaprilat 1.25 mg/ml IV Syringe, eprosartan 400 mg Tab, eprosartan 600 mg Tab, eprosartan-hydrochlorothiazide 600 mg-12.5 mg Tab, fosinopril 10 mg Tab, fosinopril 20 mg Tab, fosinopril 40 mg Tab, fosinopril-hydrochlorothiazide 10 mg-12.5 mg Tab, fosinopril MicroMD EMR Clinical Quality Measure Calculations Version 7.5

164 hydrochlorothiazide 20 mg-12.5 mg Tab, irbesartan 150 mg Tab, irbesartan 300 mg Tab, irbesartan 75 mg Tab, irbesartan-hydrochlorothiazide 150 mg mg Tab, irbesartan-hydrochlorothiazide 300 mg-12.5 mg Tab, irbesartan-hydrochlorothiazide 300 mg-25 mg Tab, Lexxel 5 mg-5 mg Tab, lisinopril 10 mg Tab, lisinopril 2.5 mg Tab, lisinopril 20 mg Tab, lisinopril 30 mg Tab, lisinopril 40 mg Tab, lisinopril 5 mg Tab, lisinoprilhydrochlorothiazide 10 mg-12.5 mg Tab, lisinopril-hydrochlorothiazide 20 mg-12.5 mg Tab, lisinopril-hydrochlorothiazide 20 mg-25 mg Tab, Mavik 1 mg Tab, Mavik 2 mg Tab, Mavik 4 mg Tab, Micardis 20 mg Tab, Micardis 40 mg Tab, Micardis 80 mg Tab, Micardis HCT 40 mg-12.5 mg Tab, Micardis HCT 80 mg-12.5 mg Tab, Micardis HCT 80 mg-25 mg Tab, moexipril 15 mg Tab, moexipril 7.5 mg Tab, moexipril-hydrochlorothiazide 15 mg-12.5 mg Tab, moexipril-hydrochlorothiazide 15 mg-25 mg Tab, moexipril-hydrochlorothiazide 7.5 mg-12.5 mg Tab, Monopril 10 mg Tab, Monopril 20 mg Tab, Monopril 40 mg Tab, Monopril HCT 10 mg-12.5 mg Tab, Monopril HCT 20 mg-12.5 mg Tab, olmesartan 20 mg Tab, olmesartan 40 mg Tab, olmesartan 5 mg Tab, olmesartan-hydrochlorothiazide 20 mg mg Tab, olmesartan-hydrochlorothiazide 40 mg-12.5 mg Tab, olmesartan-hydrochlorothiazide 40 mg-25 mg Tab, perindopril erbumine 2 mg Tab, perindopril erbumine 4 mg Tab, perindopril erbumine 8 mg Tab, Prinivil 10 mg Tab, Prinivil 2.5 mg Tab, Prinivil 20 mg Tab, Prinivil 40 mg Tab, Prinivil 5 mg Tab, Prinzide 10 mg-12.5 mg Tab, Prinzide 20 mg-12.5 mg Tab, Prinzide 20 mg-25 mg Tab, quinapril 10 mg Tab, quinapril 20 mg Tab, quinapril 40 mg Tab, quinapril 5 mg Tab, quinapril-hydrochlorothiazide 10 mg-12.5 mg Tab, quinapril-hydrochlorothiazide 20 mg-12.5 mg Tab, quinapril-hydrochlorothiazide 20 mg-25 mg Tab, ramipril 1.25 mg Cap, ramipril 10 mg Cap, ramipril 2.5 mg Cap, ramipril 5 mg Cap, telmisartan 20 mg Tab, telmisartan 40 mg Tab, telmisartan 80 mg Tab, telmisartanhydrochlorothiazide 40 mg-12.5 mg Tab, telmisartan-hydrochlorothiazide 80 mg-12.5 mg Tab, telmisartan-hydrochlorothiazide 80 mg-25 mg Tab, Teveten 400 mg Tab, Teveten 600 mg Tab, Teveten HCT 600 mg-12.5 mg Tab, trandolapril 1 mg Tab, trandolapril 2 mg Tab, trandolapril 4 mg Tab, Uniretic 15 mg-12.5 mg Tab, Uniretic 15 mg-25 mg Tab, Uniretic 7.5 mg mg Tab, Univasc 15 mg Tab, Univasc 7.5 mg Tab, valsartan 160 mg Cap, valsartan 160 mg Tab, valsartan 320 mg Tab, valsartan 40 mg Tab, valsartan 80 mg Cap, valsartan 80 mg Tab, valsartan-hydrochlorothiazide 160 mg-12.5 mg Tab, valsartan-hydrochlorothiazide 160 mg-25 mg Tab, valsartan-hydrochlorothiazide 80 mg-12.5 mg Tab, Vaseretic 10 mg-25 mg Tab, Vaseretic 5 mg-12.5 mg Tab, Vasotec 1.25 mg/ml IV, Vasotec 10 mg Tab, Vasotec 2.5 mg Tab, Vasotec 20 mg Tab, Vasotec 5 mg Tab, Zestoretic 10 mg-12.5 mg Tab, Zestoretic 20 mg-12.5 mg Tab, Zestoretic 20 mg-25 mg Tab, Zestril 10 mg Tab, Zestril 2.5 mg Tab, Zestril 20 mg Tab, Zestril 30 mg Tab, Zestril 40 mg Tab, Zestril 5 mg Tab MicroMD EMR Clinical Quality Measure Calculations Version

165 NQF 0083 / PQRI 8 HEART FAILURE: BETA BLOCKER THERAPY FOR LVSD (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 18 years and older with a diagnosis of heart failure who also have LVSD (LVEF < 40%) and who were prescribed beta-blocker therapy. Beta-blockers are recommended for all patients with symptoms of heart failure and left ventricular systolic dysfunction, unless contraindicated. Treatment with beta-blockers has been shown to provide multiple benefits to the patient, including reducing the symptoms of heart failure, improving the clinical status of patients, and decreasing the risk of mortality and hospitalizations.. Denominator: **Patients in Age Range: >= 18 **who have condition of Heart Failure recorded in their chart-(see code list) **Date Range: within the reporting period MedInfo>Medical>Problem List MedInfo>Histories>Medical History Encounter with an Assessment AND **who have been seen at least 2 times during the reporting period (see code list) **Date Range: After the date of Heart Failure diagnosis (above) and within the reporting period Encounter Levels Inpatient Discharge, Outpatient or Nursing Facility AND **have had a LVF assessment (see code list) with result <40 **Date Range: before or during encounter MedInfo> Medical> Diagnostic Test Numerator: **Patients who have been prescribed a Beta Blocker **Date Range: prior to the end of the reporting period MedInfo>Medical>Medications MicroMD EMR Clinical Quality Measure Calculations Version 7.5

166 Exclusions: **Patients with conditions of Arrhythmia, Hypotension, Asthma, Bradycardia, (see code list) **Date Range: prior to encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List MedInfo>Histories>Hospitalization History OR **Patients with condition Atrioventricular block (see code list) **Date Range: prior to encounter date and current status is active with status date <= encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List MedInfo>Histories>Hospitalization History **And do not have a pacemaker which includes : **Patients with condition Cardiac Pacer in Situ or Cardiac Pacer(see code list) **Date Range: prior to encounter date and current status is active with status date <= encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List MedInfo>Histories>Hospitalization History OR And do not have a pacemaker which includes **Patient does not have evidence of a Cardiac Pacer (see code list) **Date Range: prior to the encounter Encounter Plan (performed) MedInfo>Histories>Hospitalization History MedInfo>Histories>Surgical History MedInfo>Orders>Orders Completed OR **Patient has a documented Medication Allergy to Beta Blockers (see code list) **Date Range: prior to the encounter date MedInfo>Medical>Allergies MicroMD EMR Clinical Quality Measure Calculations Version

