{
 "schema_version": "0.1",
 "site": "www.cms.gov",
 "scan_week": "2026-W40",
 "generated_at": "2026-09-30T18:09:03.259Z",
 "source_files": [
  "docs/reports/www.cms.gov/2026-W40/",
  "data/www.cms.gov/findings.json",
  "data/www.cms.gov/2026-W40/summary.json"
 ],
 "summary": {
  "pages_known": 59115,
  "pages_scanned_this_week": 1609,
  "pages_with_known_issues": 36959,
  "findings": 42,
  "clusters": 36,
  "new_findings": 0,
  "persistent_findings": 32,
  "high_priority_findings": 22
 },
 "top_risks": [
  {
   "finding_id": "VS-8ade3360",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 141,
   "rationale": "Serious severity; affects 141 pages; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10"
  },
  {
   "finding_id": "VS-c126b6a6",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 106,
   "rationale": "Serious severity; affects 106 pages; persistent across weeks",
   "top_url": "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html"
  },
  {
   "finding_id": "VS-9074b4dd",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "severity": "Critical",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 100,
   "rationale": "Critical severity; affects 100 pages; persistent across weeks",
   "top_url": "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html"
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 90,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22"
  },
  {
   "finding_id": "VS-bd13f00a",
   "rule_id": "accesskeys",
   "rule_label": "accesskey attribute value should be unique",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 31,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html"
  },
  {
   "finding_id": "VS-be8d563e",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 10,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273"
  },
  {
   "finding_id": "VS-6175596b",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 7,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273"
  },
  {
   "finding_id": "VS-fafffee0",
   "rule_id": "label",
   "rule_label": "Form elements must have labels",
   "severity": "Critical",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 6,
   "rationale": "Critical severity; persistent across weeks",
   "top_url": "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html"
  },
  {
   "finding_id": "VS-e9fe47ac",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 3,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments"
  },
  {
   "finding_id": "VS-c613c153",
   "rule_id": "scrollable-region-focusable",
   "rule_label": "Scrollable region must have keyboard access",
   "severity": "Serious",
   "priority": "p1",
   "trend": "persistent",
   "pages_affected": 1,
   "rationale": "Serious severity; persistent across weeks",
   "top_url": "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=183&proposed=N"
  }
 ],
 "findings": [
  {
   "finding_id": "VS-8ade3360",
   "fingerprint": "8bf51706",
   "rule_id": "link-in-text-block",
   "rule_label": "Links must be distinguishable without relying on color",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 141 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 141,
    "affected_pages_previous": 366
   },
   "frequency": {
    "instances": 324,
    "pages_affected": 141,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Links must be distinguishable without relying on color (WCAG 1.4.1)",
   "description": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 141 of 1609 scanned pages (324 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-in-text-block (WCAG 1.4.1).",
   "actual_behavior": "Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 141 of 1609 scanned pages (324 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34051&lcdStatus=all&sortBy=title&ver=43",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37015&lcdStatus=all&sortBy=title&ver=27"
   ],
   "html_fragments": [
    {
     "fingerprint": "045df501",
     "html": "<a href=\"https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=36405:9\" target=\"_blank\" class=\"log-click system-link\" data-page-action=\"Clicked the Source Proposed LCD link\">DL36406</a>",
     "selectors": [
      "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]"
     ]
    },
    {
     "fingerprint": "ee477cd5",
     "html": "<a id=\"aArchiveRedirect\" data-archive-goto-forward=\"\" page-action=\"Clicked the MCD Archive Document Redirect Link\" href=\"#\" class=\"log-click\">",
     "selectors": [
      "#aArchiveRedirect"
     ]
    },
    {
     "fingerprint": "4bc0dd8f",
     "html": "<a href=\"https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=37014:4\" target=\"_blank\" class=\"log-click system-link\" data-page-action=\"Clicked the Source Proposed LCD link\">DL37015</a>",
     "selectors": [
      "#lblProposedLcd > .system-link.log-click[target=\"_blank\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 24
    },
    {
     "pattern": "/medicare-coverage-database/view/nca.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-c126b6a6",
   "fingerprint": "b6dc10f1",
   "rule_id": "html-has-lang",
   "rule_label": "<html> element must have a lang attribute",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; affects 106 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 106,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 106,
    "pages_affected": 106,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "<html> element must have a lang attribute (WCAG 3.1.1)",
   "description": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 106 of 1609 scanned pages (106 instances).",
   "remediation_tip": "Add a lang attribute to <html> (e.g. lang=\"en\").",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule html-has-lang (WCAG 3.1.1).",
   "actual_behavior": "<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 106 of 1609 scanned pages (106 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
    "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-9074b4dd",
   "fingerprint": "f1846b41",
   "rule_id": "image-alt",
   "rule_label": "Images must have alternative text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Critical severity; affects 100 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 100,
    "affected_pages_previous": 248
   },
   "frequency": {
    "instances": 100,
    "pages_affected": 100,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Images must have alternative text (WCAG 1.1.1)",
   "description": "Images must have alternative text. Detected by axe-core rule image-alt on 100 of 1609 scanned pages (100 instances).",
   "remediation_tip": "Give every <img> a meaningful alt attribute. Use alt=\"\" only for decorative images so screen readers skip them.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule image-alt (WCAG 1.1.1).",
   "actual_behavior": "Images must have alternative text. Detected by axe-core rule image-alt on 100 of 1609 scanned pages (100 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
    "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "6f85ea95",
     "html": "<img src=\"cms-site-logo.png\">",
     "selectors": [
      "img[src$=\"cms-site-logo.png\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-a0bdbdf6",
   "fingerprint": "ca0fa40f",
   "rule_id": "list",
   "rule_label": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 90,
    "affected_pages_previous": 210
   },
   "frequency": {
    "instances": 645,
    "pages_affected": 90,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)",
   "description": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 90 of 1609 scanned pages (645 instances).",
