Examples with ItemComponent org.hl7.fhir.r4.model.Claim.ItemComponent used on opensource projects

Example 11 with ItemComponent

use of org.hl7.fhir.r4.model.Claim.ItemComponent in project beneficiary-fhir-data by CMSgov.

the class HHAClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the CCW {@link HHAClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     HHAClaim}
 */
private static ExplanationOfBenefit transformClaim(HHAClaim claimGroup) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Required values not directly mapped
    eob.getMeta().addProfile(ProfileConstants.C4BB_EOB_NONCLINICIAN_PROFILE_URL);
    // Common group level fields between all claim types
    // Claim Type + Claim ID    => ExplanationOfBenefit.id
    // CLM_ID                   => ExplanationOfBenefit.identifier
    // CLM_GRP_ID               => ExplanationOfBenefit.identifier
    // BENE_ID + Coverage Type  => ExplanationOfBenefit.insurance.coverage
    // BENE_ID                  => ExplanationOfBenefit.patient (reference)
    // FINAL_ACTION             => ExplanationOfBenefit.status
    // CLM_FROM_DT              => ExplanationOfBenefit.billablePeriod.start
    // CLM_THRU_DT              => ExplanationOfBenefit.billablePeriod.end
    // CLM_PMT_AMT              => ExplanationOfBenefit.payment.amount
    TransformerUtilsV2.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimTypeV2.HHA, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    // NCH_WKLY_PROC_DT => ExplanationOfBenefit.supportinginfo.timingDate
    TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationRecievedDateSlice(eob, CcwCodebookVariable.NCH_WKLY_PROC_DT, Optional.of(claimGroup.getWeeklyProcessDate())));
    // map eob type codes into FHIR
    // NCH_CLM_TYPE_CD            => ExplanationOfBenefit.type.coding
    // EOB Type                   => ExplanationOfBenefit.type.coding
    // Claim Type                 => ExplanationOfBenefit.type.coding
    // NCH_NEAR_LINE_REC_IDENT_CD => ExplanationOfBenefit.extension
    TransformerUtilsV2.mapEobType(eob, ClaimTypeV2.HHA, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // PRVDR_NUM => ExplanationOfBenefit.provider.identifier
    TransformerUtilsV2.addProviderSlice(eob, C4BBOrganizationIdentifierType.PRN, claimGroup.getProviderNumber(), claimGroup.getLastUpdated());
    // Common group level fields between Inpatient, Outpatient Hospice, HHA and SNF
    // ORG_NPI_NUM              => ExplanationOfBenefit.provider
    // CLM_FAC_TYPE_CD          => ExplanationOfBenefit.facility.extension
    // CLM_FREQ_CD              => ExplanationOfBenefit.supportingInfo
    // CLM_MDCR_NON_PMT_RSN_CD  => ExplanationOfBenefit.extension
    // PTNT_DSCHRG_STUS_CD      => ExplanationOfBenefit.supportingInfo
    // CLM_SRVC_CLSFCTN_TYPE_CD => ExplanationOfBenefit.extension
    // NCH_PRMRY_PYR_CD         => ExplanationOfBenefit.supportingInfo
    // CLM_TOT_CHRG_AMT         => ExplanationOfBenefit.total.amount
    // NCH_PRMRY_PYR_CLM_PD_AMT => ExplanationOfBenefit.benefitBalance.financial
    TransformerUtilsV2.mapEobCommonGroupInpOutHHAHospiceSNF(eob, claimGroup.getOrganizationNpi(), claimGroup.getClaimFacilityTypeCode(), claimGroup.getClaimFrequencyCode(), claimGroup.getClaimNonPaymentReasonCode(), claimGroup.getPatientDischargeStatusCode(), claimGroup.getClaimServiceClassificationTypeCode(), claimGroup.getClaimPrimaryPayerCode(), claimGroup.getTotalChargeAmount(), claimGroup.getPrimaryPayerPaidAmount(), claimGroup.getFiscalIntermediaryNumber(), claimGroup.getLastUpdated());
    // CLM_PPS_IND_CODE => ExplanationOfBenefit.supportingInfo
    TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_PPS_IND_CD, CcwCodebookVariable.CLM_PPS_IND_CD, claimGroup.getProspectivePaymentCode());
    // ICD_DGNS_E_VRSN_CD(1-12) => diagnosis.diagnosisCodeableConcept
    for (Diagnosis diagnosis : DiagnosisUtilV2.extractDiagnoses(claimGroup)) {
        DiagnosisUtilV2.addDiagnosisCode(eob, diagnosis, ClaimTypeV2.HHA);
    }
    // Map care team
    // AT_PHYSN_NPI     => ExplanationOfBenefit.careTeam.provider
