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FHIR IG Statistics: PlanDefinition/opioidcds-10-patient-view

Packagefhir.cdc.opioid-cds-r4
Resource TypePlanDefinition
Idopioidcds-10-patient-view
FHIR VersionR4
Sourcehttp://fhir.org/guides/cdc/opioid-cds/https://build.fhir.org/ig/cqframework/opioid-cds-r4/PlanDefinition-opioidcds-10-patient-view.html
URLhttp://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-10-patient-view
Version2022.1.0
Statusdraft
Date2025-04-24
NamePlanDefinition_Recommendation_10_Patient_View
TitleRecommendation #10 - Urine Drug Testing (patient-view)
Realmus
Authorityhl7
DescriptionWhen prescribing opioids for subacute or chronic pain, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.
PurposeThe 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.
Copyright© CDC 2016+.

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Id: opioidcds-10-patient-view
Url: Recommendation #10 - Urine Drug Testing (patient-view)
Version: 2022.1.0
Identifier:

value: cdc-opioid-guidance

Name: PlanDefinition_Recommendation_10_Patient_View
Title: Recommendation #10 - Urine Drug Testing (patient-view)
Status: draft
Experimental: true
Type:

system: http://terminology.hl7.org/CodeSystem/plan-definition-type

code: eca-rule

display: ECA Rule

Date: 2025-04-24
Publisher: Centers for Disease Control and Prevention (CDC)
Description: When prescribing opioids for subacute or chronic pain, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.
Logic Definitions:
Library NameNamesequence
OpioidCDSCommon Active Ambulatory Opioid Rx 0 
define "Active Ambulatory Opioid Rx":
    if Config."Can the implementing EHR support queries for past medications by date range?" then
      (
        "Get MedicationRequest Medication as Code"("Get Active Ambulatory Medication Requests"([MedicationRequest]))
      ) Rx
        where date from Rx.authoredOn 2 years or less on or before Today()
          and Rx.medication in "Opioid analgesics with ambulatory misuse potential"
    else
        List<FHIR.MedicationRequest>{}


Library NameNamesequence
OpioidCDSREC10PatientView Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions 1 
define "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions":
  Common."Active Ambulatory Opioid Rx" AmbulatoryOpioidPrescription
    where Routines."Is Subacute or Chronic Pain Prescription?"(AmbulatoryOpioidPrescription)


Library NameNamesequence
OpioidCDSREC10PatientView Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential 2 
define "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential":
  exists ("Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions")


Library NameNamesequence
OpioidCDSRoutines Patient Age Less Than 18 3 
define "Patient Age Less Than 18":
  if (Config."Age Less than 18 Years Is Enabled") then
    AgeInYearsAt(Today()) < 18
  else false


Library NameNamesequence
OpioidCDSRoutines Condition Positive for Sickle Cell 4 
define "Condition Positive for Sickle Cell":
  if (Config."Sickle Cell Check Enabled") then
    exists(
      Common."Positive Sickle Cell Condition"
    ) 
  else false


Library NameNamesequence
OpioidCDSRoutines Is Active Cancer Treatment? 5 
define "Is Active Cancer Treatment?":
  if (Config."Active Cancer Treatment Encounters Condition Is Enabled") 
    then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period"
      or "Has Active Cancer Diagnosis on Problem List"
  else false


Library NameNamesequence
OpioidCDSRoutines Conditions Likely Terminal for Opioid Prescribing 6 
define "Conditions Likely Terminal for Opioid Prescribing":
  if (Config."End-Stage Disease Criteria Enabled") then
    exists (
      Common."US Core-Categorized Conditions" EOLC
        where EOLC.code in Common."Conditions likely terminal for opioid prescribing"
          // and EOLC.clinicalStatus in Common."Active Condition"
    )
  else false


Library NameNamesequence
OpioidCDSRoutines Is Opioid Review Useful? 7 
define "Is Opioid Review Useful?":
  not "Patient Age Less Than 18"
    and not "Condition Positive for Sickle Cell"
    and not "Is Active Cancer Treatment?"
    and not "Conditions Likely Terminal for Opioid Prescribing"


Library NameNamesequence
OpioidCDSREC10Common Inclusion Criteria For UDS Recommendation 8 
/*
@description: Determines whether an opioid review is appropriate for the patient and whether they had a UDS performed in the past year
*/
define "Inclusion Criteria For UDS Recommendation":
  Routines."Is Opioid Review Useful?"
    and not exists (
      if Config."Use Alternative UDS Lookback Period"
        then "All Opioid or Non-opioid UDS in Alternative Lookback Period"
      else "All Opioid or Non-opioid UDS in Lookback Period"
    )


Library NameNamesequence
OpioidCDSCommon US Core-Categorized Conditions 9 
// 3. Medications indicating end of life
    /* or exists (
      "Medications Indicating End of Life"
    ) */

define "US Core-Categorized Conditions":
  [Condition: category in "Encounter Diagnosis Condition Category"]
    union [Condition: category in "Problem List Condition Category"]
    union [Condition: category in "US Core Health Concern Condition Category"]


Library NameNamesequence
OpioidCDSCommon Conditions Indicating End of Life or With Limited Life Expectancy 10 
define "Conditions Indicating End of Life or With Limited Life Expectancy":
  (
    "US Core-Categorized Conditions" C
      where C.code in "Conditions likely terminal for opioid prescribing"
        and C.clinicalStatus in "Active Condition"
  )
  union
  (
    "US Core-Categorized Conditions" C
      where C.code in "Limited life expectancy conditions"
        and C.clinicalStatus in "Active Condition"
  )


Library NameNamesequence
OpioidCDSCommon Admitted/Referred/Discharged to Hospice Care 11 
define "Admitted/Referred/Discharged to Hospice Care":
  (
    if (Config."Hospice Findings Exclusion Enabled") then
      [Observation: code in "Hospice Finding Codes"] O
        where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' })
    else
      {}
  )
  union
  (
    [Encounter] E
      where date from E.period.start 1 year or less on or before Today()
        and (
          if E.hospitalization.dischargeDisposition.coding is null
              or not exists (E.hospitalization.dischargeDisposition.coding)
            then false
          else E.hospitalization.dischargeDisposition in "Hospice Disposition"
        )
        and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }
  )


Library NameNamesequence
OpioidCDSCommon End of Life Assessment 12 
define "End of Life Assessment":
    // 1. Conditions indicating end of life or with limited life expectancy
    exists (
      "Conditions Indicating End of Life or With Limited Life Expectancy"
    )
    // 2. Admitted/referred/discharged to hospice care
    or exists (
      "Admitted/Referred/Discharged to Hospice Care"
    )


Library NameNamesequence
OpioidCDSREC10Common Exclusion Criteria 13 
define "Exclusion Criteria":
  Common."End of Life Assessment"


Library NameNamesequence
OpioidCDSREC10PatientView Is Perform Drug Screen Recommendation Applicable? 14 
define "Is Perform Drug Screen Recommendation Applicable?":
  "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential"
    and Rec10Common."Inclusion Criteria For UDS Recommendation"
    and not Rec10Common."Exclusion Criteria"


Library NameNamesequence
OpioidCDSREC10Common Amphetamine Simple Identifier 15 
define "Amphetamine Simple Identifier": 'Amphetamine'


Library NameNamesequence
OpioidCDSREC10Common UDS Lookback Period 16 
// Constants

define "UDS Lookback Period":
  Interval[Today() - 12 months - 1 days, Today()]


Library NameNamesequence
OpioidCDSREC10Common All Opioid or Non-opioid UDS in Lookback Period 17 
define "All Opioid or Non-opioid UDS in Lookback Period":
  (
    [Observation: Common."All Drug Urine Screening"] Lab
      where date from Lab.effective in day of "UDS Lookback Period"
        and not (
          Lab.status in { 'unknown', 'entered-in-error', 'cancelled' }
        )
  ) X sort by date from effective desc


Library NameNamesequence
OpioidCDSREC10Common Amphetamine Screenings In Lookback Period 18 
// Amphetamines
define "Amphetamine Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Amphetamine Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Amphetamine Screenings In Lookback Period 19 
define "Positive Amphetamine Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Amphetamine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Amphetamine Screenings In Lookback Period 20 
define "Negative Amphetamine Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Amphetamine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Rx Lookback Period 21 
define "Rx Lookback Period":
  Interval[Today() - 12 months - 31 days, Today()]


Library NameNamesequence
OpioidCDSREC10Common Normalize Rx In Lookback Period 22 
define "Normalize Rx In Lookback Period":
  Common."Get MedicationRequest Medication as Code"(
    [MedicationRequest: category in Common."Community"] Rx
      where Rx.status in { 'active', 'completed', 'stopped' }
        and Rx.intent = 'order'
        and Common."GetDateFromMedicationRequest"(Rx) in day of "Rx Lookback Period"
  )


Library NameNamesequence
OpioidCDSREC10Common Amphetamine Rx In Lookback Period 23 
define "Amphetamine Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
      where Rx.medication in Common."Amphetamine Medications"


Library NameNamesequence
OpioidCDSREC10Common Barbiturate Simple Identifier 24 
define "Barbiturate Simple Identifier": 'Barbiturate'


Library NameNamesequence
OpioidCDSREC10Common Barbiturate Screenings In Lookback Period 25 
// Barbiturates
define "Barbiturate Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Barbiturate Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Barbiturate Screenings In Lookback Period 26 
define "Positive Barbiturate Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Barbiturate Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Barbiturate Screenings In Lookback Period 27 
define "Negative Barbiturate Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Barbiturate Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Barbiturate Rx In Lookback Period 28 
define "Barbiturate Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
      where Rx.medication in Common."Barbiturate Medications"


Library NameNamesequence
OpioidCDSREC10Common Benzodiazepine Simple Identifier 29 
define "Benzodiazepine Simple Identifier": 'Benzodiazepine'


Library NameNamesequence
OpioidCDSREC10Common Benzodiazepine Screenings In Lookback Period 30 
// Benzodiazepines
define "Benzodiazepine Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Benzodiazepine Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Benzodiazepine Screenings In Lookback Period 31 
define "Positive Benzodiazepine Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Benzodiazepine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Benzodiazepine Screenings In Lookback Period 32 
define "Negative Benzodiazepine Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Benzodiazepine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Benzodiazepine Rx In Lookback Period 33 
define "Benzodiazepine Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Benzodiazepine medications"


Library NameNamesequence
OpioidCDSREC10Common Buprenorphine Simple Identifier 34 
define "Buprenorphine Simple Identifier": 'Buprenorphine'