   "remediation_tip": "Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule list (WCAG 1.3.1).",
   "actual_behavior": "<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 90 of 1609 scanned pages (645 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33785&lcdStatus=all&sortBy=title&ver=40",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37281&lcdStatus=all&sortBy=title&ver=23"
   ],
   "html_fragments": [
    {
     "fingerprint": "331b743e",
     "html": "<ul style=\"box-sizing: border-b...\">",
     "selectors": [
      "#lblCmsNationalCoveragePolicy > ul:nth-child(3)",
      "ul:nth-child(5)",
      "ul:nth-child(7)"
     ]
    },
    {
     "fingerprint": "c15c6eb6",
     "html": "<ol style=\"list-style-type: upper-alpha;\">",
     "selectors": [
      "#lblCoverageIndication > ol",
      "li:nth-child(2) > ol"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 19
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-bd13f00a",
   "fingerprint": "952edfaf",
   "rule_id": "accesskeys",
   "rule_label": "accesskey attribute value should be unique",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 14,
    "affected_pages_current": 31,
    "affected_pages_previous": 87
   },
   "frequency": {
    "instances": 91,
    "pages_affected": 31,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "accesskey attribute value should be unique (WCAG criterion undetermined)",
   "description": "accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 31 of 1609 scanned pages (91 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule accesskeys.",
   "actual_behavior": "accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 31 of 1609 scanned pages (91 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html",
    "http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "de497243",
     "html": "<a accesskey=\"p\" id=\"prev_page\" href=\"P0216.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(3) > a[accesskey=\"p\"][href$=\"P0216.html\"]"
     ]
    },
    {
     "fingerprint": "841e16e2",
     "html": "<a accesskey=\"u\" id=\"up_level\" href=\"P0011.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(4) > a[accesskey=\"u\"][href$=\"P0011.html\"]"
     ]
    },
    {
     "fingerprint": "79e2a1dc",
     "html": "<a accesskey=\"n\" id=\"next_page\" href=\"P0638.html\"><img src=\"fwdpg.png\" alt=\"Next Page [Alt-n]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a>",
     "selectors": [
      "td[width=\"31\"]:nth-child(5) > a[accesskey=\"n\"][href$=\"P0638.html\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-be8d563e",
   "fingerprint": "1820bc84",
   "rule_id": "color-contrast",
   "rule_label": "Elements must meet minimum color contrast ratio thresholds",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.4.3",
   "wcag_name": "Contrast (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "high",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 10,
    "affected_pages_previous": 43
   },
   "frequency": {
    "instances": 186,
    "pages_affected": 10,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)",
   "description": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 10 of 1609 scanned pages (186 instances).",
   "remediation_tip": "Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule color-contrast (WCAG 1.4.3).",
   "actual_behavior": "Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 10 of 1609 scanned pages (186 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273",
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36704&lcdStatus=all&sortBy=title&ver=20",
    "http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "912096a4",
     "html": "<p>XX.XX Transcatheter Mitral Valve Repair (TMVR)  </p>",
     "selectors": [
      "em:nth-child(326) > font > p:nth-child(1)"
     ]
    },
    {
     "fingerprint": "4332442a",
     "html": "<strong>A.    General</strong>",
     "selectors": [
      "p:nth-child(2) > strong"
     ]
    },
    {
     "fingerprint": "f3b2aee3",
     "html": "<p>Transcatheter mitral valve repair (TMVR) is used in the treatment of mitral regurgitation.  A TMVR device involves clipping together a portion of the mitral valve leaflets as treatment for reducing",
     "selectors": [
      "em:nth-child(326) > font > p:nth-child(3)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited vision (2.4%), Without color perception (4.5%)."
   }
  },
  {
   "finding_id": "VS-6175596b",
   "fingerprint": "7ac6b8df",
   "rule_id": "listitem",
   "rule_label": "<li> elements must be contained in a <ul> or <ol>",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 7,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 115,
    "pages_affected": 7,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "<li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)",
   "description": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 7 of 1609 scanned pages (115 instances).",
   "remediation_tip": "<li> must be inside a <ul> or <ol>.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule listitem (WCAG 1.3.1).",
   "actual_behavior": "<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 7 of 1609 scanned pages (115 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273",
    "https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&ver=19",
    "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=264&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "ad415844",
     "html": "<li> When performed outside a controlled clinical study, how do outcomes and adverse events compare to the pivotal clinical studies?<p></p>  \n  \n</li>",
     "selectors": [
      "li:nth-child(40)"
     ]
    },
    {
     "fingerprint": "f20ce2b3",
     "html": "<li> How do outcomes and adverse events in subpopulations compare to patients in the pivotal clinical studies? <p></p>  \n  \n</li>",
     "selectors": [
      "li:nth-child(41)"
     ]
    },
    {
     "fingerprint": "a5a1c7c6",
     "html": "<li> What is the long term (≥ 5 year) durability of the device? <p></p>  \n  \n</li>",
     "selectors": [
      "li:nth-child(42)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-fafffee0",
   "fingerprint": "d5e15238",
   "rule_id": "label",
   "rule_label": "Form elements must have labels",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "4.1.2",
   "wcag_name": "Name, Role, Value",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "severity": "Critical",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Critical severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W40",
    "weeks_observed": 15,
    "affected_pages_current": 6,
    "affected_pages_previous": 11
   },
   "frequency": {
    "instances": 6,
    "pages_affected": 6,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Form elements must have labels (WCAG 4.1.2)",
   "description": "Form elements must have labels. Detected by axe-core rule label on 6 of 1609 scanned pages (6 instances).",
   "remediation_tip": "Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule label (WCAG 4.1.2).",
   "actual_behavior": "Form elements must have labels. Detected by axe-core rule label on 6 of 1609 scanned pages (6 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0448.html",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1518.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "b2d78865",
     "html": "<input type=\"text\" name=\"q\" id=\"q\" value=\"Search now\" size=\"10\" maxlength=\"50\" class=\"srchbox\" onfocus=\"this.value='';\">",
     "selectors": [
      "#q"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P0448.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1518.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%)."
