eCQM Title | # Appropriate Testing for Pharyngitis
eCQM Identifier (Measure Authoring Tool) | 146 | eCQM Version Number | 12.0.000
NQF Number | Not Applicable | GUID | beb1c33c-2549-4e7f-9567-05ed38448464
Measurement Period | January 1, 20XX through December 31, 20XX
Measure Steward | National Committee for Quality Assurance
Measure Developer | National Committee for Quality Assurance
Endorsed By | None
Description |
    The percentage of episodes for patients 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order on or three days after the episode date and a group A streptococcus (strep) test in the seven-day period from three days prior to the episode date through three days after the episode date
Copyright |
    This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2022 National Committee for Quality Assurance. All Rights Reserved.

    Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications.

    CPT(R) codes, descriptions and other data are copyright 2022. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.

    LOINC(R) copyright 2004-2022 Regenstrief Institute, Inc.

    This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2022 International Health Terminology Standards Development Organisation.

    ICD-10 copyright 2022 World Health Organization. All Rights Reserved.
Disclaimer |
    The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

    Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Measure Scoring | Proportion
Measure Type | Process
Stratification |
    - 3-17 years
    - 18-64 years
    - 65 years and older
Risk Adjustment |
    None
Rate Aggregation |
    None
Rationale |
    Group A streptococcal (GAS) bacterial infections and other infections that cause pharyngitis (which are most often viral) often produce the same signs and symptoms (Shulman et al., 2012). The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the Infectious Diseases Society of America all recommend a diagnostic test for Strep A to improve diagnostic accuracy and avoid unnecessary antibiotic treatment (Linder et al., 2005).

    Estimated economic costs of pediatric streptococcal pharyngitis in the United States range from $224 million to $539 million per year, including indirect costs related to parental work losses. At a higher level, the economic cost of antibiotic resistance varies but has extended as high as $20 billion in excess direct healthcare costs, with additional costs to society for lost productivity as high as $35 billion a year (2008 dollars) (Pfoh et al., 2008).
Clinical Recommendation Statement |
    Infectious Disease Society of America (2012)

    The Infectious Diseases Society of America "recommends swabbing the throat and testing for GAS pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present"
Improvement Notation |
    Higher score indicates better quality
Reference |
    Reference Type: CITATION
    Reference Text: 'Linder, J. A., Bates, D. W., Lee, G. M., et al. (2005). Antibiotic Treatment of Children with Sore Throat. JAMA, 294(18), 2315-2322.'
Reference |
    Reference Type: CITATION
    Reference Text: 'Pfoh, E., Wessels, M.R., Goldmann, D., et al. (2008). Burden and Economic Cost of Group A Streptococcal Pharyngitis. Pediatrics, 121(2), 229-234. doi: 10.1542/peds.2007-0484'
Reference |
    Reference Type: CITATION
    Reference Text: 'Shulman, S. T., Bisno, A. L., Clegg, H. W., et al. (2012). Clinical Practice Guideline for the Diagnosis and Management of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases, 55(10), E86-E102. doi:10.1093/cid/cis629'
Definition |
    None
Guidance |
    This is an episode of care measure that examines all eligible episodes for the patient. The intent is to determine whether antibiotics are being ordered appropriately. Antibiotics should only be ordered if a strep test has been performed to confirm a bacterial infection. Antibiotics should not be ordered for viral infections. Antibiotics should be ordered on or three days after the episode date.

    This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients aged 3 years and older with a diagnosis of pharyngitis that resulted in an antibiotic order from January 1 to December 28 of the measurement period.

    This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Transmission Format |
    TBD
Initial Population |
    Outpatient, telephone, online assessment (i.e., e-visit or virtual check-in), observation, or emergency department (ED) visits with a diagnosis of pharyngitis or tonsillitis from January 1 to December 28 of the measurement period and an antibiotic order on or three days after the episode date among patients 3 years or older
Denominator |
    Equals Initial Population
Denominator Exclusions |
    Exclude pharyngitis episodes when the patient had hospice care for any part of the measurement period.