Library NameNamesequence
OpioidCDSREC10Common Buprenorphine Screenings In Lookback Period 35 
// Buprenorphine
define "Buprenorphine Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Buprenorphine Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Buprenorphine Screenings In Lookback Period 36 
define "Positive Buprenorphine Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Buprenorphine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Buprenorphine Screenings In Lookback Period 37 
define "Negative Buprenorphine Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Buprenorphine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Buprenorphine Rx In Lookback Period 38 
define "Buprenorphine Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Buprenorphine Medications"


Library NameNamesequence
OpioidCDSREC10Common Cannabinoid Simple Identifier 39 
define "Cannabinoid Simple Identifier": 'Cannabinoid'


Library NameNamesequence
OpioidCDSREC10Common Cannabinoid Screenings In Lookback Period 40 
// Cannabinoids
define "Cannabinoid Screenings In Lookback Period":
  if Config."Cannabinoid Urine Screening Check Enabled"
    then (
      "All Opioid or Non-opioid UDS in Lookback Period" Lab
        where Lab.code in Common."Cannabinoid Urine Tests"
    ) else null


Library NameNamesequence
OpioidCDSCommonConfig Cannabinoid Urine Screening Check Enabled 41 
define "Cannabinoid Urine Screening Check Enabled":
  false


Library NameNamesequence
OpioidCDSREC10Common Positive Cannabinoid Screenings In Lookback Period 42 
define "Positive Cannabinoid Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Cannabinoid Screenings In Lookback Period", Config."Cannabinoid Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Negative Cannabinoid Screenings In Lookback Period 43 
define "Negative Cannabinoid Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Cannabinoid Screenings In Lookback Period", Config."Cannabinoid Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Cocaine Simple Identifier 44 
define "Cocaine Simple Identifier": 'Cocaine'


Library NameNamesequence
OpioidCDSREC10Common Cocaine Screenings In Lookback Period 45 
// Cocaine
define "Cocaine Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Cocaine Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Cocaine Screenings In Lookback Period 46 
define "Positive Cocaine Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Cocaine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Cocaine Screenings In Lookback Period 47 
define "Negative Cocaine Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Cocaine Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Fentanyl Simple Identifier 48 
define "Fentanyl Simple Identifier": 'Fentanyl'


Library NameNamesequence
OpioidCDSREC10Common Fentanyl Screenings In Lookback Period 49 
// Fentanyl
define "Fentanyl Screenings In Lookback Period":
  if Config."Opiate Urine Screening Check Enabled"
  then (
    "All Opioid or Non-opioid UDS in Lookback Period" AllLabs
      where AllLabs.code in Common."Fentanyl Urine Tests"
  ) else null


Library NameNamesequence
OpioidCDSCommonConfig Opiate Urine Screening Check Enabled 50 
// Recommendation 10
define "Opiate Urine Screening Check Enabled":
  true


Library NameNamesequence
OpioidCDSREC10Common Positive Fentanyl Screenings In Lookback Period 51 
define "Positive Fentanyl Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Fentanyl Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Negative Fentanyl Screenings In Lookback Period 52 
define "Negative Fentanyl Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Fentanyl Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Fentanyl Rx In Lookback Period 53 
define "Fentanyl Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Fentanyl Medications"


Library NameNamesequence
OpioidCDSREC10Common Heroin Simple Identifier 54 
define "Heroin Simple Identifier": 'Heroin (6-AM)'


Library NameNamesequence
OpioidCDSREC10Common Heroin Screenings In Lookback Period 55 
// Heroin
define "Heroin Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Heroin Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Heroin Screenings In Lookback Period 56 
define "Positive Heroin Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Heroin Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Heroin Screenings In Lookback Period 57 
define "Negative Heroin Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Heroin Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Methadone Simple Identifier 58 
define "Methadone Simple Identifier": 'Methadone'


Library NameNamesequence
OpioidCDSREC10Common Methadone Screenings In Lookback Period 59 
// Methadone
define "Methadone Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" Lab
    where Lab.code in Common."Methadone Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive Methadone Screenings In Lookback Period 60 
define "Positive Methadone Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Methadone Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative Methadone Screenings In Lookback Period 61 
define "Negative Methadone Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Methadone Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Methadone Rx In Lookback Period 62 
define "Methadone Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Methadone Medications"


Library NameNamesequence
OpioidCDSREC10Common Opiate Simple Identifier 63 
define "Opiate Simple Identifier": 'Opiate'


Library NameNamesequence
OpioidCDSREC10Common Opiate Screenings In Lookback Period 64 
// Opiates
define "Opiate Screenings In Lookback Period":
  if Config."Opiate Urine Screening Check Enabled"
    then (
      "All Opioid or Non-opioid UDS in Lookback Period" Lab
        where Lab.code in Common."General Opiate Urine Tests"
    ) else null


Library NameNamesequence
OpioidCDSREC10Common Positive Opiate Screenings In Lookback Period 65 
define "Positive Opiate Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Opiate Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Negative Opiate Screenings In Lookback Period 66 
define "Negative Opiate Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Opiate Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Opiate Rx In Lookback Period 67 
define "Opiate Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Opiate Medications"


Library NameNamesequence
OpioidCDSREC10Common Oxycodone Simple Identifier 68 
define "Oxycodone Simple Identifier": 'Oxycodone'


Library NameNamesequence
OpioidCDSREC10Common Oxycodone Screenings In Lookback Period 69 
// Oxycodone
define "Oxycodone Screenings In Lookback Period":
  if Config."Opiate Urine Screening Check Enabled"
    then (
      "All Opioid or Non-opioid UDS in Lookback Period" Lab
        where Lab.code in Common."Oxycodone Urine Tests"
    ) else null


Library NameNamesequence
OpioidCDSREC10Common Positive Oxycodone Screenings In Lookback Period 70 
define "Positive Oxycodone Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("Oxycodone Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Negative Oxycodone Screenings In Lookback Period 71 
define "Negative Oxycodone Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("Oxycodone Screenings In Lookback Period", Config."Opiate Urine Screening Check Enabled")


Library NameNamesequence
OpioidCDSREC10Common Oxycodone Rx In Lookback Period 72 
define "Oxycodone Rx In Lookback Period":
  "Normalize Rx In Lookback Period" Rx
    where Rx.medication in Common."Oxycodone Medications"


Library NameNamesequence
OpioidCDSREC10Common PCP Simple Identifier 73 
define "PCP Simple Identifier": 'Phencyclidine (PCP)'


Library NameNamesequence
OpioidCDSREC10Common PCP Screenings In Lookback Period 74 
// PCP
define "PCP Screenings In Lookback Period":
  "All Opioid or Non-opioid UDS in Lookback Period" AllLabs
    where AllLabs.code in Common."PCP Urine Tests"


Library NameNamesequence
OpioidCDSREC10Common Positive PCP Screenings In Lookback Period 75 
define "Positive PCP Screenings In Lookback Period":
  GetPositiveLabsInLookbackPeriod("PCP Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Negative PCP Screenings In Lookback Period 76 
define "Negative PCP Screenings In Lookback Period":
  GetNegativeLabsInLookbackPeriod("PCP Screenings In Lookback Period", true)


Library NameNamesequence
OpioidCDSREC10Common Unexpected Details 77 
// Details Logic

define "Unexpected Details":
  {
    CreateDetailWithPossibleUnexpectedNegative(
      "Amphetamine Simple Identifier", "Positive Amphetamine Screenings In Lookback Period", 
      "Negative Amphetamine Screenings In Lookback Period", "Amphetamine Rx In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Barbiturate Simple Identifier", "Positive Barbiturate Screenings In Lookback Period", 
      "Negative Barbiturate Screenings In Lookback Period", "Barbiturate Rx In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Benzodiazepine Simple Identifier", "Positive Benzodiazepine Screenings In Lookback Period", 
      "Negative Benzodiazepine Screenings In Lookback Period", "Benzodiazepine Rx In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Buprenorphine Simple Identifier", "Positive Buprenorphine Screenings In Lookback Period", 
      "Negative Buprenorphine Screenings In Lookback Period", "Buprenorphine Rx In Lookback Period"
    ),
    CreateDetailWithoutPossibleUnexpectedNegative(
      "Cannabinoid Simple Identifier", "Positive Cannabinoid Screenings In Lookback Period", 
      "Negative Cannabinoid Screenings In Lookback Period"
    ),
    CreateDetailWithoutPossibleUnexpectedNegative(
      "Cocaine Simple Identifier", "Positive Cocaine Screenings In Lookback Period", 
      "Negative Cocaine Screenings In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Fentanyl Simple Identifier", "Positive Fentanyl Screenings In Lookback Period", 
      "Negative Fentanyl Screenings In Lookback Period", "Fentanyl Rx In Lookback Period"
    ),
    CreateDetailWithoutPossibleUnexpectedNegative(
      "Heroin Simple Identifier", "Positive Heroin Screenings In Lookback Period", 
      "Negative Heroin Screenings In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Methadone Simple Identifier", "Positive Methadone Screenings In Lookback Period", 
      "Negative Methadone Screenings In Lookback Period", "Methadone Rx In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Opiate Simple Identifier", "Positive Opiate Screenings In Lookback Period", 
      "Negative Opiate Screenings In Lookback Period", "Opiate Rx In Lookback Period"
    ),
    CreateDetailWithPossibleUnexpectedNegative(
      "Oxycodone Simple Identifier", "Positive Oxycodone Screenings In Lookback Period", 
      "Negative Oxycodone Screenings In Lookback Period", "Oxycodone Rx In Lookback Period"
    ),
    CreateDetailWithoutPossibleUnexpectedNegative(
      "PCP Simple Identifier", "Positive PCP Screenings In Lookback Period", 
      "Negative PCP Screenings In Lookback Period"
    )
  }


Library NameNamesequence
OpioidCDSREC10Common Remove Substances Without Positive or Negative Results 78 
define "Remove Substances Without Positive or Negative Results":
  "Unexpected Details" Details
    where (Details.posDates is not null and Length(Details.posDates) != 0)
      or (Details.negDates is not null and Length(Details.negDates) != 0)


Library NameNamesequence
OpioidCDSREC10Common Inclusion Criteria For Unexpected Results 79 
define "Inclusion Criteria For Unexpected Results":
  Routines."Is Opioid Review Useful?"
  and AnyTrue(
    "Remove Substances Without Positive or Negative Results" Details
      return (exists Details.unexpectedPosDetails) or (exists Details.unexpectedNegDetails)
  )


Library NameNamesequence
OpioidCDSREC10PatientView Applicable Because of Unexpected Results 80 
define "Applicable Because of Unexpected Results":
  "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential"
    and Rec10Common."Inclusion Criteria For Unexpected Results"
    and not Rec10Common."Exclusion Criteria"