   }
  },
  {
   "finding_id": "VS-e9fe47ac",
   "fingerprint": "f85a6839",
   "rule_id": "link-name",
   "rule_label": "Links must have discernible text",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "medium",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 3,
    "affected_pages_previous": 3
   },
   "frequency": {
    "instances": 6,
    "pages_affected": 3,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Links must have discernible text (WCAG 2.4.4)",
   "description": "Links must have discernible text. Detected by axe-core rule link-name on 3 of 1609 scanned pages (6 instances).",
   "remediation_tip": "Give the link discernible text. Avoid empty links and icon-only links without an aria-label.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule link-name (WCAG 2.4.4).",
   "actual_behavior": "Links must have discernible text. Detected by axe-core rule link-name on 3 of 1609 scanned pages (6 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
    "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments",
    "https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=Y"
   ],
   "html_fragments": [
    {
     "fingerprint": "ebdf89ab",
     "html": "<a href=\"/media/665791\" data-once=\"linkMatch\"></a>",
     "selectors": [
      ".field--name-field-description.field--type-text-long.cms-text--prominent > a[href=\"/media/665791\"][data-once=\"linkMatch\"]"
     ]
    },
    {
     "fingerprint": "ca127ce9",
     "html": "<a href=\"/media/665791\" data-once=\"linkMatch\">\n        </a>",
     "selectors": [
      ".align-left.media--view-mode-embedded > a[href=\"/media/665791\"][data-once=\"linkMatch\"]"
     ]
    },
    {
     "fingerprint": "3ebe39d6",
     "html": "<a href=\"#3\"></a>",
     "selectors": [
      "ol[type=\"A\"] > a[href=\"#3\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/quality/clinical-laboratory-improvement-amendments",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-c613c153",
   "fingerprint": "364ee5cc",
   "rule_id": "scrollable-region-focusable",
   "rule_label": "Scrollable region must have keyboard access",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "2.1.1",
   "wcag_name": "Keyboard",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 12,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Scrollable region must have keyboard access (WCAG 2.1.1)",
   "description": "Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 1609 scanned pages (1 instances).",
   "remediation_tip": "Make scrollable regions keyboard-focusable (tabindex=\"0\") so keyboard users can scroll them.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule scrollable-region-focusable (WCAG 2.1.1).",
   "actual_behavior": "Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 1609 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=183&proposed=N"
   ],
   "html_fragments": [
    {
     "fingerprint": "4cf6e3a7",
     "html": "<pre>",
     "selectors": [
      "pre"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited manipulation/strength (13.0%), Limited reach (2.0%)."
   }
  },
  {
   "finding_id": "VS-dd1c019f",
   "fingerprint": "dec2d038",
   "rule_id": "valid-lang",
   "rule_label": "lang attribute must have a valid value",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": "3.1.2",
   "wcag_name": "Language of Parts",
   "wcag_level": "AA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 AA",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "severity": "Serious",
   "priority": "p1",
   "confidence": "low",
   "rationale": "Serious severity; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 1,
    "affected_pages_previous": 1
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "lang attribute must have a valid value (WCAG 3.1.2)",
   "description": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 1609 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule valid-lang (WCAG 3.1.2).",
   "actual_behavior": "lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 1609 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings"
   ],
   "html_fragments": [
    {
     "fingerprint": "f05b811b",
     "html": "<span lang=\"X-NONE\">[1]</span>",
     "selectors": [
      "a[href$=\"#_ftnref1\"] > span[lang=\"X-NONE\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-cb53cc4d",
   "fingerprint": "1738fa81",
   "rule_id": "sia-r111",
   "rule_label": "Target size is at least 44×44 CSS pixels (Enhanced)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.5",
   "wcag_name": "Target Size (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r111",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 155 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 155,
    "affected_pages_previous": 377
   },
   "frequency": {
    "instances": 5097,
    "pages_affected": 155,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)",
   "description": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 155 of 1609 scanned pages (5097 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r111 (WCAG 2.5.5).",
   "actual_behavior": "Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 155 of 1609 scanned pages (5097 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "Drupal",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Acquia Cloud Platform",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Amazon Web Services",
     "lift": 1.57,
     "pages_with_both": 8
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2208081b",
   "fingerprint": "40bbca09",
   "rule_id": "sia-r73",
   "rule_label": "Text has minimum contrast ratio of 4.5:1",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r73",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 153 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 153,
    "affected_pages_previous": 367
   },
   "frequency": {
    "instances": 1950,
    "pages_affected": 153,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)",
   "description": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 153 of 1609 scanned pages (1950 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r73 (WCAG 1.4.8).",
   "actual_behavior": "Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 153 of 1609 scanned pages (1950 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "Drupal",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Acquia Cloud Platform",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Amazon Web Services",
     "lift": 1.57,
     "pages_with_both": 8
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7118fead",
   "fingerprint": "0d932ac9",
   "rule_id": "sia-r61",
   "rule_label": "Form field label is visible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r61",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 146 pages; worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 146,
    "affected_pages_previous": 346
   },
   "frequency": {
    "instances": 146,
    "pages_affected": 146,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Form field label is visible (WCAG criterion undetermined)",
   "description": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 146 of 1609 scanned pages (146 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r61.",
   "actual_behavior": "Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 146 of 1609 scanned pages (146 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 3
    },
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 2
    }
   ],
   "associated_technologies": [
    {
     "technology": "Drupal",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Acquia Cloud Platform",
     "lift": 1.57,
     "pages_with_both": 8
    },
    {
     "technology": "Amazon Web Services",
     "lift": 1.57,
     "pages_with_both": 8
    }
   ],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d25f622d",
   "fingerprint": "98ff321a",
   "rule_id": "heading-order",
   "rule_label": "Heading levels should only increase by one",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 114 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 114,
    "affected_pages_previous": 265
   },
   "frequency": {
    "instances": 116,
    "pages_affected": 114,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Heading levels should only increase by one (WCAG criterion undetermined)",
   "description": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 114 of 1609 scanned pages (116 instances).",
   "remediation_tip": "Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule heading-order.",
   "actual_behavior": "Heading levels should only increase by one. Detected by axe-core rule heading-order on 114 of 1609 scanned pages (116 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title",
    "https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38814&lcdStatus=all&sortBy=title&stateRegion=all",
    "http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33569&lcdStatus=all&sortBy=title"
   ],
   "html_fragments": [
    {
     "fingerprint": "2772e8cc",
     "html": "<h3 id=\"navStickyHeader\" class=\"bg-white d-inline expand-head-pad\">Report Information</h3>",
     "selectors": [
      "#navStickyHeader"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 4
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d5d82446",
