Da Vinci Value-Based Performance Reporting Implementation Guide
1.0.0 - STU1

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## : quality-measurereport09 - JSON Representation

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    {
      "resourceType" : "MeasureReport",
      "id" : "quality-measurereport09",
      "meta" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/instance-name",
            "valueString" : "VBP Quality MeasureReport Example"
          },
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/instance-description",
            "valueMarkdown" : "This is an example Statin Use in Persons with Diabetes (SUPD) MeasureReport for the *VBP Quality MeasureReport* profile."
          }
        ],
        "source" : "http://example.org/fhir/server",
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/vbp-quality-measurereport"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport </b><a name=\"quality-measurereport09\"> </a><a name=\"hcquality-measurereport09\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceMeasureReport &quot;quality-measurereport09&quot; </p><p style=\"margin-bottom: 0px\">Information Source: http://example.org/fhir/server!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-vbp-quality-measurereport.html\">VBP Quality MeasureReport</a></p></div><p><b>DEQM Measure Scoring Extension</b>: Proportion <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-scoring.html\">MeasureScoring</a>#proportion)</span></p><p><b>Score</b>: 0</p><p><b>Measure Report Category</b>: Value-Based Performance <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org/fhir/extensions/5.1.0/CodeSystem-measurereport-category.html\">Measure Report Category</a>#vbp)</span></p><blockquote><p><b>Threshold</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-threshold.html\">Threshold</a></blockquote><p><b>value</b>: 40 %<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code% = '%')</span></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Star 2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-threshold-type.html\">Threshold Type Codes</a>#star-2)</span></p></blockquote><blockquote><p><b>Threshold</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-threshold.html\">Threshold</a></blockquote><p><b>value</b>: 50 %<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code% = '%')</span></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Star 3 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-threshold-type.html\">Threshold Type Codes</a>#star-3)</span></p></blockquote><blockquote><p><b>Threshold</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-threshold.html\">Threshold</a></blockquote><p><b>value</b>: 60 %<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code% = '%')</span></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Star 4 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-threshold-type.html\">Threshold Type Codes</a>#star-4)</span></p></blockquote><blockquote><p><b>Threshold</b></p><blockquote><p><b>url</b></p><a href=\"StructureDefinition-threshold.html\">Threshold</a></blockquote><p><b>value</b>: 70 %<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code% = '%')</span></p><blockquote><p><b>url</b></p><code>type</code></blockquote><p><b>value</b>: Star 5 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-threshold-type.html\">Threshold Type Codes</a>#star-5)</span></p></blockquote><p><b>status</b>: complete</p><p><b>type</b>: summary</p><p><b>measure</b>: <a href=\"http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR\">http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR</a></p><p><b>date</b>: 2023-01-15</p><p><b>reporter</b>: <a href=\"Organization-vbp-payer01.html\">Organization/vbp-payer01</a> &quot;ABC Payer&quot;</p><p><b>period</b>: 2022-01-01 --&gt; 2022-11-30</p><p><b>improvementNotation</b>: Increased score indicates improvement <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-measure-improvement-notation.html\">MeasureImprovementNotation</a>#increase)</span></p><blockquote><p><b>group</b></p><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>pop1</blockquote><p><b>code</b>: Calculated Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-numerator)</span></p><p><b>count</b>: 220</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>pop2</blockquote><p><b>code</b>: Calculated Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-denominator)</span></p><p><b>count</b>: 386</p></blockquote><p><b>measureScore</b>: 0.57</p><blockquote><p><b>stratifier</b></p><p><b>code</b>: Facility <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-measure-stratifier-example.html\">Measure Stratifier Example Codes</a>#facility)</span></p><blockquote><p><b>stratum</b></p><blockquote><p><b>component</b></p><p><b>code</b>: Coverage type <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#87520-3)</span></p><p><b>value</b>: health maintenance organization policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#HMO)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#LOC)</span></p><p><b>value</b>: Region 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop1</blockquote><p><b>code</b>: Calculated Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-numerator)</span></p><p><b>count</b>: 100</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop2</blockquote><p><b>code</b>: Calculated Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-denominator)</span></p><p><b>count</b>: 180</p></blockquote><p><b>measureScore</b>: 0.56</p></blockquote><blockquote><p><b>stratum</b></p><blockquote><p><b>component</b></p><p><b>code</b>: Coverage type <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#87520-3)</span></p><p><b>value</b>: health maintenance organization policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#HMO)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#LOC)</span></p><p><b>value</b>: Region 2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop3</blockquote><p><b>code</b>: Calculated Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-numerator)</span></p><p><b>count</b>: 