Library NameNamesequence
OpioidCDSCommon Style Header 81 
define "Style Header":
  '<style>\r\n  .alert-body {\r\n    width: 670px;\r\n    font-family: segoe-ui, sans-serif;\r\n    background-color: #FEFFF1;\r\n  }\r\n\r\n  .details-table {\r\n    border-collapse:collapse;\r\n    border-style: ridge;\r\n    background-color: #FEFFF1;\r\n    padding: 2px;\r\n  }\r\n\r\n  .details-caption {\r\n    border-style: ridge;\r\n    border-bottom: none;\r\n    background-color: #FEFFF1;\r\n    padding: 2px;\r\n  }\r\n\r\n  .details-table-header {\r\n    border-style: ridge;\r\n    padding: 5px;\r\n  }\r\n\r\n  .details-table-cell {\r\n    border-style: ridge;\r\n    padding: 5px;\r\n  }\r\n\r\n  .details-table-footer-cell {\r\n    border-style: ridge;\r\n    padding: 5px;\r\n    font-size: small;\r\n  }\r\n\r\n  .details-table-cell-unexpected {\r\n    border-style: ridge;\r\n    padding: 5px;\r\n    color: red;\r\n    font-weight: bold;\r\n  }\r\n\r\n  .more-text {\r\n    position: relative;\r\n    margin-bottom: 2em;\r\n  }\r\n  \r\n  .more {\r\n    display:none;\r\n  }\r\n\r\n  .show-more:checked + .more {\r\n    display:block;\r\n  }\r\n<\/style>'


Library NameNamesequence
OpioidCDSREC10Common Unexpected Div Start 82 
define "Unexpected Div Start":
  '<div class=\"alert-body\"><div><p>Patient may have <strong>unexpected urine toxicology test results<\/strong> in the past year.<\/p><\/div>'


Library NameNamesequence
OpioidCDSREC10Common Table Start 83 
define "Table Start":
  '<div><table class=\"details-table\"><caption class=\"details-caption\">Urine Toxicology Results<\/caption><tr><th class=\"details-table-header\">Substance<\/th>'


Library NameNamesequence
OpioidCDSREC10Common All Lab Dates in Lookback Period 84 
// Helpers  

define "All Lab Dates in Lookback Period":
  (
    "All Opioid or Non-opioid UDS in Lookback Period" Lab
      return date from Lab.effective
  ) X sort desc


Library NameNamesequence
OpioidCDSREC10Common Table Headers 85 
define "Table Headers":
  "All Lab Dates in Lookback Period" LabDate
    return '<th class=\"details-table-header\">' & ToString(LabDate) & '<\/th>'


Library NameNamesequence
OpioidCDSREC10Common Generate Table Rows 86 
define "Generate Table Rows":
  "Remove Substances Without Positive or Negative Results" BOT
    let row: ToString(IndexOf("Remove Substances Without Positive or Negative Results", BOT) + 1)
    return '<tr>' + GetExpectedColumn(BOT.ingredient) + Combine(
      "All Lab Dates in Lookback Period" LabDate
        let col: ToString(IndexOf("All Lab Dates in Lookback Period", LabDate) + 2)
        return all (
          if BOT.unexpectedPosDetails.date contains LabDate
            then GetUnexpectedColumn('pos', row & ':' & col)
          else if BOT.unexpectedNegDetails.udsDate contains LabDate
            then GetUnexpectedColumn('neg', row & ':' & col)
          else if BOT.posDates contains LabDate
            then GetExpectedColumn('pos*')
          else if BOT.negDates contains LabDate
            then GetExpectedColumn('neg*')
          else GetExpectedColumn('n/a')
        )
    ) + '<\/tr>'


Library NameNamesequence
OpioidCDSREC10Common Generate Footer Rows 87 
define "Generate Footer Rows":
  "Remove Substances Without Positive or Negative Results" BOT
      let row: ToString(IndexOf("Remove Substances Without Positive or Negative Results", BOT) + 1),
      colspan: Length("All Lab Dates in Lookback Period") + 1
      return Combine(
          "All Lab Dates in Lookback Period" LabDate
            let col: ToString(IndexOf("All Lab Dates in Lookback Period", LabDate) + 2)
            return all (
              if BOT.unexpectedPosDetails.date contains LabDate
                then Coalesce(
                  BOT.unexpectedPosDetails PosDetail
                    where PosDetail.date same day as LabDate
                      return '<tr>' & GetFooterColumn(colspan, row & ':' & col & ' - Possible unexpected substance found: ' & PosDetail.udsDetail) & '<\/tr>'
                )
              else if BOT.unexpectedNegDetails.udsDate contains LabDate
                then Coalesce(
                  BOT.unexpectedNegDetails NegDetail
                    where NegDetail.udsDate same day as LabDate
                      return '<tr>' & GetFooterColumn(colspan, row + ':' & col & ' - Possible unexpected negative result found: prescribed ' & NegDetail.rxDetail & ' on ' & ToString(NegDetail.rxDate)) & '<\/tr>'
                )
              else ''
            )
      )


Library NameNamesequence
OpioidCDSREC10Common Table End 88 
define "Table End":
  '<\/table><\/div>'


Library NameNamesequence
OpioidCDSREC10Common Details Table 89 
define "Details Table": 
  "Table Start" & Combine("Table Headers") 
    & '<tbody>' & Combine("Generate Table Rows") & '</tbody>' 
    & '<tfoot>' & Combine("Generate Footer Rows") & '<\/tfoot>' 
  & "Table End"


Library NameNamesequence
OpioidCDSREC10Common Expected Result Footnote 90 
define "Expected Result Footnote":
  '<div>* - These are expected results based on an analysis of the patient\'s medication list 30 days prior to the corresponding lab results.<\/div>'


Library NameNamesequence
OpioidCDSREC10Common Details More Info 91 
define "Details More Info":
  '<div id=\"box\">\r\n  <p>Note on false positives and unexpected negative results...<\/p>\r\n  <input type=\"checkbox\" class=\"show-more\"> Show more\r\n  <div class=\"more\">\r\n  <p>An unexpectedly negative test may be due to time since last dose, diversion, intermittent use, aberrant drug use behavior, or other factors, including a false negative result. Clinicians should interpret this result in the context of the overall treatment plan.<\/p>\r\n\r\n  <p>Positive results may be a false positives or could represent occasional use or possible substance use disorder.<br\/><br\/>For a review regarding interpreting possible false positive urine toxicology results, see <a target=\"_blank\" href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24986836\">http:\/\/pubmed.ncbi.nlm.nih.gov\/24986836<\/a>. It is unknown if the findings reported in this article can be extrapolated to other laboratory analyzers that were not used in the referenced studies.<br\/><br\/>For guidance regarding evaluating and addressing unexpected toxicology tests results, see <a target=\"_blank\" href=\"https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/rr\/rr7103a1.htm#Recommendation10\">Recommendation 10 of the 22 CDC Clinical Practice Guideiline<\/a>.<\/p><\/div>\r\n<\/div>'


Library NameNamesequence
OpioidCDSREC10Common Div End 92 
define "Div End": '<\/div>'


Library NameNamesequence
OpioidCDSREC10Common Get HTML Details 93 
// HTML Generation

define "Get HTML Details":
  Common."Style Header" & "Unexpected Div Start" & "Details Table" & "Expected Result Footnote" & "Details More Info" & "Div End"


Library NameNamesequence
OpioidCDSREC10PatientView Detail 94 
define "Detail":
  Rec10Common."Get HTML Details"


Library NameNamesequence
OpioidCDSRoutines Is Subacute or Chronic Pain Prescription? 95 
// End of Active Cancer Treatment Routine

/*
**  Routine #4
**  For Subacute or Chronic Pain Routine
**
**  Definition                  | Answer to Proceed   | Details                                        | Data (Terminology) Requirement
**  -----------------------------------------------------------------------------------------------------------------------------------
**  Order for opioid analgesic  | Yes                 | Order for opioid analgesics with ambulatory    | Opioid analgesics with
**  with expected supply        |                     | misuse potential with a supply duration of >=  | ambulatory misuse potential
**  duration >= 28 days         |                     | 28 days                                        |
**                              |                     |                                                |
**                              |                     | - Subacute definition = order for opioid       |
**                              |                     |   analgesics with ambulatory misuse            |
**                              |                     |   potential with a supply duration of one to   |
**                              |                     |   two months.                                  |
**                              |                     | - Chronic pain definition = order for opioid   |
**                              |                     |   analgesics with ambulatory misuse            |
**                              |                     |   potential with a supply duration of >= two   |
**                              |                     |   months.                                      |
**  -----------------------------------------------------------------------------------------------------------------------------------
**
*/

define function "Is Subacute or Chronic Pain Prescription?"(prescription FHIR.MedicationRequest):
  "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription)
    or "Is Subacute or Chronic Pain Using Validity Period"(prescription)


Library NameNamesequence
OpioidCDSRoutines Is Subacute or Chronic Pain Using Expected Supply Duration 96 
define function "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription FHIR.MedicationRequest):
  (
    prescription.dispenseRequest is not null
      and prescription.dispenseRequest.expectedSupplyDuration is not null
      and (
        Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days 
      )
  )


Library NameNamesequence
OpioidCDSCommon GetDurationInDays 97 
define function GetDurationInDays(value FHIR.Duration):
  if value is null then null
  else
    case
      when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' }
      when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' }
      when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' }
      when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' }
      when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' }
      when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' }
      when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' }
      when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' }
      when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null')
      else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value)
end


Library NameNamesequence
OpioidCDSRoutines Is Subacute or Chronic Pain Using Validity Period 98 
define function "Is Subacute or Chronic Pain Using Validity Period"(prescription FHIR.MedicationRequest):
  (
    prescription.dispenseRequest is not null
      and prescription.dispenseRequest.validityPeriod is not null
      and (
        days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 
      )
  )


Library NameNamesequence
FHIRHelpers ToDateTime 99 
define function ToDateTime(value dateTime): value.value


Library NameNamesequence
FHIRHelpers ToConcept 100 
define function ToConcept(concept FHIR.CodeableConcept):
    if concept is null then
        null
    else
        System.Concept {
            codes: concept.coding C return ToCode(C),
            display: concept.text.value
        }