   "fingerprint": "3627341e",
   "rule_id": "landmark-one-main",
   "rule_label": "Document should have one main landmark",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 106 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 106,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 106,
    "pages_affected": 106,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Document should have one main landmark (WCAG criterion undetermined)",
   "description": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 106 of 1609 scanned pages (106 instances).",
   "remediation_tip": "Each page should have exactly one <main> landmark.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-one-main.",
   "actual_behavior": "Document should have one main landmark. Detected by axe-core rule landmark-one-main on 106 of 1609 scanned pages (106 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
    "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f18df681",
   "fingerprint": "09987718",
   "rule_id": "region",
   "rule_label": "All page content should be contained by landmarks",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "affects 106 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 106,
    "affected_pages_previous": 256
   },
   "frequency": {
    "instances": 1507,
    "pages_affected": 106,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "All page content should be contained by landmarks (WCAG criterion undetermined)",
   "description": "All page content should be contained by landmarks. Detected by axe-core rule region on 106 of 1609 scanned pages (1507 instances).",
   "remediation_tip": "Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule region.",
   "actual_behavior": "All page content should be contained by landmarks. Detected by axe-core rule region on 106 of 1609 scanned pages (1507 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
    "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "268925cc",
     "html": "<tr>\n\t\t<td><img src=\"cms-site-logo.png\"></td>\n\t\t<td style=\"text-align:center;\"><h1>ICD-10-CM/PCS MS-DRG v39.0 Definitions Manual</h1><h1></h1></td>\n\t\t<td></td>\n\t\t<td></td>\n\t\t<td></td>\n\t</tr>",
     "selectors": [
      ".arrows > tbody > tr:nth-child(1)"
     ]
    },
    {
     "fingerprint": "2c87a201",
     "html": "<td width=\"31\"><a accesskey=\"p\" id=\"prev_page\" href=\"P0177.html\"><img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(3)"
     ]
    },
    {
     "fingerprint": "69d3578c",
     "html": "<td width=\"31\"><a accesskey=\"u\" id=\"up_level\" href=\"P0010.html\"><img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\"></a></td>",
     "selectors": [
      "td[width=\"31\"]:nth-child(4)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-c18be945",
   "fingerprint": "8634e2fd",
   "rule_id": "sia-r57",
   "rule_label": "Scrolling content can be accessed by keyboard",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r57",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "worsening trend",
   "trend": {
    "status": "worsening",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 60,
    "affected_pages_previous": 109
   },
   "frequency": {
    "instances": 60,
    "pages_affected": 60,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Scrolling content can be accessed by keyboard (WCAG criterion undetermined)",
   "description": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 60 of 1609 scanned pages (60 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r57.",
   "actual_behavior": "Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 60 of 1609 scanned pages (60 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc",
    "https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help",
    "https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/regulations-guidance/transmittals/{id}-transmittals",
     "count": 4
    },
    {
     "pattern": "/about-cms/what-we-do/emergency-response/how-can-we-help",
     "count": 1
    },
    {
     "pattern": "/about-cms/information-systems/privacy/privacy-act-1974-and-privacy-act-requests",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f7dba940",
   "fingerprint": "477d8088",
   "rule_id": "sia-r14",
   "rule_label": "Accessible name of link or button matches visible label",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.3",
   "wcag_name": "Label in Name",
   "wcag_level": "A",
   "wcag_version": "2.1",
   "wcag_category": "WCAG 2.1 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r14",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "Moderate severity on 54 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 54,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 153,
    "pages_affected": 54,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Accessible name of link or button matches visible label (WCAG 2.5.3)",
   "description": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 54 of 1609 scanned pages (153 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r14 (WCAG 2.5.3).",
   "actual_behavior": "Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 54 of 1609 scanned pages (153 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "WS",
      "group": "Without speech",
      "prevalence": 0.005,
      "percent": "0.5%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Without speech (0.5%)."
   }
  },
  {
   "finding_id": "VS-646b1e0b",
   "fingerprint": "afad441e",
   "rule_id": "sia-r66",
   "rule_label": "Text has enhanced contrast",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.6",
   "wcag_name": "Contrast (Enhanced)",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r66",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "Moderate severity on 54 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 54,
    "affected_pages_previous": 182
   },
   "frequency": {
    "instances": 643,
    "pages_affected": 54,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Text has enhanced contrast (WCAG 1.4.6)",
   "description": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 54 of 1609 scanned pages (643 instances).",
   "remediation_tip": "Increase text contrast to meet WCAG AAA (7:1).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r66 (WCAG 1.4.6).",
   "actual_behavior": "Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 54 of 1609 scanned pages (643 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fbf54eba",
   "fingerprint": "773d6316",
   "rule_id": "sia-r74",
   "rule_label": "Link is distinguishable without relying on color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r74",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "Moderate severity on 54 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 54,
    "affected_pages_previous": 181
   },
   "frequency": {
    "instances": 3124,
    "pages_affected": 54,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Link is distinguishable without relying on color (WCAG 1.4.8)",
   "description": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 54 of 1609 scanned pages (3124 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r74 (WCAG 1.4.8).",
   "actual_behavior": "Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 54 of 1609 scanned pages (3124 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f054f4a4",
   "fingerprint": "5fa3b5a6",
   "rule_id": "sia-r53",
   "rule_label": "Headings are structured hierarchically",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r53",
   "severity": "Moderate",
   "priority": "p2",
   "confidence": "high",
   "rationale": "Moderate severity on 53 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 53,
    "affected_pages_previous": 167
   },
   "frequency": {
    "instances": 53,
    "pages_affected": 53,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Headings are structured hierarchically (WCAG criterion undetermined)",
   "description": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 53 of 1609 scanned pages (53 instances).",
   "remediation_tip": "Use headings in a logical, non-skipping order.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r53.",
   "actual_behavior": "Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 53 of 1609 scanned pages (53 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6",
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7",
    "https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 3
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-0066c67d",
   "fingerprint": "67db3700",
   "rule_id": "empty-heading",
   "rule_label": "Headings should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "severity": "Minor",
   "priority": "p3",
   "confidence": "high",
   "rationale": "affects 104 pages; persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 104,
    "affected_pages_previous": 247
   },
   "frequency": {
    "instances": 104,
    "pages_affected": 104,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Headings should not be empty (WCAG criterion undetermined)",
   "description": "Headings should not be empty. Detected by axe-core rule empty-heading on 104 of 1609 scanned pages (104 instances).",
   "remediation_tip": "Remove empty headings or give them text. Don't use heading tags for spacing.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-heading.",
