Stool DNA test outside the three-year window

**My Thought Process for Evaluating MEMBER 40204 against the QM-CRC Measure**

Here's how I'm working through the evaluation for MEMBER 40204 against the QM-CRC measure for the 2026 measurement year.

First, I need to determine if the member falls into the denominator.
*   The member was born on March 25, 1971. By the end of 2026 (December 31, 2026), they will be 55 years old. The age criterion for the denominator is 46 through 75, so the member **meets the age requirement**.
*   The member must have continuous enrollment throughout 2026 (January 1, 2026, through December 31, 2026). The provided information states this is met, so the member **meets the continuous enrollment requirement**.
*   Therefore, the member is indeed in the **denominator**.

Next, I need to check for any exclusion criteria.
*   E1: Colorectal cancer – None indicated.
*   E2: Total colectomy – None indicated.
*   E3: Hospice – None indicated.
*   E4: Frailty and advanced illness – None indicated.
*   None of the exclusion criteria apply to this member.

Now, I move to the numerator criteria to see if the member has undergone a qualifying screening.
*   N1: FOBT/FIT during 2026 – No record of this.
*   N2: Stool DNA test during 2026 or the two years prior (meaning a three-year window from 2024-01-01 to 2026-12-31). The member has a record of a Stool DNA test on July 11, 2022. This date is **outside** the required three-year look-back window (2024, 2025, 2026). So, this test does not count towards meeting the numerator.
*   N3: Flexible sigmoidoscopy – No record of this.
*   N4: CT colonography – No record of this.
*   N5: Colonoscopy – No record of this.

Since the only screening performed (the 2022 Stool DNA test) falls outside the specified three-year look-back window for N2, and no other numerator criteria are met, the member does **not meet the numerator**.

Therefore, based on the evaluation, the member is **non_compliant**.

The specific reason for non-compliance is that the only recorded screening test, a stool DNA test from 2022, falls outside the required three-year look-back window for this measure. No other compliant screenings are present, and no exclusions apply.

I've confirmed the look-back window for N2 is indeed the three-year period of 2024, 2025, and 2026. The 2022 test clearly falls outside this. I've also verified that no other events like colonoscopies, sigmoidoscopies, CT colonography, or FOBT/FIT tests are on record, nor are there any colorectal cancer diagnoses, colectomies, or hospice statuses.

Finally, I'm constructing the JSON output. I need to ensure it reflects the "non_compliant" status and provides a concise reason. I'm checking that I only need the "status" and "reason" keys, as the measure is QM-CRC, not QM-FUM, which would require additional keys. The reason I've formulated, "The 2022 stool DNA test falls outside the three-year look-back window, and no other screenings are recorded," is clear and under the 30-word limit.

The JSON output will be:
```json
{
  "status": "non_compliant",
  "reason": "The 2022 stool DNA test falls outside the three-year look-back window, and no other screenings are recorded."
}
```

**My Thought Process on Patient CRC Screening Compliance**

Alright, let's break down this patient's colorectal cancer (CRC) screening status. I need to determine if they are compliant with the relevant measure, which involves checking their eligibility for the denominator and then their numerator services within the defined timeframes.

First, I'm looking at the denominator eligibility. The patient's date of birth is March 25, 1971. By the end of 2026, they will be 55 years old. The measure specifies an age range of 46-75 for this group, so they comfortably fall within that. Their enrollment is continuous from January 1, 2026, through December 31, 2026, with no gaps. This means they are eligible for the denominator.

Now, for exclusions. I'm scanning for any conditions that would remove them from consideration. I don't see any mention of colorectal cancer diagnosis, a prior colectomy, or hospice care. Also, their age (55) means they are younger than 66, so the specific exclusion E4 (for those 66 and older) doesn't apply. Therefore, they are not excluded.

Moving on to the numerator, which is where the actual screening services come in. I need to check if they had any of the qualifying tests within the specified windows.

*   **N1: FOBT/FIT in 2026?** No, there's no record of this.
*   **N2: Stool DNA test in 2026 or the two years prior (2024-2026)?** This is the crucial one. I see a stool DNA test recorded on July 11, 2022. However, the look-back window for this test is *during 2026 or the two years prior*, which translates to January 1, 2024, through December 31, 2026. Unfortunately, the 2022 test falls outside this three-year window.
*   **N3: Flexible sigmoidoscopy in 2026 or the four years prior (2022-2026)?** No, no record of this.
*   **N4: CT colonography in 2026 or the four years prior (2022-2026)?** No, none on file.
*   **N5: Colonoscopy in 2026 or the nine years prior (2017-2026)?** Again, no record of this.

Since the only screening event is that stool DNA test from 2022, and it doesn't meet the required timeframe for N2, they haven't met any of the numerator criteria.

Therefore, the overall status is **non_compliant**.

The specific reason for this is clear: "The member's stool DNA test in 2022 falls outside the allowed three-year look-back window."

Regarding the output format, I need to provide JSON with "status" and "reason". Since this is QM-CRC and not QM-FUM, I don't need to worry about the "met_7_day" and "met_30_day" keys.

So, the JSON output should be:
```json
{
  "status": "non_compliant",
  "reason": "The only screening on record is a stool DNA test from 2022, which falls outside the allowed three-year look-back window."
}
```

**Evaluating MEMBER 40204 for QM-CRC Measure Compliance in 2026**

My objective here is to meticulously assess MEMBER 40204's eligibility and compliance with the QM-CRC measure for the 2026 measurement year. My process begins with establishing the foundational data points: the measurement year is 2026, the member's date of birth is March 25, 1971, placing them at 55 years of age as of December 31, 2026. Crucially, their enrollment is confirmed as continuous throughout the entire measurement year, from January 1, 2026, to December 31, 2026.

The first critical step is determining denominator eligibility. I review the age requirement, which is 46 through 75 as of the end of the measurement year. With the member being 55, they comfortably meet this criterion. Next, I verify continuous enrollment, which for this measure allows for a single gap of up to 45 days. Since the member was continuously enrolled for the full year, this requirement is also met. Therefore, MEMBER 40204 is **eligible for the denominator**.

Following denominator eligibility, I systematically examine the exclusion criteria to ascertain if the member should be excluded from the measure altogether. I check for: Colorectal cancer (E1), Total colectomy (E2), Hospice care (E3), and Frailty or advanced illness (E4). Based on the available information, none of these exclusion criteria apply to MEMBER 40204. Consequently, there are **no exclusions** for this member.

With the member eligible and not excluded, I proceed to evaluate the numerator criteria to determine compliance. This involves checking for specific screening events within defined timeframes:
*   **N1: FOBT or FIT during 2026.** I find no evidence of this within the specified year.
*   **N2: Stool DNA test.** This is a three-year window, encompassing 2024, 2025, and 2026. While I note a Stool DNA test performed on July 11, 2022, this date falls outside the required three-year window for 2026 (meaning it predates 2024). Therefore, this specific test does not satisfy the numerator requirement.
*   **N3: Flexible sigmoidoscopy in a 5-year window (2022-2026).** No record of this procedure within the timeframe.
*   **N4: CT colonography in a 5-year window (2022-2026).** Again, no record of this specific test.
*   **N5: Colonoscopy in a 10-year window (2017-2026).** There is no record of a colonoscopy within this extended period.

Synthesizing these findings, the member meets the denominator criteria and has no exclusions. However, none of the numerator requirements – the specific screenings within their respective valid timeframes – have been met. The key issue is that the only recorded Stool DNA test occurred in 2022, which is outside the current three-year lookback window (2024-2026). Therefore, my conclusion is that MEMBER 40204 is **non-compliant** for the QM-CRC measure in 2026. The explicit reason for this status is the expiration of the validity period for their past Stool DNA test, rendering it ineligible for the current measurement year.

**My Thought Process for Assessing QM-CRC Compliance**

When I looked at this member's data for the QM-CRC (Colorectal Cancer Screening) measure, my primary goal was to determine if they met the numerator criteria for the 2026 measurement year, while also confirming they belonged in the denominator and were not excluded.

First, I verified the member's eligibility for the denominator. The measurement year is the entirety of 2026 (January 1st to December 31st). This specific member, identified by ID 40204, was born on March 25th, 1971. By December 31st, 2026, they will be 55 years old. The eligibility range for this measure is 46 through 75 years, so they clearly fall within that age bracket. Additionally, their enrollment status for 2026 is continuous, with no gaps from January 1st to December 31st, meaning they were continuously enrolled throughout the measurement year. Therefore, this member is definitively in the denominator.

Next, I meticulously reviewed the exclusion criteria to see if they should be removed from the eligible population.
*   **E1: Colorectal cancer:** There was no record of this.
*   **E2: Total colectomy:** No record of this either.
*   **E3: Hospice during 2026:** Again, no indication of hospice care.
*   **E4: Age 66+ and frailty/advanced illness:** Since the member is only 55, this exclusion criteria is not applicable.
With no exclusions met, the member remains in the denominator, and I need to assess numerator compliance.

Now, for the numerator compliance. I examined the different screening options within the specified timeframes:
*   **N1: FOBT or FIT during 2026:** No records of these tests were found for the year 2026.
*   **N2: Stool DNA test during 2026 or the two years prior:** This is where I had to be precise with the look-back window. The measure states "during 2026 or the two years prior." This translates to a three-year window: 2026 (year 1), 2025 (year 2), and 2024 (year 3). The member's record shows a Stool DNA test on July 11th, 2022. When I calculated the end date of the look-back window (December 31st, 2026) and subtracted two years, the start date of the window is January 1st, 2024. The 2022 test date falls outside this 2024-2026 window. I double-checked this calculation – 2022 is four years prior to 2026, not within the required three-year window.
*   **N3: Flexible sigmoidoscopy (5-year window: 2022-2026):** No records found.
*   **N4: CT colonography (5-year window: 2022-2026):** No records found.
*   **N5: Colonoscopy (10-year window: 2017-2026):** No records found.

So, to summarize my findings:
*   **Denominator:** Yes, the member meets the age and enrollment criteria.
*   **Exclusion:** No, the member does not meet any exclusion criteria.
*   **Numerator:** No, the member did not complete a qualifying screening within the specified timeframes. Specifically, the only documented screening, a Stool DNA test, occurred in 2022, which is outside the three-year look-back window required for that specific test type (2024-2026).

Consequently, the member's status is **non_compliant**. The precise reason for this non-compliance is that the Stool DNA test recorded on 2022-07-11 falls outside the required three-year look-back window for numerator compliance (2024-2026), and no other qualifying screening tests were performed within the applicable timeframes, nor were there any applicable exclusions.

This leads me to the final JSON output:
```json
{
  "status": "non_compliant",
  "reason": "The stool DNA test on 2022-07-11 falls outside the three-year look-back window, and the member has no other screenings or exclusions."
}
```
I've ensured the reason is concise (22 words) and accurately reflects the analytical process. I also confirmed there are no specific QM-FUM keys required, just the standard "status" and "reason" keys.

**Analysis of Colorectal Cancer Screening Measure (QM-CRC) for Member 40204**

My primary objective is to determine if Member 40204 is compliant with the Colorectal Cancer Screening (QM-CRC) measure for the 2026 measurement year. This involves first confirming if the member falls within the eligible population (denominator) and is not excluded, and then assessing if they meet any of the numerator criteria for screening.

**1. Denominator Eligibility:**

*   **Age:** The measure defines the eligible age range as 46-75 years as of 2026-12-31. The member's date of birth is 1971-03-25. Calculating their age on 2026-12-31: 2026 - 1971 = 55 years old. Since 55 falls squarely within the 46-75 age bracket, the member meets this criterion.
*   **Continuous Enrollment:** The requirement is for continuous enrollment throughout the entire year 2026, with a maximum allowance of one 45-day gap. The member's enrollment is recorded as 2026-01-01 through 2026-12-31, indicating full-year continuous enrollment.
*   **Conclusion for Denominator:** Based on both age and enrollment, I can confidently place Member 40204 in the denominator for this measure.

**2. Exclusions:**

Next, I need to rule out any exclusion criteria that would remove the member from consideration, even if they are in the denominator.

*   **E1 (Colorectal Cancer):** The member has no recorded history of colorectal cancer (ICD-10 codes C18-C21) on or before 2026-12-31. This exclusion does not apply.
*   **E2 (Total Colectomy):** There is no record of the member having undergone a total colectomy on or before 2026-12-31. This exclusion does not apply.
*   **E3 (Hospice):** The member was not in hospice care during 2026. This exclusion does not apply.
*   **E4 (Elderly, Frail, or Advanced Illness):** This exclusion applies to members aged 66 and older who also have frailty and advanced illness in 2026. The member is 55 years old, so this exclusion is not applicable.
*   **Conclusion for Exclusions:** The member does not meet any of the exclusion criteria and therefore remains eligible for further assessment against the numerator.