    // AT_PHYSN_UPIN    => ExplanationOfBenefit.careTeam.provider
    TransformerUtilsV2.mapCareTeam(eob, claimGroup.getAttendingPhysicianNpi(), Optional.empty(), Optional.empty(), claimGroup.getAttendingPhysicianUpin(), Optional.empty(), Optional.empty());
    // CLM_HHA_LUPA_IND_CD => ExplanationOfBenefit.supportinginfo.code
    claimGroup.getClaimLUPACode().ifPresent(c -> TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_HHA_LUPA_IND_CD, CcwCodebookVariable.CLM_HHA_LUPA_IND_CD, c));
    // CLM_HHA_RFRL_CD => ExplanationOfBenefit.supportinginfo.code
    claimGroup.getClaimReferralCode().ifPresent(c -> TransformerUtilsV2.addInformationWithCode(eob, CcwCodebookVariable.CLM_HHA_RFRL_CD, CcwCodebookVariable.CLM_HHA_RFRL_CD, c));
    // CLM_HHA_TOT_VISIT_CNT => ExplanationOfBenefit.supportinginfo.value[x]
    TransformerUtilsV2.addInformation(eob, CcwCodebookVariable.CLM_HHA_TOT_VISIT_CNT).setValue(new Quantity(claimGroup.getTotalVisitCount().intValue()));
    // CLM_ADMSN_DT => ExplanationOfBenefit.supportingInfo:admissionperiod
    TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationAdmPeriodSlice(eob, claimGroup.getCareStartDate(), Optional.empty()));
    for (HHAClaimLine line : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        // Override the default sequence
        // CLM_LINE_NUM => item.sequence
        item.setSequence(line.getLineNumber().intValue());
        // PRVDR_STATE_CD => item.location
        TransformerUtilsV2.addLocationState(item, claimGroup.getProviderStateCode());
        // HCPCS_CD           => ExplanationOfBenefit.item.productOrService
        // HCPCS_1ST_MDFR_CD  => ExplanationOfBenefit.item.modifier
        // HCPCS_2ND_MDFR_CD  => ExplanationOfBenefit.item.modifier
        TransformerUtilsV2.mapHcpcs(eob, item, line.getHcpcsCode(), Optional.empty(), Arrays.asList(line.getHcpcsInitialModifierCode(), line.getHcpcsSecondModifierCode()));
        // REV_CNTR_1ST_ANSI_CD => ExplanationOfBenefit.item.adjudication
        TransformerUtilsV2.addAdjudication(item, TransformerUtilsV2.createAdjudicationDenialReasonSlice(eob, CcwCodebookVariable.REV_CNTR_1ST_ANSI_CD, line.getRevCntr1stAnsiCd()));
        // REV_CNTR                   => ExplanationOfBenefit.item.revenue
        // REV_CNTR_RATE_AMT          => ExplanationOfBenefit.item.adjudication
        // REV_CNTR_TOT_CHRG_AMT      => ExplanationOfBenefit.item.adjudication
        // REV_CNTR_NCVRD_CHRG_AMT    => ExplanationOfBenefit.item.adjudication
        // REV_CNTR_NDC_QTY           => ExplanationOfBenefit.item.quantity
        // REV_CNTR_NDC_QTY_QLFR_CD   => ExplanationOfBenefit.modifier
        TransformerUtilsV2.mapEobCommonItemRevenue(item, eob, line.getRevenueCenterCode(), line.getRateAmount(), line.getTotalChargeAmount(), Optional.of(line.getNonCoveredChargeAmount()), line.getNationalDrugCodeQuantity(), line.getNationalDrugCodeQualifierCode());
        // Common item level fields between Outpatient, HHA and Hospice
        // REV_CNTR_DT              => ExplanationOfBenefit.item.servicedDate
        // REV_CNTR_PMT_AMT_AMT     => ExplanationOfBenefit.item.adjudication
        TransformerUtilsV2.mapEobCommonItemRevenueOutHHAHospice(item, line.getRevenueCenterDate(), line.getPaymentAmount());
        // REV_CNTR_DDCTBL_COINSRNC_CD => item.revenue
        TransformerUtilsV2.addItemRevenue(item, eob, CcwCodebookVariable.REV_CNTR_DDCTBL_COINSRNC_CD, line.getDeductibleCoinsuranceCd());
        // RNDRNG_PHYSN_UPIN => ExplanationOfBenefit.careTeam.provider
        TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.UPIN, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getRevenueCenterRenderingPhysicianUPIN());
        // RNDRNG_PHYSN_NPI => ExplanationOfBenefit.careTeam.provider
        TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getRevenueCenterRenderingPhysicianNPI());
        // REV_CNTR_STUS_IND_CD => ExplanationOfBenefit.item.revenue.extension
        TransformerUtilsV2.mapEobCommonItemRevenueStatusCode(item, eob, line.getStatusCode());
    }
    TransformerUtilsV2.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}

