FHIR IG Statistics: Measure/ANCIND04

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Narrative

Note: links and images are rebased to the (stated) source

define "Antenatal care contact":
  ["Encounter": type in BCx."Antenatal care contact"]

/*
Numerator: Number of pregnant women with four ANC contacts
Numerator Computation: COUNT of all women who had a total of at least FOUR contacts during pregnancy
*/
define Numerator:
  Count(BaseData."Antenatal care contact") >= 4

/*
By Patient Age as of the start of the Measurement Period
Age (10-14, 15-19, 20+)
*/
define "By Age":
  case
    when AgeInYearsAt(start of "Measurement Period") in Interval[10, 14] then "P10Y--P14Y"
    when AgeInYearsAt(start of "Measurement Period") in Interval[15, 19] then "P15Y--P19Y"
    when AgeInYearsAt(start of "Measurement Period") >= 20 then "P20Y--P9999Y"
    else null
  end

/*
Disaggregation: Age (10-14, 15-19, 20+)
*/
define "Age Stratifier":
  Stratifiers."By Age"

/*
  @dataElement: ANC.End.1 Reason for closing ANC record
  @activity: ANC.End End
  @description: Select the reason why you are closing the woman's ANC record
*/
define "Reason for closing ANC record":
  [Observation: Cx."Reason for closing ANC record"] O
    where O.status in { 'final', 'amended', 'corrected' }
      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false

/*
Denominator: Total number of antenatal clients with a first contact
Denominator Computation: COUNT of all women whose records were closed (ANC close form) in the last reporting period due to any of the reasons below:
*live birth
*stillbirth
*miscarriage
*abortion
*woman died
*lost to follow-up
*moved away
*/
define Denominator:
  exists (
    PatientData."Reason for closing ANC record" R
      where FC.ToInterval(R.effective) during "Measurement Period"
        and R.value as FHIR.CodeableConcept in Stratifiers."Qualifying Reason for closing ANC record Choices"
  )

/*
By Patient Education Level (none, don't know, primary, secondary, higher)
*/
define "By Education Level":
  Patient.extension E
    where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'
    return E.value as CodeableConcept

/*
Disaggregation: Education Level (none, don't know, primary, secondary, higher)
*/
define "Education Level Stratifier":
  Stratifiers."By Education Level"

/*
define "Pregnant":
  "Pregnancy" is not null
    or "Pregnancy status" in BCx."Pregnancy status - pregnant"

define "Pregnancy status":
  FHIRHelpers.ToConcept(
    Last(
      [Observation: BCx."Pregnancy status"] O
        where O.status = 'final'
        sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)
    ).value
  )
*/

define "Antenatal care case":
  ["EpisodeOfCare": type in BCx."Antenatal care case"]

/*
Initial population: Antenatal clients
*/
define "Initial Population":
  exists (BaseData."Antenatal care case")

define function ToString(value ObservationStatus): value.value

define function ToBoolean(value boolean): value.value

/*
@description: Returns the single WHO core modifier extension (if present) on the given resource with the specified id.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given resource with the specified url.
*/
define function ModifierExtension(domainResource DomainResource, id String):
  singleton from ModifierExtensions(domainResource, id)

/*
@description: Returns any WHO core modifier extensions defined on the given resource with the specified id.
@comment: NOTE: Extensions are not the preferred approach, but are used as a way to access
content that is defined by extensions but not yet surfaced in the
CQL model info.
*/
define function ModifierExtensions(domainResource DomainResource, id String):
  domainResource.modifierExtension E
	  where E.url = ('http://fhir.org/guides/who/core/StructureDefinition/' + id)
		return E

define function ToString(value uri): value.value

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
        }

define function ToCode(coding FHIR.Coding):
    if coding is null then
        null
    else
        System.Code {
          code: coding.code.value,
          system: coding.system.value,
          version: coding.version.value,
          display: coding.display.value
        }