**3. Numerator Compliance:**

Now, I must determine if the member has undergone a qualifying colorectal cancer screening within the specified timeframes for the numerator. The measure outlines several options:

*   **N1 (FOBT or FIT):** The requirement is for a fecal occult blood test (FOBT) or fecal immunochemical test (FIT) performed in 2026. There is no record of such a test for this member in 2026.
*   **N2 (Stool DNA Test):** This criterion requires a stool DNA test performed in 2026 or the two years prior. This defines a three-year window: 2026, 2025, and 2024. The member's history indicates a stool DNA test was performed on 2022-07-11. Critically, this date falls outside the required 2024-2026 window.
*   **N3 (Flexible Sigmoidoscopy):** This option allows for a flexible sigmoidoscopy performed in 2026 or the four years prior, creating a five-year window: 2022, 2023, 2024, 2025, and 2026. While the test date of 2022-07-11 falls within this 5-year window, the type of test performed was explicitly a "Stool DNA test," not a flexible sigmoidoscopy.
*   **N4 (CT Colonography):** Similar to N3, this requires a CT colonography performed in 2026 or the four years prior (2022-2026). Again, the member's documented test was a stool DNA test, not a CT colonography.
*   **N5 (Colonoscopy):** This is the broadest criterion, requiring a colonoscopy performed in 2026 or the nine years prior (2017-2026). There is no record of the member having had a colonoscopy within this timeframe.

**4. Final Determination:**

*   The member is in the denominator.
*   The member is not excluded.
*   The member has not met any of the numerator criteria. Specifically, the recorded stool DNA test on 2022-07-11 is outside the defined three-year look-back period (2024-2026) for this particular test type. No other compliant screenings were documented.

Therefore, my conclusion is that Member 40204 is **non_compliant** with the QM-CRC measure.

**Reasoning for Non-Compliance:** The member's stool DNA test performed on 2022-07-11 is outside the required three-year numerator window (2024-2026), and no other compliant screenings were documented.

**Required Output Structure:**

Based on my analysis, the output should contain the following keys: `status` and `reason`. I have confirmed that the specific keys `met_7_day` and `met_30_day` are only applicable to QM-FUM and not QM-CRC.

```json
{
  "status": "non_compliant",
  "reason": "The member's stool DNA test from 2022-07-11 falls outside the three-year numerator window and no other screenings were performed."
}
```

**My Thought Process for QM-CRC Compliance**

Alright, let's break down this member's compliance for the QM-CRC (Colorectal Cancer Screening) measure for the 2026 measurement year.

First, I need to establish the foundational details:
*   The measurement year is the entirety of 2026, from January 1st to December 31st.
*   The member is identified as 40204.
*   Their Date of Birth is March 25, 1971.
*   Calculating their age on December 31, 2026: 2026 minus 1971 gives me 55 years. This is crucial because the eligible age range for this measure is 46 through 75 years old on December 31st of the measurement year. So, at 55, they fall squarely within the eligible age bracket.
*   Their enrollment status is continuous for the entire measurement year 2026. This meets the continuous enrollment requirement, which allows for no more than one gap of 45 days. Since there's no gap, they're good here.

Based on this, the member *is* in the **denominator**. They are the correct age and continuously enrolled.

Now, I need to check for any **exclusions** that would take them out of consideration even if they meet the denominator criteria.
*   **E1:** Do they have a diagnosis of colorectal cancer (codes C18-C21) on or before December 31, 2026? No, there's no indication of this.
*   **E2:** Have they had a total colectomy on or before December 31, 2026? No, this isn't noted.
*   **E3:** Were they in hospice during the measurement year 2026? Again, no information suggests this.
*   **E4:** Are they age 66 or older AND experiencing frailty plus advanced illness during the measurement year? They are only 55, so this exclusion is not applicable.

It appears that **no exclusions are met** for this member.

The next critical step is to determine if they meet any of the **numerator** criteria – meaning, did they have a qualifying screening test within the specified timeframe? I'll go through each type of test relevant to the measure:

*   **N1: FOBT or FIT during 2026.** Was there a Flexible Obstetric and Birth Control test (FOBT) or Fecal Immunochemical Test (FIT) performed during 2026? No, there's no record of this.

*   **N2: Stool DNA test during 2026 or the two years prior (three-year window).** This is where the member's history comes in.
    *   The window for a Stool DNA test is the measurement year (2026) plus the two years prior, making it 2024, 2025, and 2026.
    *   The member's history shows a Stool DNA test performed on July 11, 2022.
    *   Looking at the window (2024-01-01 to 2026-12-31), the test date of July 11, 2022, clearly falls *outside* this three-year window. It's more than three calendar years prior to the end of the measurement year.

*   **N3: Flexible sigmoidoscopy during 2026 or the four years prior (five-year window).** The member has no record of this test. (Just as a note for my own completeness, the five-year window would cover 2022-2026, but the test type is wrong for this criterion).

*   **N4: CT colonography during 2026 or the four years prior (five-year window).** The member has no record of this test. (Similarly, the five-year window here would cover 2022-2026, but it's the wrong test type).

*   **N5: Colonoscopy during 2026 or the nine years prior (ten-year window).** The member has no record of this test. (The ten-year window would cover 2017-2026, but again, it's not the specific test performed).

So, reviewing the numerator:
*   The member is in the denominator.
*   No exclusions apply.
*   The only screening test on record is a Stool DNA test from July 11, 2022.
*   This Stool DNA test is *outside* the three-year look-back window (2024-2026) required for compliance under criterion N2.
*   No other qualifying screenings were performed within their respective windows.

Therefore, the member is **non-compliant**.

The specific **reason** for non-compliance is that the stool DNA test occurred on 2022-07-11, which is outside the three-year look-back window required for that specific test type, and no other qualifying screenings were performed within their respective windows. I need to ensure this reason is concise and accurate, reflecting the core issue.

Finalizing the output:
*   **Status:** "non_compliant"
*   **Reason:** "The stool DNA test on 2022-07-11 is outside the three-year numerator window and no other qualifying screenings were performed." (19 words)

I also noted that measures like QM-FUM have additional keys (`met_7_day`, `met_30_day`), but since this is QM-CRC, those are not required. The output should only include `status` and `reason`.

Alright, let's break down this QM-CRC evaluation for Member 40204, and walk through my thought process step-by-step, as I see it.

First, I need to get a clear picture of what's being asked. The core task is to determine Member 40204's status against the QM-CRC quality measure for the 2026 measurement year. This means I need to figure out if they're compliant, non-compliant, excluded, or simply not eligible for this particular measure.

To do that, I have to meticulously dissect the QM-CRC measure specification itself. I'll start by defining the **denominator** – who are the eligible members? The criteria here are quite specific: they need to be between 46 and 75 years old as of the end of the measurement year (December 31, 2026), and they must have had continuous enrollment throughout that entire year, with at most one short gap of no more than 45 days.

Next, I'll focus on the **numerator** – what counts as compliance? For QM-CRC, there are several ways a member can achieve compliance, each with its own look-back period, all measured as of December 31, 2026:
*   A stool-based test like FOBT or FIT done in 2026 (N1).
*   A stool DNA test performed within a three-year window: 2026, 2025, or 2024 (N2).
*   A flexible sigmoidoscopy done within a five-year window: 2026, 2025, 2024, 2023, or 2022 (N3).
*   A CT colonography also within a five-year window: 2026, 2025, 2024, 2023, or 2022 (N4).
*   And finally, a colonoscopy, which has the longest look-back: anytime in 2026 or the nine years prior, making it a ten-year window from 2017 through 2026 (N5).

Then, I have to consider the **exclusions**. These are reasons why a member might be removed from the evaluation, even if they meet the denominator criteria. These include:
*   Having a diagnosis of colorectal cancer (codes C18-C21) on or before December 31, 2026 (E1).
*   Having undergone a total colectomy on or before December 31, 2026 (E2).
*   Being in hospice care at any point during 2026 (E3).
*   A more complex exclusion for older members: anyone aged 66 or older as of December 31, 2026, who also experienced frailty and advanced illness during 2026 (E4).

Now, I'll bring Member 40204 into the picture and start comparing their specific details against these rules.
*   **Member Details:** I'm told their DOB is March 25, 1971. This means as of December 31, 2026, they'll be 55 years old. Their enrollment is solid – continuous from January 1, 2026, to December 31, 2026. Critically, their history includes a Stool DNA test on July 11, 2022, and no other relevant procedures or diagnoses are mentioned.

My evaluation proceeds in a logical sequence:

**Step 1: Check Eligibility (Denominator).**
*   **Age:** 55 is well within the 46-75 age range. So, they pass this.
*   **Enrolment:** Continuous for the entire year. They pass this too.
*   **Conclusion:** Since both conditions are met, Member 40204 is definitely within the denominator. This means their status cannot possibly be "not_eligible."

**Step 2: Check for Exclusions.**
*   **E1 (Colorectal cancer):** The information explicitly states "No colorectal cancer." So, no exclusion here.
*   **E2 (Total colectomy):** Similarly, "No colectomy" means no exclusion.
*   **E3 (Hospice):** "No hospice" recorded, so that's not an exclusion factor.
*   **E4 (Age/Frailty/Advanced Illness):** The member is 55, which is less than the 66 threshold for this exclusion. Therefore, this exclusion doesn't apply.
*   **Conclusion:** Member 40204 is not excluded by any of the defined criteria. This means their status cannot be "excluded."

**Step 3: Check for Compliance (Numerator).**
This is where I determine if they actually met the criteria for *doing* the screening. I need to see if they meet *any one* of the numerator conditions (N1 through N5):
*   **N1 (FOBT/FIT in 2026):** The records show "No faecal occult blood test on record." This numerator criterion is not met.
*   **N2 (Stool DNA in 2024-2026):** The member had a Stool DNA test, yes, but it was on July 11, 2022. The look-back period for this specific test type is three years, meaning it would need to be from 2024, 2025, or 2026. Their 2022 test falls outside this window. So, this criterion is not met.
*   **N3 (Flex Sig in 2022-2026):** The record states "No sigmoidoscopy." Not met.
*   **N4 (CT colonography in 2022-2026):** The record states "No CT colonography." Not met.
*   **N5 (Colonoscopy in 2017-2026):** The record states "No colonoscopy." Not met.
*   **Conclusion:** After reviewing all the numerator options, the member hasn't met any of them.

**Step 4: Final Determination.**
So, to summarize my findings:
*   The member is **eligible** for the denominator.
*   The member is **not excluded**.
*   The member **does not meet any numerator criteria** for compliance.
Therefore, the only remaining status is **"non_compliant"**.

**Step 5: Formulate the Reason.**
I need to articulate *why* they are non-compliant. The key issue is that their only recorded screening test, the 2022 stool DNA test, is too old for the specific look-back period required for that test type under QM-CRC. None of the other screening methods were performed within their respective look-back windows. My formulated reason is: "The member's stool DNA test from 2022 is outside the three-year look-back window, and no other screening is recorded." This clearly explains the situation.

Finally, I construct the JSON output based on this determination. The request is specific to QM-CRC, so I don't need to include things like `met_7_day` or `met_30_day` which are related to different measures (like QM-FUM). The JSON is complete with the status and the precise reason.

```json
{
  "status": "non_compliant",
  "reason": "The member's stool DNA test from 2022 is outside the three-year look-back window, and no other screening is recorded."
}
```

Alright, let's break down how I'm approaching this evaluation of a member's record against the QM-CRC quality measure. My primary goal is to definitively determine if this member is compliant or not, and to clearly articulate why.

First off, I need to establish if they even belong in the group we're measuring. That means checking the **denominator criteria**. I'll look at their age first. The measure is for individuals between 46 and 75 years old as of the end of the measurement year, which is December 31, 2026. Their birthdate is March 25, 1971, which makes them 55 in 2026. Perfect, they fall squarely within the required age range. Next, I need to confirm they were continuously enrolled throughout the entire measurement year, 2026. The record explicitly states "2026-01-01 through 2026-12-31, continuous." This satisfies the requirement of being enrolled for the full year with no significant gaps, so they're definitely in the denominator.

Once I've confirmed they're eligible, I need to see if they fall into any **exclusion categories**. The measure has several. I'll check for a history of colorectal cancer – the record says "No colorectal cancer," so they're not excluded on that basis. Then I'll look for a total colectomy – again, the record states "no colectomy." Hospice care is another exclusion; the record indicates "no hospice." Finally, there's an exclusion for members aged 66 and older with frailty or advanced illness. This member is only 55, so this specific exclusion doesn't apply. Therefore, I can confidently say this member is *not* excluded from the measure.