Example 12 with ItemComponent

use of org.hl7.fhir.r4.model.Claim.ItemComponent in project beneficiary-fhir-data by CMSgov.

the class CarrierClaimTransformerV2 method transformClaim.

/**
 * @param claimGroup the CCW {@link CarrierClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     CarrierClaim}
 */
private static ExplanationOfBenefit transformClaim(CarrierClaim claimGroup, Optional<Boolean> includeTaxNumbers) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Required values not directly mapped
    eob.getMeta().addProfile(ProfileConstants.C4BB_EOB_NONCLINICIAN_PROFILE_URL);
    // TODO: ExplanationOfBenefit.outcome is a required field. Needs to be mapped.
    // eob.setOutcome(?)
    // Common group level fields between all claim types
    // Claim Type + Claim ID => ExplanationOfBenefit.id
    // CLM_ID => ExplanationOfBenefit.identifier
    // CLM_GRP_ID => ExplanationOfBenefit.identifier
    // BENE_ID + Coverage Type => ExplanationOfBenefit.insurance.coverage
    // (reference)
    // BENE_ID => ExplanationOfBenefit.patient (reference)
    // FINAL_ACTION => ExplanationOfBenefit.status
    // CLM_FROM_DT => ExplanationOfBenefit.billablePeriod.start
    // CLM_THRU_DT => ExplanationOfBenefit.billablePeriod.end
    // CLM_PMT_AMT => ExplanationOfBenefit.payment.amount
    TransformerUtilsV2.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimTypeV2.CARRIER, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    // NCH_WKLY_PROC_DT => ExplanationOfBenefit.supportinginfo.timingDate
    TransformerUtilsV2.addInformation(eob, TransformerUtilsV2.createInformationRecievedDateSlice(eob, CcwCodebookVariable.NCH_WKLY_PROC_DT, Optional.of(claimGroup.getWeeklyProcessDate())));
    // map eob type codes into FHIR
    // NCH_CLM_TYPE_CD            => ExplanationOfBenefit.type.coding
    // EOB Type                   => ExplanationOfBenefit.type.coding
    // Claim Type (Professional)  => ExplanationOfBenefit.type.coding
    // NCH_NEAR_LINE_REC_IDENT_CD => ExplanationOfBenefit.extension
    TransformerUtilsV2.mapEobType(eob, ClaimTypeV2.CARRIER, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // CARR_CLM_PRMRY_PYR_PD_AMT => ExplanationOfBenefit.total.amount
    TransformerUtilsV2.addTotal(eob, TransformerUtilsV2.createTotalAdjudicationAmountSlice(eob, CcwCodebookVariable.CLM_TOT_CHRG_AMT, C4BBAdjudication.PRIOR_PAYER_PAID, claimGroup.getPrimaryPayerPaidAmount()));
    // Common group level fields between Carrier and DME
    // BENE_ID =>
    // CARR_NUM                       => ExplanationOfBenefit.extension
    // CLM_CLNCL_TRIL_NUM             => ExplanationOfBenefit.extension
    // CARR_CLM_CASH_DDCTBL_APLD_AMT  => ExplanationOfBenefit.benefitBalance.financial
    // CARR_CLM_PMT_DNL_CD            => ExplanationOfBenefit.extension
    // RFR_PHYSN_NPI                  => ExplanationOfBenefit.referral.identifier
    // => ExplanationOfBenefit.careteam.provider
    // RFR_PHYSN_UPIN                 => ExplanationOfBenefit.referral.identifier
    // => ExplanationOfBenefit.careteam.provider
    // CARR_CLM_PRVDR_ASGNMT_IND_SW   => ExplanationOfBenefit.extension
    // NCH_CLM_PRVDR_PMT_AMT          => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CLM_BENE_PMT_AMT           => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CARR_CLM_SBMTD_CHRG_AMT    => ExplanationOfBenefit.benefitBalance.financial
    // NCH_CARR_CLM_ALOWD_AMT         => ExplanationOfBenefit.benefitBalance.financial
    // CLM_DISP_CD                    => ExplanationOfBenefit.disposition
    // CARR_CLM_CNTL_NUM              => ExplanationOfBenefit.extension
    TransformerUtilsV2.mapEobCommonGroupCarrierDME(eob, claimGroup.getBeneficiaryId(), claimGroup.getCarrierNumber(), claimGroup.getClinicalTrialNumber(), claimGroup.getBeneficiaryPartBDeductAmount(), claimGroup.getPaymentDenialCode(), claimGroup.getReferringPhysicianNpi(), claimGroup.getReferringPhysicianUpin(), claimGroup.getProviderAssignmentIndicator(), claimGroup.getProviderPaymentAmount(), claimGroup.getBeneficiaryPaymentAmount(), claimGroup.getSubmittedChargeAmount(), claimGroup.getAllowedChargeAmount(), claimGroup.getClaimDispositionCode(), claimGroup.getClaimCarrierControlNumber());