167 Code Lists for Measure Encounter Level Outpatient Encounter Level Nursing Facility 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99305, 99306, 99307, 99308, 99309, Heart Failure - ICD , , , , , , , , , 428.0, 428.1, , , , , , , , , , , , , LVF Assessment Diagnostic Test - CPT Arryhythmia ICD , , 78451, 78452, 78453, 78454, 78468, 78472, 78473, 78481, 78483, 78494, 78496, 93303, 93304, 93306, 93307, 93308, 93312, 93313, 93314, 93315, 93316, 93317, 93350, 93351, 93352, Hypotension - ICD 458.0, 458.1, , , 458.8, Asthma - ICD , , , , , , , , , , , , , Bradycardia ICD , , Atrioventricular Block ICD Cardiac Pacer in Situ ICD Medications BETA Blocker 426.0, , V45.01 atenolol 100 mg Tab, atenolol 25 mg Tab, atenolol 5 mg/10 ml IV, atenolol 50 mg Tab, atenolol-chlorthalidone 100 mg-25 mg Tab, atenolol-chlorthalidone 50 mg-25 mg Tab, Betachron 120 mg 24 hr Cap, Betachron 160 mg 24 hr Cap, Betachron 60 mg 24 hr Cap, Betachron 80 mg 24 hr Cap, betaxolol 10 mg Tab, betaxolol 20 mg Tab, bisoprolol fumarate 10 mg Tab, bisoprolol fumarate 5 mg Tab, bisoprolol-hydrochlorothiazide 10 mg-6.25 mg Tab, bisoprolol-hydrochlorothiazide 2.5 mg-6.25 mg Tab, bisoprololhydrochlorothiazide 5 mg-6.25 mg Tab, Blocadren 10 mg Tab, Blocadren 20 mg Tab, Blocadren 5 mg Tab, carvedilol 12.5 mg Tab, carvedilol 25 mg Tab, carvedilol mg Tab, carvedilol 6.25 mg Tab, Coreg 12.5 mg Tab, Coreg 25 mg Tab, Coreg mg Tab, Coreg 6.25 mg Tab, Corgard 120 mg Tab, Corgard 160 mg Tab, Corgard 20 mg Tab, Corgard 40 mg Tab, Corgard 80 mg Tab, Corzide 40 mg-5 mg Tab, Corzide 80 mg-5 mg Tab, Inderal 1 mg/ml IV, Inderal 10 mg Tab, Inderal 20 mg Tab, Inderal 40 mg Tab, Inderal 60 mg Tab, Inderal 80 mg Tab, Inderal 90 mg Tab, Inderal LA 120 mg 24 hr Cap, Inderal LA 160 mg 24 hr Cap, Inderal LA 60 mg 24 hr Cap, Inderal LA 80 mg 24 hr Cap, Inderide 40 mg-25 mg Tab, Inderide 80 mg-25 mg Tab, Inderide-40/ MicroMD EMR Clinical Quality Measure Calculations Version 7.5

168 40 mg-25 mg Tab, Inderide-80/25 80 mg-25 mg Tab, InnoPran XL 120 mg 24 hr Cap, InnoPran XL 80 mg 24 hr Cap, Kerlone 10 mg Tab, Kerlone 20 mg Tab, labetalol 100 mg Tab, labetalol 200 mg Tab, labetalol 25 mg/5 ml (5 mg/ml) IV Syringe, labetalol 300 mg Tab, labetalol 5 mg/ml IV, labetalol 5 mg/ml IV Syringe, Levatol 20 mg Tab, Lopressor 100 mg Tab, Lopressor 5 mg/5 ml IV, Lopressor 5 mg/5 ml IV Syringe, Lopressor 50 mg Tab, Lopressor HCT 100 mg- 25 mg Tab, Lopressor HCT 100 mg-50 mg Tab, Lopressor HCT 50 mg-25 mg Tab, Lorol 40 mg Tab, metoprolol 5 mg/5 ml IV, metoprolol 5 mg/5 ml IV Cartridge, metoprolol 5 mg/5 ml IV Syringe, metoprolol succinate ER 100 mg 24 hr Tab, metoprolol succinate ER 200 mg 24 hr Tab, metoprolol succinate ER 25 mg 24 hr Tab, metoprolol succinate ER 50 mg 24 hr Tab, metoprolol tartrate 100 mg Tab, metoprolol tartrate 25 mg Tab, metoprolol tartrate 50 mg Tab, metoprolol-hydrochlorothiazide 100 mg-25 mg Tab, metoprololhydrochlorothiazide 100 mg-50 mg Tab, metoprolol-hydrochlorothiazide 50 mg-25 mg Tab, nadolol 120 mg Tab, nadolol 160 mg Tab, nadolol 20 mg Tab, nadolol 40 mg Tab, nadolol 80 mg Tab, nadolol-bendroflumethiazide 40 mg-5 mg Tab, nadolol-bendroflumethiazide 80 mg-5 mg Tab, Normodyne 100 mg Tab, Normodyne 200 mg Tab, Normodyne 300 mg Tab, Normodyne 5 mg/ml IV, Normodyne 5 mg/ml IV Syringe, penbutolol 20 mg Tab, pindolol 10 mg Tab, pindolol 5 mg Tab, Procard 10 mg Tab, Procard 20 mg Tab, Procard 40 mg Tab, Pronol 10 mg Tab, Pronol 20 mg Tab, Pronol 40 mg Tab, Pronol 80 mg Tab, propranolol 1 mg/ml IV, propranolol 1 mg/ml IV Syringe, propranolol 10 mg Tab, propranolol 20 mg Tab, propranolol 20 mg/5 ml Oral Soln, propranolol 40 mg Tab, propranolol 40 mg/5 ml Oral Soln, propranolol 60 mg Tab, propranolol 80 mg Tab, propranolol 80 mg/ml Oral Drops, propranolol 90 mg Tab, propranolol ER 120 mg 24 hr Cap, propranolol ER 120 mg 24 hr Cap extended release, propranolol ER 160 mg 24 hr Cap extended release, propranolol ER 60 mg 24 hr Cap extended release, propranolol ER 80 mg 24 hr Cap, propranolol ER 80 mg 24 hr Cap extended release, propranololhydrochlorothiazide 40 mg-25 mg Tab, propranolol-hydrochlorothiazide 80 mg-25 mg Tab, Senormin 50 mg Tab, Tenoretic mg-25 mg Tab, Tenoretic mg-25 mg Tab, Tenormin 100 mg Tab, Tenormin 25 mg Tab, Tenormin 5 mg/10 ml IV, Tenormin 50 mg Tab, Tenormin Calendar Pak 50 mg Tab, timolol 10 mg Tab, timolol 20 mg Tab, timolol 5 mg Tab, Toprol XL 100 mg 24 hr Tab, Toprol XL 200 mg 24 hr Tab, Toprol XL 25 mg 24 hr Tab, Toprol XL 50 mg 24 hr Tab, Trandate 100 mg Tab, Trandate 200 mg Tab, Trandate 300 mg Tab, Trandate 5 mg/ml IV, Trandate 5 mg/ml IV Syringe, Visken 10 mg Tab, Visken 5 mg Tab, Zebeta 10 mg Tab, Zebeta 5 mg Tab, Ziac 10 mg mg Tab, Ziac 2.5 mg-6.25 mg Tab, Ziac 5 mg-6.25 mg Tab MicroMD EMR Clinical Quality Measure Calculations Version

169 NQF 0084 / PQRI 200 HEART FAILURE: WARFARIN THERAPY FOR PATIENTS WITH ATRIAL FIB (ALTERNATE) Description: Clinical Rationale: Percentage of patients aged 18 years and older with a diagnosis of heart failure and LVSD (LVEF < 40%) who were prescribed ACE inhibitor or ARB therapy. LVSD: Left Ventricular Systolic Dysfunction LVEF: Left Ventricular Ejection Fraction In the absence of contraindications, ACE Inhibitors or ARBs are recommended for all patients with symptoms of heart failure and reduced left ventricular systolic function, as measured by left ventricular ejection fraction (LVEF). Both drugs have been shown to decrease mortality and hospitalizations. Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD). Denominator: **Patients in Age Range: >= 18 **who have condition of Heart Failure and Atrial Fibrillation recorded in their chart-(see code list) **Date Range: prior to the encounter MedInfo>Medical>Problem List MedInfo>Histories>Medical History MedInfo>Histories>Hospitalization History MedInfo>Histories>Surgical Procedure Encounter Assessment **who have been seen at least 2 times during the reporting period (see code list) **Date Range: After the date of Heart Failure diagnosis (above) and within the reporting period Encounter Levels Outpatient or Nursing Facility Numerator: **Patients who have been prescribed Warfarin therapy (see code list) **Date Range: prior to the end of reporting period MedInfo>Medical>Medications MicroMD EMR Clinical Quality Measure Calculations Version 7.5