   "actual_behavior": "Headings should not be empty. Detected by axe-core rule empty-heading on 104 of 1609 scanned pages (104 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
    "https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
    "https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "c6c37699",
     "html": "<h1></h1>",
     "selectors": [
      "h1:nth-child(2)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-2cd767ca",
   "fingerprint": "3123e4f3",
   "rule_id": "sia-r78",
   "rule_label": "Table header has scope",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r78",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 35 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 35,
    "affected_pages_previous": 101
   },
   "frequency": {
    "instances": 52,
    "pages_affected": 35,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Table header has scope (WCAG criterion undetermined)",
   "description": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 35 of 1609 scanned pages (52 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r78.",
   "actual_behavior": "Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 35 of 1609 scanned pages (52 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9",
    "https://www.cms.gov/cms-l564-request-employment-information"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 10
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-179ad9b3",
   "fingerprint": "0e001fcc",
   "rule_id": "sia-r113",
   "rule_label": "Target size is at least 24×24 CSS pixels or has spacing (Minimum)",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.5.8",
   "wcag_name": "Target Size (Minimum)",
   "wcag_level": "AA",
   "wcag_version": "2.2",
   "wcag_category": "WCAG 2.2 AA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r113",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 29 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 29,
    "affected_pages_previous": 79
   },
   "frequency": {
    "instances": 82,
    "pages_affected": 29,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)",
   "description": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 29 of 1609 scanned pages (82 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r113 (WCAG 2.5.8).",
   "actual_behavior": "Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 29 of 1609 scanned pages (82 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 15
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 3
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "LM",
      "group": "Limited manipulation/strength",
      "prevalence": 0.13,
      "percent": "13.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LR",
      "group": "Limited reach",
      "prevalence": 0.02,
      "percent": "2.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-d6097011",
   "fingerprint": "b46c5395",
   "rule_id": "sia-r68",
   "rule_label": "Presentational children of an element are not focusable",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r68",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 19,
    "affected_pages_previous": 45
   },
   "frequency": {
    "instances": 36,
    "pages_affected": 19,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Presentational children of an element are not focusable (WCAG 1.3.1)",
   "description": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 19 of 1609 scanned pages (36 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r68 (WCAG 1.3.1).",
   "actual_behavior": "Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 19 of 1609 scanned pages (36 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14",
    "http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx",
     "count": 5
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 4
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-04a9d28c",
   "fingerprint": "02cfba82",
   "rule_id": "presentational-attr",
   "rule_label": "Presentational attribute (use CSS)",
   "engine": "deprecated-html",
   "tool": "deprecated-html",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": null,
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "Moderate severity on 19 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 19,
    "affected_pages_previous": 40
   },
   "frequency": {
    "instances": 205,
    "pages_affected": 19,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Presentational attribute (use CSS) (WCAG criterion undetermined)",
   "description": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 1609 scanned pages (205 instances).",
   "remediation_tip": null,
   "suggested_fix": "Not captured by automated scan — requires manual testing.",
   "expected_behavior": "Element passes deprecated-html rule presentational-attr.",
   "actual_behavior": "Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 1609 scanned pages (205 instances).",
   "testing_environment": "Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html",
    "https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html",
    "https://www.cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?bc=17&ncacaldoctype=all&ncaid=282&sortBy=status&status=all"
   ],
   "html_fragments": [
    {
     "fingerprint": "9c73fd4b",
     "html": "<img src=\"bakpg.png\" alt=\"Previous Page [Alt-p]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "f9ef1f44",
     "html": "<img src=\"uptop.png\" alt=\"Up a level [Alt-u]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    },
    {
     "fingerprint": "1cc6b28a",
     "html": "<img src=\"fwdpg.png\" alt=\"Next Page [Alt-n]\" height=\"14\" width=\"31\" vspace=\"0\" hspace=\"0\" align=\"bottom\" border=\"0\">",
     "selectors": [
      "img"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 2
    },
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-0ba8ce9d",
   "fingerprint": "1b1ae391",
   "rule_id": "scope-attr-valid",
   "rule_label": "scope attribute should be used correctly",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 14,
    "affected_pages_previous": 38
   },
   "frequency": {
    "instances": 280,
    "pages_affected": 14,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "scope attribute should be used correctly (WCAG criterion undetermined)",
   "description": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 14 of 1609 scanned pages (280 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule scope-attr-valid.",
   "actual_behavior": "scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 14 of 1609 scanned pages (280 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "6c47e81e",
     "html": "<td valign=\"top\" scope=\"row\">  <p>November 18, 2013</p></td>",
     "selectors": [
      ".MsoNormalTable[border=\"1\"]:nth-child(42) > tbody > tr:nth-child(2) > td[scope=\"row\"][valign=\"top\"]"
     ]
    },
    {
     "fingerprint": "da52bdeb",
     "html": "<td valign=\"top\" scope=\"row\">  <p>December 18, 2013</p></td>",
     "selectors": [
      ".MsoNormalTable[border=\"1\"]:nth-child(42) > tbody > tr:nth-child(3) > td[scope=\"row\"][valign=\"top\"]"
     ]
    },
    {
     "fingerprint": "e88948e1",
     "html": "<td valign=\"top\" scope=\"row\">  <p>May 15, 2014</p></td>",
     "selectors": [
      ".MsoNormalTable[border=\"1\"]:nth-child(42) > tbody > tr:nth-child(4) > td[scope=\"row\"][valign=\"top\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 8
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-fa44f293",
   "fingerprint": "a01b2a6c",
   "rule_id": "page-has-heading-one",
   "rule_label": "Page should contain a level-one heading",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "high",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 12,
    "affected_pages_previous": 17
   },
   "frequency": {
    "instances": 12,
    "pages_affected": 12,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Page should contain a level-one heading (WCAG criterion undetermined)",
   "description": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 12 of 1609 scanned pages (12 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule page-has-heading-one.",
   "actual_behavior": "Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 12 of 1609 scanned pages (12 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program",
    "https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy",
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "88cfebb1",
     "html": "<html lang=\"en\" dir=\"ltr\" prefix=\"og: https://ogp.me/ns#\" class=\" js\" style=\"--vw: 12.8px; --vh: 8px;\">",
     "selectors": [
      "html"
     ]
    },
    {
     "fingerprint": "3e866d4c",
     "html": "<html>",
     "selectors": [
      "html"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare/medicaid-coordination/states/medicaid-integrity-program",
     "count": 2
    },
    {
     "pattern": "/medicaid-chip/community-engagement-support/eligibility-made-easy",
     "count": 1
    },
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-4408605e",
   "fingerprint": "265d5c76",
   "rule_id": "sia-r46",
   "rule_label": "Element has required aria-owns",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r46",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 9,