    // ICD_DGNS_VRSN_CD(1-12) => diagnosis.diagnosisCodeableConcept
    for (Diagnosis diagnosis : DiagnosisUtilV2.extractDiagnoses(claimGroup)) {
        DiagnosisUtilV2.addDiagnosisCode(eob, diagnosis, ClaimTypeV2.CARRIER);
    }
    // CARR_CLM_RFRNG_PIN_NUM => ExplanationOfBenefit.careteam.provider
    TransformerUtilsV2.addCareTeamMember(eob, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.REFERRING, Optional.ofNullable(claimGroup.getReferringProviderIdNumber()));
    // CARR_CLM_ENTRY_CD => ExplanationOfBenefit.extension
    eob.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_CLM_ENTRY_CD, claimGroup.getClaimEntryCode()));
    // Process line items
    for (CarrierClaimLine line : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        // LINE_NUM => ExplanationOfBenefit.item.sequence
        item.setSequence(line.getLineNumber().intValue());
        // PRF_PHYSN_NPI => ExplanationOfBenefit.careTeam.provider
        Optional<CareTeamComponent> performing = TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getPerformingPhysicianNpi());
        // Fall back to UPIN if NPI not present
        if (!line.getPerformingPhysicianNpi().isPresent()) {
            performing = TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.UPIN, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PERFORMING, line.getPerformingPhysicianUpin());
        }
        // Update the responsible flag
        performing.ifPresent(p -> {
            p.setResponsible(true);
            // PRVDR_SPCLTY => ExplanationOfBenefit.careTeam.qualification
            p.setQualification(TransformerUtilsV2.createCodeableConcept(eob, CcwCodebookVariable.PRVDR_SPCLTY, line.getProviderSpecialityCode()));
            // CARR_LINE_PRVDR_TYPE_CD => ExplanationOfBenefit.careTeam.extension
            p.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_PRVDR_TYPE_CD, line.getProviderTypeCode()));
            // PRTCPTNG_IND_CD => ExplanationOfBenefit.careTeam.extension
            p.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRTCPTNG_IND_CD, line.getProviderParticipatingIndCode()));
        });
        // ORG_NPI_NUM => ExplanationOfBenefit.careTeam.provider
        TransformerUtilsV2.addCareTeamMember(eob, item, C4BBPractitionerIdentifierType.NPI, C4BBClaimProfessionalAndNonClinicianCareTeamRole.PRIMARY, line.getOrganizationNpi());
        // CARR_LINE_RDCD_PMT_PHYS_ASTN_C => ExplanationOfBenefit.item.adjudication
        TransformerUtilsV2.addAdjudication(item, TransformerUtilsV2.createAdjudicationDenialReasonSlice(eob, CcwCodebookVariable.CARR_LINE_RDCD_PMT_PHYS_ASTN_C, String.valueOf(line.getReducedPaymentPhysicianAsstCode())));
        // HCPCS_CD               => ExplanationOfBenefit.item.productOrService
        // HCPCS_1ST_MDFR_CD      => ExplanationOfBenefit.item.modifier
        // HCPCS_2ND_MDFR_CD      => ExplanationOfBenefit.item.modifier
        // CARR_CLM_HCPCS_YR_CD   => ExplanationOfBenefit.item.modifier.version
        TransformerUtilsV2.mapHcpcs(eob, item, line.getHcpcsCode(), claimGroup.getHcpcsYearCode(), Arrays.asList(line.getHcpcsInitialModifierCode(), line.getHcpcsSecondModifierCode()));
        // tax num should be as a extension
        if (includeTaxNumbers.orElse(false)) {
            item.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.TAX_NUM, line.getProviderTaxNumber()));
        }
        // CARR_LINE_ANSTHSA_UNIT_CNT => ExplanationOfBenefit.item.extension
        if (line.getAnesthesiaUnitCount().compareTo(BigDecimal.ZERO) > 0) {
            item.addExtension(TransformerUtilsV2.createExtensionQuantity(CcwCodebookVariable.CARR_LINE_ANSTHSA_UNIT_CNT, line.getAnesthesiaUnitCount()));
        }
        // CARR_LINE_MTUS_CNT => ExplanationOfBenefit.item.extension
        if (!line.getMtusCount().equals(BigDecimal.ZERO)) {