170 Exclusions: **Patients with conditions of anemias and bleeding disorders, esophageal and GI bleed, Intracranial hemorrhage, leukemias / myeloproliferative disorders, hematuria, hemoptysis, hemorrhage, liver disorders. (see code lists) **Date Range: prior to encounter date Encounter Assessment MedInfo>Histories>Medical History MedInfo>Medical>Problem List OR **Patients who have a Medication Allergy to Warfarin therapy (see code list) **Date Range: prescribed prior to the encounter date MedInfo>Medical>Allergies Code Lists for Measure Encounter Level Outpatient Encounter Level Nursing Facility 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, , 99305, 99306, 99307, 99308, 99309, Heart Failure - ICD , , , , , , , , , 428.0, 428.1, , , , , , , , , , , , , Atrial Fibrillation - ICD Anemias and Bleeding Disorders - ICD 280.0, 280.9, 285.1, 286.0, 286.1, 286.2, 286.3, 286.4, 286.5, 286.6, 286.7, 286.9, , , , , , 287.4, , , Esophageal and GI Bleed - ICD Intracranial Hemorrhage - ICD 530.7, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 569.3, 578.0, 578.1, , 431, 432.0, 432.1, 432.9, MicroMD EMR Clinical Quality Measure Calculations Version

171 Leukemias/ Myeloproliferative Disorders - ICD Hematuria - ICD Hemoptysis - ICD 786.3, , Hemorrhage - ICD Liver Disorders - ICD 570, 571.2, Medication Warfarin Therapy , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Athrombin-K 5 mg Tab, Coufarin 10 mg Tab, Coufarin 2 mg Tab, Coufarin 2.5 mg Tab, Coufarin 5 mg Tab, Coufarin 7.5 mg Tab, Coumadin 1 mg Tab, Coumadin 10 mg Tab, Coumadin 2 mg Tab, Coumadin 2.5 mg Tab, Coumadin 3 mg Tab, Coumadin 4 mg Tab, Coumadin 5 mg IV Solution, Coumadin 5 mg Tab, Coumadin 6 mg Tab, Coumadin 7.5 mg Tab, Jantoven 1 mg Tab, Jantoven 10 mg Tab, Jantoven 2 mg Tab, Jantoven 2.5 mg Tab, Jantoven 3 mg Tab, Jantoven 4 mg Tab, Jantoven 5 mg Tab, Jantoven 6 mg Tab, Jantoven 7.5 mg Tab, Panwarfin 10 mg Tab, Panwarfin 2 mg Tab, Panwarfin 2.5 mg Tab, Panwarfin 5 mg Tab, Panwarfin 7.5 mg Tab, Sofarin 2 mg Tab, Sofarin 2.5 mg Tab, Sofarin 5 mg Tab, warfarin 1 mg Tab, warfarin 10 mg Tab, warfarin 2 mg Tab, warfarin 2.5 mg Tab, warfarin 3 mg Tab, warfarin 4 mg Tab, warfarin 5 mg IV Solution, warfarin 5 mg Tab, warfarin 6 mg Tab, warfarin 7.5 mg Tab NQF 0086 / PQRI 12 PRIMARY OPEN ANGLE GLAUCOMA: OPTIC NERVE EVALUATION (NOT SUPPORTED) Description: Clinical Rationale: Denominator: Numerator: Exclusions: This measure is not supported or calculated by MicroMD EMR. Intentionally left blank. Intentionally left blank. Intentionally left blank. Intentionally left blank MicroMD EMR Clinical Quality Measure Calculations Version 7.5

172 NQF 0088 / PQRI 18 DIABETIC RETINOPATHY DOCUMENTATION OF PRESENCE OF MACULAR EDEMA AND LEVEL OF SEVERITY RETINOPATHY (NOT SUPPORTED) Description: Clinical Rationale: Denominator: Numerator: Exclusions: This measure is not supported or calculated by MicroMD EMR. Intentionally left blank. Intentionally left blank. Intentionally left blank. Intentionally left blank. NQF 0089 / PQRI 19 DIABETIC RETINOPATHY COMMUNICATING WITH THE PHYSICIAN MANAGING ONGOING DIABETES CARE. (NOT SUPPORTED) Description: Clinical Rationale: Denominator: Numerator: Exclusions: This measure is not supported or calculated by MicroMD EMR. Intentionally left blank. Intentionally left blank. Intentionally left blank. Intentionally left blank. NQF 0105 / PQRI 9 ANTI-DEPRESSANT MEDICATION MANAGEMENT: A: EFFECTIVE ACUTE PHASE TREATMENT B: EFFECTIVE CONTINUATION (ALTERNATE) Description: The percentage of patients 18 years of age and older who were diagnosed with a new episode of major depression, treated with antidepressant medication, and who remained on an antidepressant medication treatment. (Behavioral Health Provider) MicroMD EMR Clinical Quality Measure Calculations Version

173 Clinical Rationale: This multi-component measure assesses different facets of the successful pharmacological management of depression. Depression has a significant impact on patients quality of life which includes: interference with completing work responsibilities, lack of motivation, and difficulty in concentrating, discomfort, and dealing with coworkers. Depression contributes significantly to poor disease outcomes and premature death. Studies have shown that increasing the intensity of depression treatment may be an important key to improvements in outcomes and cost-effectiveness and that appropriate therapy improves the daily functioning and overall health of patients with depression. Clinical guidelines for depression stress the importance of effective clinical management in: increasing patients medication compliance; monitoring treatment effectiveness by providers, and identifying and managing side effects. If pharmacological treatment is initiated, appropriate dosing and continuation of therapy through the acute and continuation phases decreases recurrence of depression. Thus, evaluation of length of treatment serves as an important indicator of success in promoting patient compliance with the establishment and maintenance of an effective medication regimen. Denominator: **Patients in Age Range: >= 18 (date of birth is >= 224 months beforethe measurement period end date) AND **who have met one or more of the conditions below: MicroMD EMR Clinical Quality Measure Calculations Version 7.5

174 Condition 1 **who have condition of Major Depression recorded in their chart-(see code list) **Date Range: <=245 days before the beginning of the measurement period or <= 120 days after the beginning of the measurement period MedInfo>Medical>Problem List Encounter Assessment MedInfo>Histories>Medical History MedInfo>Histories>Hospitalization History AND ** who was prescribed Antidepressant Medications (see code list) MedInfo>Medical>Medications - Antidepressant Medications **Date Range: Between 30 days before First Diagnosis of Major Depression until 14 days after First Diagnosis of Major Depression NOTE First Diagnosis is calculated with date range <=245 days before the beginning of the measurement period or <= 120 days after the beginning of the measurement period. MicroMD EMR Clinical Quality Measure Calculations Version

175 Condition 2 **who have been seen at least 2 times on different dates **Date Range: <=245 days before the beginning of the measurement period or <= 120 days after the beginning of the measurement period Encounters with Encounter Levels ED specified. (see code list) Encounters with Encounter Levels Outpatient BH specified. (see code list) Encounters with Encounter Levels Outpatient BH POS specified with Modifier (see code list) MedInfo>Histories>Hospitalization History(see code list- CPT Codes for encounter levels : ED,Outpatient BH, Outpatient BH POS with Modifier, Non-acute Inpatient or Acute Inpatient NOTE All these Encounters should have an Assessment of Major Depression and Hospitalization History should have diagnosis of Major Depression recorded in their chart (See ICD codes) AND ** who was prescribed Antidepressant Medications (see code list) MedInfo>Medical>Medications - Antidepressant Medications **Date Range: Between 30 days before First Encounter (see above) until 14 days after First Encounter (see above) OR Between 30 days before First Hospitalization History (see above) until 14 days after First Hospitalization History (see above) MicroMD EMR Clinical Quality Measure Calculations Version 7.5