    Exclude pharyngitis episodes when the patient had a comorbid condition during the 12 months prior to or on the episode date.

    Exclude pharyngitis episodes where the patient is taking antibiotics in the 30 days prior to the episode date.

    Exclude pharyngitis episodes where the patient had a competing diagnosis on or three days after the episode date.
Numerator |
    A group A streptococcus test in the seven-day period from three days prior to the episode date through three days after the episode date
Numerator Exclusions |
    Not Applicable
Denominator Exceptions |
    None
Supplemental Data Elements |
    For every patient evaluated by this measure also identify payer, race, ethnicity and sex

## Table of Contents

- Population Criteria
- Definitions
- Functions
- Terminology
- Data Criteria (QDM Data Elements)
- Supplemental Data Elements
- Risk Adjustment Variables

### Population Criteria

- - Initial Population

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")>= 3
              return EncounterWithPharyngitis

- - Denominator

    - -     "Initial Population"

- - Denominator Exclusions

    - -     "Encounters and Assessments with Hospice Patient"
              union "Encounter With Comorbid Condition Prior"
              union "Encounter With Antibiotic Active In 30 Days Prior to Episode Date"
              union "Encounter With Competing Diagnosis for Upper Respiratory Infection"

- - Numerator

    - -     from
              "Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
              "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where ( Global."NormalizeInterval" ( GroupAStreptococcusTest.relevantDatetime, GroupAStreptococcusTest.relevantPeriod ) starts during day of Interval[(
                  end of EncounterWithPharyngitis.relevantPeriod
                ) - 3 days, (
                  end of EncounterWithPharyngitis.relevantPeriod
                ) + 3 days]
              )
              return EncounterWithPharyngitis

- - Numerator Exclusions

    - -     None

- - Denominator Exceptions

    - -     None

- - Stratification 1

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")in Interval[3, 17]
              return EncounterWithPharyngitis

- - Stratification 2

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")in Interval[18, 64]
              return EncounterWithPharyngitis

- - Stratification 3

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")>= 65
              return EncounterWithPharyngitis

### Definitions

- - Denominator

    - -     "Initial Population"

  - Denominator Exclusions

    - -     "Encounters and Assessments with Hospice Patient"
              union "Encounter With Comorbid Condition Prior"
              union "Encounter With Antibiotic Active In 30 Days Prior to Episode Date"
              union "Encounter With Competing Diagnosis for Upper Respiratory Infection"

  - Encounter With Antibiotic Active In 30 Days Prior to Episode Date

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic
                such that ( Global."NormalizeInterval" ( ActiveAntibiotic.relevantDatetime, ActiveAntibiotic.relevantPeriod ) overlaps day of Interval[start of EncounterWithPharyngitis.relevantPeriod - 30 days, start of EncounterWithPharyngitis.relevantPeriod - 1 day])
              return EncounterWithPharyngitis

  - Encounter With Antibiotic Ordered Within Three Days

    - -     "Qualifying Encounters" EDOrAmbulatoryVisit
              with ["Medication, Order": "Antibiotic Medications for Pharyngitis"] AntibioticOrdered
                such that ( start of EDOrAmbulatoryVisit.relevantPeriod ) 3 days or less on or before day of AntibioticOrdered.authorDatetime

  - Encounter With Comorbid Condition Prior

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              with ["Diagnosis": "Comorbid Conditions for Respiratory Conditions"] ComorbidCondition
                such that start of ComorbidCondition.prevalencePeriod in day of Interval[start of EncounterWithPharyngitis.relevantPeriod - 1 year, start of EncounterWithPharyngitis.relevantPeriod]
              return EncounterWithPharyngitis

  - Encounter With Competing Diagnosis for Upper Respiratory Infection

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              with ["Diagnosis": "Competing Conditions for Respiratory Conditions"] CompetingCondition
                such that CompetingCondition.prevalencePeriod starts 3 days or less on or after day of start of EncounterWithPharyngitis.relevantPeriod
              return EncounterWithPharyngitis