            item.addExtension(TransformerUtilsV2.createExtensionQuantity(CcwCodebookVariable.CARR_LINE_MTUS_CNT, line.getMtusCount()));
        }
        // CARR_LINE_MTUS_CD => ExplanationOfBenefit.item.extension
        line.getMtusCode().ifPresent(code -> item.addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_MTUS_CNT, code)));
        // Common item level fields between Carrier and DME
        // LINE_SRVC_CNT            => ExplanationOfBenefit.item.quantity
        // LINE_CMS_TYPE_SRVC_CD    => ExplanationOfBenefit.item.category
        // LINE_PLACE_OF_SRVC_CD    => ExplanationOfBenefit.item.location
        // BETOS_CD                 => ExplanationOfBenefit.item.extension
        // LINE_1ST_EXPNS_DT        => ExplanationOfBenefit.item.servicedPeriod
        // LINE_LAST_EXPNS_DT       => ExplanationOfBenefit.item.servicedPeriod
        // LINE_NCH_PMT_AMT         => ExplanationOfBenefit.item.adjudication
        // LINE_PMT_80_100_CD       => ExplanationOfBenefit.item.adjudication.extension
        // PAID_TO_PATIENT          => ExplanationOfBenefit.item.adjudication
        // LINE_PRVDR_PMT_AMT       => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PTB_DDCTBL_AMT => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PRMRY_PYR_CD   => ExplanationOfBenefit.item.extension
        // LINE_BENE_PRMRY_PYR_PD_AMT => ExplanationOfBenefit.item.adjudication
        // LINE_COINSRNC_AMT        => ExplanationOfBenefit.item.adjudication
        // LINE_SBMTD_CHRG_AMT      => ExplanationOfBenefit.item.adjudication
        // LINE_ALOWD_CHRG_AMT      => ExplanationOfBenefit.item.adjudication
        // LINE_BENE_PRMRY_PYR_CD   => ExplanationOfBenefit.item.extension
        // LINE_SERVICE_DEDUCTIBLE  => ExplanationOfBenefit.item.extension
        // LINE_HCT_HGB_TYPE_CD     => Observation.code
        // LINE_HCT_HGB_RSLT_NUM    => Observation.value
        // LINE_NDC_CD              => ExplanationOfBenefit.item.productOrService
        TransformerUtilsV2.mapEobCommonItemCarrierDME(item, eob, claimGroup.getClaimId(), item.getSequence(), line.getServiceCount(), line.getPlaceOfServiceCode(), line.getFirstExpenseDate(), line.getLastExpenseDate(), line.getBeneficiaryPaymentAmount(), line.getProviderPaymentAmount(), line.getBeneficiaryPartBDeductAmount(), line.getPrimaryPayerCode(), line.getPrimaryPayerPaidAmount(), line.getBetosCode(), line.getPaymentAmount(), line.getPaymentCode(), line.getCoinsuranceAmount(), line.getSubmittedChargeAmount(), line.getAllowedChargeAmount(), line.getProcessingIndicatorCode(), line.getServiceDeductibleCode(), line.getHctHgbTestTypeCode(), line.getHctHgbTestResult(), line.getCmsServiceTypeCode(), line.getNationalDrugCode());
        // LINE_ICD_DGNS_CD      => ExplanationOfBenefit.item.diagnosisSequence
        // LINE_ICD_DGNS_VRSN_CD => ExplanationOfBenefit.item.diagnosisSequence
        DiagnosisUtilV2.addDiagnosisLink(eob, item, Diagnosis.from(line.getDiagnosisCode(), line.getDiagnosisCodeVersion(), DiagnosisLabel.OTHER), ClaimTypeV2.CARRIER);
        // PRVDR_STATE_CD => ExplanationOfBenefit.item.location.extension
        line.getProviderStateCode().ifPresent(code -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRVDR_STATE_CD, code)));
        // PRVDR_ZIP => ExplanationOfBenefit.item.location.extension
        line.getProviderZipCode().ifPresent(code -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.PRVDR_ZIP, code)));
        // CARR_LINE_PRCNG_LCLTY_CD => ExplanationOfBenefit.item.location.extension
        item.getLocation().addExtension(TransformerUtilsV2.createExtensionCoding(eob, CcwCodebookVariable.CARR_LINE_PRCNG_LCLTY_CD, line.getLinePricingLocalityCode()));
        // CARR_LINE_CLIA_LAB_NUM => ExplanationOfBenefit.item.location.extension
        line.getCliaLabNumber().ifPresent(num -> item.getLocation().addExtension(TransformerUtilsV2.createExtensionIdentifier(CcwCodebookVariable.CARR_LINE_CLIA_LAB_NUM, num)));
    }
    TransformerUtilsV2.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}