176 Condition 3 **who have been seen at least 1 time during the reporting period (see code list) **Date Range: <=245 days before the beginning of the measurement period or <= 120 days after the beginning of the measurement period Encounters with Encounter Levels Non-acute Inpatient specified. (see code list) Encounters with Encounter Levels Acute Inpatient specified. (see code list) MedInfo>Histories>Hospitalization History(see code list -CPT Codes for encounter levels : ED,Outpatient BH, Outpatient BH POS with Modifier, Non-acute Inpatient or Acute Inpatient NOTE All these Encounters should have an Assessment of Major Depression and Hospitalization History should have diagnosis of Major Depression recorded in their chart (See ICD codes) AND ** who was prescribed Antidepressant Medications (see code list) MedInfo>Medical>Medications - Antidepressant Medications **Date Range: Between 30 days before First Encounter (see above) until 14 days after First Encounter (see above) OR Between 30 days before First Hospitalization History (see above) until 14 days after First Hospitalization History (see above) MicroMD EMR Clinical Quality Measure Calculations Version

177 AND NOT **who had the condition of Major Depression or Depression recorded in their chart-(see code list) **Date Range: <= 120 days before First Diagnosis of Major Depression MedInfo>Medical>Problem List Encounter Assessment MedInfo>Histories>Medical History MedInfo>Histories>Hospitalization History NOTE First Diagnosis of Major Depression is calculated with date range <=245 days before the beginning of the measurement period or <= 120 days after the beginning of the measurement period OR ** who was prescribed Antidepressant Medications (see code list) MedInfo>Medical>Medications - Antidepressant Medications **Date Range: <= 90 days before First Instance of Antidepressant Medications NOTE First Instance of Antidepressant Medications is calculated with date range between 30 days before First Diagnosis of Major Depression until 14 days after First Diagnosis of Major Depression Numerator: Numerator (1): **Antidepressant Medications prescribed for >= 84 days (MicroMD EMR will check the prescription records for each patient and review the duration and number of refill to determine the 84 or more days that the medication was prescribed for) **Date Range: <= 114 days after First diagnosis of Major Depression (See code list for medications) Exclusions: Numerator (2): **Antidepressant Medications prescribed for >= 180 days (MicroMD EMR will check the prescription records for each patient and review the duration and number of refill to determine the 180 or more days that the medication was prescribed for) **Date Range: <= 231 days after First diagnosis of Major Depression (See code list for medications) None MicroMD EMR Clinical Quality Measure Calculations Version 7.5

178 Code Lists for Measure Encounter Level ED 99281, 99282, 99283, 99284, Encounter Level Outpatient BH Encounter Level Outpatient BH req POS 90804, 90805, 90806, 90807, 90808, 90809, 90810, 90811, 90812, 90813, 90814, 90815, 98960, 98961, 98962, 99078, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99408, 99409, 99411, 99412, , 90802, 90816, 90817, 90818, 90819, 90821, 90822, 90823, 90824, 90826, 90827, 90828, 90829, 90845, 90847, 90849, 90853, 90857, 90862, 90875, 90876, 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, Encounter POS Modifier 03, 05, 07, 09, 11, 12, 13, 14, 15, 20, 22, 33, 49, 50, 52, 53, 57, 71, 72 Encounter non-acute inpatient 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, Encounter acute inpatient 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, Depression - ICD , , 296.4, , , , , , , , 296.5, , , , , , , , 296.6, , , , , , , , 296.7, 296.8, , , , , 296.9, , , 309.0, Major Depression ICD , , , , , , , , , , , , 298.0, 300.4, 309.1, 311 Medications - Antidepressants Amitid 10 mg Tab, Amitid 100 mg Tab, Amitid 25 mg Tab, Amitid 50 mg Tab, Amitid 75 mg Tab, amitriptyline 10 mg Tab, amitriptyline 10 mg/ml IM, amitriptyline 100 mg Tab, amitriptyline 150 mg Tab, amitriptyline 25 mg Tab, amitriptyline 50 mg Tab, amitriptyline 75 mg Tab, amitriptylinechlordiazepoxide 12.5 mg-5 mg Tab, amitriptyline-chlordiazepoxide 25 mg- 10 mg Tab, amoxapine 100 mg Tab, amoxapine 150 mg Tab, amoxapine 25 mg Tab, amoxapine 50 mg Tab, Anafranil 25 mg Cap, Anafranil 50 mg Cap, Anafranil 75 mg Cap, Asendin 100 mg Tab, Asendin 150 mg Tab, Asendin 25 mg Tab, Asendin 50 mg Tab, Atapryl 5 mg Tab, Aventyl 10 mg Cap, Aventyl 10 mg/5 ml Oral Soln, Aventyl 25 mg Cap, Carbex 5 mg Tab, Celexa 10 mg Tab, Celexa 10 mg/5 ml Oral Soln, Celexa 20 mg Tab, Celexa 40 mg Tab, citalopram 10 mg Tab, citalopram 10 mg/5 ml Oral Soln, citalopram 20 mg Tab, citalopram 40 mg Tab, clomipramine 25 mg Cap, clomipramine 50 mg Cap, clomipramine 75 mg Cap, Cymbalta 20 mg Cap, MicroMD EMR Clinical Quality Measure Calculations Version

179 Cymbalta 30 mg Cap, Cymbalta 60 mg Cap, Deconil 25 mg Tab, desvenlafaxine ER 100 mg 24 hr Tab, desvenlafaxine ER 50 mg 24 hr Tab, Desyrel 100 mg Tab, Desyrel 150 mg Tab, Desyrel 300 mg Tab, Desyrel 50 mg Tab, doxepin 3 mg Tab, duloxetine 20 mg Cap, Delayed Release, duloxetine 30 mg Cap, Delayed Release, duloxetine 60 mg Cap, Delayed Release, Duo-Vil mg-10 mg Tab, Duo-Vil mg-25 mg Tab, E- Vill mg Tab, E-Vill mg Tab, E-Vill mg Tab, E-Vill mg Tab, E-Vill mg Tab, Effexor 100 mg Tab, Effexor 25 mg Tab, Effexor 37.5 mg Tab, Effexor 50 mg Tab, Effexor 75 mg Tab, Effexor XR 150 mg 24 hr Cap, Effexor XR 37.5 mg 24 hr Cap, Effexor XR 75 mg 24 hr Cap, Elavil 10 mg Tab, Elavil 10 mg/ml IM, Elavil 100 mg Tab, Elavil 150 mg Tab, Elavil 25 mg Tab, Elavil 50 mg Tab, Elavil 75 mg Tab, Eldepryl 5 mg Cap, Eldepryl 5 mg Tab, Emitrip 100 mg Tab, Emitrip 50 mg Tab, Emsam 12 mg/24 hr Transderm 24 hr Patch, Emsam 6 mg/24 hr Transderm 24 hr Patch, Emsam 9 mg/24 hr Transderm 24 hr Patch, Endep 10 mg Tab, Endep 100 mg Tab, Endep 150 mg Tab, Endep 25 mg Tab, Endep 50 mg Tab, Endep 75 mg Tab, Enovil 10 mg/ml IM, escitalopram 10 mg Tab, escitalopram 20 mg Tab, escitalopram 5 mg Tab, escitalopram 5 mg/5 ml Oral Soln, Etnofril 10 mg Tab, Etnofril 25 mg Tab, Etrafon mg-10 mg Tab, Etrafon mg-25 mg Tab, Etrafon A mg-10 mg Tab, Etrafon Forte mg-25 mg Tab, fluoxetine 10 mg Cap, fluoxetine 10 mg Tab, fluoxetine 15 mg Tab, fluoxetine 20 mg Cap, fluoxetine 20 mg Tab, fluoxetine 40 mg Cap, fluoxetine 90 mg Cap, Delayed Release, fluvoxamine 100 mg Tab, fluvoxamine 25 mg Tab, fluvoxamine 50 mg Tab, fluvoxamine ER 100 mg 24 hr Cap, fluvoxamine ER 150 mg 24 hr Cap, Imavate 25 mg Tab, Imavate 50 mg Tab, imipramine 10 mg Tab, imipramine 25 mg Tab, imipramine 50 mg Tab, imipramine pamoate 100 mg Cap, imipramine pamoate 125 mg Cap, imipramine pamoate 150 mg Cap, imipramine pamoate 75 mg Cap, isocarboxazid 10 mg Tab, Janimine 10 mg Tab, Janimine 25 mg Tab, Janimine 50 mg Tab, Kenvil 10 mg Tab, Kenvil 100 mg Tab, Kenvil 25 mg Tab, Kenvil 50 mg Tab, Kenvil 75 mg Tab, Lexapro 10 mg Tab, Lexapro 20 mg Tab, Lexapro 5 mg Tab, Lexapro 5 mg/5 ml Oral Soln, Limbitrol 12.5 mg-5 mg Tab, Limbitrol DS 25 mg-10 mg Tab, Ludiomil 25 mg Tab, Ludiomil 50 mg Tab, Ludiomil 75 mg Tab, Luvox 100 mg Tab, Luvox 25 mg Tab, Luvox 50 mg Tab, Luvox CR 100 mg 24 hr Cap, Luvox CR 150 mg 24 hr Cap, maprotiline 25 mg Tab, maprotiline 50 mg Tab, maprotiline 75 mg Tab, Marplan 10 mg Tab, mirtazapine 15 mg Tab, mirtazapine 15 mg Tab, Rapid Dissolve, mirtazapine 30 mg Tab, mirtazapine 30 mg Tab, Rapid Dissolve, mirtazapine 45 mg Tab, mirtazapine 45 mg Tab, Rapid Dissolve, mirtazapine 7.5 mg Tab, Nardil 15 mg Tab, Norfranil 25 mg Tab, Norfranil 50 mg Tab, nortriptyline 10 mg Cap, nortriptyline 10 mg/5 ml Oral Soln, nortriptyline 25 mg Cap, nortriptyline 50 mg Cap, nortriptyline 75 mg Cap, olanzapine-fluoxetine 12 mg-25 mg Cap, olanzapine-fluoxetine 12 mg-50 mg Cap, olanzapine MicroMD EMR Clinical Quality Measure Calculations Version 7.5