    "affected_pages_previous": 20
   },
   "frequency": {
    "instances": 17,
    "pages_affected": 9,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Element has required aria-owns (WCAG 1.3.1)",
   "description": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 9 of 1609 scanned pages (17 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r46 (WCAG 1.3.1).",
   "actual_behavior": "Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 9 of 1609 scanned pages (17 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15",
    "https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57863&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 8
    },
    {
     "pattern": "/newsroom/fact-sheets/marketplace-2024-open-enrollment-period-report-national-snapshot-2",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-7a0e5645",
   "fingerprint": "15da996e",
   "rule_id": "sia-r4",
   "rule_label": "Document has a valid lang attribute",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "3.1.1",
   "wcag_name": "Language of Page",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r4",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 9 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 9,
    "affected_pages_previous": 32
   },
   "frequency": {
    "instances": 9,
    "pages_affected": 9,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Document has a valid lang attribute (WCAG 3.1.1)",
   "description": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 9 of 1609 scanned pages (9 instances).",
   "remediation_tip": "Add a valid lang attribute to <html>.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r4 (WCAG 3.1.1).",
   "actual_behavior": "Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 9 of 1609 scanned pages (9 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
    "https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-a24eaa8c",
   "fingerprint": "8d462fe1",
   "rule_id": "sia-r2",
   "rule_label": "Image has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.1.1",
   "wcag_name": "Non-text Content",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r2",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 8 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 8,
    "affected_pages_previous": 31
   },
   "frequency": {
    "instances": 8,
    "pages_affected": 8,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Image has accessible name (WCAG 1.1.1)",
   "description": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 8 of 1609 scanned pages (8 instances).",
   "remediation_tip": "Give every <img> an accessible name (alt text), or alt=\"\" if purely decorative.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r2 (WCAG 1.1.1).",
   "actual_behavior": "Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 8 of 1609 scanned pages (8 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
    "https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-3c632d31",
   "fingerprint": "7d010b8c",
   "rule_id": "sia-r64",
   "rule_label": "Element has required owned roles",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.3.1",
   "wcag_name": "Info and Relationships",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r64",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "Moderate severity on 8 pages",
   "trend": {
    "status": "improving",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 8,
    "affected_pages_previous": 30
   },
   "frequency": {
    "instances": 8,
    "pages_affected": 8,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Element has required owned roles (WCAG 1.3.1)",
   "description": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 8 of 1609 scanned pages (8 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r64 (WCAG 1.3.1).",
   "actual_behavior": "Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 8 of 1609 scanned pages (8 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
    "https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html",
     "count": 1
    },
    {
     "pattern": "/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-388b5438",
   "fingerprint": "e21585c3",
   "rule_id": "sia-r80",
   "rule_label": "Scrollable element is keyboard accessible",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r80",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 6,
    "affected_pages_previous": 8
   },
   "frequency": {
    "instances": 62,
    "pages_affected": 6,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Scrollable element is keyboard accessible (WCAG 1.4.8)",
   "description": "Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 6 of 1609 scanned pages (62 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r80 (WCAG 1.4.8).",
   "actual_behavior": "Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 6 of 1609 scanned pages (62 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12",
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58747&articleStatus=all&bc=3&sortBy=title&ver=63"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 4
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 2
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-48291402",
   "fingerprint": "50880f5a",
   "rule_id": "sia-r71",
   "rule_label": "iframe element is not empty",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.8",
   "wcag_name": "Visual Presentation",
   "wcag_level": "AAA",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.x AAA",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r71",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 3,
    "affected_pages_previous": 8
   },
   "frequency": {
    "instances": 21,
    "pages_affected": 3,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "iframe element is not empty (WCAG 1.4.8)",
   "description": "iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 3 of 1609 scanned pages (21 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r71",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r71 (WCAG 1.4.8).",
   "actual_behavior": "iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 3 of 1609 scanned pages (21 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8",
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8",
    "http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=3&sortBy=title&ver=52"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/view/article.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-efd91fdd",
   "fingerprint": "12434796",
   "rule_id": "sia-r62",
   "rule_label": "Link in text block is visually distinguishable without color",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "1.4.1",
   "wcag_name": "Use of Color",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r62",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 1,
    "affected_pages_previous": 6
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Link in text block is visually distinguishable without color (WCAG 1.4.1)",
   "description": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 1609 scanned pages (2 instances).",
   "remediation_tip": "Make links visually distinguishable from surrounding text (not by color alone).",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r62 (WCAG 1.4.1).",
   "actual_behavior": "Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 1609 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WPC",
      "group": "Without color perception",
      "prevalence": 0.045,
      "percent": "4.5%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without color perception (4.5%), Limited vision (2.4%)."
   }
  },
  {
   "finding_id": "VS-28ebd979",
   "fingerprint": "032345cc",
   "rule_id": "sia-r11",
   "rule_label": "Link has accessible name",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": "2.4.4",
   "wcag_name": "Link Purpose (In Context)",
   "wcag_level": "A",
   "wcag_version": "2.0",
   "wcag_category": "WCAG 2.0 A",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r11",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 14,
    "affected_pages_current": 1,
    "affected_pages_previous": null
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Link has accessible name (WCAG 2.4.4)",
   "description": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 1609 scanned pages (2 instances).",
   "remediation_tip": "Give the link an accessible name via text content or aria-label.",
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r11 (WCAG 2.4.4).",
   "actual_behavior": "Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 1609 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare/quality/clinical-laboratory-improvement-amendments",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [
     {
      "code": "WV",
      "group": "Without vision",
      "prevalence": 0.01,
      "percent": "1.0%",
      "estimatedExcluded": null
     },
     {
      "code": "LV",
      "group": "Limited vision",
      "prevalence": 0.024,
      "percent": "2.4%",
      "estimatedExcluded": null
     },
     {
      "code": "LCLA",
      "group": "Limited cognitive, language, or learning ability",
      "prevalence": 0.11,
      "percent": "11.0%",
      "estimatedExcluded": null
     }
    ],
    "summary": "Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%)."