Library NameNamesequence
OpioidCDSREC10Common CreateDetailWithPossibleUnexpectedNegative 101 
define function CreateDetailWithPossibleUnexpectedNegative(TheSubstance String, ThePosLabs List<Observation>, TheNegLabs List<Observation>, TheMeds List<MedicationRequest>):
  {
    ingredient: TheSubstance,
    posDates: (
      ThePosLabs PosLab
        return date from PosLab.effective
    ),
    negDates: (
      TheNegLabs NegLab
        return date from NegLab.effective
    ),
    unexpectedPosDetails: (
      ThePosLabs PosLab
        where not exists (
          TheMeds Rx
            where Common.GetDateFromMedicationRequest(Rx)
              in day of Interval[
                date from PosLab.effective - 31 days,
                date from PosLab.effective - 1 days
              ]
        )
        return {
          date: date from PosLab.effective,
          udsDetail:
            if exists(PosLab.code.coding)
              then PosLab.code.coding[0].display
              else 'Unable to determine a detailed identifier'
        }
    ),
    unexpectedNegDetails: (
      from TheNegLabs NegLab,
        ( if exists(TheMeds) then TheMeds else { null as MedicationRequest } ) Rx
        let medDate: Common.GetDateFromMedicationRequest(Rx)
          where medDate in day of Interval[date from NegLab.effective - 31 days, date from NegLab.effective - 1 days]
          return {
            udsDate: date from NegLab.effective,
            udsDetail: if exists (NegLab.code.coding) then NegLab.code.coding[0].display else 'Unable to determine a detailed identifier',
            rxDate: medDate,
            rxDetail: 
              if Rx.medication.text is not null then Rx.medication.text
              else if exists (Rx.medication.coding) and Rx.medication.coding[0].display is not null then Rx.medication.coding[0].display 
              else 'Unable to determine a detailed identifier'
          }
    )
  }


Library NameNamesequence
OpioidCDSCommon GetDateFromMedicationRequest 102 
define function "GetDateFromMedicationRequest"(med FHIR.MedicationRequest):
  if med is null then
    null
  else if med.authoredOn is not null then
    date from med.authoredOn
  else
    Max(
      med.dosageInstruction DI
        return Coalesce(
          // If there are timing events, take the latest.
          Max(DI.timing.event E return date from E),
          // Otherwise, if there's a Period, use its start.
          if DI.timing.repeat is not null
             and DI.timing.repeat.bounds is FHIR.Period
          then
            date from start of FHIRHelpers.ToInterval(DI.timing.repeat.bounds as FHIR.Period)
          else
            null
        )
    )


Library NameNamesequence
OpioidCDSREC10Common GetPositiveLabsInLookbackPeriod 103 
define function GetPositiveLabsInLookbackPeriod(Labs List<FHIR.Observation>, Enabled Boolean):
  if Enabled
    then Labs Lab
     where StartsWith(Lower(Lab.value as FHIR.string), 'pos')
  else {}


Library NameNamesequence
FHIRHelpers ToString 104 
define function ToString(value ObservationStatus): value.value


Library NameNamesequence
OpioidCDSREC10Common GetNegativeLabsInLookbackPeriod 105 
define function GetNegativeLabsInLookbackPeriod(Labs List<FHIR.Observation>, Enabled Boolean):
  if Enabled
    then Labs Lab
     where StartsWith(Lower(Lab.value as FHIR.string), 'neg')
  else {}


Library NameNamesequence
OpioidCDSCommon Get MedicationRequest Medication as Code 106 
define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>):
  value Rx
    let Med: 
      if Rx.medication is Reference then singleton from (
        [Medication] M
          where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/')))
      ) else null
    return 
      MedicationRequest {
        id: Rx.id,
        status: Rx.status,
        intent: Rx.intent,
        category: Rx.category,
        medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept,
        subject: Rx.subject,
        authoredOn: Rx.authoredOn,
        recorder: Rx.recorder,
        dosageInstruction: Rx.dosageInstruction,
        dispenseRequest: Rx.dispenseRequest
      }


Library NameNamesequence
OpioidCDSREC10Common CreateDetailWithoutPossibleUnexpectedNegative 107 
define function CreateDetailWithoutPossibleUnexpectedNegative(TheSubstance String, ThePosLabs List<Observation>, TheNegLabs List<Observation>):
  {
    ingredient: TheSubstance,
    posDates: (
      ThePosLabs PosLab
        return date from PosLab.effective
    ),
    negDates: (
      TheNegLabs NegLab
        return date from NegLab.effective
    ),
    unexpectedPosDetails: (
      ThePosLabs PosLab
        return {
          date: date from PosLab.effective,
          udsDetail: if exists (PosLab.code.coding) then PosLab.code.coding[0].display else 'Unable to determine a detailed identifier'
        }
    ),
    unexpectedNegDetails: {
      null as Tuple{ udsDate System.Date, udsDetail System.String, rxDate System.Date, rxDetail System.String }
    }
  }


Library NameNamesequence
OpioidCDSREC10Common GetExpectedColumn 108 
define function GetExpectedColumn(Content String):
  '<td class=\"details-table-cell\">' & Content & '<\/td>'
Knowledge Capability: shareable computable executable publishable
Use Context:
codevaluedisplay
focus 82423001 Chronic pain (finding)
focus
Purpose:

The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.
Usage: Before starting opioids and periodically (at least annually) during opioid therapy, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed opioids and other prescription and nonprescription controlled substances that increase risk for overdose when combined with opioids, including nonprescribed and illicit opioids and benzodiazepines.
Copyright:

© CDC 2016+.
Related Artifacts:

Documentation
Libraries:
Library - Recommendation #10 Patient View - Urine Drug Testing
Actions:
1. Consider the Benefits and Risks of Conducting a Urine Toxicology Screen: Consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances. For guidance regarding utilizing toxicology tests when prescribing opioids, see [Recommendation 10 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=evidence%20type%3A%204).-,Implementation%20Considerations,-Toxicology%20testing%20should).
When: Named Event: patient-view
If: Applicability: Patient has not had a urine screening in the past 12 months (Is Perform Drug Screen Recommendation Applicable?)
Then:
: Document - Ordered toxicology screen
Then:
: Document - Risks outweigh benefits
Then:
: Snooze* - N/A see comment, snooze 3 months
Then:
2. Patient May Have Unexpected Toxicology Test Results: Patient may have unexpected urine toxicology test results in the past year
When: Named Event: patient-view
If: Applicability: Urine screening tested positive for cocaine, opiates or PCP (Applicable Because of Unexpected Results)
Then:
: Document - Will repeat urine drug screen more frequently
Then:
: Will consult with patient regarding possible unexpected test results
Then:
: Document - Will assess patient for substance use disorder
Then:
: Snooze* - Patient's test results were expected, snooze for 3 months
Then:
: Snooze* - N/A snooze for 3 months
Then:

Source

{
  "resourceType": "PlanDefinition",
  "id": "opioidcds-10-patient-view",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition",
      "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library Common",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0"
        },
        {
          "type": "depends-on",
          "display": "Library Routines",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Library Rec10Common",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC10Common|2022.1.0"
        },
        {
          "type": "depends-on",
          "display": "Library Config",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig|2022.1.0"
        },
        {
          "type": "depends-on",
          "display": "Value set Encounter Diagnosis Condition Category",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category"
        },
        {
          "type": "depends-on",
          "display": "Value set Problem List Condition Category",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category"
        },
        {
          "type": "depends-on",
          "display": "Value set US Core Health Concern Condition Category",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"
        },
        {
          "type": "depends-on",
          "display": "Value set Conditions likely terminal for opioid prescribing",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/conditions-likely-terminal-for-opioid-prescribing"
        },
        {
          "type": "depends-on",
          "display": "Value set Active Condition",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active"
        },
        {
          "type": "depends-on",
          "display": "Value set Limited life expectancy conditions",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions"
        },
        {
          "type": "depends-on",
          "display": "Value set All Drug Urine Screening",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/all-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Amphetamine Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/amphetamine-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Community",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community"
        },
        {
          "type": "depends-on",
          "display": "Value set Amphetamine Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/amphetamines-class-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Barbiturate Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/barbiturate-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Barbiturate Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/barbiturate-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Benzodiazepine Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/benzodiazepine-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Benzodiazepine medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/benzodiazepine-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Buprenorphine Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Buprenorphine Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/buprenorphine-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Cocaine Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/cocaine-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Fentanyl Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/fentanyl-type-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Heroin Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/heroin-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Methadone Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/methadone-urine-drug-screening-tests"
        },
        {
          "type": "depends-on",
          "display": "Value set Methadone Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/methadone-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Opiate Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/non-synthetic-opioid-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set Oxycodone Medications",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/oxycodone-medications"
        },
        {
          "type": "depends-on",
          "display": "Value set PCP Urine Tests",
          "resource": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/phencyclidine-urine-drug-screening-tests"
        }
      ],
      "parameter": [
        {
          "name": "Is Perform Drug Screen Recommendation Applicable?",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Applicable Because of Unexpected Results",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Detail",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "string"
        }
      ],
      "dataRequirement": [
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "category",
            "code",
            "clinicalStatus"
          ],
          "codeFilter": [
            {
              "path": "category",
              "valueSet": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category"
            }
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "category",
            "code",
            "clinicalStatus"
          ],
          "codeFilter": [
            {
              "path": "category",
              "valueSet": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category"
            }
          ]
        },
        {
          "type": "Condition",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Condition"
          ],
          "mustSupport": [
            "category",
            "code",
            "clinicalStatus"
          ],
          "codeFilter": [
            {
              "path": "category",
              "valueSet": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"
            }
          ]
        },
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "period",
            "period.start",
            "status",
            "status.value"
          ]
        },
        {
          "type": "Observation",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Observation"
          ],
          "mustSupport": [
            "code",
            "effective",
            "status"
          ],
          "codeFilter": [
            {
              "path": "code",
              "valueSet": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/all-urine-drug-screening-tests"
            }
          ]
        },
        {
          "type": "MedicationRequest",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
          ],
          "mustSupport": [
            "category",
            "status",
            "intent",
            "id",
            "subject",
            "authoredOn",
            "recorder",
            "dosageInstruction",
            "dispenseRequest",
            "medication"
          ],
          "codeFilter": [
            {
              "path": "category",
              "valueSet": "http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability",
      "valueCode": "shareable"
    },
    {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability",
      "valueCode": "computable"
    },
    {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability",
      "valueCode": "executable"
    },
    {
      "url": "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability",
      "valueCode": "publishable"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "Active Ambulatory Opioid Rx"
        },
        {
          "url": "statement",
          "valueString": "define \"Active Ambulatory Opioid Rx\":\n    if Config.\"Can the implementing EHR support queries for past medications by date range?\" then\n      (\n        \"Get MedicationRequest Medication as Code\"(\"Get Active Ambulatory Medication Requests\"([MedicationRequest]))\n      ) Rx\n        where date from Rx.authoredOn 2 years or less on or before Today()\n          and Rx.medication in \"Opioid analgesics with ambulatory misuse potential\"\n    else\n        List<FHIR.MedicationRequest>{}"
        },
        {
          "url": "displaySequence",
          "valueInteger": 0
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10PatientView"
        },
        {
          "url": "name",
          "valueString": "Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions"
        },
        {
          "url": "statement",
          "valueString": "define \"Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions\":\n  Common.\"Active Ambulatory Opioid Rx\" AmbulatoryOpioidPrescription\n    where Routines.\"Is Subacute or Chronic Pain Prescription?\"(AmbulatoryOpioidPrescription)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 1
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10PatientView"
        },
        {
          "url": "name",
          "valueString": "Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential"
        },
        {
          "url": "statement",
          "valueString": "define \"Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential\":\n  exists (\"Chronic Pain Opioid Analgesic with Ambulatory Misuse Potential Prescriptions\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 2
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Patient Age Less Than 18"
        },
        {
          "url": "statement",
          "valueString": "define \"Patient Age Less Than 18\":\n  if (Config.\"Age Less than 18 Years Is Enabled\") then\n    AgeInYearsAt(Today()) < 18\n  else false"
        },
        {
          "url": "displaySequence",
          "valueInteger": 3
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Condition Positive for Sickle Cell"
        },
        {
          "url": "statement",
          "valueString": "define \"Condition Positive for Sickle Cell\":\n  if (Config.\"Sickle Cell Check Enabled\") then\n    exists(\n      Common.\"Positive Sickle Cell Condition\"\n    ) \n  else false"
        },
        {
          "url": "displaySequence",
          "valueInteger": 4
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Is Active Cancer Treatment?"
        },
        {
          "url": "statement",
          "valueString": "define \"Is Active Cancer Treatment?\":\n  if (Config.\"Active Cancer Treatment Encounters Condition Is Enabled\") \n    then \"Has Two or More Encounters with Cancer Diagnosis During Encounter Period\"\n      or \"Has Active Cancer Diagnosis on Problem List\"\n  else false"
        },
        {
          "url": "displaySequence",
          "valueInteger": 5
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Conditions Likely Terminal for Opioid Prescribing"
        },
        {
          "url": "statement",
          "valueString": "define \"Conditions Likely Terminal for Opioid Prescribing\":\n  if (Config.\"End-Stage Disease Criteria Enabled\") then\n    exists (\n      Common.\"US Core-Categorized Conditions\" EOLC\n        where EOLC.code in Common.\"Conditions likely terminal for opioid prescribing\"\n          // and EOLC.clinicalStatus in Common.\"Active Condition\"\n    )\n  else false"
        },
        {
          "url": "displaySequence",
          "valueInteger": 6
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Is Opioid Review Useful?"
        },
        {
          "url": "statement",
          "valueString": "define \"Is Opioid Review Useful?\":\n  not \"Patient Age Less Than 18\"\n    and not \"Condition Positive for Sickle Cell\"\n    and not \"Is Active Cancer Treatment?\"\n    and not \"Conditions Likely Terminal for Opioid Prescribing\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 7
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Inclusion Criteria For UDS Recommendation"
        },
        {
          "url": "statement",
          "valueString": "/*\n@description: Determines whether an opioid review is appropriate for the patient and whether they had a UDS performed in the past year\n*/\ndefine \"Inclusion Criteria For UDS Recommendation\":\n  Routines.\"Is Opioid Review Useful?\"\n    and not exists (\n      if Config.\"Use Alternative UDS Lookback Period\"\n        then \"All Opioid or Non-opioid UDS in Alternative Lookback Period\"\n      else \"All Opioid or Non-opioid UDS in Lookback Period\"\n    )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 8
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "US Core-Categorized Conditions"
        },
        {
          "url": "statement",
          "valueString": "// 3. Medications indicating end of life\n    /* or exists (\n      \"Medications Indicating End of Life\"\n    ) */\n\ndefine \"US Core-Categorized Conditions\":\n  [Condition: category in \"Encounter Diagnosis Condition Category\"]\n    union [Condition: category in \"Problem List Condition Category\"]\n    union [Condition: category in \"US Core Health Concern Condition Category\"]"
        },
        {
          "url": "displaySequence",
          "valueInteger": 9
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "Conditions Indicating End of Life or With Limited Life Expectancy"
        },
        {
          "url": "statement",
          "valueString": "define \"Conditions Indicating End of Life or With Limited Life Expectancy\":\n  (\n    \"US Core-Categorized Conditions\" C\n      where C.code in \"Conditions likely terminal for opioid prescribing\"\n        and C.clinicalStatus in \"Active Condition\"\n  )\n  union\n  (\n    \"US Core-Categorized Conditions\" C\n      where C.code in \"Limited life expectancy conditions\"\n        and C.clinicalStatus in \"Active Condition\"\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 10
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "Admitted/Referred/Discharged to Hospice Care"
        },
        {
          "url": "statement",
          "valueString": "define \"Admitted/Referred/Discharged to Hospice Care\":\n  (\n    if (Config.\"Hospice Findings Exclusion Enabled\") then\n      [Observation: code in \"Hospice Finding Codes\"] O\n        where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' })\n    else\n      {}\n  )\n  union\n  (\n    [Encounter] E\n      where date from E.period.start 1 year or less on or before Today()\n        and (\n          if E.hospitalization.dischargeDisposition.coding is null\n              or not exists (E.hospitalization.dischargeDisposition.coding)\n            then false\n          else E.hospitalization.dischargeDisposition in \"Hospice Disposition\"\n        )\n        and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 11
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "End of Life Assessment"
        },
        {
          "url": "statement",
          "valueString": "define \"End of Life Assessment\":\n    // 1. Conditions indicating end of life or with limited life expectancy\n    exists (\n      \"Conditions Indicating End of Life or With Limited Life Expectancy\"\n    )\n    // 2. Admitted/referred/discharged to hospice care\n    or exists (\n      \"Admitted/Referred/Discharged to Hospice Care\"\n    )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 12
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Exclusion Criteria"
        },
        {
          "url": "statement",
          "valueString": "define \"Exclusion Criteria\":\n  Common.\"End of Life Assessment\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 13
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10PatientView"
        },
        {
          "url": "name",
          "valueString": "Is Perform Drug Screen Recommendation Applicable?"
        },
        {
          "url": "statement",
          "valueString": "define \"Is Perform Drug Screen Recommendation Applicable?\":\n  \"Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential\"\n    and Rec10Common.\"Inclusion Criteria For UDS Recommendation\"\n    and not Rec10Common.\"Exclusion Criteria\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 14
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Amphetamine Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Amphetamine Simple Identifier\": 'Amphetamine'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 15
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "UDS Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Constants\n\ndefine \"UDS Lookback Period\":\n  Interval[Today() - 12 months - 1 days, Today()]"
        },
        {
          "url": "displaySequence",
          "valueInteger": 16
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "All Opioid or Non-opioid UDS in Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"All Opioid or Non-opioid UDS in Lookback Period\":\n  (\n    [Observation: Common.\"All Drug Urine Screening\"] Lab\n      where date from Lab.effective in day of \"UDS Lookback Period\"\n        and not (\n          Lab.status in { 'unknown', 'entered-in-error', 'cancelled' }\n        )\n  ) X sort by date from effective desc"
