Commercial use is defined as the sale, license, or distribution of the performance measures for commercial gain, or incorporation of the performance measures into a product or service that is sold, licensed, or distributed for commercial gain. Commercial uses of the PPMS require a license agreement between the user and the AMA (on be- half of the Consortium) or the ACC or the AHA. Neither the AMA, ACC, AHA, the Consortium, nor its members shall be responsible for any use of this PPMS. The measures and specifications are provided as is without warranty of any kind. Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of the code sets. The AMA, the ACC, the AHA, the National Committee for Quality Assurance (NCQA), and the Physician Consor- tium for Performance Improvement (PCPI) and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT) or other cod- ing contained in the specifications. CPT contained in the measures specifications is copyright 2004 2012 American Medical Association. LOINC copyright 2004 2012 Regenstrief Insti- tute, Inc. This material contains SNOMED CLINICAL TERMS (SNOMED CT) copy- right 2004 2012 International Health Terminology Standards Development Organization. All rights reserved. This document underwent a 14-day peer review between March 18, 2019, and April 1, 2019, and a 30-day public comment period between March 18, 2019, and April 16, 2019. The American Heart Association and the American College of Cardiology make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or busi- ness interest of a member of the writing panel. 