180 fluoxetine 3 mg-25 mg Cap, olanzapine-fluoxetine 6 mg-25 mg Cap, olanzapine-fluoxetine 6 mg-50 mg Cap, Oleptro ER 150 mg 24 hr Tab, Oleptro ER 300 mg 24 hr Tab, Pamelor 10 mg Cap, Pamelor 10 mg/5 ml Oral Soln, Pamelor 25 mg Cap, Pamelor 50 mg Cap, Pamelor 75 mg Cap, Parnate 10 mg Tab, paroxetine 10 mg Tab, paroxetine 10 mg/5 ml Oral Susp, paroxetine 20 mg Tab, paroxetine 30 mg Tab, paroxetine 40 mg Tab, paroxetine ER 12.5 mg 24 hr Tab, paroxetine ER 25 mg 24 hr Tab, paroxetine ER 37.5 mg 24 hr Tab, paroxetine mesylate 10 mg Tab, paroxetine mesylate 20 mg Tab, paroxetine mesylate 30 mg Tab, paroxetine mesylate 40 mg Tab, Paxil 10 mg Tab, Paxil 10 mg/5 ml Oral Susp, Paxil 20 mg Tab, Paxil 30 mg Tab, Paxil 40 mg Tab, Paxil CR 12.5 mg 24 hr Tab, Paxil CR 25 mg 24 hr Tab, Paxil CR 37.5 mg 24 hr Tab, Per-Trip 2 mg-10 mg Tab, Per-Trip 2 mg-25 mg Tab, Per-Trip 4 mg-10 mg Tab, Per-Trip 4 mg-25 mg Tab, Per-Trip 4 mg-50 mg Tab, perphenazine-amitriptyline 2 mg- 10 mg Tab, perphenazine-amitriptyline 2 mg-25 mg Tab, perphenazineamitriptyline 4 mg-10 mg Tab, perphenazine-amitriptyline 4 mg-25 mg Tab, perphenazine-amitriptyline 4 mg-50 mg Tab, PEXEVA 10 mg Tab, PEXEVA 20 mg Tab, PEXEVA 30 mg Tab, PEXEVA 40 mg Tab, phenelzine 15 mg Tab, Pristiq 100 mg 24 hr Tab, Pristiq 50 mg 24 hr Tab, protriptyline 10 mg Tab, protriptyline 5 mg Tab, Prozac 10 mg Cap, Prozac 10 mg Tab, Prozac 20 mg Cap, Prozac 40 mg Cap, Prozac Weekly 90 mg Cap, Q.E.L 10 mg Tab, Q.E.L 100 mg Tab, Q.E.L 25 mg Tab, Q.E.L 50 mg Tab, Q.E.L 75 mg Tab, Rapiflux 20 mg Tab, Re-Live 25 mg Tab, Re-Live 50 mg Tab, Remeron 15 mg Tab, Remeron 30 mg Tab, Remeron 45 mg Tab, Remeron SolTab 15 mg, Remeron SolTab 30 mg, Remeron SolTab 45 mg, Sarafem 10 mg Cap, Sarafem 10 mg Tab, Sarafem 15 mg Tab, Sarafem 20 mg Cap, Sarafem 20 mg Tab, selegiline 1.25 mg Tab, Rapid Dissolve, selegiline 12 mg/24 hr Transderm 24 hr Patch, selegiline 5 mg Cap, selegiline 5 mg Tab, selegiline 6 mg/24 hr Transderm 24 hr Patch, selegiline 9 mg/24 hr Transderm 24 hr Patch, Selfemra 10 mg Cap, Selfemra 20 mg Cap, sertraline 100 mg Tab, sertraline 20 mg/ml Oral Concentrate, sertraline 25 mg Tab, sertraline 50 mg Tab, Silenor 3 mg Tab, Sk-Amitriptyline 10 mg Tab, Sk-Amitriptyline 100 mg Tab, Sk-Amitriptyline 150 mg Tab, Sk-Amitriptyline 25 mg Tab, Sk- Amitriptyline 50 mg Tab, Sk-Amitriptyline 75 mg Tab, Sk-Pramine 10 mg Tab, Sk-Pramine 25 mg Tab, Sk-Pramine 50 mg Tab, Stabanil 25 mg Tab, Surmontil 100 mg Cap, Surmontil 25 mg Cap, Surmontil 50 mg Cap, Symbyax 12 mg-25 mg Cap, Symbyax 12 mg-50 mg Cap, Symbyax 3 mg-25 mg Cap, Symbyax 6 mg-25 mg Cap, Symbyax 6 mg-50 mg Cap, Tofranil 10 mg Tab, Tofranil 25 mg Tab, Tofranil 50 mg Tab, Tofranil-PM 100 mg Cap, Tofranil-PM 125 mg Cap, Tofranil-PM 150 mg Cap, Tofranil-PM 75 mg Cap, tranylcypromine 10 mg Tab, trazodone 100 mg Tab, trazodone 150 mg Tab, trazodone 300 mg Tab, trazodone 50 mg Tab, trazodone ER 150 mg 24 hr Tab, trazodone ER 300 mg 24 hr Tab, Triavil mg-10 mg Tab, Triavil mg-25 mg Tab, Triavil mg-10 mg Tab, Triavil 4- MicroMD EMR Clinical Quality Measure Calculations Version

181 25 4 mg-25 mg Tab, Triavil mg-50 mg Tab, trimipramine 100 mg Cap, trimipramine 25 mg Cap, trimipramine 50 mg Cap, Vanatrip 50 mg Tab, venlafaxine 100 mg Tab, venlafaxine 25 mg Tab, venlafaxine 37.5 mg Tab, venlafaxine 50 mg Tab, venlafaxine 75 mg Tab, venlafaxine ER 150 mg 24 hr Cap, venlafaxine ER 150 mg 24 hr Tab, venlafaxine ER 225 mg 24 hr Tab, venlafaxine ER 37.5 mg 24 hr Cap, venlafaxine ER 37.5 mg 24 hr Tab, venlafaxine ER 75 mg 24 hr Cap, venlafaxine ER 75 mg 24 hr Tab, Vivactil 10 mg Tab, Vivactil 5 mg Tab, Zelapar 1.25 mg Tab, Rapid Dissolve, Zoloft 100 mg Tab, Zoloft 20 mg/ml Oral Concentrate, Zoloft 25 mg Tab, Zoloft 50 mg Tab NQF 0385 / PQRI 72 ONCOLOGY COLON CANCER: CHEMO FOR STATE III COLON CANCER PATIENTS (NON-SUPPORTED) Description: Clinical Rationale: Denominator: Numerator: Exclusions: This measure is not supported or calculated by MicroMD EMR. Intentionally left blank. Intentionally left blank. Intentionally left blank. Intentionally left blank. NQF 0387 / PQRI 71 ONCOLOGY BREAST CANCER: HORMONAL THERAPY FOR STATE IC-IIIC ER/PR POSITIVE BREAST CANCER (NOT SUPPORTED) Description: Clinical Rationale: Denominator: Numerator: Exclusions: This measure is not supported or calculated by MicroMD EMR. Intentionally left blank. Intentionally left blank. Intentionally left blank. Intentionally left blank. NQF 0389 / PQRI 102 PROSTATE CANCER: AVOIDANCE OF OVERUSE OF BONE SCAN FOR STAGING LOW RISK CANCER PATIENTS (ALTERNATE) MicroMD EMR Clinical Quality Measure Calculations Version 7.5