10</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop4</blockquote><p><b>code</b>: Calculated Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-denominator)</span></p><p><b>count</b>: 13</p></blockquote><p><b>measureScore</b>: 0.08</p></blockquote><blockquote><p><b>stratum</b></p><blockquote><p><b>component</b></p><p><b>code</b>: Coverage type <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#87520-3)</span></p><p><b>value</b>: preferred provider organization policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#PPO)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#LOC)</span></p><p><b>value</b>: Region 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop5</blockquote><p><b>code</b>: Calculated Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-numerator)</span></p><p><b>count</b>: 100</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop6</blockquote><p><b>code</b>: Calculated Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-denominator)</span></p><p><b>count</b>: 1880</p></blockquote><p><b>measureScore</b>: 0.56</p></blockquote><blockquote><p><b>stratum</b></p><blockquote><p><b>component</b></p><p><b>code</b>: Coverage type <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#87520-3)</span></p><p><b>value</b>: preferred provider organization policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#PPO)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: location <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ActCode.html\">ActCode</a>#LOC)</span></p><p><b>value</b>: Region 2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop7</blockquote><p><b>code</b>: Calculated Numerator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-numerator)</span></p><p><b>count</b>: 10</p></blockquote><blockquote><p><b>population</b></p><blockquote><p><b>id</b></p>strat-pop8</blockquote><p><b>code</b>: Calculated Denominator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-vbp-measure-population.html\">Value-Based Performance Measure Population Type Codes</a>#calculated-denominator)</span></p><p><b>count</b>: 13</p></blockquote><p><b>measureScore</b>: 0.08</p></blockquote></blockquote></blockquote></div>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/extension-measureScoring",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/measure-scoring",
                "code" : "proportion"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/score",
          "valueDecimal" : 0
        },
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/measurereport-category",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/CodeSystem/measurereport-category",
                "code" : "vbp"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "threshold",
              "valueQuantity" : {
                "value" : 40,
                "system" : "http://unitsofmeasure.org",
                "code" : "%"
              }
            },
            {
              "url" : "type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/threshold-type",
                    "code" : "star-2"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/threshold"
        },
        {
          "extension" : [
            {
              "url" : "threshold",
              "valueQuantity" : {
                "value" : 50,
                "system" : "http://unitsofmeasure.org",
                "code" : "%"
              }
            },
            {
              "url" : "type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/threshold-type",
                    "code" : "star-3"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/threshold"
        },
        {
          "extension" : [
            {
              "url" : "threshold",
              "valueQuantity" : {
                "value" : 60,
                "system" : "http://unitsofmeasure.org",
                "code" : "%"
              }
            },
            {
              "url" : "type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/threshold-type",
                    "code" : "star-4"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/threshold"
        },
        {
          "extension" : [
            {
              "url" : "threshold",
              "valueQuantity" : {
                "value" : 70,
                "system" : "http://unitsofmeasure.org",
                "code" : "%"
              }
            },
            {
              "url" : "type",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/threshold-type",
                    "code" : "star-5"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-vbpr/StructureDefinition/threshold"
        }
      ],
      "status" : "complete",
      "type" : "summary",
      "measure" : "http://example.org/Measure/measure-statin-use-diabetes-supd-FHIR",
      "date" : "2023-01-15",
      "reporter" : {
        🔗 "reference" : "Organization/vbp-payer01"
      },
      "period" : {
        "start" : "2022-01-01",
        "end" : "2022-11-30"
      },
      "improvementNotation" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/measure-improvement-notation",
            "code" : "increase",
            "display" : "Increased score indicates improvement"
          }
        ]
      },
      "group" : [
        {
          "population" : [
            {
              "id" : "pop1",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                    "code" : "calculated-numerator"
                  }
                ]
              },
              "count" : 220
            },
            {
              "id" : "pop2",
              "code" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                    "code" : "calculated-denominator"
                  }
                ]
              },
              "count" : 386
            }
          ],
          "measureScore" : {
            "value" : 0.57
          },
          "stratifier" : [
            {
              "code" : [
                {
                  "coding" : [
                    {