Now that I know they're eligible and not excluded, the crucial part is to see if they meet the **numerator compliance**. This means checking if they've had one of the approved CRC screening tests by the end of 2026. I'll go through each option:
*   **FOBT/FIT in 2026:** The record shows "no faecal occult blood test on record." This isn't met.
*   **Stool DNA test:** This requires a test within a three-year window – 2026, 2025, or 2024. They *did* have a stool DNA test, but it was on July 11, 2022. That date is too far back, falling outside the required 2024-2026 look-back period. So, this criterion is also not met.
*   **Flexible sigmoidoscopy:** This has a five-year look-back (2022-2026). The record states "No ... sigmoidoscopy." Not met.
*   **CT colonography:** Also a five-year look-back (2022-2026). The record says "No ... CT colonography." Not met.
*   **Colonoscopy:** This has the longest look-back, ten years (2017-2026). The record indicates "No colonoscopy." Not met.

Since they didn't meet *any* of the numerator requirements, their **final status** is clearly "non_compliant." The **reason** for this non-compliance is specific: their only recorded stool DNA test is outside the allowable look-back period, and no other qualifying screening has been documented.

Finally, I'll assemble this into the **JSON output**. The `status` will be "non_compliant," and the `reason` will succinctly state, "The member's stool DNA test from 2022 is outside the three-year look-back period for that test." This reason is concise, under the word limit, and directly points to the specific failure to meet the measure's criteria. The JSON structure itself is straightforward and correct.

Okay, I've thoroughly reviewed the member's record against the QM-CRC quality measure, and here's my thought process to arrive at the conclusion.

First, I needed to confirm if this member even qualified to be evaluated – that is, if they were in the **denominator**. This involved two key checks:

1.  **Age:** I looked at the member's Date of Birth, which is 1971-03-25. For the measurement year ending 2026-12-31, this member will be 55 years old (2026 - 1971 = 55). The QM-CRC measure specifies an age range of 46 to 75. Since 55 falls squarely within that range, the age requirement is met.

2.  **Continuous Enrollment:** I checked for continuous enrollment throughout the entire measurement year, from 2026-01-01 to 2026-12-31. The record confirms continuous enrollment for this period, so this criterion is also satisfied.

My initial conclusion from these checks is that the member **is indeed in the denominator**, meaning they are eligible for this quality measure assessment.

Next, I moved on to **checking for any required exclusions**. These are situations where a member might be eligible but should be excluded from the measure's denominator. I went through each potential exclusion:

1.  **E1 (Colorectal cancer diagnosis):** The record explicitly states "No colorectal cancer." So, this exclusion doesn't apply.

2.  **E2 (Total colectomy):** The record indicates "no colectomy." This exclusion is also not applicable.

3.  **E3 (Hospice care):** The record states "no hospice." Therefore, this exclusion doesn't apply.

4.  **E4 (Age 66+ with frailty/advanced illness):** The member is 55, which is below the age threshold of 66 for this specific exclusion. So, this doesn't apply either.

Based on this review, I determined that the member **is not subject to any of the specified exclusions**.

Now, for the crucial part: determining **numerator compliance**. This is where I look to see if the member has met the required screening criteria within the defined timeframe. The measure allows for several types of screenings, and I checked each one:

1.  **N1 (FOBT/FIT):** The record clearly states "no faecal occult blood test on record." This specific screening is not met.

2.  **N2 (Stool DNA test):** The requirement here is for a test performed during 2026 or the two years prior, meaning a three-year look-back window from 2024-01-01 to 2026-12-31. I found a Stool DNA test recorded for 2022-07-11. Unfortunately, this date falls *outside* the required look-back period (2024, 2025, 2026). Therefore, this screening is not compliant.

3.  **N3 (Flexible sigmoidoscopy):** The record indicates "no sigmoidoscopy." This is not met.

4.  **N4 (CT colonography):** The record shows "no CT colonography." This is not met.

5.  **N5 (Colonoscopy):** The record states "No colonoscopy." This is also not met.

My assessment of the numerator criteria is that the member **does not meet any of the required conditions**.

Finally, I synthesized these findings into a **final determination**:

*   The member **is in the denominator** (eligible).
*   The member **is not excluded**.
*   The member **does not meet the numerator criteria**.

Therefore, the **status is "non_compliant."**

To articulate the reason precisely, I focused on why the numerator wasn't met. The member did have a stool DNA test, but its date was outside the defined look-back window. There were no other compliant screenings documented. So, the reason is: "The member's 2022 stool DNA test is outside the three-year look-back window, and no other qualifying screening is on record."

I did a quick double-check of my logic: age is correct, enrollment is correct, exclusions are correctly identified as not applicable, and the numerator assessment, particularly the look-back for the stool DNA test, is accurate. The final determination and the formulated reason directly reflect these findings.

This leads me to the output provided:
```json
{
  "status": "non_compliant",
  "reason": "The member's 2022 stool DNA test is outside the three-year look-back window, and no other qualifying screening is on record."
}
```

Let me work through this measure.

Member 40204:
- DOB: 1971-03-25, so age 55 on 2026-12-31.
- Enrolment: 2026-01-01 through 2026-12-31, continuous — satisfies continuous enrolment (no gaps).

Denominator eligibility:
- Age 46 through 75 as of 2026-12-31: 55 — yes, in range.
- Continuous enrolment: full year 2026 — yes.

So in denominator.

Exclusions:
- E1 colorectal cancer: none on record. No.
- E2 total colectomy: none. No.
- E3 hospice during MY: none. No.
- E4 age 66+ with frailty and advanced illness: not age 66+, no. No.

Not excluded.

Numerator — any of:
- N1 FOBT/FIT during 2026: none. No.
- N2 Stool DNA test during 2026 or two years prior (three-year window): look-back from 2026-12-31 — 2026, 2025, 2024. Member had stool DNA test 2022-07-11. That's outside the three-year window (which is 2024-2026). No.
- N3 flex sig during 2026 or four years prior (five-year window 2022-2026): none. No.
- N4 CT colonography 2022-2026: none. No.
- N5 colonoscopy 2026 or nine years prior (ten-year window 2017-2026): none. No.

No numerator met. In denominator, not excluded, doesn't meet numerator → non_compliant.

Reason: Stool DNA test was 2022-07-11, outside the three-year look-back window for N2 (which covers 2024-2026), and no other screening in any applicable window.

This is a non-QM-FUM measure, so the met_7_day and met_30_day keys don't apply.

Let me write the answer.

Let me evaluate this member against the QM-CRC measure specification.

**Eligible Population (Denominator):**
- Age: 55 years old on 2026-12-31. The requirement is 46 through 75. ✓
- Continuous enrolment: 2026-01-01 through 2026-12-31, continuous. ✓

So the member enters the denominator.

**Exclusions:**
- E1: No colorectal cancer. ✓ (not excluded)
- E2: No colectomy. ✓ (not excluded)
- E3: No hospice. ✓ (not excluded)
- E4: Age 66 or older? No, member is 55. So E4 does not apply. ✓ (not excluded)

No exclusions met.

**Numerator:**
- N1: Faecal occult blood test or FIT during 2026? No.
- N2: Stool DNA test during 2026 or the two years prior (three-year window). The window is 2024-01-01 through 2026-12-31. The member had a stool DNA test on 2022-07-11. That is outside the three-year window. 2026 minus 2 years = 2024. So the window starts 2024-01-01. 2022-07-11 is before that. ✗
- N3: Flexible sigmoidoscopy during 2026 or four years prior (five-year window: 2022-01-01 through 2026-12-31)? No sigmoidoscopy on record. ✗
- N4: CT colonography during 2026 or four years prior? No. ✗
- N5: Colonoscopy during 2026 or nine years prior? No. ✗

The member does not meet any numerator criterion.

Wait, let me re-check N2. The three-year window: "during 2026 or the two years prior." So that's 2024, 2025, and 2026. The test was on 2022-07-11, which is not within this window.

So the member is non_compliant.

Status: non_compliant
Reason: Stool DNA test on 2022-07-11 falls outside the three-year look-back window; no other screening on record.

The member is 55 years old on 2026-12-31 (DOB 1971-03-25).
Enrolment: continuous 2026-01-01 through 2026-12-31.
Denominator: Age 46-75, continuous enrolment. Member is eligible.
Exclusions: None (no CRC, no colectomy, no hospice, age < 66).
Numerator:
N1. FOBT/FIT in 2026: None.
N2. Stool DNA test in 2026 or 2 years prior (2024, 2025, 2026).
Member had Stool DNA test on 2022-07-11. This is outside the 3-year window (2024-01-01 to 2026-12-31).
N3. Flex sig in 5-year window: None.
N4. CT colonography in 5-year window: None.
N5. Colonoscopy in 10-year window: None.

So the member does not meet the numerator.
Status: non_compliant.
Reason: Stool DNA test was in 2022, outside the three-year look-back window for 2026.
Let's check the date: 2026-12-31 minus 3 years is 2024-01-01. 2022-07-11 is before 2024-01-01.
Reason: Stool DNA test on 2022-07-11 falls outside the three-year look-back window.
Word count check: "Stool DNA test on 2022-07-11 falls outside the three-year look-back window." (13 words).

Let's double check.
N2: Stool DNA test during 2026 or the two years prior (three-year window).
Measurement year: 2026. Two years prior: 2024, 2025. Window: 2024-01-01 to 2026-12-31.
Test date: 2022-07-11.
Result: non_compliant.
Reason: Stool DNA test on 2022-07-11 is outside the three-year look-back window.
No other tests.
No exclusions.
Eligible.
Status: non_compliant
Reason: Stool DNA test on 2022-07-11 is outside the three-year look-back window.

We need answer JSON with status, reason. Also for QM-FUM only extra keys, but this is QM-CRC, so only status and reason required. Need evaluate member 40204 under measure QM-CRC.

Let's parse.

Measurement year 2026-01-01 through 2026-12-31.

Eligible population: Age 46 through 75 as of 2026-12-31. DOB 1971-03-25. On 2026-12-31, age = 2026 - 1971 = 55 (birthday March 25, 2026 passed, so 55). Within 46-75. Good.

Continuous enrolment: full measurement year with no more than one gap of up to 45 days. Enrolment: 2026-01-01 through 2026-12-31, continuous. So meets denominator (eligible). Not excluded? Evaluate exclusions.

Exclusions:
E1. Colorectal cancer any time on or before 2026-12-31. No.
E2. Total colectomy any time on or before 2026-12-31. No.
E3. Hospice at any time during MY. No.
E4. Age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during MY. Member age 55, not 66 or older. So no exclusion.

Thus not excluded. Evaluate numerator.

Numerator: any one of N1-N5 by look-back window measured back from 2026-12-31.

N1: FOBT or FIT during 2026. None on record. No faecal occult blood test on record. (No FIT/FOBT). So N1 not met.

N2: Stool DNA test during 2026 or two years prior (three-year window). What is three-year window measured back from 2026-12-31? Usually look-back window includes measurement year plus prior years? The spec says "during 2026 or the two years prior (three-year window)". So dates from 2024-01-01 through 2026-12-31? Or measured back from 2026-12-31: during 2026 or the two years prior means 2024, 2025, 2026? Actually if measured back from 2026-12-31, a three-year window might be 2023-12-31? Let's interpret carefully.

Measure specs often say: "Stool DNA test during the measurement year or the two years prior to the measurement year" = three-year window. The measurement year is 2026, two years prior are 2024 and 2025? Or the two years prior to the measurement year: 2024 and 2025? Wait, "during 2026 or the two years prior (three-year window)" means the years 2026, 2025, and 2024? Let's count: if measurement year is 2026, then "two years prior" are 2024 and 2025? The year prior to 2026 is 2025, two years prior is 2024. Plus 2026 = 3 years: 2024, 2025, 2026. But "measured back from 2026-12-31" means the window ends 2026-12-31 and extends back 3 years: from 2023-12-31? Actually if you measure back from 2026-12-31 for a 3-year window, the window is 2023-12-31 to 2026-12-31 (or 2024-01-01 to 2026-12-31 depending inclusive). The phrase "(three-year window)" suggests the period consists of 3 years: measurement year plus two prior years (2024, 2025, 2026). Some HEDIS measures: Colorectal cancer screening: "Stool DNA (mt-sDNA) test during the measurement year or the two years prior to the measurement year" (3-year window). So includes MY and two prior calendar years: 2024, 2025, 2026. If a test occurred 2022-07-11, that is more than two years prior to 2026; it's four years prior. So not in window. Let's check: test date 2022-07-11. Measurement year 2026. Two years prior are 2024 and 2025. 2022 is four years prior. So out of window. Also if measured back from 2026-12-31 by 3 years, earliest date would be 2023-12-31 (or 2024-01-01). 2022-07-11 is before that. So not met N2.

N3: Flexible sigmoidoscopy during 2026 or four years prior (five-year window). No sigmoidoscopy. So not met.

N4: CT colonography during 2026 or four years prior (five-year window). No CT colonography. Not met.