Example 13 with ItemComponent

use of org.hl7.fhir.r4.model.Claim.ItemComponent in project beneficiary-fhir-data by CMSgov.

the class R4ExplanationOfBenefitResourceProviderIT method assertEobEquals.

/**
 * Compares two ExplanationOfBenefit objects in detail while working around serialization issues
 * like comparing "0" and "0.0" or creation differences like using "Quantity" vs "SimpleQuantity"
 *
 * @param expected the expected
 * @param actual the actual
 */
private static void assertEobEquals(ExplanationOfBenefit expected, ExplanationOfBenefit actual) {
    // ID in the bundle will have `ExplanationOfBenefit/` in front, so make sure the last bit
    // matches up
    assertTrue(actual.getId().endsWith(expected.getId()));
    // Clean them out so we can do a deep compare later
    actual.setId("");
    expected.setId("");
    // If there are any contained resources, they might have lastupdate times in them too
    assertEquals(expected.getContained().size(), actual.getContained().size());
    for (int i = 0; i < expected.getContained().size(); i++) {
        Resource expectedContained = expected.getContained().get(i);
        Resource actualContained = actual.getContained().get(i);
        expectedContained.getMeta().setLastUpdated(null);
        actualContained.getMeta().setLastUpdated(null);
        // TODO: HAPI seems to be inserting the `#` in the ID of the contained element.
        // This is incorrect according to the FHIR spec:
        // https://build.fhir.org/references.html#contained
        // This works around that problem
        assertEquals("#" + expectedContained.getId(), actualContained.getId());
        expectedContained.setId("");
        actualContained.setId("");
    }
    // Dates are not easy to compare so just make sure they are there
    assertNotNull(actual.getMeta().getLastUpdated());
    // We compared all of meta that we care about so get it out of the way
    expected.getMeta().setLastUpdated(null);
    actual.getMeta().setLastUpdated(null);
    // Created is required, but can't be compared
    assertNotNull(actual.getCreated());
    expected.setCreated(null);
    actual.setCreated(null);
    // Extensions may have `valueMoney` elements
    assertEquals(expected.getExtension().size(), actual.getExtension().size());
    for (int i = 0; i < expected.getExtension().size(); i++) {
        Extension expectedEx = expected.getExtension().get(i);
        Extension actualEx = actual.getExtension().get(i);
        // We have to deal with Money objects separately
        if (expectedEx.hasValue() && expectedEx.getValue() instanceof Money) {
            assertTrue(actualEx.getValue() instanceof Money);
            assertCurrencyEquals((Money) expectedEx.getValue(), (Money) actualEx.getValue());
            // Now remove since we validated so we can compare the rest directly
            expectedEx.setValue(null);
            actualEx.setValue(null);
        }
    }
    // SupportingInfo can have `valueQuantity` that has the 0 vs 0.0 issue
    assertEquals(expected.getSupportingInfo().size(), actual.getSupportingInfo().size());
    for (int i = 0; i < expected.getSupportingInfo().size(); i++) {
        SupportingInformationComponent expectedSup = expected.getSupportingInfo().get(i);
        SupportingInformationComponent actualSup = actual.getSupportingInfo().get(i);
        // We have to deal with Money objects separately
        if (expectedSup.hasValueQuantity()) {
            assertTrue(actualSup.hasValueQuantity());
            assertEquals(expectedSup.getValueQuantity().getValue().floatValue(), actualSup.getValueQuantity().getValue().floatValue(), 0.0);
            // Now remove since we validated so we can compare the rest directly
            expectedSup.setValue(null);
            actualSup.setValue(null);
        }
    }
    // line items
    assertEquals(expected.getItem().size(), actual.getItem().size());
    for (int i = 0; i < expected.getItem().size(); i++) {
        ItemComponent expectedItem = expected.getItem().get(i);
        ItemComponent actualItem = actual.getItem().get(i);
        // Compare value directly because SimpleQuantity vs Quantity can't be compared
        assertEquals(expectedItem.getQuantity().getValue().floatValue(), actualItem.getQuantity().getValue().floatValue(), 0.0);
        expectedItem.setQuantity(null);
        actualItem.setQuantity(null);
        assertEquals(expectedItem.getAdjudication().size(), actualItem.getAdjudication().size());
        for (int j = 0; j < expectedItem.getAdjudication().size(); j++) {
            AdjudicationComponent expectedAdj = expectedItem.getAdjudication().get(j);
            AdjudicationComponent actualAdj = actualItem.getAdjudication().get(j);
            // Here is where we start getting into trouble with "0" vs "0.0", so we do this manually
            if (expectedAdj.hasAmount()) {
                assertNotNull(actualAdj.getAmount());
                assertCurrencyEquals(expectedAdj.getAmount(), actualAdj.getAmount());
            } else {
                // If expected doesn't have an amount, actual shouldn't
                assertFalse(actualAdj.hasAmount());
            }
            // We just checked manually, so null them out and check the rest of the fields
            expectedAdj.setAmount(null);
            actualAdj.setAmount(null);
        }
    }
    // Total has the same problem with values
    assertEquals(expected.getTotal().size(), actual.getTotal().size());
    for (int i = 0; i < expected.getTotal().size(); i++) {
        TotalComponent expectedTot = expected.getTotal().get(i);
        TotalComponent actualTot = actual.getTotal().get(i);
        if (expectedTot.hasAmount()) {
            assertNotNull(actualTot.getAmount());
            assertCurrencyEquals(expectedTot.getAmount(), actualTot.getAmount());
        } else {
            // If expected doesn't have an amount, actual shouldn't
            assertFalse(actualTot.hasAmount());
        }
        expectedTot.setAmount(null);
        actualTot.setAmount(null);
    }
    // Benefit Balance Financial components
    assertEquals(expected.getBenefitBalance().size(), actual.getBenefitBalance().size());
    for (int i = 0; i < expected.getBenefitBalance().size(); i++) {
        BenefitBalanceComponent expectedBen = expected.getBenefitBalance().get(i);
        BenefitBalanceComponent actualBen = actual.getBenefitBalance().get(i);
        assertEquals(expectedBen.getFinancial().size(), actualBen.getFinancial().size());
        for (int j = 0; j < expectedBen.getFinancial().size(); j++) {
            BenefitComponent expectedFinancial = expectedBen.getFinancial().get(j);
            BenefitComponent actualFinancial = actualBen.getFinancial().get(j);
            // Are we dealing with Money?
            if (expectedFinancial.hasUsedMoney()) {
                assertNotNull(actualFinancial.getUsedMoney());
                assertCurrencyEquals(expectedFinancial.getUsedMoney(), actualFinancial.getUsedMoney());
                // Clean up
                expectedFinancial.setUsed(null);
                actualFinancial.setUsed(null);
            }
        }
    }
    // As does payment
    if (expected.hasPayment()) {
        assertTrue(actual.hasPayment());
        assertCurrencyEquals(expected.getPayment().getAmount(), actual.getPayment().getAmount());
    } else {
        // If expected doesn't have an amount, actual shouldn't
        assertFalse(actual.hasPayment());
    }
    expected.getPayment().setAmount(null);
    actual.getPayment().setAmount(null);
    // Now for the grand finale, we can do an `equalsDeep` on the rest
    assertTrue(expected.equalsDeep(actual));
}

Example 14 with ItemComponent

use of org.hl7.fhir.r4.model.Claim.ItemComponent in project beneficiary-fhir-data by CMSgov.

the class CarrierClaimTransformerTest method assertMatches.