Source

{
  "resourceType": "Measure",
  "id": "ANCIND04",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/computable-measure-cqfm"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "contained": [
    {
      "resourceType": "Library",
      "id": "effective-data-requirements",
      "extension": [
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding": {
            "system": "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code": "P10Y--P14Y",
            "display": "10-14 years"
          }
        },
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding": {
            "system": "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code": "P15Y--P19Y",
            "display": "15-19 years"
          }
        },
        {
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-directReferenceCode",
          "valueCoding": {
            "system": "http://ohie.org/CodeSystem/iso-8601-derived-periods",
            "code": "P20Y--P9999Y",
            "display": "20+ years"
          }
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCBaseDataElements"
            },
            {
              "url": "name",
              "valueString": "Antenatal care contact"
            },
            {
              "url": "statement",
              "valueString": "define \"Antenatal care contact\":\n  [\"Encounter\": type in BCx.\"Antenatal care contact\"]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 0
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCIND04"
            },
            {
              "url": "name",
              "valueString": "Numerator"
            },
            {
              "url": "statement",
              "valueString": "/*\nNumerator: Number of pregnant women with four ANC contacts\nNumerator Computation: COUNT of all women who had a total of at least FOUR contacts during pregnancy\n*/\ndefine Numerator:\n  Count(BaseData.\"Antenatal care contact\") >= 4"
            },
            {
              "url": "displaySequence",
              "valueInteger": 1
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCStratifiers"
            },
            {
              "url": "name",
              "valueString": "By Age"
            },
            {
              "url": "statement",
              "valueString": "/*\nBy Patient Age as of the start of the Measurement Period\nAge (10-14, 15-19, 20+)\n*/\ndefine \"By Age\":\n  case\n    when AgeInYearsAt(start of \"Measurement Period\") in Interval[10, 14] then \"P10Y--P14Y\"\n    when AgeInYearsAt(start of \"Measurement Period\") in Interval[15, 19] then \"P15Y--P19Y\"\n    when AgeInYearsAt(start of \"Measurement Period\") >= 20 then \"P20Y--P9999Y\"\n    else null\n  end"
            },
            {
              "url": "displaySequence",
              "valueInteger": 2
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCIND04"
            },
            {
              "url": "name",
              "valueString": "Age Stratifier"
            },
            {
              "url": "statement",
              "valueString": "/*\nDisaggregation: Age (10-14, 15-19, 20+)\n*/\ndefine \"Age Stratifier\":\n  Stratifiers.\"By Age\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 3
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCDataElements"
            },
            {
              "url": "name",
              "valueString": "Reason for closing ANC record"
            },
            {
              "url": "statement",
              "valueString": "/*\n  @dataElement: ANC.End.1 Reason for closing ANC record\n  @activity: ANC.End End\n  @description: Select the reason why you are closing the woman's ANC record\n*/\ndefine \"Reason for closing ANC record\":\n  [Observation: Cx.\"Reason for closing ANC record\"] O\n    where O.status in { 'final', 'amended', 'corrected' }\n      and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false"
            },
            {
              "url": "displaySequence",
              "valueInteger": 4
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCIND04"
            },
            {
              "url": "name",
              "valueString": "Denominator"
            },
            {
              "url": "statement",
              "valueString": "/*\nDenominator: Total number of antenatal clients with a first contact\nDenominator Computation: COUNT of all women whose records were closed (ANC close form) in the last reporting period due to any of the reasons below:\n*live birth\n*stillbirth\n*miscarriage\n*abortion\n*woman died\n*lost to follow-up\n*moved away\n*/\ndefine Denominator:\n  exists (\n    PatientData.\"Reason for closing ANC record\" R\n      where FC.ToInterval(R.effective) during \"Measurement Period\"\n        and R.value as FHIR.CodeableConcept in Stratifiers.\"Qualifying Reason for closing ANC record Choices\"\n  )"
            },
            {
              "url": "displaySequence",
              "valueInteger": 5
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCStratifiers"
            },
            {
              "url": "name",
              "valueString": "By Education Level"
            },
            {
              "url": "statement",
              "valueString": "/*\nBy Patient Education Level (none, don't know, primary, secondary, higher)\n*/\ndefine \"By Education Level\":\n  Patient.extension E\n    where E.url = 'http://smart.who.int/anc/StructureDefinition/educationlevel'\n    return E.value as CodeableConcept"
            },
            {
              "url": "displaySequence",
              "valueInteger": 6
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCIND04"
            },
            {
              "url": "name",
              "valueString": "Education Level Stratifier"
            },
            {
              "url": "statement",
              "valueString": "/*\nDisaggregation: Education Level (none, don't know, primary, secondary, higher)\n*/\ndefine \"Education Level Stratifier\":\n  Stratifiers.\"By Education Level\""
            },
            {