N5: Colonoscopy during 2026 or nine years prior (ten-year window). No colonoscopy. Not met.

Thus numerator not met. Member in denominator, not excluded, does not meet numerator => status "non_compliant".

Reason: one sentence, under 30 words, naming the specific criterion or date that decided it. We need identify decisive criterion. Age/enrollment ok, no exclusions, but no qualifying screening in required windows; last stool DNA 2022-07-11 is outside the three-year window (needs 2024-2026). So reason: "In denominator (age 55, continuous enrollment, no exclusions), but no CRC screening in look-back windows; 2022-07-11 stool DNA is outside the three-year window." Need under 30 words. Let's count. 
"In denominator (age 55, continuous enrollment, no exclusions), but no CRC screening in look-back windows; 2022-07-11 stool DNA is outside the three-year window."

Word count: In(1) denominator(2) (age(3) 55,(4) continuous(5) enrollment,(6) no(7) exclusions),(8) but(9) no(10) CRC(11) screening(12) in(13) look-back(14) windows;(15) 2022-07-11(16) stool(17) DNA(18) is(19) outside(20) the(21) three-year(22) window.(23) Under 30 words. Good. Could also mention N2 not met due date. Need ensure reason names specific criterion or date that decided it. The date decided: stool DNA 2022-07-11 outside N2 three-year window. Also no other numerator events. But reason mentions no CRC screening in look-back windows; 2022 stool DNA outside three-year window. That's enough.

Check if status could be "compliant"? Wait: The member had a stool DNA test in 2022. Does N2 possibly include "during 2026 or the two years prior" meaning if measurement year is 2026, two years prior are 2024 and 2025, yes. But if some measures define "three-year window" as the 3 years before the end of measurement year: 2023-12-31 to 2026-12-31 (which includes parts of 2023, 2024, 2025, 2026? Actually 3 years back from 2026-12-31 is 2023-12-31. A test on 2022-07-11 is before 2023-12-31, so not included. If window is 2024-01-01 to 2026-12-31, also not included. So definitely outside.

But wait, maybe look-back windows are counted by years before the measurement year, not including measurement year? Let's parse: "by the look-back window measured back from 2026-12-31". For N5 colonoscopy during 2026 or the nine years prior (ten-year window). Nine years prior to 2026 are 2017-2025? Plus 2026 = ten years: 2017-2026. That matches usual HEDIS colonoscopy 10-year window: MY plus 9 prior years = 2017-2026. For N2: during 2026 or two years prior (three-year window) = 2024-2026 (MY + 2 prior years). Yes. So 2022 is not included. Good.

Check age: DOB 1971-03-25. On 2026-12-31, age 55. Wait 2026 - 1971 = 55. Birthday in March, so on Dec 31, had turned 55 in March 2026. Yes. Eligible age 46-75. Good.

Continuous enrollment: full year 2026-01-01 through 2026-12-31, continuous. Meets. No gap.

Exclusions: none.

Thus non_compliant.

Need output exactly one fenced JSON code block and nothing else. JSON object with keys status and reason (since not QM-FUM, no met_7_day/met_30_day). Use null? Not needed. Status string exactly one of allowed: "non_compliant". Reason string.

Let's construct JSON:

```json
{
  "status": "non_compliant",
  "reason": "In denominator (age 55, continuous enrollment, no exclusions), but no CRC screening in look-back windows; 2022-07-11 stool DNA is outside the three-year window."
}
```

Check reason length: count again precisely with contraction? "In denominator (age 55, continuous enrollment, no exclusions), but no CRC screening in look-back windows; 2022-07-11 stool DNA is outside the three-year window." Words separated by spaces/punctuation? Usually words: In(1) denominator(2) (age(3) 55,(4) continuous(5) enrollment,(6) no(7) exclusions),(8) but(9) no(10) CRC(11) screening(12) in(13) look-back(14) windows;(15) 2022-07-11(16) stool(17) DNA(18) is(19) outside(20) the(21) three-year(22) window.(23). Good.

Could there be any nuance: The numerator requires any one of N1-N5. The record says: "No colonoscopy, no sigmoidoscopy, no CT colonography, no faecal occult blood test on record." It had a stool DNA test, negative, 2022-07-11. That is a stool DNA test, but not during the three-year window. So it doesn't count. Therefore non_compliant. Good.

Should we mention "no exclusions" maybe reason must name specific criterion or date that decided it. The deciding criterion is the N2 three-year window date 2022-07-11 outside. And numerator not met. The reason says no CRC screening in look-back windows; 2022-07-11 stool DNA outside three-year window. That names date and criterion. Good.

Check if they want "status" and "reason" only. The task says Required JSON keys: "status" string, "reason" string. Items drawn from QM-FUM require two further keys. This is QM-CRC, so only status and reason. No other keys.

Make sure no preamble. Output exactly:

```json
{
  "status": "non_compliant",
  "reason": "In denominator (age 55, continuous enrollment, no exclusions), but no CRC screening in look-back windows; 2022-07-11 stool DNA is outside the three-year window."
}
```

Wait, should I check if "continuous enrolment: the full measurement year with no more than one gap of up to 45 days." The record: "Enrolment: 2026-01-01 through 2026-12-31, continuous." Yes.

One more nuance: For N2, "Stool DNA test during 2026 or the two years prior (three-year window)." If a test was done in 2022, it is more than two years prior; out. If interpreted as measured back from 2026-12-31, a 3-year window would be 2023-12-31 to 2026-12-31. 2022-07-11 is before that. Out. Good.

What about E4: Age 66 or older as of 2026-12-31 AND both frailty and advanced illness. Age 55, so no.

All set.

Need ensure JSON has no trailing comma. Use double quotes. The date in reason includes hyphens, fine.

One more check: Does "non_compliant" require the member is in denominator, not excluded, does not meet numerator. Yes.

Could status be "not_eligible" due to age? No, age 55 eligible.

Could the member be "excluded" due to the stool DNA test? No, stool DNA is a screening test, not an exclusion. Negative result doesn't exclude. Exclusions are colorectal cancer, total colectomy, hospice, or age 66+ with frailty+advanced illness. None.

Thus final answer. Ensure only fenced JSON code block, nothing else. The fenced block uses ```json ... ```. No other text.

Let's produce final.

We need answer JSON. Need apply measure QM-CRC.

Member 40204. DOB 1971-03-25. Age on 2026-12-31: 2026-12-31 minus 1971-03-25 = 55 years old (turned 55 on 2026-03-25). Age 46 through 75 inclusive? Eligible population age: 46 through 75 years as of 2026-12-31. 55 is within 46-75, so age eligible.

Continuous enrolment: full measurement year 2026-01-01 through 2026-12-31, continuous. No gap. Meets continuous enrolment.

Denominator: Age 46-75 on 2026-12-31 and continuous enrolment full year with no more than one gap up to 45 days. Yes.

Now exclusions before numerator. Required exclusions:
E1 colorectal cancer any time on or before 2026-12-31: none.
E2 total colectomy any time on or before 2026-12-31: none.
E3 hospice any time during measurement year: none.
E4 age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during measurement year. Member is 55, not 66 or older, so E4 not met. No frailty/advanced illness documented anyway.

So no exclusions. Now numerator: any one of N1-N5 by look-back from 2026-12-31.
Record: 2022-07-11 Stool DNA test, negative. No other tests. Need assess N2: Stool DNA test during 2026 or the two years prior (three-year window). Measurement year 2026. Three-year window: 2026, 2025, 2024? Wait "during 2026 or the two years prior (three-year window)." Measurement back from 2026-12-31. Two years prior means 2025 and 2024? Let's parse: during 2026 or the two years prior = years 2026, 2025, 2024 (2026 plus prior two years = 3-year window). If measurement year is 2026, the two years prior are 2025 and 2024. So window includes 2024-01-01 through 2026-12-31? Or maybe from 2024-01-01 to 2026-12-31 inclusive, i.e., services on or after 2024-01-01 and on or before 2026-12-31. But the test date is 2022-07-11. That's in 2022. Let's check: If window is 2026 or two years prior (2024-2026), 2022 is four years prior? Let's count: prior years: 2025 (1 year prior), 2024 (2 years prior). 2023 is 3 years prior, 2022 is 4 years prior. So 2022-07-11 is outside the 3-year stool DNA window. Not compliant via N2.

Check N1: FOBT/FIT during 2026. None.
N3: Flexible sigmoidoscopy during 2026 or four years prior (five-year window). 2026 + four prior years = 2022, 2023, 2024, 2025, 2026? Wait "during 2026 or the four years prior (five-year window)". If measurement year 2026, four years prior are 2025, 2024, 2023, 2022. That's a five-year window: 2022-01-01 through 2026-12-31 if counting years 2022-2026 inclusive. But the test we have is Stool DNA, not flexible sigmoidoscopy. So N3 not met (no sigmoidoscopy on record). The date doesn't matter because service type is different.
N4: CT colonography during 2026 or four years prior (five-year window) = 2022-2026. None on record.
N5: Colonoscopy during 2026 or nine years prior (ten-year window) = 2017-2026. None on record.

So numerator? Only history is stool DNA test in 2022. N2 window is 2024-2026, so not met. Thus does not meet numerator. Not excluded, in denominator, does not meet numerator => status "non_compliant".

Wait need check: "Numerator — any one of the following, by the look-back window measured back from 2026-12-31:
N1. Faecal occult blood test or faecal immunochemical test during 2026.
N2. Stool DNA test during 2026 or the two years prior (three-year window).
N3. Flexible sigmoidoscopy during 2026 or the four years prior (five-year window).
N4. CT colonography during 2026 or the four years prior (five-year window).
N5. Colonoscopy during 2026 or the nine years prior (ten-year window)."

Need compute look-back windows exactly. Let's be careful about "measured back from 2026-12-31". For N2: "during 2026 or the two years prior (three-year window)". If we measure back from 2026-12-31, a three-year window would be from 2024-01-01? Wait three years prior to end of 2026? Let's think: Window length of 3 years ending 2026-12-31: start date would be 2024-01-01 (2024, 2025, 2026) or perhaps 2023-12-31 to 2026-12-31 if measured as 3 years back from 2026-12-31? Usually HEDIS measures: "during the measurement year or the two years prior to the measurement year" means services on or after January 1 of the year two years prior (i.e., 2024) through December 31 of measurement year (2026). Actually HEDIS colorectal cancer screening: stool DNA (sDNA) test during the measurement year or the two years prior to the measurement year (a 3-year window). For MY 2026, that would be 2024, 2025, 2026 (dates 2024-01-01 to 2026-12-31). Wait HEDIS: For colonoscopy, during the measurement year or the nine years prior (a 10-year window). If MY 2026, the 10-year window is 2017-2026 (Jan 1, 2017 through Dec 31, 2026). For flexible sigmoidoscopy/CT colonography: 5-year window is 2022-2026 (Jan 1, 2022 through Dec 31, 2026). For FIT/FOBT: during the measurement year (2026) only. Yes these are standard HEDIS CRC specs. So N2 is 2024-2026. The member had stool DNA in 2022-07-11. 2022 is outside the 3-year window (which is 2024-2026). So numerator not met.

But wait: Could N2 be interpreted as "during 2026 or the two years prior" meaning the two prior calendar years are 2025 and 2024, yes. So 2022 is 4 years prior to 2026 (2025 is 1 year prior, 2024 is 2 years prior, 2023 is 3 years prior, 2022 is 4 years prior). Yes outside.

Check N3/N4: five-year window = 2022-2026. The member's stool DNA is not a flexible sigmoidoscopy or CT colonography, so not relevant. No procedure of those types. N5 ten-year window 2017-2026, no colonoscopy.

Thus non_compliant.

Need reason string: one sentence, under 30 words, naming specific criterion or date that decided it. Should state member is in denominator (age 55, continuous enrolment) but stool DNA test from 2022-07-11 is outside the N2 three-year window (2024-2026), and no other screening, so numerator not met.

Need ensure under 30 words. Let's draft: "Age 55 and continuously enrolled in 2026 place member in denominator; only screening is stool DNA on 2022-07-11, outside the 2024–2026 N2 window, so numerator not met." Count words: Age(1) 55(2) and(3) continuously(4) enrolled(5) in(6) 2026(7) place(8) member(9) in(10) denominator;(11) only(12) screening(13) is(14) stool(15) DNA(16) on(17) 2022-07-11,(18) outside(19) the(20) 2024–2026(21) N2(22) window,(23) so(24) numerator(25) not(26) met.(27) 27 words. Under 30. It references date and criterion. Good.

Need output only JSON with keys status and reason. For QM-CRC, no met_7_day/met_30_day (those are only for QM-FUM). So object:
{
  "status": "non_compliant",
  "reason": "Age 55 and continuously enrolled in 2026 place member in denominator; only screening is stool DNA on 2022-07-11, outside the 2024–2026 N2 window, so numerator not met."
}

Check if status string exactly one of: "compliant", "non_compliant", "excluded", "not_eligible". Yes.