182 Description: Clinical Rationale: Denominator: Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy, OR cryotherapy who did not have a bone scan performed at any time since diagnosis of prostate cancer. NOTE Lower score is better on this one. A bone scan is generally not required for staging prostate cancer in men with a low risk of recurrence and receiving primary therapy. This measure is written as a negative measure so that the performance goal is 100%, consistent with the other measures for this condition. **Patients who have condition of Prostate Cancer recorded in their chart- (see code list) **Date Range: prior to the end of the reporting period MedInfo>Medical>Problem List Entry ( with a beginning date <= encounter date) or an Encounter with an Assessment (beginning date <= encounter date) AND **who have received Prostate Cancer Treatment (see code list) **Date Range: during the reporting period Encounter Plan MedInfo>Histories>Surgical Procedure MedInfo>Histories>Surgical History MedInfo>Orders>Procedure Orders Performed MedInfo>Histories>Hospitalization History NOTE Reporting will look at the CPT codes or Procedure names related to the treatment. AND **PSA was <=10 (see code list) **Date Range: during the reporting period MedInfo>Medical>Lab Result AND **Gleason Score was <=6 (see code list) **Date Range: during the reporting period MedInfo>Medical>Diagnostic Test Result MicroMD EMR Clinical Quality Measure Calculations Version

183 Numerator: Exclusions: **Patients who have not had a Bone Scan performed (see code list) **Date Range: during the reporting period MedInfo>Medical>Diagnostic Test Result (is not present) **Patients with Active Diagnosis Pain Related to Prostate Cancer(see code list) **Date Range: prior to the end of the reporting period Encounter Assessment MedInfo>Medical>Problem List OR **Patients with Procedure Performed Salvage Therapy (see code lists) **Date Range: during the reporting period Encounter Plan (performed) MedInfo>Orders>Procedure Orders (Performed) MedInfo>Histories>Surgical Procedures MedInfo>Histories>Surgical History Code Lists for Measure Prostate Cancer - ICD 185 Prostate Cancer Treatment - CPT Prostate Cancer Treatment - Procedure OR **Patients with Diagnostic Study Performed: Bone Scan (see code list) **Date Range: during the reporting period MedInfo>Medical>Diagnostic Test Result 55810, 55812, 55815, 55840, 55842, 55845, 55866, 55873, 77427, 77776, 77777, 77778, Cryosurgery PSA CPT Codes 84152, 84153, PSA LOINC , , , , , , , , , , , , , , , , , , , , Salvage Therapy CPT 55860, 55862, 55865, 55875, Pain related to Prostate Cancer ICD 338.3, 724.1, 724.5, 724.6, , , , , , V76.44, V84.03 Bone Scan - CPT 78300, 78305, 78306, 78315, 78320, 78350, MicroMD EMR Clinical Quality Measure Calculations Version 7.5

184 Gleason Score CPT G9077, 3268F NQF 0421 / PQRI 128 ADULT WEIGHT SCREENING AND FOLLOW-UP (CORE) Description: Clinical Rationale: Percentage of patients aged 18 years and older with a calculated BMI in the past six months or during the current visit documented in the medical record AND if the most recent BMI is outside parameters, a follow-up plan is documented. Of the Medicare population, 37 percent are overweight, and 18 percent are obese. Between 1991 and 1998, the prevalence of obesity among persons age increased by 45 percent (American Obesity Association). According to a 1998 survey, only 52 percent of adults age 50 or older reported being asked during routine medical check-ups about physical activity or exercise. The likelihood of being asked about exercise during a routine checkup declined with age (Center for the Advancement of Health, 2004). Elderly patients with unintentional weight loss are at higher risk for infection, depression and death. In one study it was found that a BMI of less than 22 kg per m2 in women and less than 23.5 in men is associated with increased mortality. In another study it was found that the optimal BMI in the elderly is 24 to 29 kg per m2. (Huffman, G. B., Evaluation and Treatment of Unintentional Weight Loss in the Elderly, American Family Physician, 2002 Feb, 4: ) Denominator: **Patients in Age Range: >= 65 (Denominator 1) **Patients in Age Range: (Denominator 2) Numerator: **who have been seen at least 1 time during the reporting period (see code list) Encounters with Encounter Levels specified. **Vital Signs - Must contain height and weight to automatically calculate the BMI. **Date Range: up to 6 months prior to the encounter MedInfo>Medical>Vital Signs MicroMD EMR Clinical Quality Measure Calculations Version

185 Exclusions: **Numerator 1 will calculate those patients with BMI in the normal range and those outside of the normal range that have a follow up plan documented. (Age Group 65 and older) BMI in Normal Range = 22 to 29.9 BMI < 22 = lower range and a follow up plan is documented BMI >=30 = upper range and a follow up plan is documented NOTE For follow-up plan, an Encounter Plan is required (see code list) **Numerator 2 will calculate those patients with BMI in the normal range and those outside of the normal range that have a follow up plan documented. (Age Group 18-64) BMI in Normal Range = 18.5 to 24.9 BMI < 18.5 = lower range and a follow up plan is documented BMI >= 25 = upper range and a follow up plan is documented NOTE For follow-up plan, an Encounter Plan is required (see code list) **Patients with an active diagnosis of Pregnancy documented in their chart (see code list) **Date Range: prior to the encounter Encounter Assessment MedInfo>Medical>Problem List OR **Patients with a Terminal Illness (see code list) **Date Range: less than 6 months prior to the encounter Encounter Assessment MedInfo>Medical>Problem List OR **Patients whose BMI was not calculated during the encounter **Date Range: during the reporting period Encounter Plan (see code list) OR Problem List with a begin date <= 6 months prior to encounter (799.89) Encounter Plan is documented using one of the following codes: G8421 BMI not calculated G8422 Patient not eligible for BMI calculation MicroMD EMR Clinical Quality Measure Calculations Version 7.5

186 Code Lists for Measure Encounter Level Outpatient w/clinician Pregnancy - ICD v22.0, v22.1, v22.2 Terminal Illness - ICD Encounter Plan is documented using one of the following codes: (Numerator) BMI Not Calculated during encounter HCPCS (Exclusion) 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 97001, 97003, 97802, 97803, 98960, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, G8419 BMI outside of normal parameters and no follow up plan documented G8418 BMI <22 and follow up plan documented G8417 BMI >=30 and follow up plan documented G8420 BMI calculated and within normal parameters G BMI not calculated G Patient not eligible for BMI calculation NQF 0575 DIABETES: HGA1C CONTROL <8.0% (ALTERNATE) Description: Clinical Rationale: The percentage of patients years of age with diabetes (type 1 or type 2) who had HbA1c <8.0%. This measure evaluates the percentage of patients in a specific age demographic who were diagnosed with type 1 or type 2 diabetes and who demonstrate adequate blood sugar control with an HbA1c level lower than 8 percent. Diabetes mellitus (diabetes) is a group of diseases characterized by high blood glucose levels caused by the body s inability to correctly produce or utilize the hormone insulin. It is recognized as a leading cause of death and disability in the U.S. and is highly underreported as a cause of death. Diabetes of either type may cause life-threatening, life-ending or life-altering complications, including poor blood sugar control. Studies have shown that improved glycemic control is correlated with a 40% decline in the development of associated microvascular complications (i.e., eye, kidney and nerve diseases)( ADA 2009). Clinical guidelines recommend regular HbA1c testing to facilitate patients ability to improve and sustain acceptable levels (ADA 2009). This measure facilitates the maintenance and long-term management of adequate blood sugar levels for patients diagnosed with diabetes. MicroMD EMR Clinical Quality Measure Calculations Version