                      "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/measure-stratifier-example",
                      "code" : "facility"
                    }
                  ]
                }
              ],
              "stratum" : [
                {
                  "component" : [
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://loinc.org",
                            "code" : "87520-3"
                          }
                        ]
                      },
                      "value" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "HMO"
                          }
                        ]
                      }
                    },
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "LOC"
                          }
                        ]
                      },
                      "value" : {
                        "text" : "Region 1"
                      }
                    }
                  ],
                  "population" : [
                    {
                      "id" : "strat-pop1",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-numerator"
                          }
                        ]
                      },
                      "count" : 100
                    },
                    {
                      "id" : "strat-pop2",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-denominator"
                          }
                        ]
                      },
                      "count" : 180
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.56
                  }
                },
                {
                  "component" : [
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://loinc.org",
                            "code" : "87520-3"
                          }
                        ]
                      },
                      "value" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "HMO"
                          }
                        ]
                      }
                    },
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "LOC"
                          }
                        ]
                      },
                      "value" : {
                        "text" : "Region 2"
                      }
                    }
                  ],
                  "population" : [
                    {
                      "id" : "strat-pop3",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-numerator"
                          }
                        ]
                      },
                      "count" : 10
                    },
                    {
                      "id" : "strat-pop4",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-denominator"
                          }
                        ]
                      },
                      "count" : 13
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.08
                  }
                },
                {
                  "component" : [
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://loinc.org",
                            "code" : "87520-3"
                          }
                        ]
                      },
                      "value" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "PPO"
                          }
                        ]
                      }
                    },
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "LOC"
                          }
                        ]
                      },
                      "value" : {
                        "text" : "Region 1"
                      }
                    }
                  ],
                  "population" : [
                    {
                      "id" : "strat-pop5",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-numerator"
                          }
                        ]
                      },
                      "count" : 100
                    },
                    {
                      "id" : "strat-pop6",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-denominator"
                          }
                        ]
                      },
                      "count" : 1880
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.56
                  }
                },
                {
                  "component" : [
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://loinc.org",
                            "code" : "87520-3"
                          }
                        ]
                      },
                      "value" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "PPO"
                          }
                        ]
                      }
                    },
                    {
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                            "code" : "LOC"
                          }
                        ]
                      },
                      "value" : {
                        "text" : "Region 2"
                      }
                    }
                  ],
                  "population" : [
                    {
                      "id" : "strat-pop7",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-numerator"
                          }
                        ]
                      },
                      "count" : 10
                    },
                    {
                      "id" : "strat-pop8",
                      "code" : {
                        "coding" : [
                          {
                            "system" : "http://hl7.org/fhir/us/davinci-vbpr/CodeSystem/vbp-measure-population",
                            "code" : "calculated-denominator"
                          }
                        ]
                      },
                      "count" : 13
                    }
                  ],
                  "measureScore" : {
                    "value" : 0.08
                  }
                }
              ]
            }
          ]
        }
      ]
    }