Need consider if any exclusion? E4: age 66 or older as of 2026-12-31 AND both frailty and advanced illness. Member is 55 so no. None.

Check continuous enrolment: "the full measurement year with no more than one gap of up to 45 days." Enrolment: 2026-01-01 through 2026-12-31, continuous. That's full year. Good.

Age: 46 through 75 years as of 2026-12-31. DOB 1971-03-25. On 2026-12-31, age = 55 (since birthday in March 2026 passed). 55 within 46-75. Good.

Wait: If DOB is 1971-03-25, in 2026 they turn 55 on March 25, 2026 (2026 - 1971 = 55). Yes.

Now, check if stool DNA test in 2022 could meet N2 if window was 2022-2024? No, measurement year is 2026. N2 is "during 2026 or the two years prior" meaning 2024 and 2025 are prior. 2022 is four years prior. If someone misinterprets "two years prior" as prior to measurement year end? Let's verify using HEDIS-like logic: N5 colonoscopy ten-year window for MY2026: "during 2026 or the nine years prior" = 2017 through 2026 (since 9 years prior to 2026 are 2017-2025? Wait count: 2026 is year 0 (measurement year). Nine years prior: 2025(1),2024(2),2023(3),2022(4),2021(5),2020(6),2019(7),2018(8),2017(9). So years 2017-2026 inclusive = 10 years. Correct. For N3/N4 five-year window: four years prior: 2025(1),2024(2),2023(3),2022(4). Plus 2026 => 2022-2026. So if there were a CT colonography in 2022-07-11, it would be within N4 window. But the service is stool DNA, not CT colonography. So no.

But what about N2: two years prior: 2025(1),2024(2). Plus 2026 = 2024-2026. The stool DNA test is 2022-07-11, so not within. If it were a flexible sigmoidoscopy or CT colonography, 2022-07-11 would be within the 5-year window (2022-2026), so would meet N3/N4 if procedure type matched. But it's stool DNA, so not.

Thus non_compliant.

The reason needs to name specific criterion or date that decided it. The deciding criterion: N2 window (2024–2026) not met by 2022-07-11 stool DNA; no other numerator event. Or could say "Age 55 and continuous enrolment make member eligible, but the sole stool DNA test on 2022-07-11 falls outside the N2 three-year window (2024–2026), so numerator not met." This names date and criterion. Good.

Need ensure no extra keys. Only status and reason. Use en dash? JSON string can contain "–" (en dash) or hyphen. Use "2024-2026" to be safe with plain ASCII? The reason can have "2024-2026". The prompt says dates ISO 8601. "2022-07-11" is ISO. "2024-2026" isn't a date, it's a range; use "2024-2026" with hyphens. Need report dollar amounts? Not relevant. No QM-FUM keys.

Let's double-check member record: "No colonoscopy, no sigmoidoscopy, no CT colonography, no faecal occult blood test on record. No colorectal cancer, no colectomy, no hospice." So indeed only 2022-07-11 Stool DNA test, negative. So numerator not met.

Could there be an issue with negative result? Numerator doesn't require result, just test performed. So negative doesn't matter.

Status non_compliant.

Let's craft final JSON:
```json
{
  "status": "non_compliant",
  "reason": "Age 55 and continuous enrolment in 2026 place member in denominator; only screening is stool DNA on 2022-07-11, outside the 2024-2026 N2 window, so numerator not met."
}
```
Count words in reason: Age(1) 55(2) and(3) continuous(4) enrolment(5) in(6) 2026(7) place(8) member(9) in(10) denominator;(11) only(12) screening(13) is(14) stool(15) DNA(16) on(17) 2022-07-11,(18) outside(19) the(20) 2024-2026(21) N2(22) window,(23) so(24) numerator(25) not(26) met.(27). Good. Under 30.

One nuance: "continuous enrolment: the full measurement year with no more than one gap of up to 45 days." Member enrolment is continuous 2026-01-01 through 2026-12-31. So yes.

Wait: The measurement year is 2026-01-01 through 2026-12-31. Enrolment same. Good.

Double-check if age 46 through 75 as of 2026-12-31 inclusive? Yes 55.

No exclusions. So denominator met.

Thus final answer exactly fenced JSON code block and nothing else. No preamble.

Let's ensure no trailing commas. Use 2-space indentation? Not required, but fine.

Final.

We need answer JSON only. Task: QM-CRC measure. Measurement year 2026. Member DOB 1971-03-25, age 55 on 2026-12-31. Eligible population: age 46-75 as of 2026-12-31. 55 is within, continuous enrolment full year no gap, so denominator yes.

Exclusions: E1 colorectal cancer any time on or before 2026-12-31: none. E2 total colectomy: none. E3 hospice during MY: none. E4 age 66 or older AND frailty and advanced illness documented during MY. Age 55, not 66 or older, so E4 no. So no exclusions.

Numerator: any one:
N1 FIT/FOBT during 2026: none.
N2 Stool DNA test during 2026 or two years prior (three-year window). Need interpret: measurement year 2026 plus two years prior: years 2026, 2025, 2024? Or "during 2026 or the two years prior" = 2026, 2025, 2024. Stool DNA test occurred 2022-07-11. That's more than two years prior (2022 vs 2024/2025/2026). 2022 is 4 years prior to 2026 (window back from 2026-12-31: 2022-07-11 to 2026-12-31 is about 4 years 5 months). For N2 three-year window: look-back window measured back from 2026-12-31. Three-year window includes dates from 2024-01-01? Or 2023-12-31 to 2026-12-31? Need decide inclusive. "during 2026 or the two years prior" => years 2026, 2025, 2024. So earliest Jan 1 2024. The test 2022-07-11 outside. Therefore N2 not met.

N3 flexible sigmoidoscopy during 2026 or four years prior (five-year window): none.
N4 CT colonography same: none.
N5 colonoscopy during 2026 or nine years prior (ten-year window): none. Record says no colonoscopy, no sigmoidoscopy, no CT colonography, no FOBT. So no numerator. Therefore status "non_compliant". Reason: one sentence under 30 words naming specific criterion or date that decided it. Could say: "Stool DNA test was on 2022-07-11, outside the three-year window ending 2026-12-31; no other screening met." Need under 30 words. Check words: "Stool DNA test was on 2022-07-11, outside the three-year window ending 2026-12-31; no other screening met." Count: Stool(1) DNA(2) test(3) was(4) on(5) 2022-07-11,(6) outside(7) the(8) three-year(9) window(10) ending(11) 2026-12-31;(12) no(13) other(14) screening(15) met.(16). Under 30. Good. It names date and criterion. Or "No numerator screening: stool DNA 2022-07-11 is outside the three-year window; other modalities absent." Count: No(1) numerator(2) screening:(3) stool(4) DNA(5) 2022-07-11(6) is(7) outside(8) the(9) three-year(10) window;(11) other(12) modalities(13) absent.(14). Good.

But check if there is nuance: The QM-CRC tasks only require status and reason. No met_7_day etc (those are for QM-FUM). The instructions say "Items drawn from measure QM-FUM require two further keys...". This item is QM-CRC, so we do NOT include those keys. Required keys: status, reason. Only those two. Do not add keys. Output exactly one fenced JSON code block. Ensure no additional keys. Use JSON null? Not needed.

Let's double-check eligibility. Age on 2026-12-31: DOB 1971-03-25. On 2026-12-31, birthday in March already passed, so age = 2026-1971 = 55. Yes. Within 46-75 inclusive. Continuous enrolment Jan 1-Dec 31: yes. Not excluded. Numerator: N2 stool DNA test during 2026 or two years prior. Let's parse "measured back from 2026-12-31". For N1: "during 2026". N2: "during 2026 or the two years prior (three-year window)." If look-back from 2026-12-31, a three-year window could be 2024-01-01 through 2026-12-31? Or 2023-12-31 through 2026-12-31? Actually a three-year window measured back from 2026-12-31: If inclusive of exactly 3 years prior to date, subtract 3 years: 2023-12-31. But because measurement year is calendar year, they often say "during the measurement year or the two years prior" meaning years 2024, 2025, 2026? Wait HEDIS CRC measure: "Colonoscopy in the past 10 years, flexible sigmoidoscopy in past 5 years, CT colonography in past 5 years, FIT-DNA (stool DNA) in past 3 years, FOBT/FIT in past year." The年 measurement year is 2026. "During the measurement year or the two years prior" means the three-year period from January 1, 2024 through December 31, 2026. Because measurement year plus two prior calendar years = 2026, 2025, 2024. Yes. 2022 is outside. So non-compliant.

But wait the test says "No colonoscopy, no sigmoidoscopy, no CT colonography, no faecal occult blood test on record." Stool DNA test in 2022 negative. No colorectal cancer etc. So numerator no.

What about "Stool DNA test, negative." The measure N2: "Stool DNA test during 2026 or the two years prior". It does not require negative/positive, just test done. But date outside. So not met.

Now reason. The task: "reason string — one sentence, under 30 words, naming the specific criterion or date that decided it". Need under 30 words. Could be: "Stool DNA test on 2022-07-11 falls outside the three-year window ending 2026-12-31; no other numerator screening is on record." Count: Stool(1) DNA(2) test(3) on(4) 2022-07-11(5) falls(6) outside(7) the(8) three-year(9) window(10) ending(11) 2026-12-31;(12) no(13) other(14) numerator(15) screening(16) is(17) on(18) record.(19). Under 30, one sentence. Good. It names date and criterion. Ensure no semicolon issue? It's one sentence with semicolon. Fine.

Alternatively reason: "Age 55 with continuous enrolment places member in denominator; stool DNA 2022-07-11 is outside the three-year window and no other screening occurred." Count: Age(1) 55(2) with(3) continuous(4) enrolment(5) places(6) member(7) in(8) denominator;(9) stool(10) DNA(11) 2022-07-11(12) is(13) outside(14) the(15) three-year(16) window(17) and(18) no(19) other(20) screening(21) occurred.(22). Under 30. But the deciding criterion for non_compliant is not meeting numerator; naming denominator maybe okay but instruction says "naming the specific criterion or date that decided it". The decision non_compliant is because numerator not met. The specific criterion is N2 window. Better to mention numerator/window. The first reason mentions numerator screening and date. Good.

Let's ensure no extra keys. JSON object: {"status":"non_compliant","reason":"Stool DNA test on 2022-07-11 falls outside the three-year window ending 2026-12-31; no other numerator screening is on record."}

Check date formatting: The task says dates are ISO 8601, but in prose reason we can use ISO. We did. Good.

Double-check if the JSON must be in a fenced code block exactly:
```json
{ ... }
```
No other text. They said "Reply with exactly one fenced JSON code block and nothing else. No preamble, no commentary before or after, no second code block." So final message must be:

```json
{"status":"non_compliant","reason":"Stool DNA test on 2022-07-11 falls outside the three-year window ending 2026-12-31; no other numerator screening is on record."}
```

Wait: In JSON, strings with hyphens etc fine. No need to escape. Use double quotes.

Let's verify word count exactly for reason: "Stool DNA test on 2022-07-11 falls outside the three-year window ending 2026-12-31; no other numerator screening is on record." Words: Stool(1) DNA(2) test(3) on(4) 2022-07-11(5) falls(6) outside(7) the(8) three-year(9) window(10) ending(11) 2026-12-31;(12) no(13) other(14) numerator(15) screening(16) is(17) on(18) record.(19). Under 30. Good.

Could there be a subtle issue about the enrolment: "2026-01-01 through 2026-12-31, continuous." That is full measurement year with no gap. Good.

Could there be exclusion E4? Age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during MY. Member age 55, not 66, so not. Frailty/advanced illness not mentioned anyway. So not excluded.

Status non_compliant because in denominator, not excluded, does not meet numerator. Yes.

One more thought: Is a negative stool DNA test in 2022 possibly still within ten-year? No, N2 is specifically stool DNA (3-year). N5 colonoscopy is 10-year, but this is stool DNA, not colonoscopy. So not N5. The "no colonoscopy" means N5 not met. Good.

Now final. Ensure only code block. No trailing spaces? Fine.

Let's formulate final answer.

We need to evaluate the member record against measure QM-CRC. Let's parse the details.

Measure: QM-CRC — Colorectal Cancer Screening.
Measurement year: 2026-01-01 through 2026-12-31.

Eligible population (denominator):
- Age: 46 through 75 years as of 2026-12-31.
- Continuous enrollment: full measurement year with no more than one gap of up to 45 days.

Member 40204:
- DOB: 1971-03-25. Age as of 2026-12-31: 2026 - 1971 = 55. So 55 years old. This is within 46-75. So age criterion satisfied.
- Enrollment: 2026-01-01 through 2026-12-31, continuous. So continuous enrollment satisfied.
Thus, member is in denominator.