   }
  },
  {
   "finding_id": "VS-8806389c",
   "fingerprint": "ffb2ae06",
   "rule_id": "landmark-unique",
   "rule_label": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W25",
    "last_observed": "2026-W40",
    "weeks_observed": 16,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)",
   "description": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 1 of 1609 scanned pages (1 instances).",
   "remediation_tip": "When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. \"Primary\" and \"Footer\" navigation) so screen-reader users can tell them apart.",
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule landmark-unique.",
   "actual_behavior": "Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 1 of 1609 scanned pages (1 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4474&page=1"
   ],
   "html_fragments": [
    {
     "fingerprint": "e366fea7",
     "html": "<span class=\"views-field views-field-field-topic\" role=\"region\" aria-label=\"Related search topics\">\n<a href=\"/newsroom/search?about[]=33506&amp;keys= \" data-once=\"linkMatch\">Administration</a>\n</span>",
     "selectors": [
      ".views-field-field-topic[aria-label=\"Related search topics\"][role=\"region\"]:nth-child(1)"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/apps/media/press/factsheet.asp",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-f2542d87",
   "fingerprint": "9cf75a1e",
   "rule_id": "sia-r79",
   "rule_label": "Duplicate role landmark is labeled",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r79",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 1,
    "affected_pages_previous": 5
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Duplicate role landmark is labeled (WCAG criterion undetermined)",
   "description": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 1 of 1609 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r79.",
   "actual_behavior": "Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 1 of 1609 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&proposed=N"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-7fbb8b20",
   "fingerprint": "79bb1ee9",
   "rule_id": "sia-r59",
   "rule_label": "Element with orientation is not locked",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r59",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W40",
    "weeks_observed": 14,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 1,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Element with orientation is not locked (WCAG criterion undetermined)",
   "description": "Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 1609 scanned pages (1 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r59.",
   "actual_behavior": "Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 1609 scanned pages (1 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-e43903a1",
   "fingerprint": "49842005",
   "rule_id": "sia-r75",
   "rule_label": "Form field error is identified and described",
   "engine": "alfa",
   "tool": "Siteimprove Alfa",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Undetermined",
   "rule_url": "https://alfa.siteimprove.com/rules/sia-r75",
   "severity": "Moderate",
   "priority": "p3",
   "confidence": "low",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W26",
    "last_observed": "2026-W40",
    "weeks_observed": 14,
    "affected_pages_current": 1,
    "affected_pages_previous": 2
   },
   "frequency": {
    "instances": 2,
    "pages_affected": 1,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Form field error is identified and described (WCAG criterion undetermined)",
   "description": "Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 1609 scanned pages (2 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75",
   "expected_behavior": "Element passes Siteimprove Alfa rule sia-r75.",
   "actual_behavior": "Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 1609 scanned pages (2 instances).",
   "testing_environment": "Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html"
   ],
   "html_fragments": [],
   "url_patterns": [
    {
     "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  },
  {
   "finding_id": "VS-d69fc059",
   "fingerprint": "c827d812",
   "rule_id": "empty-table-header",
   "rule_label": "Table header text should not be empty",
   "engine": "axe-core",
   "tool": "axe-core",
   "wcag_sc": null,
   "wcag_name": null,
   "wcag_level": null,
   "wcag_version": null,
   "wcag_category": "Best Practice",
   "rule_url": "https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "severity": "Minor",
   "priority": "p4",
   "confidence": "medium",
   "rationale": "persistent across weeks",
   "trend": {
    "status": "persistent",
    "first_observed": "2026-W24",
    "last_observed": "2026-W40",
    "weeks_observed": 17,
    "affected_pages_current": 9,
    "affected_pages_previous": 28
   },
   "frequency": {
    "instances": 15,
    "pages_affected": 9,
    "total_pages_scanned": 1609
   },
   "on_key_page": false,
   "summary": "Table header text should not be empty (WCAG criterion undetermined)",
   "description": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 9 of 1609 scanned pages (15 instances).",
   "remediation_tip": null,
   "suggested_fix": "See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI",
   "expected_behavior": "Element passes axe-core rule empty-table-header.",
   "actual_behavior": "Table header text should not be empty. Detected by axe-core rule empty-table-header on 9 of 1609 scanned pages (15 instances).",
   "testing_environment": "Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.",
   "representative_urls": [
    "https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html",
    "https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html"
   ],
   "html_fragments": [
    {
     "fingerprint": "43aeeac2",
     "html": "<th scope=\"col\">&nbsp;</th>",
     "selectors": [
      ".MsoNormalTable[border=\"1\"]:nth-child(90) > tbody > tr:nth-child(1) > th:nth-child(1)",
      "tr:nth-child(2) > th:nth-child(1)"
     ]
    },
    {
     "fingerprint": "4c333a89",
     "html": "<th scope=\"col\">&nbsp; </th>",
     "selectors": [
      ".MsoNormalTable[border=\"1\"]:nth-child(131) > tbody > tr:nth-child(1) > th:nth-child(1)"
     ]
    },
    {
     "fingerprint": "01e71718",
     "html": "<th scope=\"col\" width=\"10\">&nbsp;</th>",
     "selectors": [
      "th[width=\"10\"]"
     ]
    }
   ],
   "url_patterns": [
    {
     "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/view/lcd.aspx",
     "count": 2
    },
    {
     "pattern": "/medicare-coverage-database/details/nca-decision-memo.aspx",
     "count": 1
    }
   ],
   "associated_technologies": [],
   "impact": {
    "groups": [],
    "summary": "Not captured by automated scan — requires manual testing."
   }
  }
 ],
 "clusters": {
  "by_wcag_criterion": [
   {
    "cluster_id": "140fec0b",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.8",
    "wcag_name": "Visual Presentation",
    "wcag_level": "AAA",
    "findings": [
     "VS-2208081b",
     "VS-fbf54eba",
     "VS-388b5438",
     "VS-48291402"
    ],
    "total_pages_affected": 216,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b393058c",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.5",
    "wcag_name": "Target Size (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-cb53cc4d"
    ],
    "total_pages_affected": 155,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "75cf28e4",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-7118fead"
    ],
    "total_pages_affected": 146,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "77bde739",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.1",
    "wcag_name": "Use of Color",
    "wcag_level": "A",
    "findings": [
     "VS-8ade3360",
     "VS-efd91fdd"
    ],
    "total_pages_affected": 142,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "423bd52e",
    "type": "wcag_criterion",
    "wcag_sc": "1.3.1",
    "wcag_name": "Info and Relationships",
    "wcag_level": "A",