              "url": "displaySequence",
              "valueInteger": 7
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCBaseDataElements"
            },
            {
              "url": "name",
              "valueString": "Antenatal care case"
            },
            {
              "url": "statement",
              "valueString": "/*\ndefine \"Pregnant\":\n  \"Pregnancy\" is not null\n    or \"Pregnancy status\" in BCx.\"Pregnancy status - pregnant\"\n\ndefine \"Pregnancy status\":\n  FHIRHelpers.ToConcept(\n    Last(\n      [Observation: BCx.\"Pregnancy status\"] O\n        where O.status = 'final'\n        sort by FHIRHelpers.ToDateTime(effective as FHIR.dateTime)\n    ).value\n  )\n*/\n\ndefine \"Antenatal care case\":\n  [\"EpisodeOfCare\": type in BCx.\"Antenatal care case\"]"
            },
            {
              "url": "displaySequence",
              "valueInteger": 8
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "ANCIND04"
            },
            {
              "url": "name",
              "valueString": "Initial Population"
            },
            {
              "url": "statement",
              "valueString": "/*\nInitial population: Antenatal clients\n*/\ndefine \"Initial Population\":\n  exists (BaseData.\"Antenatal care case\")"
            },
            {
              "url": "displaySequence",
              "valueInteger": 9
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value ObservationStatus): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 10
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToBoolean"
            },
            {
              "url": "statement",
              "valueString": "define function ToBoolean(value boolean): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 11
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "WHOCommon"
            },
            {
              "url": "name",
              "valueString": "ModifierExtension"
            },
            {
              "url": "statement",
              "valueString": "/*\n@description: Returns the single WHO core modifier extension (if present) on the given resource with the specified id.\n@comment: This function uses singleton from to ensure that a run-time exception is thrown if there\nis more than one extension on the given resource with the specified url.\n*/\ndefine function ModifierExtension(domainResource DomainResource, id String):\n  singleton from ModifierExtensions(domainResource, id)"
            },
            {
              "url": "displaySequence",
              "valueInteger": 12
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "WHOCommon"
            },
            {
              "url": "name",
              "valueString": "ModifierExtensions"
            },
            {
              "url": "statement",
              "valueString": "/*\n@description: Returns any WHO core modifier extensions defined on the given resource with the specified id.\n@comment: NOTE: Extensions are not the preferred approach, but are used as a way to access\ncontent that is defined by extensions but not yet surfaced in the\nCQL model info.\n*/\ndefine function ModifierExtensions(domainResource DomainResource, id String):\n  domainResource.modifierExtension E\n\t  where E.url = ('http://fhir.org/guides/who/core/StructureDefinition/' + id)\n\t\treturn E"
            },
            {
              "url": "displaySequence",
              "valueInteger": 13
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToString"
            },
            {
              "url": "statement",
              "valueString": "define function ToString(value uri): value.value"
            },
            {
              "url": "displaySequence",
              "valueInteger": 14
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-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": 15
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        },
        {
          "extension": [
            {
              "url": "libraryName",
              "valueString": "FHIRHelpers"
            },
            {
              "url": "name",
              "valueString": "ToCode"
            },
            {
              "url": "statement",
              "valueString": "define function ToCode(coding FHIR.Coding):\n    if coding is null then\n        null\n    else\n        System.Code {\n          code: coding.code.value,\n          system: coding.system.value,\n          version: coding.version.value,\n          display: coding.display.value\n        }"
            },
            {
              "url": "displaySequence",
              "valueInteger": 16
            }
          ],
          "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition"
        }
      ],
      "name": "EffectiveDataRequirements",
      "status": "active",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/library-type",
            "code": "module-definition"
          }
        ]
      },
      "relatedArtifact": [
        {
          "type": "depends-on",
          "display": "Library BaseData",
          "resource": "http://smart.who.int/anc/Library/ANCBaseDataElements"
        },
        {
          "type": "depends-on",
          "display": "Library BCx",
          "resource": "http://smart.who.int/anc/Library/ANCBaseConcepts"
        },
        {
          "type": "depends-on",
          "display": "Library Stratifiers",
          "resource": "http://smart.who.int/anc/Library/ANCStratifiers"
        },
        {
          "type": "depends-on",
          "display": "Library PatientData",
          "resource": "http://smart.who.int/anc/Library/ANCDataElements"
        },
        {
          "type": "depends-on",
          "display": "Library Cx",
          "resource": "http://smart.who.int/anc/Library/ANCConcepts"
        },
        {
          "type": "depends-on",
          "display": "Library FHIRHelpers",
          "resource": "http://smart.who.int/anc/Library/FHIRHelpers|4.0.1"
        },
        {
          "type": "depends-on",
          "display": "Library WC",