/**
 * Verifies that the {@link ExplanationOfBenefit} "looks like" it should, if it were produced from
 * the specified {@link CarrierClaim}.
 *
 * @param claim the {@link CarrierClaim} that the {@link ExplanationOfBenefit} was generated from
 * @param eob the {@link ExplanationOfBenefit} that was generated from the specified {@link
 *     CarrierClaim}
 * @param includedTaxNumbers whether or not to include tax numbers are expected to be included in
 *     the result (see {@link
 *     ExplanationOfBenefitResourceProvider#HEADER_NAME_INCLUDE_TAX_NUMBERS}, defaults to <code>
 *     false</code>)
 * @throws FHIRException (indicates test failure)
 */
static void assertMatches(CarrierClaim claim, ExplanationOfBenefit eob, Optional<Boolean> includedTaxNumbers) throws FHIRException {
    // Test to ensure group level fields between all claim types match
    TransformerTestUtils.assertEobCommonClaimHeaderData(eob, claim.getClaimId(), claim.getBeneficiaryId(), ClaimType.CARRIER, claim.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claim.getDateFrom()), Optional.of(claim.getDateThrough()), Optional.of(claim.getPaymentAmount()), claim.getFinalAction());
    // Test to ensure common group fields between Carrier and DME match
    TransformerTestUtils.assertEobCommonGroupCarrierDMEEquals(eob, claim.getBeneficiaryId(), claim.getCarrierNumber(), claim.getClinicalTrialNumber(), claim.getBeneficiaryPartBDeductAmount(), claim.getPaymentDenialCode(), claim.getReferringPhysicianNpi(), claim.getProviderAssignmentIndicator(), claim.getProviderPaymentAmount(), claim.getBeneficiaryPaymentAmount(), claim.getSubmittedChargeAmount(), claim.getAllowedChargeAmount());
    assertEquals(5, eob.getDiagnosis().size());
    assertEquals(1, eob.getItem().size());
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.PRPAYAMT, claim.getPrimaryPayerPaidAmount(), eob);
    CarrierClaimLine claimLine1 = claim.getLines().get(0);
    ItemComponent eobItem0 = eob.getItem().get(0);
    assertEquals(claimLine1.getLineNumber(), new BigDecimal(eobItem0.getSequence()));
    TransformerTestUtils.assertCareTeamEquals(claimLine1.getPerformingPhysicianNpi().get(), ClaimCareteamrole.PRIMARY, eob);
    CareTeamComponent performingCareTeamEntry = TransformerTestUtils.findCareTeamEntryForProviderNpi(claimLine1.getPerformingPhysicianNpi().get(), eob.getCareTeam());
    TransformerTestUtils.assertHasCoding(CcwCodebookVariable.PRVDR_SPCLTY, claimLine1.getProviderSpecialityCode(), performingCareTeamEntry.getQualification());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_PRVDR_TYPE_CD, claimLine1.getProviderTypeCode(), performingCareTeamEntry);
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRTCPTNG_IND_CD, claimLine1.getProviderParticipatingIndCode(), performingCareTeamEntry);
    TransformerTestUtils.assertExtensionCodingEquals(performingCareTeamEntry, TransformerConstants.CODING_NPI_US, TransformerConstants.CODING_NPI_US, "" + claimLine1.getOrganizationNpi().get());
    CareTeamComponent taxNumberCareTeamEntry = TransformerTestUtils.findCareTeamEntryForProviderTaxNumber(claimLine1.getProviderTaxNumber(), eob.getCareTeam());
    if (includedTaxNumbers.orElse(false)) {
        assertNotNull(taxNumberCareTeamEntry);
    } else {
        assertNull(taxNumberCareTeamEntry);
    }
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRVDR_STATE_CD, claimLine1.getProviderStateCode(), eobItem0.getLocation());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.PRVDR_STATE_CD, claimLine1.getProviderStateCode(), eobItem0.getLocation());
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_PRCNG_LCLTY_CD, claimLine1.getLinePricingLocalityCode(), eobItem0.getLocation());
    TransformerTestUtils.assertHasCoding(TransformerConstants.CODING_SYSTEM_HCPCS, "" + claim.getHcpcsYearCode().get(), null, claimLine1.getHcpcsCode().get(), eobItem0.getService().getCoding());
    assertEquals(1, eobItem0.getModifier().size());
    TransformerTestUtils.assertHcpcsCodes(eobItem0, claimLine1.getHcpcsCode(), claimLine1.getHcpcsInitialModifierCode(), claimLine1.getHcpcsSecondModifierCode(), claim.getHcpcsYearCode(), 0);
    if (claimLine1.getAnesthesiaUnitCount().compareTo(BigDecimal.ZERO) > 0) {
        TransformerTestUtils.assertExtensionQuantityEquals(CcwCodebookVariable.CARR_LINE_ANSTHSA_UNIT_CNT, claimLine1.getAnesthesiaUnitCount(), eobItem0.getService());
    }
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.CARR_LINE_MTUS_CD, claimLine1.getMtusCode(), eobItem0);
    TransformerTestUtils.assertExtensionQuantityEquals(CcwCodebookVariable.CARR_LINE_MTUS_CNT, claimLine1.getMtusCount(), eobItem0);
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.CARR_LINE_RDCD_PMT_PHYS_ASTN_C, claimLine1.getReducedPaymentPhysicianAsstCode(), eobItem0.getAdjudication());
    TransformerTestUtils.assertExtensionIdentifierEquals(CcwCodebookVariable.CARR_LINE_CLIA_LAB_NUM, claimLine1.getCliaLabNumber(), eobItem0.getLocation());
    // verify {@link
    // TransformerUtils#mapEobType(CodeableConcept,ClaimType,Optional,Optional)}
    // method worked as expected for this claim type
    TransformerTestUtils.assertMapEobType(eob.getType(), ClaimType.CARRIER, Optional.of(org.hl7.fhir.dstu3.model.codesystems.ClaimType.PROFESSIONAL), Optional.of(claim.getNearLineRecordIdCode()), Optional.of(claim.getClaimTypeCode()));
    // Test to ensure common item fields between Carrier and DME match
    TransformerTestUtils.assertEobCommonItemCarrierDMEEquals(eobItem0, eob, claimLine1.getServiceCount(), claimLine1.getPlaceOfServiceCode(), claimLine1.getFirstExpenseDate(), claimLine1.getLastExpenseDate(), claimLine1.getBeneficiaryPaymentAmount(), claimLine1.getProviderPaymentAmount(), claimLine1.getBeneficiaryPartBDeductAmount(), claimLine1.getPrimaryPayerCode(), claimLine1.getPrimaryPayerPaidAmount(), claimLine1.getBetosCode(), claimLine1.getPaymentAmount(), claimLine1.getPaymentCode(), claimLine1.getCoinsuranceAmount(), claimLine1.getSubmittedChargeAmount(), claimLine1.getAllowedChargeAmount(), claimLine1.getProcessingIndicatorCode(), claimLine1.getServiceDeductibleCode(), claimLine1.getDiagnosisCode(), claimLine1.getDiagnosisCodeVersion(), claimLine1.getHctHgbTestTypeCode(), claimLine1.getHctHgbTestResult(), claimLine1.getCmsServiceTypeCode(), claimLine1.getNationalDrugCode());
    // Test lastUpdated
    TransformerTestUtils.assertLastUpdatedEquals(claim.getLastUpdated(), eob);
}