187 Denominator: **Patients in Age Range: >= 17 and <=74 **Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period OR MedInfo>Medical>Medications **who have condition of Diabetes recorded in their chart-(see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment **And who have had at least 1 Acute Inpatient or ED visit **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of ED or Acute Inpatient (see CPT code list) MedInfo>Histories>Hospitalization History (see CPT code list) MedInfo>Histories>Hospitalization History (Emergency Room only checked) OR **Who have had At least 2 encounters, non-acute Inpatient, Outpatient or Ophthalmology occurring on 2 different dates **Date Range: up to 2 years prior to the end of the reporting period Encounter with Level of Non-acute Inpatient, Outpatient or Ophthalmology (see CPT code list) Encounter with Assessment of Encounter Outpatient (See ICD code list) MedInfo>Histories>Hospitalization History (see CPT, ICD code list) NOTE Reporting will look at ICD codes of Encounter Outpatient in Hospitaliazation History. Numerator: **Patients whose HbA1c is < 8.0 Lab Test completed for CPT/LOINC Codes (see code list) NOTE Most recent lab result within the reporting period will be used. NOTE Lab result values should be entered without any special characters, for example 9.1% should be entered as 9.1 to be counted MicroMD EMR Clinical Quality Measure Calculations Version 7.5

188 Exclusions: **Patients with an active diagnosis of polycystic ovaries **Date Range : before the end of the reporting period OR MedInfo>Medical>Problem List Encounter Assessment **Patients with an active diagnosis of gestational diabetes or steroid induced diabetes **Date Range : up to 2 years prior to the end of the reporting period MedInfo>Medical>Problem List Encounter Assessment AND **who are Patients taking diabetic medications (see code list) **Date Range: up to 2 years prior to the end of the reporting period MedInfo>Medical>Medications Code Lists for Measure Encounter Level Acute Inpatient or ED Encounter Level Non- Acute Inpatient Encounter Level Opthamological services Encounter Outpatient CPT 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, , 99255, 99291, 99281, 99282, 99823, 99284, , 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, , 92003, 92004, 92005, 92006, 92007, 92008, 92009, 92010, 92011, 92012, 92013, , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, , 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, Encounter Outpatient ICD V70.0, V70.3, V70.5, V70.6, V70.8, V70.9 HbA1c CPT 83036, HbA1c LOINC , , Polycystic Ovaries ICD Gestational Diabetes - ICD 648.8, , , , , Steroid Induced Diabetes 249, 249.0, , , 249.1, , , 249.2, , , 249.3, , , 249.4, , , 249.5, , , 249.6, , MicroMD EMR Clinical Quality Measure Calculations Version

189 ICD , 249.7, , , 249.8, , , 249.9, , , 251.8, Medications Indicative of Diabetes acarbose 100 mg Tab, acarbose 25 mg Tab, acarbose 50 mg Tab, acetohexamide 250 mg Tab, acetohexamide 500 mg Tab, Actoplus MET 15 mg-500 mg Tab, Actoplus MET 15 mg-850 mg Tab, Actos 15 mg Tab, Actos 30 mg Tab, Actos 45 mg Tab, Amaryl 1 mg Tab, Amaryl 2 mg Tab, Amaryl 4 mg Tab, Apidra 100 unit/ml Sub-Q, Apidra 100 unit/ml SubQ Cartridge, Apidra SoloStar 100 unit/ml Sub-Q Insulin Pen, AVANDAMET 1 mg-500 mg Tab, AVANDAMET 2 mg-1,000 mg Tab, AVANDAMET 2 mg-500 mg Tab, AVANDAMET 4 mg-1,000 mg Tab, AVANDAMET 4 mg-500 mg Tab, Avandaryl 4 mg-1 mg Tab, Avandaryl 4 mg-2 mg Tab, Avandaryl 4 mg-4 mg Tab, Avandaryl 8 mg-2 mg Tab, Avandaryl 8 mg-4 mg Tab, Avandia 2 mg Tab, Avandia 4 mg Tab, Avandia 8 mg Tab, Byetta 10 mcg/0.04 ml per dose Sub-Q Pen Injector, Byetta 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Chlorabetic mg Tab, chlorpropamide 100 mg Tab, chlorpropamide 250 mg Tab, Diabeta 1.25 mg Tab, Diabeta 2.5 mg Tab, Diabeta 5 mg Tab, Diabinese 100 mg Tab, Diabinese 250 mg Tab, Dibatrol 100 mg Tab, Dibatrol 250 mg Tab, DUETACT 30 mg-2 mg Tab, DUETACT 30 mg-4 mg Tab, Dymelor 250 mg Tab, Dymelor 500 mg Tab, exenatide 10 mcg/0.04 ml per dose Sub-Q Pen Injector, exenatide 5 mcg/0.02 ml per dose Sub-Q Pen Injector, Fortamet 1,000 mg 24 hr Tab Ctrl Rel, Fortamet 500 mg 24 hr Tab Ctrl Rel, glimepiride 1 mg Tab, glimepiride 2 mg Tab, glimepiride 4 mg Tab, glipizide 10 mg Tab, glipizide 5 mg Tab, glipizide ER 10 mg 24 hour Tab, glipizide ER 2.5 mg 24 hour Tab, glipizide ER 5 mg 24 hour Tab, glipizide-metformin 2.5 mg-250 mg Tab, glipizide-metformin 2.5 mg-500 mg Tab, glipizide-metformin 5 mg-500 mg Tab, Glucamide 100 mg Tab, Glucamide 250 mg Tab, Glucophage 1,000 mg Tab, Glucophage 500 mg Tab, Glucophage 850 mg Tab, Glucophage XR 500 mg 24 hr Tab, Glucophage XR 750 mg 24 hr Tab, Glucotrol 10 mg Tab, Glucotrol 5 mg Tab, Glucotrol XL 10 mg 24 hr Tab, Glucotrol XL 2.5 mg 24 hr Tab, Glucotrol XL 5 mg 24 hr Tab, Glucovance 1.25 mg-250 mg Tab, Glucovance 2.5 mg-500 mg Tab, Glucovance 5 mg-500 mg Tab, Glumetza 1,000 mg 24 hr Tab, Glumetza 500 mg 24 hr Tab, glyburide 1.25 mg Tab, glyburide 2.5 mg Tab, glyburide 5 mg Tab, glyburide micronized 1.5 mg Tab, glyburide micronized 3 mg Tab, glyburide micronized 4.5 mg Tab, glyburide micronized 6 mg Tab, glyburide-metformin 1.25 mg-250 mg Tab, glyburide-metformin 2.5 mg-500 mg Tab, glyburide-metformin 5 mg-500 mg Tab, Glycron 1.5 mg Tab, Glycron 3 mg Tab, Glycron 4.5 mg Tab, Glycron 6 mg Tab, Glynase 1.5 mg Tab, Glynase 3 mg Tab, Glynase 6 mg Tab, Glyset 100 mg Tab, Glyset 25 mg Tab, Glyset 50 mg Tab, Humalog 100 unit/ml Sub-Q, Humalog 100 unit/ml SubQ Cartridge, Humalog KwikPen 100 unit/ml Sub-Q Pen, Humalog Mix unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (50-50) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (50-50) Sub-Q Pen, Humalog Mix unit/ml (75-25) Sub-Q Pen, Humalog Mix unit/ml (75-25) Susp, Sub-Q Inj, Humalog Mix KwikPen 100 unit/ml (75-25) Sub-Q Pen, Humalog Pen 100 unit/ml SubQ, Humulin L 100 unit/ml Susp, Sub-Q Inj, Icn-Tolam 500 mg Tab, Iletin I Protamine,Zinc 100 unit/ml Susp, Sub-Q Inj, Iletin I Protamine,Zinc 40 unit/ml Susp, Sub-Q Inj, Iletin I Regular 100 unit/ml Injection, Iletin I Regular 40 unit/ml Injection, Iletin I Semilente 100 unit/ml Susp, Sub-Q Inj, Iletin I Semilente 40 unit/ml Susp, Sub- Q Inj, Iletin II Lente (Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Beef) 100 unit/ml Susp, Sub-Q Inj, Iletin II Protamine,Zinc(Pork) 100 unit/ml Susp, Sub-Q Inj, Iletin II Regular (Pork) 100 unit/ml Injection, Iletin II Regular(Beef) 100 unit/ml MicroMD EMR Clinical Quality Measure Calculations Version 7.5