          "resource": "http://smart.who.int/anc/Library/WHOCommon"
        },
        {
          "type": "depends-on",
          "display": "Library FC",
          "resource": "http://smart.who.int/anc/Library/FHIRCommon"
        },
        {
          "type": "depends-on",
          "display": "Code system ISO-8601-Derived Periods",
          "resource": "http://ohie.org/CodeSystem/iso-8601-derived-periods"
        },
        {
          "type": "depends-on",
          "display": "Value set Antenatal care contact",
          "resource": "http://smart.who.int/anc/ValueSet/antenatal-care-contact"
        },
        {
          "type": "depends-on",
          "display": "Value set Reason for closing ANC record",
          "resource": "http://smart.who.int/anc/ValueSet/anc-end-1"
        },
        {
          "type": "depends-on",
          "display": "Value set Qualifying Reason for closing ANC record Choices",
          "resource": "http://smart.who.int/anc/ValueSet/qualifying-reason-for-closing-anc-record-choices"
        },
        {
          "type": "depends-on",
          "display": "Value set Antenatal care case",
          "resource": "http://smart.who.int/anc/ValueSet/antenatal-care-case"
        }
      ],
      "parameter": [
        {
          "name": "Measurement Period",
          "use": "in",
          "min": 0,
          "max": "1",
          "type": "Period"
        },
        {
          "name": "Numerator",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Age Stratifier",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "Coding"
        },
        {
          "name": "Denominator",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        },
        {
          "name": "Education Level Stratifier",
          "use": "out",
          "min": 0,
          "max": "*",
          "type": "CodeableConcept"
        },
        {
          "name": "Initial Population",
          "use": "out",
          "min": 0,
          "max": "1",
          "type": "boolean"
        }
      ],
      "dataRequirement": [
        {
          "type": "Encounter",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Encounter"
          ],
          "mustSupport": [
            "type"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://smart.who.int/anc/ValueSet/antenatal-care-contact"
            }
          ]
        },
        {
          "type": "Patient",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Patient"
          ],
          "mustSupport": [
            "url",
            "value"
          ]
        },
        {
          "type": "Observation",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/Observation"
          ],
          "mustSupport": [
            "code",
            "status",
            "effective",
            "value"
          ],
          "codeFilter": [
            {
              "path": "code",
              "valueSet": "http://smart.who.int/anc/ValueSet/anc-end-1"
            }
          ]
        },
        {
          "type": "EpisodeOfCare",
          "profile": [
            "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare"
          ],
          "mustSupport": [
            "type"
          ],
          "codeFilter": [
            {
              "path": "type",
              "valueSet": "http://smart.who.int/anc/ValueSet/antenatal-care-case"
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference": {
        "reference": "Device/cqf-tooling"
      }
    },
    {
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-softwaresystem",
      "valueReference": {
        "reference": "Device/cqf-tooling"
      }
    },
    {
      "id": "effective-data-requirements",
      "url": "http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-effectiveDataRequirements",
      "valueReference": {
        "reference": "#effective-data-requirements"
      }
    }
  ],
  "url": "http://smart.who.int/anc/Measure/ANCIND04",
  "version": "0.3.0",
  "name": "ANCIND04",
  "title": "ANC.IND.04 Percentage of pregnant women with at least four ANC contacts",
  "status": "draft",
  "experimental": false,
  "date": "2025-06-24T13:58:48-06:00",
  "publisher": "World Health Organization (WHO)",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "https://www.who.int"
        }
      ]
    }
  ],
  "description": "Percentage of pregnant women with at least four ANC contacts",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001"
        }
      ]
    }
  ],
  "library": [
    "http://smart.who.int/anc/Library/ANCIND04"
  ],
  "scoring": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-scoring",
        "code": "proportion"
      }
    ]
  },
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/measure-type",
          "code": "process"
        }
      ]
    }
  ],
  "improvementNotation": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
        "code": "increase"
      }
    ]
  },
  "group": [
    {
      "id": "group-1",
      "population": [
        {
          "id": "initial-population",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "initial-population"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Initial Population"
          }
        },
        {
          "id": "denominator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "denominator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Denominator"
          }
        },
        {
          "id": "numerator",
          "code": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/measure-population",
                "code": "numerator"
              }
            ]
          },
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Numerator"
          }
        }
      ],
      "stratifier": [
        {
          "id": "by-age",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Age Stratifier"
          }
        },
        {
          "id": "by-education-level",
          "criteria": {
            "language": "text/cql-identifier",
            "expression": "Education Level Stratifier"
          }
        }
      ]
    }
  ]
}