    "findings": [
     "VS-a0bdbdf6",
     "VS-6175596b",
     "VS-d6097011",
     "VS-4408605e",
     "VS-3c632d31"
    ],
    "total_pages_affected": 133,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "8af1f05d",
    "type": "wcag_criterion",
    "wcag_sc": "3.1.1",
    "wcag_name": "Language of Page",
    "wcag_level": "A",
    "findings": [
     "VS-c126b6a6",
     "VS-7a0e5645"
    ],
    "total_pages_affected": 115,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "e08c8d69",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d25f622d"
    ],
    "total_pages_affected": 114,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "945c7205",
    "type": "wcag_criterion",
    "wcag_sc": "1.1.1",
    "wcag_name": "Non-text Content",
    "wcag_level": "A",
    "findings": [
     "VS-9074b4dd",
     "VS-a24eaa8c"
    ],
    "total_pages_affected": 108,
    "max_severity": "Critical"
   },
   {
    "cluster_id": "91fd3b4c",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-d5d82446"
    ],
    "total_pages_affected": 106,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "0649d9b9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f18df681"
    ],
    "total_pages_affected": 106,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "7774d667",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-0066c67d"
    ],
    "total_pages_affected": 104,
    "max_severity": "Minor"
   },
   {
    "cluster_id": "36ac08de",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-c18be945"
    ],
    "total_pages_affected": 60,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "fd9ed1c5",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.3",
    "wcag_name": "Label in Name",
    "wcag_level": "A",
    "findings": [
     "VS-f7dba940"
    ],
    "total_pages_affected": 54,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "71f257a8",
    "type": "wcag_criterion",
    "wcag_sc": "1.4.6",
    "wcag_name": "Contrast (Enhanced)",
    "wcag_level": "AAA",
    "findings": [
     "VS-646b1e0b"
    ],
    "total_pages_affected": 54,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "b05da4e9",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-f054f4a4"
    ],
    "total_pages_affected": 53,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "4b43ba23",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-2cd767ca"
    ],
    "total_pages_affected": 35,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "05fbc261",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-bd13f00a"
    ],
    "total_pages_affected": 31,
    "max_severity": "Serious"
   },
   {
    "cluster_id": "24c4a455",
    "type": "wcag_criterion",
    "wcag_sc": "2.5.8",
    "wcag_name": "Target Size (Minimum)",
    "wcag_level": "AA",
    "findings": [
     "VS-179ad9b3"
    ],
    "total_pages_affected": 29,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "66669a92",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-04a9d28c"
    ],
    "total_pages_affected": 19,
    "max_severity": "Moderate"
   },
   {
    "cluster_id": "aa39dafc",
    "type": "wcag_criterion",
    "wcag_sc": null,
    "wcag_name": null,
    "wcag_level": null,
    "findings": [
     "VS-0ba8ce9d"
    ],
    "total_pages_affected": 14,
    "max_severity": "Moderate"
   }
  ],
  "by_url_pattern": [
   {
    "cluster_id": "64453d83",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/article.aspx",
    "findings": [
     "VS-2cd767ca",
     "VS-179ad9b3",
     "VS-d6097011",
     "VS-4408605e",
     "VS-388b5438",
     "VS-48291402"
    ],
    "total_pages": 42
   },
   {
    "cluster_id": "7d8c5ddc",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/lcd.aspx",
    "findings": [
     "VS-a0bdbdf6",
     "VS-be8d563e",
     "VS-6175596b",
     "VS-d6097011",
     "VS-388b5438",
     "VS-48291402",
     "VS-efd91fdd",
     "VS-d69fc059"
    ],
    "total_pages": 35
   },
   {
    "cluster_id": "034daebc",
    "type": "url_pattern",
    "pattern": "/medicare-coverage-database/view/ncacal-decision-memo.aspx",
    "findings": [
     "VS-6175596b",
     "VS-e9fe47ac",
     "VS-c613c153",
     "VS-0ba8ce9d",
     "VS-f2542d87",
     "VS-d69fc059"
    ],
    "total_pages": 16
   },
   {
    "cluster_id": "82c9a6c6",
    "type": "url_pattern",
    "pattern": "/medicare/quality/clinical-laboratory-improvement-amendments",
    "findings": [
     "VS-e9fe47ac",
     "VS-28ebd979"
    ],
    "total_pages": 3
   },
   {
    "cluster_id": "ecf875d9",
    "type": "url_pattern",
    "pattern": "/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html",
    "findings": [
     "VS-7fbb8b20",
     "VS-e43903a1"
    ],
    "total_pages": 2
   }
  ]
 },
 "technology_findings": [
  {
   "technology": "reCAPTCHA",
   "finding": "axe:link-in-text-block",
   "lift": 3.1,
   "pages_with_both": 12,
   "technology_pages": 31,
   "interpretation": "Pages using reCAPTCHA are 3.1× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "reCAPTCHA",
   "finding": "axe:list",
   "lift": 3.05,
   "pages_with_both": 10,
   "technology_pages": 31,
   "interpretation": "Pages using reCAPTCHA are 3.05× more likely to have finding axe:list."
  },
  {
   "technology": "jsDelivr",
   "finding": "axe:link-in-text-block",
   "lift": 2.81,
   "pages_with_both": 13,
   "technology_pages": 37,
   "interpretation": "Pages using jsDelivr are 2.81× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:link-in-text-block",
   "lift": 2.81,
   "pages_with_both": 13,
   "technology_pages": 37,
   "interpretation": "Pages using Bootstrap are 2.81× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "Microsoft ASP.NET",
   "finding": "axe:link-in-text-block",
   "lift": 2.81,
   "pages_with_both": 13,
   "technology_pages": 37,
   "interpretation": "Pages using Microsoft ASP.NET are 2.81× more likely to have finding axe:link-in-text-block."
  },
  {
   "technology": "jsDelivr",
   "finding": "axe:list",
   "lift": 2.81,
   "pages_with_both": 11,
   "technology_pages": 37,
   "interpretation": "Pages using jsDelivr are 2.81× more likely to have finding axe:list."
  },
  {
   "technology": "Bootstrap",
   "finding": "axe:list",
   "lift": 2.81,
   "pages_with_both": 11,
   "technology_pages": 37,
   "interpretation": "Pages using Bootstrap are 2.81× more likely to have finding axe:list."
  },
  {
   "technology": "Microsoft ASP.NET",
   "finding": "axe:list",
   "lift": 2.81,
   "pages_with_both": 11,
   "technology_pages": 37,
   "interpretation": "Pages using Microsoft ASP.NET are 2.81× more likely to have finding axe:list."
  }
 ],
 "third_party_findings": [
  {
   "origin": "jsdelivr.net",
   "pages_served": 102,
   "pages_with_findings": 73,
   "finding_co_occurrence_rate": 0.72,
   "median_bytes": 8320,
   "example_pages": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title"
   ]
  },
  {
   "origin": "gstatic.com",
   "pages_served": 78,
   "pages_with_findings": 51,
   "finding_co_occurrence_rate": 0.65,
   "median_bytes": 1543594,
   "example_pages": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40168&lcdStatus=all&sortBy=title&ver=8"
   ]
  },
  {
   "origin": "google.com",
   "pages_served": 78,
   "pages_with_findings": 51,
   "finding_co_occurrence_rate": 0.65,
   "median_bytes": 42160,
   "example_pages": [
    "https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10",
    "https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3",
    "http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40168&lcdStatus=all&sortBy=title&ver=8"
   ]
  }
 ],
 "metadata": {
  "generator": "vital-core",
  "schema_version": "0.1",
  "total_pages_scanned": 1609,
  "notes": [
   "Healthy pages (no known issues) are intentionally excluded.",
   "Representative examples are used instead of complete occurrence lists.",
   "Fingerprints are stable hashes for tracking recurring patterns over time.",
   "Fragment fingerprints normalize volatile attributes (id, style, data-*) before hashing.",
   "Technology lift values indicate association, not causation.",
   "Confidence reflects sample size: high=10+ affected pages, medium=3-9, low=1-2."
  ]
 }
}