Now, exclusions:
- E1: Colorectal cancer (C18-C21) any time on or before 2026-12-31. Member has none.
- E2: Total colectomy any time on or before 2026-12-31. Member has none.
- E3: Hospice at any time during measurement year. Member has none.
- E4: Age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during measurement year. Member is 55, so does not meet age part. No exclusion.

Thus no exclusions apply. Evaluate numerator.

Numerator: any one of the following by look-back window measured back from 2026-12-31:
- N1. FOBT or FIT during 2026. Member has no faecal occult blood test on record. So no.
- N2. Stool DNA test during 2026 or the two years prior (three-year window). The three-year window is 2024-01-01 through 2026-12-31? Wait, "during 2026 or the two years prior (three-year window)". The look-back is measured back from 2026-12-31. So three-year window would be 2024-01-01 to 2026-12-31? Actually, "during 2026 or the two years prior (three-year window)" means the service date must fall within 2024-01-01 through 2026-12-31 inclusive (i.e., 3 years). Let's check: 2026, plus two years prior = 2024, 2025, 2026. So window is 2024-01-01 to 2026-12-31. The member had a stool DNA test on 2022-07-11. That is before 2024. So it does not fall within the three-year window. Therefore N2 is not met.
- N3. Flexible sigmoidoscopy during 2026 or the four years prior (five-year window). Member has none.
- N4. CT colonography during 2026 or the four years prior (five-year window). Member has none.
- N5. Colonoscopy during 2026 or the nine years prior (ten-year window). Member has none.

Thus numerator not met.

Therefore status: "non_compliant".
Reason: one sentence, under 30 words, naming specific criterion or date that decided it. The deciding factor is the lack of a qualifying screening test in the look-back window. We can say something like: "No qualifying colorectal cancer screening test in the required look-back window." Let's count words: No (1) qualifying (2) colorectal (3) cancer (4) screening (5) test (6) in (7) the (8) required (9) look-back (10) window (11). That's 11 words. Good.

Check if any nuance: The stool DNA test in 2022 is outside the 3-year window. Should we mention it? The reason should name the specific criterion or date that decided it. The criterion is the absence of numerator events. We can say: "No qualifying screening test during the measurement year or look-back period." That's 10 words.

Double-check age: 1971-03-25 to 2026-12-31 is 55 years. Yes.

Enrollment continuous: yes.

No exclusions.

Numerator: Stool DNA test on 2022-07-11. For N2, window is 2026 or two years prior: that would be 2024-01-01 to 2026-12-31? Wait, exactly: "during 2026 or the two years prior (three-year window)". This phrasing is a bit ambiguous. Could it mean the test must be in 2026, or in the two years prior to 2026 (i.e., 2024 and 2025)? So the window is 2024-01-01 to 2026-12-31. 2022-07-11 is outside. So not numerator.

But what if "two years prior" means 2023 and 2024? Actually, if measurement year is 2026, the two years prior are 2024 and 2025? Wait, "prior" could be interpreted as the two full calendar years before 2026: 2024 and 2025. But the spec says "three-year window". So it's 2024, 2025, 2026. That's three years. So 2022 is definitely out.

For N5, colonoscopy ten-year window: 2017-01-01 to 2026-12-31. No colonoscopy.

Thus non_compliant.

Reason: "No qualifying screening test in the numerator look-back window." That's fine.

Let's ensure JSON format exactly: one fenced JSON code block and nothing else. Keys: "status", "reason". No extra keys.

```json
{
  "status": "non_compliant",
  "reason": "No qualifying screening test in the numerator look-back window."
}
```

Wait, need to ensure under 30 words. Yes.

Is there any required key for QM-FUM? The prompt says "Items drawn from measure QM-FUM require two further keys: 'met_7_day' boolean, 'met_30_day' boolean." But this measure is QM-CRC, so those keys are not required. The task says "Required JSON keys: 'status' string, 'reason' string." And for QM-FUM only, add those. So for QM-CRC, just those two.

Double-check: "Exclusions are evaluated before the numerator. A member who meets both an exclusion and the numerator is 'excluded', not 'compliant'." Not relevant.

"A member who never enters the denominator is 'not_eligible' even if a compliance event is present in the record." Not relevant.

Thus answer is straightforward.

But wait, there is a nuance: The member had a stool DNA test in 2022. The look-back for stool DNA is "during 2026 or the two years prior (three-year window)". If we measure back from 2026-12-31, a three-year window would be from 2023-12-31? No, typically a "three-year window" ending on 2026-12-31 would start on 2024-01-01. But sometimes in HEDIS, the look-back is exactly N years back from the end of the measurement year. For a three-year window, it would be from 2023-12-31? Actually, HEDIS often defines windows as "January 1 of the year prior to the measurement year through December 31 of the measurement year" for certain tests. But the spec here says "during 2026 or the two years prior (three-year window)". That is explicit: 2026, 2025, 2024. So 2022 is out.

Even if interpreted as "within the last 3 years" from 2026-12-31, the start date would be 2023-12-31? Wait, "last 3 years" from 2026-12-31 could mean 2023-12-31 to 2026-12-31. But the spec says "during 2026 or the two years prior". That phrasing suggests calendar years, not rolling 36 months. So 2024-2026.

But even if it were rolling 36 months, 2022-07-11 to 2026-12-31 is >4 years. So still out.

Thus non_compliant is correct.

One more check: Age 55 is within 46-75. Yes.

Enrollment continuous full year. Yes.

No exclusions. Yes.

So final answer: non_compliant.

I will output exactly the JSON block.

 The user wants me to evaluate a member against the QM-CRC (Colorectal Cancer Screening) measure specification.

Let me break down the member record and the measure:

**Member Record:**
- Member 40204
- DOB: 1971-03-25
- Age on 2026-12-31: 55 years old (eligible since 46-75)
- Enrollment: 2026-01-01 through 2026-12-31, continuous (meets continuous enrollment requirement)
- History:
  - 2022-07-11: Stool DNA test, negative
- No other relevant screenings on record
- No exclusions: no CRC, no colectomy, no hospice

**Measure QM-CRC details:**
- Measurement year: 2026-01-01 through 2026-12-31
- Eligible population (denominator):
  - Age: 46 through 75 years as of 2026-12-31. Member is 55, so eligible.
  - Continuous enrollment: full measurement year with no more than one gap up to 45 days. Member has continuous enrollment 2026-01-01 through 2026-12-31, so meets this.

- Numerator (any one of the following by look-back from 2026-12-31):
  - N1: FOBT or FIT during 2026. Not present.
  - N2: Stool DNA test during 2026 or the two years prior (three-year window). The window would be 2024-01-01 to 2026-12-31. Member had Stool DNA on 2022-07-11, which is before 2024-01-01. So this does NOT satisfy N2.
  - N3: Flexible sigmoidoscopy during 2026 or four years prior (five-year window: 2022-01-01 to 2026-12-31). Not present.
  - N4: CT colonography during 2026 or four years prior (five-year window: 2022-01-01 to 2026-12-31). Not present.
  - N5: Colonoscopy during 2026 or nine years prior (ten-year window: 2017-01-01 to 2026-12-31). Not present.

Wait, let me recalculate the windows:
- N2: Stool DNA test during 2026 or the two years prior (three-year window). Look-back from 2026-12-31: 2026-12-31 minus 2 years = 2024-12-31? Or is it during 2026 or the two years prior, meaning 2024, 2025, 2026? Let me read carefully: "during 2026 or the two years prior (three-year window)". This means calendar years 2024, 2025, and 2026, or equivalently from 2024-01-01 to 2026-12-31. The Stool DNA test was on 2022-07-11, which is outside this window.

Actually, I need to be careful with the wording. The measure says:
- N2: Stool DNA test during 2026 or the two years prior (three-year window).
"Two years prior" could mean the two full years before 2026: 2024 and 2025. Or it could mean looking back 24 months from 2026-12-31 to 2024-12-31. Either way, 2022-07-11 is outside.

Similarly for N3: "during 2026 or the four years prior (five-year window)" — this would be 2022-2026. The Stool DNA test was 2022-07-11, but that's a Stool DNA test, not a flexible sigmoidoscopy.

So the member does NOT meet any numerator criteria.

- Required exclusions:
  - E1: Colorectal cancer (C18-C21) any time on or before 2026-12-31. Not present.
  - E2: Total colectomy any time on or before 2026-12-31. Not present.
  - E3: Hospice at any time during measurement year. Not present.
  - E4: Age 66+ as of 2026-12-31 AND both frailty and advanced illness documented during measurement year. Member is 55, so this doesn't apply.

Since member is in denominator, not excluded, and does not meet numerator, status is "non_compliant".

Reason should name the specific criterion or date that decided it. For non_compliant, it's that no numerator event occurred in the required look-back periods. Specifically, the Stool DNA test was too old (2022-07-11, outside the three-year window for N2). So the reason could be something like "No numerator screening occurred within the required look-back window."

Let me check if the Stool DNA test from 2022-07-11 could count for anything else:
- N2: Stool DNA during 2026 or two years prior (three-year window: 2024-01-01 to 2026-12-31). 2022-07-11 is outside.

Wait, let me reconsider the exact wording: "during 2026 or the two years prior". Does "the two years prior" mean 2024 and 2025? Or does it mean a rolling 3-year window? In HEDIS specifications, it's usually calendar year based or specific look-back. The wording "(three-year window)" suggests that the total window spans 3 years. So from 2024-01-01 to 2026-12-31 if calendar year based, or from 2024-01-01 to 2026-12-31? Actually "during 2026 or the two years prior" most naturally means calendar years 2024, 2025, 2026. But sometimes in measures it's "during the measurement year or the X years prior" meaning a rolling window. However, the parenthetical "(three-year window)" suggests the total span is 3 years, which would be 2024-01-01 to 2026-12-31 if anchored at the end, or 2024, 2025, 2026 if calendar-based. Either way, July 2022 is outside.

Similarly N3 and N4: five-year window 2022-2026? If "during 2026 or the four years prior" means 2022-2026 inclusive. But N3 requires flexible sigmoidoscopy, and the member didn't have that. N4 requires CT colonography. The member had a Stool DNA test.

N5: Colonoscopy during 2026 or nine years prior (ten-year window: 2017-2026). Not present.

So the member is non-compliant.

Status: "non_compliant"
Reason: "No numerator screening occurred within the required look-back window."

Wait, but is there any exclusion I missed? No.
Is the member eligible? Yes, age 55, continuous enrollment.
So denominator yes. Not excluded. Numerator no.

The required keys are:
- "status": string
- "reason": string

Since this is not a QM-FUM task, I don't need the extra booleans.

Let me check if I need to output the booleans. The instructions say:
"Items drawn from measure QM-FUM require two further keys..."
This is QM-CRC, so no extra keys needed.

Just status and reason.

Let me make sure the reason is under 30 words and names the specific criterion or date.

Possible reasons:
- "Stool DNA test on 2022-07-11 is outside the three-year look-back window." (11 words) — This is precise.
- "No numerator screening occurred within the required look-back period." (9 words)

Actually, saying the Stool DNA test is outside the window is good because it references the specific event. But is it the deciding factor? The deciding factor is that none of N1-N5 are met. The Stool DNA test exists but is too old. So I could say: "Stool DNA test on 2022-07-11 falls outside the three-year window; no other numerator event present." That's 13 words.

Or simply: "No colorectal cancer screening numerator event occurred within the required timeframe." (11 words)

But maybe I should be more specific about the most recent event. However, the task says "name the specific criterion or date that decided it". The criterion is the failure to meet N1-N5.

Let me go with: "No screening numerator event occurred within the required look-back window." (10 words)

Or: "Stool DNA test from 2022-07-11 is outside the three-year look-back window." This names the date that is relevant (the only screening test present). But it doesn't necessarily say there are no others. However, since the record explicitly says no other tests, this is effectively the reason.

Wait, but looking at the member record again: "2022-07-11 Stool DNA test, negative. No colonoscopy, no sigmoidoscopy, no CT colonography, no faecal occult blood test on record."

So indeed, the only thing that might have counted was the Stool DNA test, but it's too old.

Therefore: "Stool DNA test on 2022-07-11 is outside the three-year look-back window; no numerator met." 

Let me count words: Stool(1) DNA(2) test(3) on(4) 2022-07-11(5) is(6) outside(7) the(8) three-year(9) look-back(10) window;(11) no(12) numerator(13) met.(14) That's 14 words, under 30.

Is there any ambiguity about whether "Stool DNA test" during 2024-2026 is required? The specification says "during 2026 or the two years prior (three-year window)". If the window is calendar years 2024-2026, then July 2022 is definitely out.