190 Injection, Iletin II Regular(Pork)Conc 500 unit/ml Injection, Insulase 250 mg Tab, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q, insulin asp prt-insulin aspart 100 unit/ml (70-30) Sub-Q Pen, insulin asp prt-insulin aspart 100 unit/ml (70-30) SubQ Cartridge, insulin aspart 100 unit/ml Sub-Q, insulin aspart 100 unit/ml Sub-Q Pen, insulin aspart 100 unit/ml SubQ Cartridge, insulin beef 100 unit/ml Injection, insulin detemir 100 unit/ml Sub-Q, insulin detemir 100 unit/ml Sub-Q Pen, insulin glargine 100 unit/ml (3 ml) Sub-Q Pen, insulin glargine 100 unit/ml Sub-Q, insulin glargine 100 unit/ml SubQ Cartridge, insulin glulisine 100 unit/ml Sub-Q, insulin glulisine 100 unit/ml Sub-Q Pen, insulin glulisine 100 unit/ml SubQ Cartridge, insulin lispro 100 unit/ml Sub-Q, insulin lispro 100 unit/ml Sub-Q Pen, insulin lispro 100 unit/ml SubQ Cartridge, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (50-50) Sub-Q Pen, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q, insulin lispro protamine susp&ins.lispro 100 unit/ml (75-25) Sub-Q Pen, insulin pork 100 unit/ml Injection, insulin pork 40 unit/ml Injection, insulin protamine zinc beef 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef pure 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin protamine Zn beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin protamine Zn pork pure 100 unit/ml Susp, Sub-Q Inj, Insulin Purified Regular(Pork) 100 unit/ml Injection, Insulin R Purified Pork 100 unit/ml Injection, insulin regular beef-pork 100 unit/ml Injection, insulin regular beef-pork 40 unit/ml Injection, insulin regular pork 100 unit/ml Injection, insulin regular pork, conc. 500 unit/ml Injection, Insulin Regular Purified Pork 100 unit/ml Injection, insulin zinc human recomb 100 unit/ml Susp, Sub-Q Inj, insulin zinc human semi-syn 100 unit/ml Susp, Sub-Q Inj, insulin zinc pork purified 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 100 unit/ml Susp, Sub-Q Inj, insulin zinc prompt beef-pork 40 unit/ml Susp, Sub-Q Inj, insulin zinc prompt pork pure 100 unit/ml Susp, Sub-Q Inj, Janumet 50 mg-1,000 mg Tab, Janumet 50 mg-500 mg Tab, Januvia 100 mg Tab, Januvia 25 mg Tab, Januvia 50 mg Tab, Lantus 100 unit/ml Sub-Q, Lantus 100 unit/ml SubQ Cartridge, Lantus Solostar 100 unit/ml (3 ml) Sub-Q Insulin Pen, Levemir 100 unit/ml Sub-Q, Levemir Flexpen 100 unit/ml Sub-Q Insulin Pen, Metaglip 2.5 mg-250 mg Tab, Metaglip 2.5 mg-500 mg Tab, Metaglip 5 mg-500 mg Tab, metformin 1,000 mg Tab, metformin 500 mg Tab, metformin 500 mg/5 ml Oral Soln, metformin 850 mg Tab, metformin ER 1,000 mg 24 hr Tab Ctrl Rel, metformin ER 1,000 mg 24 hr Tab, gastric retention, metformin ER 500 mg 24 hr Tab, metformin ER 500 mg 24 hr Tab Ctrl Rel, metformin ER 500 mg 24 hr Tab, gastric retention, metformin ER 750 mg 24 hr Tab, Micronase 1.25 mg Tab, Micronase 2.5 mg Tab, Micronase 5 mg Tab, miglitol 100 mg Tab, miglitol 25 mg Tab, miglitol 50 mg Tab, miglustat 100 mg Cap, Monotard Human Lente 100 unit/ml Susp, Sub-Q Inj, nateglinide 120 mg Tab, nateglinide 60 mg Tab, Novolin L (Semi-Synthetic) 100 unit/ml Susp, Sub-Q Inj, Novolin L 100 unit/ml for Sub-Q Injection, Novolog 100 unit/ml Sub-Q, Novolog Flexpen 100 unit/ml Sub-Q, Novolog Mix unit/ml (70-30) Sub-Q, Novolog Mix unit/ml (70-30) SubQ Cartridge, Novolog Mix FlexPen 100 unit/ml (70-30) Sub-Q, Oribetic 500 mg Tab, Orinase 500 mg Tab, Orinase Diagnostic 1 gram IV Solution, pioglitazone 15 mg Tab, pioglitazone 30 mg Tab, pioglitazone 45 mg Tab, pioglitazone-glimepiride 30 mg-2 mg Tab, pioglitazoneglimepiride 30 mg-4 mg Tab, pioglitazone-metformin 15 mg-500 mg Tab, pioglitazone-metformin 15 mg-850 mg Tab, pramlintide 1,500 mcg/1.5 ml Sub-Q Pen Injector, pramlintide 2,700 mcg/2.7 ml Sub-Q Pen Injector, pramlintide 600 mcg/ml Sub-Q, Prandimet 1 mg-500 mg Tab, Prandimet 2 mg-500 mg Tab, Prandin 0.5 mg MicroMD EMR Clinical Quality Measure Calculations Version

191 Tab, Prandin 1 mg Tab, Prandin 2 mg Tab, Precose 100 mg Tab, Precose 25 mg Tab, Precose 50 mg Tab, Purified Pork Insulin 100 unit/ml Injection, Purified Pork Insulin 40 unit/ml Injection, repaglinide 0.5 mg Tab, repaglinide 1 mg Tab, repaglinide 2 mg Tab, repaglinide-metformin 1 mg-500 mg Tab, repaglinide-metformin 2 mg-500 mg Tab, Rezulin 200 mg Tab, Rezulin 300 mg Tab, Rezulin 400 mg Tab, RIOMET 500 mg/5 ml Oral Soln, Ronase 100 mg Tab, Ronase 250 mg Tab, Ronase 500 mg Tab, rosiglitazone 2 mg Tab, rosiglitazone 4 mg Tab, rosiglitazone 8 mg Tab, rosiglitazoneglimepiride 4 mg-1 mg Tab, rosiglitazone-glimepiride 4 mg-2 mg Tab, rosiglitazoneglimepiride 4 mg-4 mg Tab, rosiglitazone-glimepiride 8 mg-2 mg Tab, rosiglitazoneglimepiride 8 mg-4 mg Tab, rosiglitazone-metformin 1 mg-500 mg Tab, rosiglitazonemetformin 2 mg-1,000 mg Tab, rosiglitazone-metformin 2 mg-500 mg Tab, rosiglitazone-metformin 4 mg-1,000 mg Tab, rosiglitazone-metformin 4 mg-500 mg Tab, sitagliptin 100 mg Tab, sitagliptin 25 mg Tab, sitagliptin 50 mg Tab, sitagliptinmetformin 50 mg-1,000 mg Tab, sitagliptin-metformin 50 mg-500 mg Tab, Starlix 120 mg Tab, Starlix 60 mg Tab, Symlin 600 mcg/ml Sub-Q, SymlinPen 120 2,700 mcg/2.7 ml Sub-Q Pen Injector, SymlinPen 60 1,500 mcg/1.5 ml Sub-Q Pen Injector, Tolamide 250 mg Tab, tolazamide 100 mg Tab, tolazamide 250 mg Tab, tolazamide 500 mg Tab, tolbutamide 1 gram IV Solution, tolbutamide 500 mg Tab, Tolinase 100 mg Tab, Tolinase 250 mg Tab, Tolinase 500 mg Tab, troglitazone 200 mg Tab, troglitazone 300 mg Tab, troglitazone 400 mg Tab, Velosulin R 100 unit/ml Injection, ZAVESCA 100 mg Cap Diabetes ICD 250, 250.0, , , , , , , , , , , , , , , , , 250.4, , , , , , , , , , , , , 250.7, , , , , 250.8, , , , , 250.9, , , , , 357.2, 362.0, , , , , , , , , 648.0, , , , , MicroMD EMR Clinical Quality Measure Calculations Version 7.5

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193 Henry Schein MicroMD 760 Boardman-Canfield Road Boardman, OH