        },
        {
          "url": "displaySequence",
          "valueInteger": 17
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Amphetamine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Amphetamines\ndefine \"Amphetamine Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Amphetamine Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 18
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Amphetamine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Amphetamine Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Amphetamine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 19
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Amphetamine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Amphetamine Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Amphetamine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 20
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Rx Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Rx Lookback Period\":\n  Interval[Today() - 12 months - 31 days, Today()]"
        },
        {
          "url": "displaySequence",
          "valueInteger": 21
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Normalize Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Normalize Rx In Lookback Period\":\n  Common.\"Get MedicationRequest Medication as Code\"(\n    [MedicationRequest: category in Common.\"Community\"] Rx\n      where Rx.status in { 'active', 'completed', 'stopped' }\n        and Rx.intent = 'order'\n        and Common.\"GetDateFromMedicationRequest\"(Rx) in day of \"Rx Lookback Period\"\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 22
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Amphetamine Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Amphetamine Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n      where Rx.medication in Common.\"Amphetamine Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 23
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Barbiturate Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Barbiturate Simple Identifier\": 'Barbiturate'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 24
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Barbiturate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Barbiturates\ndefine \"Barbiturate Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Barbiturate Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 25
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Barbiturate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Barbiturate Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Barbiturate Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 26
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Barbiturate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Barbiturate Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Barbiturate Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 27
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Barbiturate Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Barbiturate Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n      where Rx.medication in Common.\"Barbiturate Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 28
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Benzodiazepine Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Benzodiazepine Simple Identifier\": 'Benzodiazepine'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 29
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Benzodiazepine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Benzodiazepines\ndefine \"Benzodiazepine Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Benzodiazepine Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 30
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Benzodiazepine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Benzodiazepine Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Benzodiazepine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 31
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Benzodiazepine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Benzodiazepine Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Benzodiazepine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 32
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Benzodiazepine Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Benzodiazepine Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Benzodiazepine medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 33
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Buprenorphine Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Buprenorphine Simple Identifier\": 'Buprenorphine'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 34
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Buprenorphine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Buprenorphine\ndefine \"Buprenorphine Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Buprenorphine Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 35
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Buprenorphine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Buprenorphine Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Buprenorphine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 36
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Buprenorphine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Buprenorphine Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Buprenorphine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 37
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Buprenorphine Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Buprenorphine Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Buprenorphine Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 38
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Cannabinoid Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Cannabinoid Simple Identifier\": 'Cannabinoid'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 39
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Cannabinoid Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Cannabinoids\ndefine \"Cannabinoid Screenings In Lookback Period\":\n  if Config.\"Cannabinoid Urine Screening Check Enabled\"\n    then (\n      \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n        where Lab.code in Common.\"Cannabinoid Urine Tests\"\n    ) else null"
        },
        {
          "url": "displaySequence",
          "valueInteger": 40
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommonConfig"
        },
        {
          "url": "name",
          "valueString": "Cannabinoid Urine Screening Check Enabled"
        },
        {
          "url": "statement",
          "valueString": "define \"Cannabinoid Urine Screening Check Enabled\":\n  false"
        },
        {
          "url": "displaySequence",
          "valueInteger": 41
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Cannabinoid Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Cannabinoid Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Cannabinoid Screenings In Lookback Period\", Config.\"Cannabinoid Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 42
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Cannabinoid Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Cannabinoid Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Cannabinoid Screenings In Lookback Period\", Config.\"Cannabinoid Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 43
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Cocaine Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Cocaine Simple Identifier\": 'Cocaine'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 44
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Cocaine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Cocaine\ndefine \"Cocaine Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Cocaine Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 45
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Cocaine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Cocaine Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Cocaine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 46
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Cocaine Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Cocaine Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Cocaine Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 47
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Fentanyl Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Fentanyl Simple Identifier\": 'Fentanyl'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 48
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Fentanyl Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Fentanyl\ndefine \"Fentanyl Screenings In Lookback Period\":\n  if Config.\"Opiate Urine Screening Check Enabled\"\n  then (\n    \"All Opioid or Non-opioid UDS in Lookback Period\" AllLabs\n      where AllLabs.code in Common.\"Fentanyl Urine Tests\"\n  ) else null"
        },
        {
          "url": "displaySequence",
          "valueInteger": 49
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommonConfig"
        },
        {
          "url": "name",
          "valueString": "Opiate Urine Screening Check Enabled"
        },
        {
          "url": "statement",
          "valueString": "// Recommendation 10\ndefine \"Opiate Urine Screening Check Enabled\":\n  true"
        },
        {
          "url": "displaySequence",
          "valueInteger": 50
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Fentanyl Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Fentanyl Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Fentanyl Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 51
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Fentanyl Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Fentanyl Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Fentanyl Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 52
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Fentanyl Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Fentanyl Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Fentanyl Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 53
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Heroin Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Heroin Simple Identifier\": 'Heroin (6-AM)'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 54
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Heroin Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Heroin\ndefine \"Heroin Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Heroin Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 55
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Heroin Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Heroin Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Heroin Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 56
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Heroin Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Heroin Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Heroin Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 57
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Methadone Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Methadone Simple Identifier\": 'Methadone'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 58
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Methadone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Methadone\ndefine \"Methadone Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n    where Lab.code in Common.\"Methadone Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 59
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Methadone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Methadone Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Methadone Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 60
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Methadone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Methadone Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Methadone Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 61
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Methadone Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Methadone Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Methadone Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 62
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Opiate Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Opiate Simple Identifier\": 'Opiate'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 63
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Opiate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Opiates\ndefine \"Opiate Screenings In Lookback Period\":\n  if Config.\"Opiate Urine Screening Check Enabled\"\n    then (\n      \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n        where Lab.code in Common.\"General Opiate Urine Tests\"\n    ) else null"
        },
        {
          "url": "displaySequence",
          "valueInteger": 64
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Opiate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Opiate Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Opiate Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 65
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Opiate Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Opiate Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Opiate Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 66
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Opiate Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Opiate Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Opiate Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 67
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Oxycodone Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"Oxycodone Simple Identifier\": 'Oxycodone'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 68
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Oxycodone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Oxycodone\ndefine \"Oxycodone Screenings In Lookback Period\":\n  if Config.\"Opiate Urine Screening Check Enabled\"\n    then (\n      \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n        where Lab.code in Common.\"Oxycodone Urine Tests\"\n    ) else null"
        },
        {
          "url": "displaySequence",
          "valueInteger": 69
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive Oxycodone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive Oxycodone Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"Oxycodone Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 70
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative Oxycodone Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative Oxycodone Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"Oxycodone Screenings In Lookback Period\", Config.\"Opiate Urine Screening Check Enabled\")"
        },
        {
          "url": "displaySequence",
          "valueInteger": 71
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Oxycodone Rx In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Oxycodone Rx In Lookback Period\":\n  \"Normalize Rx In Lookback Period\" Rx\n    where Rx.medication in Common.\"Oxycodone Medications\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 72
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "PCP Simple Identifier"
        },
        {
          "url": "statement",
          "valueString": "define \"PCP Simple Identifier\": 'Phencyclidine (PCP)'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 73
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "PCP Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// PCP\ndefine \"PCP Screenings In Lookback Period\":\n  \"All Opioid or Non-opioid UDS in Lookback Period\" AllLabs\n    where AllLabs.code in Common.\"PCP Urine Tests\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 74
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Positive PCP Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Positive PCP Screenings In Lookback Period\":\n  GetPositiveLabsInLookbackPeriod(\"PCP Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 75
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Negative PCP Screenings In Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "define \"Negative PCP Screenings In Lookback Period\":\n  GetNegativeLabsInLookbackPeriod(\"PCP Screenings In Lookback Period\", true)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 76