Could the three-year window mean 2023-2026? No, 2026 minus two years prior = 2024. Or rolling 36 months: 2023-12-31 to 2026-12-31? That's three years. Wait, three years back from 2026-12-31 would be 2023-12-31. But the text says "during 2026 or the two years prior". In HEDIS, the FOBT is during the measurement year. FIT-DNA is during the measurement year or the 2 years prior (which is a 3-year window). So the years are 2024, 2025, 2026. That makes it 2024-01-01 to 2026-12-31 roughly. 2022 is definitely out.

Thus, non_compliant is correct.

One more check: Is the member continuous enrolled with no more than one gap of up to 45 days? The record says "Enrolment: 2026-01-01 through 2026-12-31, continuous." So yes.

Therefore:
```json
{
  "status": "non_compliant",
  "reason": "Stool DNA test on 2022-07-11 is outside the three-year look-back window."
}
```

Or maybe I should mention N2 specifically? "Stool DNA test on 2022-07-11 is outside the N2 three-year look-back window." That adds specificity.

"Stool DNA test on 2022-07-11 predates the N2 three-year look-back window." (10 words) — good.

Actually, since there are no other numerator events, simply saying no numerator event occurred might be more direct. But naming the date is more informative. I'll include N2.

Final check: 55 years old on 2026-12-31. Born 1971-03-25. On 2026-03-25 they turn 55. On 2026-12-31 they are indeed 55. Age 46 through 75: yes.

All good.

Wait, I need to make sure about the JSON format. Only one fenced JSON code block. No text outside.

Keys: status, reason. No extra keys.

```json
{
  "status": "non_compliant",
  "reason": "Stool DNA test on 2022-07-11 falls outside the N2 three-year look-back window."
}
```

Or without N2: "Stool DNA test on 2022-07-11 falls outside the three-year look-back window."

I think just saying "three-year window" is fine since the measure mentions it. But "N2" makes it very specific. Let me keep it concise.

"Stool DNA test on 2022-07-11 predates the three-year numerator window." (10 words)

Actually, the reason field is a string. I'll write: "Stool DNA test on 2022-07-11 is outside the three-year look-back window."

10 words. Good.

One final thought: Could the Stool DNA test count for N5? No, N5 is colonoscopy. N2 is Stool DNA. N2 is the only possible match, and it's outside the window.

Status is definitely non_compliant.

The instructions say: "A member who never enters the denominator is 'not_eligible' even if a compliance event is present in the record." Not applicable since they enter denominator.

Also: "Exclusions are evaluated before the numerator." No exclusions apply.

Everything seems straightforward.

 The user wants me to evaluate member 40204 against the QM-CRC (Colorectal Cancer Screening) measure for measurement year 2026.

Let me break down the requirements:

**Measure QM-CRC**
- Measurement year: 2026-01-01 through 2026-12-31

**Denominator (Eligible Population):**
- Age: 46 through 75 years as of 2026-12-31.
- Continuous enrollment: full measurement year with no more than one gap of up to 45 days.

**Member details:**
- DOB: 1971-03-25
- Age as of 2026-12-31: 55 years old (2026 - 1971 = 55, and Dec > Mar, so 55). This is within 46-75 range.
- Enrollment: 2026-01-01 through 2026-12-31, continuous. This meets the continuous enrollment requirement.

So the member is in the denominator.

**Required Exclusions:**
- E1: Colorectal cancer (C18-C21) any time on or before 2026-12-31. Member has none.
- E2: Total colectomy any time on or before 2026-12-31. Member has none.
- E3: Hospice at any time during the measurement year. Member has none.
- E4: Age 66+ as of 2026-12-31 AND both frailty and advanced illness documented during measurement year. Member is 55, so doesn't apply.

No exclusions met.

**Numerator:** Any one of the following, look-back from 2026-12-31:
- N1: Faecal occult blood test or faecal immunochemical test during 2026. Member has none.
- N2: Stool DNA test during 2026 or the two years prior (three-year window). This means 2024, 2025, 2026. Member had stool DNA test on 2022-07-11. 2022 is outside the three-year window (2024-2026). So this does not count.
- N3: Flexible sigmoidoscopy during 2026 or the four years prior (five-year window). Member has none.
- N4: CT colonography during 2026 or the four years prior (five-year window). Member has none.
- N5: Colonoscopy during 2026 or the nine years prior (ten-year window). Member has none.

Wait, let me double check the look-back window for N2. "during 2026 or the two years prior (three-year window)". So the window is 2024-01-01 through 2026-12-31? Or is it exactly three years back from 2026-12-31? The spec says "by the look-back window measured back from 2026-12-31" and describes N2 as "during 2026 or the two years prior (three-year window)". So the three-year window would be 2024-01-01 to 2026-12-31. 

The member's stool DNA test was 2022-07-11. That's before 2024-01-01, so it's outside the window.

Therefore, no numerator criteria met.

Status should be "non_compliant".

Reason: Need one sentence under 30 words naming the specific criterion or date that decided it. The decision is that no numerator event occurred within the required look-back windows. Specifically, the stool DNA test was outside the three-year window.

Wait, I need to be careful. The reason should explain why they are non_compliant. Something like: "No colorectal screening test in the required look-back window from 2026-12-31." Or "Stool DNA test on 2022-07-11 falls outside the three-year look-back window." That might be more precise.

Let me count words: "Stool DNA test on 2022-07-11 falls outside the three-year look-back window." That's 10 words. Good.

Or: "No qualifying screening service occurred within the applicable look-back periods." 9 words.

But maybe naming the specific criterion is better. Actually, the reason should name the specific criterion or date that decided it. The member had a stool DNA test but it was too old. So citing that specific date and why it doesn't count is good.

Actually, looking at the measure spec again: N2 is "Stool DNA test during 2026 or the two years prior (three-year window)." The test was in 2022, which is outside the three-year window. So the deciding factor is that no numerator criteria were met.

Let me phrase: "No numerator screening test fell within the required look-back window ending 2026-12-31." 12 words.

Or: "Stool DNA test on 2022-07-11 is outside the three-year look-back window." 10 words. This is very specific.

But the member also had no other tests. The reason for non-compliance is simply that no qualifying event was found. But if there's a specific date in the record that is relevant but doesn't qualify, mentioning it might be good. However, the task says "naming the specific criterion or date that decided it". The decision of non-compliance is decided by the absence of any qualifying numerator event. 

Actually, for non-compliant, the reason is usually the absence of the numerator event. But if there's a date that is close but excluded, it might be worth mentioning. I'll say: "No qualifying colorectal cancer screening in the numerator look-back windows." That's 9 words.

Wait, let me reconsider the look-back window interpretation. "during 2026 or the two years prior (three-year window)". If the measurement year is 2026, then "two years prior" could mean 2024 and 2025. So 2022 is definitely outside.

What about N5? Colonoscopy during 2026 or the nine years prior (ten-year window). That would be 2017-2026. Member has none.

So definitely non_compliant.

Required keys:
- status: "non_compliant"
- reason: string

No mention of QM-FUM extra keys. Wait, the prompt says: "Items drawn from measure QM-FUM require two further keys: 'met_7_day' boolean, 'met_30_day' boolean". This measure is QM-CRC, not QM-FUM. So those keys are NOT required.

Therefore, only status and reason.

Let me format as JSON.

```json
{
  "status": "non_compliant",
  "reason": "No qualifying colorectal cancer screening in the numerator look-back windows."
}
```

Or should I mention the stool DNA test date? "Stool DNA test on 2022-07-11 falls outside the three-year look-back window." This names a specific date that decided it (i.e., decided that N2 is not met). I think this is better because it's more precise about why the member isn't compliant despite having a history.

Actually, the prompt says "naming the specific criterion or date that decided it". The criterion is the absence of numerator events. But if I mention the 2022 date, it explains why the member isn't compliant based on the available history. I think either works, but being specific about the date might be stronger.

Let me verify: "Stool DNA test on 2022-07-11 falls outside the three-year window." 9 words. Good.

But wait, is the stool DNA test a "Stool DNA test" as required by N2? The record says "2022-07-11 Stool DNA test, negative." Yes. So N2 was almost met but for the timing. That is indeed the deciding factor (the only relevant history).

I'll go with that.

Wait, is "Stool DNA test" exactly the wording? The spec says "Stool DNA test". The record says "Stool DNA test". Good.

One final check: Are there any other required keys? The task says: "Required JSON keys: 'status' string, 'reason' string". Then it mentions the QM-FUM extra keys, but this is QM-CRC. So only two keys.

Double check age: DOB 1971-03-25. As of 2026-12-31: 2026-1971 = 55, and month 12 > month 3, so 55. Correct. Within 46-75.

Enrollment: continuous full year. Correct.

No exclusions.

Result: non_compliant.

JSON formatting: exactly one fenced JSON code block and nothing else.

```json
{
  "status": "non_compliant",
  "reason": "Stool DNA test on 2022-07-11 falls outside the three-year look-back window."
}
```

I should make sure the reason is under 30 words. It is 9 words. Perfect.

Wait, one more thought: Does "three-year window" mean 2022 could be included if it's within 3 years from 2026-12-31? 2022-07-11 to 2026-12-31 is about 4 years and 5 months. The spec says "during 2026 or the two years prior (three-year window)". This phrasing strongly suggests calendar years interpretation: 2026, 2025, 2024. But even if interpreted as exactly 3 years back from 2026-12-31, that would be 2023-12-31. 2022-07-11 is still before that. So either way, it's outside.

Therefore, non_compliant is correct.

I will output the JSON. 

Let me work through this member against the QM-CRC measure systematically.

MEMBER 40204 DETAILS:
- DOB: 1971-03-25
- Age on 2026-12-31: 55 years old
- Enrolment: 2026-01-01 through 2026-12-31, continuous (no gaps)
- Stool DNA test on 2022-07-11, negative
- No other screening procedures mentioned
- No cancer, colectomy, or hospice

STEP 1: CHECK ELIGIBILITY (DENOMINATOR)

Age requirement: 46-75 years as of 2026-12-31
- Member is 55 on 2026-12-31 ✓ MEETS

Continuous enrolment: Full measurement year with no more than one gap of up to 45 days
- Enrolment 2026-01-01 through 2026-12-31, continuous ✓ MEETS

Member IS IN DENOMINATOR.

STEP 2: CHECK EXCLUSIONS

E1. Colorectal cancer (C18-C21) any time on or before 2026-12-31
- No colorectal cancer documented ✗ NOT EXCLUDED

E2. Total colectomy any time on or before 2026-12-31
- No colectomy documented ✗ NOT EXCLUDED

E3. Hospice at any time during the measurement year
- No hospice documented ✗ NOT EXCLUDED

E4. Age 66 or older as of 2026-12-31 AND both frailty and advanced illness during measurement year
- Member is 55, not 66+ ✗ NOT EXCLUDED

Member is NOT EXCLUDED.

STEP 3: CHECK NUMERATOR

The numerator requires ANY ONE of the following by the look-back window:
N1. Faecal occult blood test or faecal immunochemical test during 2026
- No such test on record - NOT MET

N2. Stool DNA test during 2026 or the two years prior, so the window spans 2024-01-01 through 2026-12-31
- Recorded test was 2022-07-11, which falls outside this three-year window - NOT MET so far, need to check remaining criteria.

N3. Flexible sigmoidoscopy in the five-year window (2022-01-01 through 2026-12-31) - none on record, NOT MET

N4. CT colonography in the same five-year window - none on record, NOT MET

N5. Colonoscopy in the ten-year window (2017-01-01 through 2026-12-31) - none on record, NOT MET

All numerator criteria fail.

Status: non_compliant, in denominator, not excluded, numerator not met.

Reason (under 30 words): "Stool DNA test from 2022 outside required three-year window; no qualifying screening during 2026 or applicable lookback periods."

Confirming the window: measured back from 2026-12-31, spanning 2024-01-01 through 2026-12-31 (2026 plus two prior years). The 2022-07-11 test falls outside this range.

```json
{
  "status": "non_compliant",
  "reason": "Stool DNA test from 2022 fails three-year lookback for N2; no other qualifying screening on record."
}
```

Or the two years prior, so a 2022 test falls outside that range. Final phrasing: "Stool DNA test from 2022 predates three-year lookback requirement; no other qualifying screening recorded."

Let me work through this systematically using the QM-CRC measure specification.

**Step 1: Check Eligibility (Denominator)**

Age: Member is born 1971-03-25, so on 2026-12-31 they are:
- 2026 - 1971 = 55 years old
- The measure requires age 46-75 as of 2026-12-31
- 55 is within 46-75 ✓

Continuous enrolment: 2026-01-01 through 2026-12-31, continuous
- Full measurement year with no more than one gap of up to 45 days
- Record states "continuous" enrollment
- Meets requirement ✓

Member IS eligible for the denominator.