  - Encounter With Pharyngitis or Tonsillitis With Antibiotic

    - -     from
              "Encounter With Antibiotic Ordered Within Three Days" VisitWithAntibiotic,
              "Pharyngitis or Tonsillitis" AcutePharyngitisTonsillitis
              where AcutePharyngitisTonsillitis.prevalencePeriod starts during day of VisitWithAntibiotic.relevantPeriod
              return VisitWithAntibiotic

  - Encounters and Assessments with Hospice Patient

    - -     "Initial Population" EligibleEncounters
              where Hospice."Has Hospice Services"

  - Group A Streptococcus Lab Test With Result

    - -     ["Laboratory Test, Performed": "Group A Streptococcus Test"] GroupAStreptococcusTest
              where GroupAStreptococcusTest.result is not null

  - Hospice.Has Hospice Services

    - -     exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter
                where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
                    or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
                )
                  and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"
            )
              or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter
                  where HospiceEncounter.relevantPeriod overlaps day of "Measurement Period"
              )
              or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment
                  where HospiceAssessment.result ~ "Yes (qualifier value)"
                    and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps day of "Measurement Period"
              )
              or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder
                  where HospiceOrder.authorDatetime during day of "Measurement Period"
              )
              or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed
                  where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps day of "Measurement Period"
              )
            or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis
                  where HospiceCareDiagnosis.prevalencePeriod overlaps day of "Measurement Period"
              )

  - Initial Population

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")>= 3
              return EncounterWithPharyngitis

  - Numerator

    - -     from
              "Group A Streptococcus Lab Test With Result" GroupAStreptococcusTest,
              "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where ( Global."NormalizeInterval" ( GroupAStreptococcusTest.relevantDatetime, GroupAStreptococcusTest.relevantPeriod ) starts during day of Interval[(
                  end of EncounterWithPharyngitis.relevantPeriod
                ) - 3 days, (
                  end of EncounterWithPharyngitis.relevantPeriod
                ) + 3 days]
              )
              return EncounterWithPharyngitis

  - Pharyngitis or Tonsillitis

    - -     ( ["Diagnosis": "Acute Pharyngitis"]
                union ["Diagnosis": "Acute Tonsillitis"]
            )

  - Qualifying Encounters

    - -     ( ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"]
              union ["Encounter, Performed": "Home Healthcare Services"]
              union ["Encounter, Performed": "Initial Hospital Observation Care"]
              union ["Encounter, Performed": "Medical Disability Exam"]
              union ["Encounter, Performed": "Observation"]
              union ["Encounter, Performed": "Office Visit"]
              union ["Encounter, Performed": "Telephone Visits"]
              union ["Encounter, Performed": "Online Assessments"]
              union ["Encounter, Performed": "Outpatient Consultation"]
              union ["Encounter, Performed": "Preventive Care Services Established Office Visit, 18 and Up"]
              union ["Encounter, Performed": "Preventive Care Services Group Counseling"]
              union ["Encounter, Performed": "Unlisted preventive medicine service"]
              union ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"]
              union ["Encounter, Performed": "Preventive Care Services Individual Counseling"]
              union ["Encounter, Performed": "Preventive Care Services Initial Office Visit, 18 and Up"]
              union ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] ) ValidEncounters
              where ValidEncounters.relevantPeriod ends during day of Interval[start of "Measurement Period",
              end of "Measurement Period" - 3 days]

  - SDE Ethnicity

    - -     ["Patient Characteristic Ethnicity": "Ethnicity"]

  - SDE Payer

    - -     ["Patient Characteristic Payer": "Payer"]

  - SDE Race

    - -     ["Patient Characteristic Race": "Race"]

  - SDE Sex

    - -     ["Patient Characteristic Sex": "ONC Administrative Sex"]

  - Stratification 1

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")in Interval[3, 17]
              return EncounterWithPharyngitis

  - Stratification 2

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")in Interval[18, 64]
              return EncounterWithPharyngitis

