Thanks for this scoring guide and the qualifiers associated with it, remember that for small practices (those with fewer than 15 clinicians and/or special status designation) the IA points are worth dble, so one high level activity meet full category performance or 2 medium level activities. In addition, though this is a QCDR google group, if clinicians reported less than 6 quality measures or did not include an outcome measure via a "qualified registry", then they are subject to EMA and they could have their denominator reduced if it is determined they could have reported 6 etc..