**Step 2: Check Exclusions**

E1. Colorectal cancer (C18-C21) any time on or before 2026-12-31
- Record states "No colorectal cancer"
- Not excluded ✓

E2. Total colectomy any time on or before 2026-12-31
- Record states "no colectomy"
- Not excluded ✓

E3. Hospice at any time during the measurement year
- Record states "no hospice"
- Not excluded ✓

E4. Age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during the measurement year
- Member is 55 years old on 2026-12-31
- Does not meet the age criterion (66+)
- Not excluded ✓

Member is NOT excluded.

**Step 3: Check Numerator**

The member needs at least ONE of the following:

N1. Faecal occult blood test or faecal immunochemical test during 2026
- Record states "No... faecal occult blood test on record"
- Not met ✗

N2. Stool DNA test during 2026 or the two years prior (three-year window)
- Window covers 2024-01-01 through 2026-12-31
- Checking record for stool DNA test result

"2022-07-11 Stool DNA test, negative" — this predates the window (pre-2024)
- Not met ✗

N3. Flexible sigmoidoscopy, five-year window (2022-01-01 through 2026-12-31)
- Record states "no sigmoidoscopy on record"
- Not met ✗

N4. CT colonography, same five-year window
- Record states "No... CT colonography on record"
- Not met ✗

N5. Colonoscopy during 2

026 or the nine years prior (ten-year window)
- Window: 2017-01-01 through 2026-12-31
- Record states "No colonoscopy on record"
- Not met ✗

None of the numerator criteria are satisfied.

**Step 4: Status**
- Eligible, not excluded, numerator not met → "non_compliant"

The reason centers on the absence of any qualifying screening in 2026, with the last stool DNA test back in 2022 falling outside the current window.

**Reason:**

"Stool DNA test (2022-07-11) is outside the three-year look-back window (2024-2026); no other screenings documented within their required windows."

That's specific and cites the actual date and criterion — clean and under 30 words.

Final: "No colorectal cancer screening within measurement year or required look-back windows."

Let me work through this systematically.

MEMBER 40204 ANALYSIS:

1. **Eligibility for Denominator (QM-CRC)**

Age requirement:
- DOB: 1971-03-25
- Age on 2026-12-31: 55 years old
- Requirement: 46-75 years old
- ✓ MEETS AGE REQUIREMENT

Continuous enrolment:
- 2026-01-01 through 2026-12-31, continuous
- Requirement: full measurement year with no more than one gap of up to 45 days
- ✓ MEETS ENROLMENT REQUIREMENT

Member IS IN THE DENOMINATOR.

2. **Exclusions Check (evaluated before numerator)**

E1. Colorectal cancer (C18-C21) any time on or before 2026-12-31
- Record says "No colorectal cancer"
- ✗ NOT EXCLUDED

E2. Total colectomy any time on or before 2026-12-31
- Record says "no colectomy"
- ✗ NOT EXCLUDED

E3. Hospice at any time during the measurement year
- Record says "no hospice"
- ✗ NOT EXCLUDED

E4. Age 66 or older as of 2026-12-31 AND both frailty and advanced illness documented during the measurement year
- Age 55, not 66+
- ✗ NOT EXCLUDED (doesn't meet age requirement for this exclusion)

Member is NOT EXCLUDED.

3. **Numerator Check**

Now I need to check if the member meets any of the numerator criteria:

N1. Faecal occult blood test or faecal immunochemical test during 2026
- Record says "No faecal occult blood test on record"
- ✗ NOT MET

N2. Stool DNA test during 2026 or the two years prior (three-year window)
- Three-year window: 2024-01-01 through 2026-12-31
- Record shows: "2022-07-11 Stool DNA test, negative"
- The test was in 2022, which is OUTSIDE the three-year window (2024-2026)
- ✗ NOT MET

Checking N3 next — flexible sigmoidoscopy within the five-year window (2026 and four years prior).

Nothing on record either, same for CT colonography and colonoscopy checks that follow — all come back with no documentation. Every numerator criterion fails, so the member doesn't meet the numerator. Moving to final status: denominator inclusion is confirmed YES.

Excluded: NO, numerator met: NO, giving status "non_compliant". The core issue is that the stool DNA test from 2022 sits outside the required 3-year window (2024-2026), and nothing else qualifies. Trying to phrase this tightly: "Most recent stool DNA test (2022-07-11) falls outside three-year look-back window; no other screening tests documented." That's concise enough — 20 words, captures the specific date and criterion that decided the outcome.

periods; prior stool DNA (2022) predates 3-year window."

The window for N2 spans 2024-01-01 through 2026-12-31 (2026 plus two years prior). The stool DNA test from 2022-07-11 falls before this window entirely, so it doesn't count. No other screening method appears in the record for the required period.

'll settle on: "Stool DNA test (2022-07-11) precedes three-year look-back window (2024-2026); no other screening documented during measurement year." — 16 words, clean and within limit.

-07-11) outside three-year window (2024-2026).

That's 17 words total.

Testing alternate phrasings for conciseness and specificity - I want the reason to name the specific date/criterion driving the decision. Landing on something like: "Stool DNA test (2022-07-11) predates required three-year look-back window (2024-2026); no other qualifying screening documented." This is 16 words, concise and specific.

Finalizing: "No qualifying colorectal screening during 2026 or required look-back periods; stool DNA test from 2022 is outside the three-year window." This directly states the criterion failure and cites the disqualifying date.

Double-checking eligibility: age 55 at year-end falls within 46-75 range, continuous enrollment confirmed for full year, so denominator inclusion holds. Checking exclusions: no colorectal cancer history, no total colectomy, no hospice enrollment—none trigger removal from denominator.

Numerator review: no FOBT/FIT in 2026, stool DNA from 2022 falls outside the 2024-2026 window, no sigmoidoscopy or CT colonography within 2022-2026, and no colonoscopy documented in the applicable 2017-2026 lookback.

**Status: non_compliant** confirmed. Member sits in denominator, isn't excluded, but fails every numerator path—the only screening on file predates the required window.

Tightening the reason string: "Most recent screening (stool DNA, 2022-07-11) predates required three-year look-back window (2024-2026); no other screening on record." Checking word count and parenthetical formatting for the date entries.

```json
{
  "status": "non_compliant",
  "reason": "Most recent screening (stool DNA, 2022-07-11) predates required three-year look-back window (2024-2026); no other screening on record."
}
```

The closest match is N2 (stool DNA), just outside the eligible timeframe.

11, is, outside, the, required, three-year, look-back, window - 17 words total.

The measure permits several test types, but the member only has one documented screening (stool DNA, 2022), which falls outside the window. Other test types are absent entirely, so this is the deciding fact.

Settling on: "No qualifying colorectal screening documented; stool DNA test from 2022 predates required three-year look-back window (2024-2026)." - 16 words, concise and decisive.

```json
{
  "status": "non_compliant",
  "reason": "No qualifying colorectal screening documented; stool DNA test from 2022 predates required three-year look-back window (2024-2026)."
}
```

This captures both the general gap and the specific reason the one test on file doesn't count.

We need answer user? Need infer likely medical coding/quality measure? We have member record, asks nothing explicit. Need produce final answer. Need inspect: Member 40204, DOB 1971-03-25, 55 on 2026-12-31. Enrolment continuous. Stool DNA test 2022-07-11 negative. No other tests. Need likely determine QM-CRC compliance? Could be from prompt missing instruction? Need answer likely: not compliant for CRC screening measurement year 2026? Let's analyze.

We need maybe provide numerator status? It may be quality measure Colorectal Cancer Screening. Measurement year 2026, age 46-75, continuous enrollment. Numerator includes stool DNA test in 2026 or two years prior (three-year window)? User says:
NUMERATOR ...
N2. Stool DNA test during 2026 or the two years prior (three-year window).
But measurement year 2026: two years prior = 2025 and 2024? Three-year window 2024-01-01 to 2026-12-31. Test 2022 is outside. So not numerator, denominator yes, exclusions no. Status non_compliant. Reason: Stool DNA test 2022-07-11 outside 3-year lookback; no qualifying screening. If asked for exclusion maybe not eligible? Age 55 eligible. So answer likely QM-CRC status non_compliant.

But maybe they expect HEDIS code? Maybe "QM-CRC: Not Compliant"? Need see initial instruction: Member Record. No question. We must infer likely answer from previous tasks? The user only provided record, maybe wants classification/explanation. We should answer succinctly. Include status, reason.

Need maybe calculate look-back window. If measurement year 2026, N2 stool DNA during 2026 or the two years prior: 2024, 2025. The 2022 test is outside. Also maybe flexible sigmoidoscopy etc absent. So not compliant.

Need ensure date math: DOB 1971-03-25. Age on 2026-12-31 = 55 (turns 55 on 2026-03-25). Denominator 46-75. Continuous. Exclusions none. Numerator? Stool DNA negative 2022-07-11. Lookback includes 2024-2026 only. Not numerator.

Could stool DNA from 2022 count if measure date is 2026? No. If measurement year is 2025? But measure year says 2026-01-01 to 2026-12-31. Stool DNA test during 2025 or two years prior? For HEDIS 2026, stool DNA three-year window: 2023? Wait HEDIS: Colorectal Cancer Screening 2025: stool DNA test in the measurement year or the two years prior (i.e., 2023-2025). For 2026: 2024-2026. The user says same.

Need maybe output "Non-compliant".

Potential ambiguity: The date 2022-07-11 was three years prior to 2025? For measurement year 2026, exactly 4 years before? 2022 to 2026 = 4 years. Not count. If 2026 measurement year, three-year window includes 2024,2025,2026. Not 2022.

Need final answer maybe structured:
- QM-CRC: Non-compliant.
- Eligible? Yes, age/enrollment.
- Excluded? No.
- Reason: Only colorectal screening is stool DNA 2022-07-11, outside the three-year lookback for the 2026 measurement year.

Need maybe include if need improvement? But final only answer.

Given no explicit ask, likely they expect quality measure determination. We can deliver robust. Keep concise.

Double-check measure text: "Measurement year: 2026-01-01 through 2026-12-31." Age 46 through 75 as of 2026-12-31. numerator any one by look-back window measured back from 2026-12-31:
N2. Stool DNA test during 2026 or the two years prior (three-year window).
This wording ambiguous: by the look-back window measured back from 2026-12-31: "during 2026 or the two years prior" could mean 2026, 2025, 2024. 2022-07-11 no.

Need final in plain English. Maybe include "QM-CRC status: Non-compliant (denominator yes, numerator no)". Good.

 Ensure no weird.

We are asked to place Member 40204 against measure QM-CRC. Let's go through the criteria.

Measure QM-CRC: Colorectal Cancer Screening. Measurement year 2026.

Eligible population: Age 46-75 as of 2026-12-31. Member DOB 1971-03-25, so age as of 2026-12-31: 2026-1971 = 55, and birthday in March, so 55. So age eligible.

Continuous enrolment: full measurement year with no more than one gap of up to 45 days. Member record says enrolment 2026-01-01 through 2026-12-31, continuous. So continuous enrolment met.

So member is in denominator unless excluded.

Exclusions: 
E1. Colorectal cancer (C18-C21) any time on or before 2026-12-31. None recorded.
E2. Total colectomy any time on or before 2026-12-31. None.
E3. Hospice at any time during measurement year. None.
E4. Age 66 or older AND both frailty and advanced illness documented during measurement year. Age 55, not 66 or older. So not applicable.

No exclusions. So member is in denominator and not excluded.

Now numerator: any one of several screenings by look-back windows from 2026-12-31.

N1. Faecal occult blood test or faecal immunochemical test during 2026. None recorded.
N2. Stool DNA test during 2026 or the two years prior (three-year window). That means date must be in 2026, 2025, or 2024. The stool DNA test was 2022-07-11, which is outside the three-year window (2024-01-01 to 2026-12-31). So N2 not met.
N3. Flexible sigmoidoscopy during 2026 or four years prior (five-year window): 2026, 2025, 2024, 2023, 2022. None.
N4. CT colonography during 2026 or four years prior (five-year window): same, none.
N5. Colonoscopy during 2026 or nine years prior (ten-year window): 2026 down to 2017. None recorded.

No numerator criteria met. So status is "non_compliant".

Reason: No qualifying colorectal cancer screening test in the required look-back periods (e.g., stool DNA test on 2022-07-11 is outside the three-year window).

We need keys: "status", "reason". For QM-CRC, no additional keys like met_7_day etc. Those were for QM-FUM.

Thus output: status: "non_compliant", reason: "Stool DNA test on 2022-07-11 is outside the three-year window, and no other eligible screening test was found." Condense to under 30 words: "No qualifying screening test; stool DNA on 2022-07-11 falls outside the 3-year window." That's 14 words.

So JSON.

No need for "met_7_day" etc. That's only for QM-FUM.

Thus produce JSON block.