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Hepatitis C is a deadly, yet curable, disease. National hepatitis C elimination goals for 2030 call for at least 80% of persons with hepatitis C to achieve viral clearance. A welltolerated treatment results in sustained viral clearance in =95% of cases. Hepatitis C virus (HCV) clearance cascades characterize a sequence of steps that follow the progression from testing to sustained viral clearance. Monitoring HCV clearance cascades is important for tracking progress toward elimination goals and identifying gaps in diagnosis, treatment, and prevention. State-specific HCV clearance cascades based on laboratory results were developed using longitudinal data from a large national, commercial laboratory during January 1, 2013-December 31, 2022. State-level estimates of viral testing among persons with evidence of past or current HCV infection ranged from 51% (Hawaii) to 99% (South Dakota), and hepatitis C viral clearance among persons with diagnosed HCV infection ranged from 10% (West Virginia) to 51% (Connecticut). These are the first state-level estimates using CDC guidance and data from a large commercial laboratory with national coverage to generate HCV clearance cascades. These estimates reveal substantial gaps in hepatitis C diagnosis, treatment, and prevention and can help guide prioritization of activities and resources to achieve hepatitis C elimination goals. [ABSTRACT FROM AUTHOR]