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Unexpected Details"
        },
        {
          "url": "statement",
          "valueString": "// Details Logic\n\ndefine \"Unexpected Details\":\n  {\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Amphetamine Simple Identifier\", \"Positive Amphetamine Screenings In Lookback Period\", \n      \"Negative Amphetamine Screenings In Lookback Period\", \"Amphetamine Rx In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Barbiturate Simple Identifier\", \"Positive Barbiturate Screenings In Lookback Period\", \n      \"Negative Barbiturate Screenings In Lookback Period\", \"Barbiturate Rx In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Benzodiazepine Simple Identifier\", \"Positive Benzodiazepine Screenings In Lookback Period\", \n      \"Negative Benzodiazepine Screenings In Lookback Period\", \"Benzodiazepine Rx In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Buprenorphine Simple Identifier\", \"Positive Buprenorphine Screenings In Lookback Period\", \n      \"Negative Buprenorphine Screenings In Lookback Period\", \"Buprenorphine Rx In Lookback Period\"\n    ),\n    CreateDetailWithoutPossibleUnexpectedNegative(\n      \"Cannabinoid Simple Identifier\", \"Positive Cannabinoid Screenings In Lookback Period\", \n      \"Negative Cannabinoid Screenings In Lookback Period\"\n    ),\n    CreateDetailWithoutPossibleUnexpectedNegative(\n      \"Cocaine Simple Identifier\", \"Positive Cocaine Screenings In Lookback Period\", \n      \"Negative Cocaine Screenings In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Fentanyl Simple Identifier\", \"Positive Fentanyl Screenings In Lookback Period\", \n      \"Negative Fentanyl Screenings In Lookback Period\", \"Fentanyl Rx In Lookback Period\"\n    ),\n    CreateDetailWithoutPossibleUnexpectedNegative(\n      \"Heroin Simple Identifier\", \"Positive Heroin Screenings In Lookback Period\", \n      \"Negative Heroin Screenings In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Methadone Simple Identifier\", \"Positive Methadone Screenings In Lookback Period\", \n      \"Negative Methadone Screenings In Lookback Period\", \"Methadone Rx In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Opiate Simple Identifier\", \"Positive Opiate Screenings In Lookback Period\", \n      \"Negative Opiate Screenings In Lookback Period\", \"Opiate Rx In Lookback Period\"\n    ),\n    CreateDetailWithPossibleUnexpectedNegative(\n      \"Oxycodone Simple Identifier\", \"Positive Oxycodone Screenings In Lookback Period\", \n      \"Negative Oxycodone Screenings In Lookback Period\", \"Oxycodone Rx In Lookback Period\"\n    ),\n    CreateDetailWithoutPossibleUnexpectedNegative(\n      \"PCP Simple Identifier\", \"Positive PCP Screenings In Lookback Period\", \n      \"Negative PCP Screenings In Lookback Period\"\n    )\n  }"
        },
        {
          "url": "displaySequence",
          "valueInteger": 77
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Remove Substances Without Positive or Negative Results"
        },
        {
          "url": "statement",
          "valueString": "define \"Remove Substances Without Positive or Negative Results\":\n  \"Unexpected Details\" Details\n    where (Details.posDates is not null and Length(Details.posDates) != 0)\n      or (Details.negDates is not null and Length(Details.negDates) != 0)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 78
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Inclusion Criteria For Unexpected Results"
        },
        {
          "url": "statement",
          "valueString": "define \"Inclusion Criteria For Unexpected Results\":\n  Routines.\"Is Opioid Review Useful?\"\n  and AnyTrue(\n    \"Remove Substances Without Positive or Negative Results\" Details\n      return (exists Details.unexpectedPosDetails) or (exists Details.unexpectedNegDetails)\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 79
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10PatientView"
        },
        {
          "url": "name",
          "valueString": "Applicable Because of Unexpected Results"
        },
        {
          "url": "statement",
          "valueString": "define \"Applicable Because of Unexpected Results\":\n  \"Patient Is Being Prescribed Opioid Analgesic with Ambulatory Misuse Potential\"\n    and Rec10Common.\"Inclusion Criteria For Unexpected Results\"\n    and not Rec10Common.\"Exclusion Criteria\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 80
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "Style Header"
        },
        {
          "url": "statement",
          "valueString": "define \"Style Header\":\n  '<style>\\r\\n  .alert-body {\\r\\n    width: 670px;\\r\\n    font-family: segoe-ui, sans-serif;\\r\\n    background-color: #FEFFF1;\\r\\n  }\\r\\n\\r\\n  .details-table {\\r\\n    border-collapse:collapse;\\r\\n    border-style: ridge;\\r\\n    background-color: #FEFFF1;\\r\\n    padding: 2px;\\r\\n  }\\r\\n\\r\\n  .details-caption {\\r\\n    border-style: ridge;\\r\\n    border-bottom: none;\\r\\n    background-color: #FEFFF1;\\r\\n    padding: 2px;\\r\\n  }\\r\\n\\r\\n  .details-table-header {\\r\\n    border-style: ridge;\\r\\n    padding: 5px;\\r\\n  }\\r\\n\\r\\n  .details-table-cell {\\r\\n    border-style: ridge;\\r\\n    padding: 5px;\\r\\n  }\\r\\n\\r\\n  .details-table-footer-cell {\\r\\n    border-style: ridge;\\r\\n    padding: 5px;\\r\\n    font-size: small;\\r\\n  }\\r\\n\\r\\n  .details-table-cell-unexpected {\\r\\n    border-style: ridge;\\r\\n    padding: 5px;\\r\\n    color: red;\\r\\n    font-weight: bold;\\r\\n  }\\r\\n\\r\\n  .more-text {\\r\\n    position: relative;\\r\\n    margin-bottom: 2em;\\r\\n  }\\r\\n  \\r\\n  .more {\\r\\n    display:none;\\r\\n  }\\r\\n\\r\\n  .show-more:checked + .more {\\r\\n    display:block;\\r\\n  }\\r\\n<\\/style>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 81
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Unexpected Div Start"
        },
        {
          "url": "statement",
          "valueString": "define \"Unexpected Div Start\":\n  '<div class=\\\"alert-body\\\"><div><p>Patient may have <strong>unexpected urine toxicology test results<\\/strong> in the past year.<\\/p><\\/div>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 82
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Table Start"
        },
        {
          "url": "statement",
          "valueString": "define \"Table Start\":\n  '<div><table class=\\\"details-table\\\"><caption class=\\\"details-caption\\\">Urine Toxicology Results<\\/caption><tr><th class=\\\"details-table-header\\\">Substance<\\/th>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 83
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "All Lab Dates in Lookback Period"
        },
        {
          "url": "statement",
          "valueString": "// Helpers  \n\ndefine \"All Lab Dates in Lookback Period\":\n  (\n    \"All Opioid or Non-opioid UDS in Lookback Period\" Lab\n      return date from Lab.effective\n  ) X sort desc"
        },
        {
          "url": "displaySequence",
          "valueInteger": 84
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Table Headers"
        },
        {
          "url": "statement",
          "valueString": "define \"Table Headers\":\n  \"All Lab Dates in Lookback Period\" LabDate\n    return '<th class=\\\"details-table-header\\\">' & ToString(LabDate) & '<\\/th>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 85
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Generate Table Rows"
        },
        {
          "url": "statement",
          "valueString": "define \"Generate Table Rows\":\n  \"Remove Substances Without Positive or Negative Results\" BOT\n    let row: ToString(IndexOf(\"Remove Substances Without Positive or Negative Results\", BOT) + 1)\n    return '<tr>' + GetExpectedColumn(BOT.ingredient) + Combine(\n      \"All Lab Dates in Lookback Period\" LabDate\n        let col: ToString(IndexOf(\"All Lab Dates in Lookback Period\", LabDate) + 2)\n        return all (\n          if BOT.unexpectedPosDetails.date contains LabDate\n            then GetUnexpectedColumn('pos', row & ':' & col)\n          else if BOT.unexpectedNegDetails.udsDate contains LabDate\n            then GetUnexpectedColumn('neg', row & ':' & col)\n          else if BOT.posDates contains LabDate\n            then GetExpectedColumn('pos*')\n          else if BOT.negDates contains LabDate\n            then GetExpectedColumn('neg*')\n          else GetExpectedColumn('n/a')\n        )\n    ) + '<\\/tr>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 86
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Generate Footer Rows"
        },
        {
          "url": "statement",
          "valueString": "define \"Generate Footer Rows\":\n  \"Remove Substances Without Positive or Negative Results\" BOT\n      let row: ToString(IndexOf(\"Remove Substances Without Positive or Negative Results\", BOT) + 1),\n      colspan: Length(\"All Lab Dates in Lookback Period\") + 1\n      return Combine(\n          \"All Lab Dates in Lookback Period\" LabDate\n            let col: ToString(IndexOf(\"All Lab Dates in Lookback Period\", LabDate) + 2)\n            return all (\n              if BOT.unexpectedPosDetails.date contains LabDate\n                then Coalesce(\n                  BOT.unexpectedPosDetails PosDetail\n                    where PosDetail.date same day as LabDate\n                      return '<tr>' & GetFooterColumn(colspan, row & ':' & col & ' - Possible unexpected substance found: ' & PosDetail.udsDetail) & '<\\/tr>'\n                )\n              else if BOT.unexpectedNegDetails.udsDate contains LabDate\n                then Coalesce(\n                  BOT.unexpectedNegDetails NegDetail\n                    where NegDetail.udsDate same day as LabDate\n                      return '<tr>' & GetFooterColumn(colspan, row + ':' & col & ' - Possible unexpected negative result found: prescribed ' & NegDetail.rxDetail & ' on ' & ToString(NegDetail.rxDate)) & '<\\/tr>'\n                )\n              else ''\n            )\n      )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 87
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Table End"
        },
        {
          "url": "statement",
          "valueString": "define \"Table End\":\n  '<\\/table><\\/div>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 88
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Details Table"
        },
        {
          "url": "statement",
          "valueString": "define \"Details Table\": \n  \"Table Start\" & Combine(\"Table Headers\") \n    & '<tbody>' & Combine(\"Generate Table Rows\") & '</tbody>' \n    & '<tfoot>' & Combine(\"Generate Footer Rows\") & '<\\/tfoot>' \n  & \"Table End\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 89
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Expected Result Footnote"
        },
        {
          "url": "statement",
          "valueString": "define \"Expected Result Footnote\":\n  '<div>* - These are expected results based on an analysis of the patient\\'s medication list 30 days prior to the corresponding lab results.<\\/div>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 90
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Details More Info"
        },
        {
          "url": "statement",
          "valueString": "define \"Details More Info\":\n  '<div id=\\\"box\\\">\\r\\n  <p>Note on false positives and unexpected negative results...<\\/p>\\r\\n  <input type=\\\"checkbox\\\" class=\\\"show-more\\\"> Show more\\r\\n  <div class=\\\"more\\\">\\r\\n  <p>An unexpectedly negative test may be due to time since last dose, diversion, intermittent use, aberrant drug use behavior, or other factors, including a false negative result. Clinicians should interpret this result in the context of the overall treatment plan.<\\/p>\\r\\n\\r\\n  <p>Positive results may be a false positives or could represent occasional use or possible substance use disorder.<br\\/><br\\/>For a review regarding interpreting possible false positive urine toxicology results, see <a target=\\\"_blank\\\" href=\\\"https:\\/\\/pubmed.ncbi.nlm.nih.gov\\/24986836\\\">http:\\/\\/pubmed.ncbi.nlm.nih.gov\\/24986836<\\/a>. It is unknown if the findings reported in this article can be extrapolated to other laboratory analyzers that were not used in the referenced studies.<br\\/><br\\/>For guidance regarding evaluating and addressing unexpected toxicology tests results, see <a target=\\\"_blank\\\" href=\\\"https:\\/\\/www.cdc.gov\\/mmwr\\/volumes\\/71\\/rr\\/rr7103a1.htm#Recommendation10\\\">Recommendation 10 of the 22 CDC Clinical Practice Guideiline<\\/a>.<\\/p><\\/div>\\r\\n<\\/div>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 91
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Div End"
        },
        {
          "url": "statement",
          "valueString": "define \"Div End\": '<\\/div>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 92
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "Get HTML Details"
        },
        {
          "url": "statement",
          "valueString": "// HTML Generation\n\ndefine \"Get HTML Details\":\n  Common.\"Style Header\" & \"Unexpected Div Start\" & \"Details Table\" & \"Expected Result Footnote\" & \"Details More Info\" & \"Div End\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 93
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10PatientView"
        },
        {
          "url": "name",
          "valueString": "Detail"
        },
        {
          "url": "statement",
          "valueString": "define \"Detail\":\n  Rec10Common.\"Get HTML Details\""
        },
        {
          "url": "displaySequence",
          "valueInteger": 94
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Is Subacute or Chronic Pain Prescription?"
        },
        {
          "url": "statement",
          "valueString": "// End of Active Cancer Treatment Routine\n\n/*\n**  Routine #4\n**  For Subacute or Chronic Pain Routine\n**\n**  Definition                  | Answer to Proceed   | Details                                        | Data (Terminology) Requirement\n**  -----------------------------------------------------------------------------------------------------------------------------------\n**  Order for opioid analgesic  | Yes                 | Order for opioid analgesics with ambulatory    | Opioid analgesics with\n**  with expected supply        |                     | misuse potential with a supply duration of >=  | ambulatory misuse potential\n**  duration >= 28 days         |                     | 28 days                                        |\n**                              |                     |                                                |\n**                              |                     | - Subacute definition = order for opioid       |\n**                              |                     |   analgesics with ambulatory misuse            |\n**                              |                     |   potential with a supply duration of one to   |\n**                              |                     |   two months.                                  |\n**                              |                     | - Chronic pain definition = order for opioid   |\n**                              |                     |   analgesics with ambulatory misuse            |\n**                              |                     |   potential with a supply duration of >= two   |\n**                              |                     |   months.                                      |\n**  -----------------------------------------------------------------------------------------------------------------------------------\n**\n*/\n\ndefine function \"Is Subacute or Chronic Pain Prescription?\"(prescription FHIR.MedicationRequest):\n  \"Is Subacute or Chronic Pain Using Expected Supply Duration\"(prescription)\n    or \"Is Subacute or Chronic Pain Using Validity Period\"(prescription)"
        },
        {
          "url": "displaySequence",
          "valueInteger": 95
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Is Subacute or Chronic Pain Using Expected Supply Duration"
        },
        {
          "url": "statement",
          "valueString": "define function \"Is Subacute or Chronic Pain Using Expected Supply Duration\"(prescription FHIR.MedicationRequest):\n  (\n    prescription.dispenseRequest is not null\n      and prescription.dispenseRequest.expectedSupplyDuration is not null\n      and (\n        Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days \n      )\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 96