  - Stratification 3

    - -     "Encounter With Pharyngitis or Tonsillitis With Antibiotic" EncounterWithPharyngitis
              where AgeInYearsAt(date from start of "Measurement Period")>= 65
              return EncounterWithPharyngitis

### Functions

- - Global.NormalizeInterval(pointInTime DateTime, period Interval<DateTime>)

    - -     if pointInTime is not null then Interval[pointInTime, pointInTime]
              else if period is not null then period
              else null as Interval<DateTime>

### Terminology

- code "Discharge to healthcare facility for hospice care (procedure)" ("SNOMEDCT Code (428371000124100)")
- code "Discharge to home for hospice care (procedure)" ("SNOMEDCT Code (428361000124107)")
- code "Hospice care [Minimum Data Set]" ("LOINC Code (45755-6)")
- code "Unlisted preventive medicine service" ("CPT Code (99429)")
- code "Yes (qualifier value)" ("SNOMEDCT Code (373066001)")
- valueset "Acute Pharyngitis" (2.16.840.1.113883.3.464.1003.102.12.1011)
- valueset "Acute Tonsillitis" (2.16.840.1.113883.3.464.1003.102.12.1012)
- valueset "Antibiotic Medications for Pharyngitis" (2.16.840.1.113883.3.464.1003.196.12.1001)
- valueset "Comorbid Conditions for Respiratory Conditions" (2.16.840.1.113883.3.464.1003.102.12.1025)
- valueset "Competing Conditions for Respiratory Conditions" (2.16.840.1.113883.3.464.1003.102.12.1017)
- valueset "Emergency Department Evaluation and Management Visit" (2.16.840.1.113883.3.464.1003.101.12.1010)
- valueset "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307)
- valueset "Ethnicity" (2.16.840.1.114222.4.11.837)
- valueset "Group A Streptococcus Test" (2.16.840.1.113883.3.464.1003.198.12.1012)
- valueset "Home Healthcare Services" (2.16.840.1.113883.3.464.1003.101.12.1016)
- valueset "Hospice Care Ambulatory" (2.16.840.1.113883.3.526.3.1584)
- valueset "Hospice Diagnosis" (2.16.840.1.113883.3.464.1003.1165)
- valueset "Hospice Encounter" (2.16.840.1.113883.3.464.1003.1003)
- valueset "Initial Hospital Observation Care" (2.16.840.1.113883.3.464.1003.101.12.1002)
- valueset "Medical Disability Exam" (2.16.840.1.113883.3.464.1003.101.12.1073)
- valueset "Observation" (2.16.840.1.113883.3.464.1003.101.12.1086)
- valueset "Office Visit" (2.16.840.1.113883.3.464.1003.101.12.1001)
- valueset "ONC Administrative Sex" (2.16.840.1.113762.1.4.1)
- valueset "Online Assessments" (2.16.840.1.113883.3.464.1003.101.12.1089)
- valueset "Outpatient Consultation" (2.16.840.1.113883.3.464.1003.101.12.1008)
- valueset "Payer" (2.16.840.1.114222.4.11.3591)
- valueset "Preventive Care Services Established Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1025)
- valueset "Preventive Care Services Group Counseling" (2.16.840.1.113883.3.464.1003.101.12.1027)
- valueset "Preventive Care Services Individual Counseling" (2.16.840.1.113883.3.464.1003.101.12.1026)
- valueset "Preventive Care Services Initial Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1023)
- valueset "Preventive Care Services, Initial Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1022)
- valueset "Preventive Care, Established Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1024)
- valueset "Race" (2.16.840.1.114222.4.11.836)
- valueset "Telephone Visits" (2.16.840.1.113883.3.464.1003.101.12.1080)

### Data Criteria (QDM Data Elements)

- "Assessment, Performed: Hospice care [Minimum Data Set]" using "Hospice care [Minimum Data Set] (LOINC Code 45755-6)"
- "Diagnosis: Acute Pharyngitis" using "Acute Pharyngitis (2.16.840.1.113883.3.464.1003.102.12.1011)"
- "Diagnosis: Acute Tonsillitis" using "Acute Tonsillitis (2.16.840.1.113883.3.464.1003.102.12.1012)"
- "Diagnosis: Comorbid Conditions for Respiratory Conditions" using "Comorbid Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1025)"
- "Diagnosis: Competing Conditions for Respiratory Conditions" using "Competing Conditions for Respiratory Conditions (2.16.840.1.113883.3.464.1003.102.12.1017)"
- "Diagnosis: Hospice Diagnosis" using "Hospice Diagnosis (2.16.840.1.113883.3.464.1003.1165)"
- "Encounter, Performed: Emergency Department Evaluation and Management Visit" using "Emergency Department Evaluation and Management Visit (2.16.840.1.113883.3.464.1003.101.12.1010)"
- "Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient (2.16.840.1.113883.3.666.5.307)"
- "Encounter, Performed: Home Healthcare Services" using "Home Healthcare Services (2.16.840.1.113883.3.464.1003.101.12.1016)"
- "Encounter, Performed: Hospice Encounter" using "Hospice Encounter (2.16.840.1.113883.3.464.1003.1003)"
- "Encounter, Performed: Initial Hospital Observation Care" using "Initial Hospital Observation Care (2.16.840.1.113883.3.464.1003.101.12.1002)"
- "Encounter, Performed: Medical Disability Exam" using "Medical Disability Exam (2.16.840.1.113883.3.464.1003.101.12.1073)"
- "Encounter, Performed: Observation" using "Observation (2.16.840.1.113883.3.464.1003.101.12.1086)"
- "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)"
- "Encounter, Performed: Online Assessments" using "Online Assessments (2.16.840.1.113883.3.464.1003.101.12.1089)"
- "Encounter, Performed: Outpatient Consultation" using "Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008)"
- "Encounter, Performed: Preventive Care Services Established Office Visit, 18 and Up" using "Preventive Care Services Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025)"
- "Encounter, Performed: Preventive Care Services Group Counseling" using "Preventive Care Services Group Counseling (2.16.840.1.113883.3.464.1003.101.12.1027)"
- "Encounter, Performed: Preventive Care Services Individual Counseling" using "Preventive Care Services Individual Counseling (2.16.840.1.113883.3.464.1003.101.12.1026)"
- "Encounter, Performed: Preventive Care Services Initial Office Visit, 18 and Up" using "Preventive Care Services Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023)"
- "Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17" using "Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022)"
- "Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17" using "Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024)"
- "Encounter, Performed: Telephone Visits" using "Telephone Visits (2.16.840.1.113883.3.464.1003.101.12.1080)"
- "Encounter, Performed: Unlisted preventive medicine service" using "Unlisted preventive medicine service (CPT Code 99429)"
- "Intervention, Order: Hospice Care Ambulatory" using "Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584)"
- "Intervention, Performed: Hospice Care Ambulatory" using "Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584)"
- "Laboratory Test, Performed: Group A Streptococcus Test" using "Group A Streptococcus Test (2.16.840.1.113883.3.464.1003.198.12.1012)"
- "Medication, Active: Antibiotic Medications for Pharyngitis" using "Antibiotic Medications for Pharyngitis (2.16.840.1.113883.3.464.1003.196.12.1001)"
- "Medication, Order: Antibiotic Medications for Pharyngitis" using "Antibiotic Medications for Pharyngitis (2.16.840.1.113883.3.464.1003.196.12.1001)"
- "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)"
- "Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)"
- "Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)"
- "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)"

### Supplemental Data Elements

- SDE Ethnicity

  - -     ["Patient Characteristic Ethnicity": "Ethnicity"]

- SDE Payer

  - -     ["Patient Characteristic Payer": "Payer"]

- SDE Race

  - -     ["Patient Characteristic Race": "Race"]

- SDE Sex

  - -     ["Patient Characteristic Sex": "ONC Administrative Sex"]

### Risk Adjustment Variables

- None

Measure Set |
    None