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "GetDurationInDays"
        },
        {
          "url": "statement",
          "valueString": "define function GetDurationInDays(value FHIR.Duration):\n  if value is null then null\n  else\n    case\n      when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' }\n      when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' }\n      when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' }\n      when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' }\n      when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' }\n      when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' }\n      when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' }\n      when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' }\n      when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null')\n      else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value)\nend"
        },
        {
          "url": "displaySequence",
          "valueInteger": 97
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSRoutines"
        },
        {
          "url": "name",
          "valueString": "Is Subacute or Chronic Pain Using Validity Period"
        },
        {
          "url": "statement",
          "valueString": "define function \"Is Subacute or Chronic Pain Using Validity Period\"(prescription FHIR.MedicationRequest):\n  (\n    prescription.dispenseRequest is not null\n      and prescription.dispenseRequest.validityPeriod is not null\n      and (\n        days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 \n      )\n  )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 98
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "FHIRHelpers"
        },
        {
          "url": "name",
          "valueString": "ToDateTime"
        },
        {
          "url": "statement",
          "valueString": "define function ToDateTime(value dateTime): value.value"
        },
        {
          "url": "displaySequence",
          "valueInteger": 99
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "FHIRHelpers"
        },
        {
          "url": "name",
          "valueString": "ToConcept"
        },
        {
          "url": "statement",
          "valueString": "define function ToConcept(concept FHIR.CodeableConcept):\n    if concept is null then\n        null\n    else\n        System.Concept {\n            codes: concept.coding C return ToCode(C),\n            display: concept.text.value\n        }"
        },
        {
          "url": "displaySequence",
          "valueInteger": 100
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "CreateDetailWithPossibleUnexpectedNegative"
        },
        {
          "url": "statement",
          "valueString": "define function CreateDetailWithPossibleUnexpectedNegative(TheSubstance String, ThePosLabs List<Observation>, TheNegLabs List<Observation>, TheMeds List<MedicationRequest>):\n  {\n    ingredient: TheSubstance,\n    posDates: (\n      ThePosLabs PosLab\n        return date from PosLab.effective\n    ),\n    negDates: (\n      TheNegLabs NegLab\n        return date from NegLab.effective\n    ),\n    unexpectedPosDetails: (\n      ThePosLabs PosLab\n        where not exists (\n          TheMeds Rx\n            where Common.GetDateFromMedicationRequest(Rx)\n              in day of Interval[\n                date from PosLab.effective - 31 days,\n                date from PosLab.effective - 1 days\n              ]\n        )\n        return {\n          date: date from PosLab.effective,\n          udsDetail:\n            if exists(PosLab.code.coding)\n              then PosLab.code.coding[0].display\n              else 'Unable to determine a detailed identifier'\n        }\n    ),\n    unexpectedNegDetails: (\n      from TheNegLabs NegLab,\n        ( if exists(TheMeds) then TheMeds else { null as MedicationRequest } ) Rx\n        let medDate: Common.GetDateFromMedicationRequest(Rx)\n          where medDate in day of Interval[date from NegLab.effective - 31 days, date from NegLab.effective - 1 days]\n          return {\n            udsDate: date from NegLab.effective,\n            udsDetail: if exists (NegLab.code.coding) then NegLab.code.coding[0].display else 'Unable to determine a detailed identifier',\n            rxDate: medDate,\n            rxDetail: \n              if Rx.medication.text is not null then Rx.medication.text\n              else if exists (Rx.medication.coding) and Rx.medication.coding[0].display is not null then Rx.medication.coding[0].display \n              else 'Unable to determine a detailed identifier'\n          }\n    )\n  }"
        },
        {
          "url": "displaySequence",
          "valueInteger": 101
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "GetDateFromMedicationRequest"
        },
        {
          "url": "statement",
          "valueString": "define function \"GetDateFromMedicationRequest\"(med FHIR.MedicationRequest):\n  if med is null then\n    null\n  else if med.authoredOn is not null then\n    date from med.authoredOn\n  else\n    Max(\n      med.dosageInstruction DI\n        return Coalesce(\n          // If there are timing events, take the latest.\n          Max(DI.timing.event E return date from E),\n          // Otherwise, if there's a Period, use its start.\n          if DI.timing.repeat is not null\n             and DI.timing.repeat.bounds is FHIR.Period\n          then\n            date from start of FHIRHelpers.ToInterval(DI.timing.repeat.bounds as FHIR.Period)\n          else\n            null\n        )\n    )"
        },
        {
          "url": "displaySequence",
          "valueInteger": 102
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "GetPositiveLabsInLookbackPeriod"
        },
        {
          "url": "statement",
          "valueString": "define function GetPositiveLabsInLookbackPeriod(Labs List<FHIR.Observation>, Enabled Boolean):\n  if Enabled\n    then Labs Lab\n     where StartsWith(Lower(Lab.value as FHIR.string), 'pos')\n  else {}"
        },
        {
          "url": "displaySequence",
          "valueInteger": 103
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "FHIRHelpers"
        },
        {
          "url": "name",
          "valueString": "ToString"
        },
        {
          "url": "statement",
          "valueString": "define function ToString(value ObservationStatus): value.value"
        },
        {
          "url": "displaySequence",
          "valueInteger": 104
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "GetNegativeLabsInLookbackPeriod"
        },
        {
          "url": "statement",
          "valueString": "define function GetNegativeLabsInLookbackPeriod(Labs List<FHIR.Observation>, Enabled Boolean):\n  if Enabled\n    then Labs Lab\n     where StartsWith(Lower(Lab.value as FHIR.string), 'neg')\n  else {}"
        },
        {
          "url": "displaySequence",
          "valueInteger": 105
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSCommon"
        },
        {
          "url": "name",
          "valueString": "Get MedicationRequest Medication as Code"
        },
        {
          "url": "statement",
          "valueString": "define function \"Get MedicationRequest Medication as Code\"(value List<MedicationRequest>):\n  value Rx\n    let Med: \n      if Rx.medication is Reference then singleton from (\n        [Medication] M\n          where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/')))\n      ) else null\n    return \n      MedicationRequest {\n        id: Rx.id,\n        status: Rx.status,\n        intent: Rx.intent,\n        category: Rx.category,\n        medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept,\n        subject: Rx.subject,\n        authoredOn: Rx.authoredOn,\n        recorder: Rx.recorder,\n        dosageInstruction: Rx.dosageInstruction,\n        dispenseRequest: Rx.dispenseRequest\n      }"
        },
        {
          "url": "displaySequence",
          "valueInteger": 106
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "CreateDetailWithoutPossibleUnexpectedNegative"
        },
        {
          "url": "statement",
          "valueString": "define function CreateDetailWithoutPossibleUnexpectedNegative(TheSubstance String, ThePosLabs List<Observation>, TheNegLabs List<Observation>):\n  {\n    ingredient: TheSubstance,\n    posDates: (\n      ThePosLabs PosLab\n        return date from PosLab.effective\n    ),\n    negDates: (\n      TheNegLabs NegLab\n        return date from NegLab.effective\n    ),\n    unexpectedPosDetails: (\n      ThePosLabs PosLab\n        return {\n          date: date from PosLab.effective,\n          udsDetail: if exists (PosLab.code.coding) then PosLab.code.coding[0].display else 'Unable to determine a detailed identifier'\n        }\n    ),\n    unexpectedNegDetails: {\n      null as Tuple{ udsDate System.Date, udsDetail System.String, rxDate System.Date, rxDetail System.String }\n    }\n  }"
        },
        {
          "url": "displaySequence",
          "valueInteger": 107
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "extension": [
        {
          "url": "libraryName",
          "valueString": "OpioidCDSREC10Common"
        },
        {
          "url": "name",
          "valueString": "GetExpectedColumn"
        },
        {
          "url": "statement",
          "valueString": "define function GetExpectedColumn(Content String):\n  '<td class=\\\"details-table-cell\\\">' & Content & '<\\/td>'"
        },
        {
          "url": "displaySequence",
          "valueInteger": 108
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
    },
    {
      "id": "effective-data-requirements",
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
      "valueCanonical": "#effective-data-requirements"
    },
    {
      "url": "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem",
      "valueReference": {
        "reference": "Device/cqf-tooling"
      }
    }
  ],
  "url": "http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-10-patient-view",
  "identifier": [
    {
      "use": "official",
      "value": "cdc-opioid-guidance"
    }
  ],
  "version": "2022.1.0",
  "name": "PlanDefinition_Recommendation_10_Patient_View",
  "title": "Recommendation #10 - Urine Drug Testing (patient-view)",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code": "eca-rule",
        "display": "ECA Rule"
      }
    ]
  },
  "status": "draft",
  "experimental": true,
  "date": "2025-04-24",
  "publisher": "Centers for Disease Control and Prevention (CDC)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.cdc.gov"
        }
      ]
    }
  ],
  "description": "When prescribing opioids for subacute or chronic pain, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.",
  "useContext": [
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "focus",
        "display": "Clinical Focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "82423001",
            "display": "Chronic pain (finding)"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "focus",
        "display": "Clinical Focus"
      },
      "valueCodeableConcept": {
        "text": "Subacute pain"
      }
    }
  ],
  "purpose": "The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.",
  "usage": "Before starting opioids and periodically (at least annually) during opioid therapy, clinicians should consider the benefits and risks of toxicology testing to assess for prescribed opioids and other prescription and nonprescription controlled substances that increase risk for overdose when combined with opioids, including nonprescribed and illicit opioids and benzodiazepines.",
  "copyright": "© CDC 2016+.",
  "topic": [
    {
      "text": "Opioid Prescribing"
    }
  ],
  "author": [
    {
      "name": "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name": "Bryn Rhodes"
    },
    {
      "name": "Floyd Eisenberg, MD, MPH"
    },
    {
      "name": "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact": [
    {
      "type": "documentation",
      "display": "2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain",
      "url": "https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf",
      "document": {
        "contentType": "application/pdf",
        "language": "en-US",
        "url": "https://www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7103a1-H.pdf"
      }
    }
  ],
  "library": [
    "http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC10PatientView"
  ],
  "action": [
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                "code": "weak",
                "display": "Weak"
              }
            ]
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/evidence-quality",
                "code": "very-low",
                "display": "Very Low quality"
              }
            ]
          }
        }
      ],
      "prefix": "1.",
      "title": "Consider the Benefits and Risks of Conducting a Urine Toxicology Screen",
      "description": "Consider the benefits and risks of toxicology testing to assess for prescribed medications as well as other prescribed and nonprescribed controlled substances.\r\n\r\nFor guidance regarding utilizing toxicology tests when prescribing opioids, see [Recommendation 10 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#:~:text=evidence%20type%3A%204).-,Implementation%20Considerations,-Toxicology%20testing%20should).",
      "priority": "urgent",
      "trigger": [
        {
          "type": "named-event",
          "name": "patient-view"
        }
      ],
      "condition": [
        {
          "kind": "applicability",
          "expression": {
            "description": "Patient has not had a urine screening in the past 12 months",
            "language": "text/cql.identifier",
            "expression": "Is Perform Drug Screen Recommendation Applicable?"
          }
        }
      ],
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/action-type",
            "code": "create",
            "display": "Create"
          }
        ]
      },
      "definitionCanonical": "http://fhir.org/guides/cdc/opioid-cds/ActivityDefinition/opioidcds-urine-screening-request",
      "action": [
        {
          "description": "Document - Ordered toxicology screen"
        },
        {
          "description": "Document - Risks outweigh benefits"
        },
        {
          "description": "Snooze* - N/A see comment, snooze 3 months"
        }
      ]
    },
    {
      "extension": [
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                "code": "weak",
                "display": "Weak"
              }
            ]
          }
        },
        {
          "url": "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
          "valueCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/evidence-quality",
                "code": "very-low",
                "display": "Very Low quality"
              }
            ]
          }
        }
      ],
      "prefix": "2.",
      "title": "Patient May Have Unexpected Toxicology Test Results",
      "description": "Patient may have unexpected urine toxicology test results in the past year",
      "priority": "urgent",
      "trigger": [
        {
          "type": "named-event",
          "name": "patient-view"
        }
      ],
      "condition": [
        {
          "kind": "applicability",
          "expression": {
            "description": "Urine screening tested positive for cocaine, opiates or PCP",
            "language": "text/cql.identifier",
            "expression": "Applicable Because of Unexpected Results"
          }
        }
      ],
      "dynamicValue": [
        {
          "path": "action.description",
          "expression": {
            "language": "text/cql.identifier",
            "expression": "Detail"
          }
        }
      ],
      "action": [
        {
          "description": "Document - Will repeat urine drug screen more frequently"
        },
        {
          "description": "Will consult with patient regarding possible unexpected test results"
        },
        {
          "description": "Document - Will assess patient for substance use disorder"
        },
        {
          "description": "Snooze* - Patient's test results were expected, snooze for 3 months"
        },
        {
          "description": "Snooze* - N/A snooze for 3 months"
        }
      ]
    }
  ]
}