Example 15 with ItemComponent

use of org.hl7.fhir.r4.model.Claim.ItemComponent in project beneficiary-fhir-data by CMSgov.

the class OutpatientClaimTransformerTest method assertMatches.

/**
 * Verifies that the {@link ExplanationOfBenefit} "looks like" it should, if it were produced from
 * the specified {@link OutpatientClaim}.
 *
 * @param claim the {@link OutpatientClaim} that the {@link ExplanationOfBenefit} was generated
 *     from
 * @param eob the {@link ExplanationOfBenefit} that was generated from the specified {@link
 *     OutpatientClaim}
 * @throws FHIRException (indicates test failure)
 */
static void assertMatches(OutpatientClaim claim, ExplanationOfBenefit eob) throws FHIRException {
    // Test to ensure group level fields between all claim types match
    TransformerTestUtils.assertEobCommonClaimHeaderData(eob, claim.getClaimId(), claim.getBeneficiaryId(), ClaimType.OUTPATIENT, claim.getClaimGroupId().toPlainString(), MedicareSegment.PART_B, Optional.of(claim.getDateFrom()), Optional.of(claim.getDateThrough()), Optional.of(claim.getPaymentAmount()), claim.getFinalAction());
    // test the common field provider number is set as expected in the EOB
    TransformerTestUtils.assertProviderNumber(eob, claim.getProviderNumber());
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.NCH_BENE_PTB_DDCTBL_AMT, claim.getDeductibleAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.NCH_PROFNL_CMPNT_CHRG_AMT, claim.getProfessionalComponentCharge(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.NCH_BENE_PTB_COINSRNC_AMT, claim.getCoinsuranceAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.CLM_OP_PRVDR_PMT_AMT, claim.getProviderPaymentAmount(), eob);
    TransformerTestUtils.assertAdjudicationTotalAmountEquals(CcwCodebookVariable.CLM_OP_BENE_PMT_AMT, claim.getBeneficiaryPaymentAmount(), eob);
    // Test to ensure common group fields between Inpatient, Outpatient and SNF
    TransformerTestUtils.assertEobCommonGroupInpOutSNFEquals(eob, claim.getBloodDeductibleLiabilityAmount(), claim.getOperatingPhysicianNpi(), claim.getOtherPhysicianNpi(), claim.getClaimQueryCode(), claim.getMcoPaidSw());
    // Test to ensure common group fields between Inpatient, Outpatient HHA, Hospice
    // and SNF match
    TransformerTestUtils.assertEobCommonGroupInpOutHHAHospiceSNFEquals(eob, claim.getOrganizationNpi(), claim.getClaimFacilityTypeCode(), claim.getClaimFrequencyCode(), claim.getClaimNonPaymentReasonCode(), claim.getPatientDischargeStatusCode().get(), claim.getClaimServiceClassificationTypeCode(), claim.getClaimPrimaryPayerCode(), claim.getAttendingPhysicianNpi(), claim.getTotalChargeAmount(), claim.getPrimaryPayerPaidAmount(), claim.getFiscalIntermediaryNumber(), claim.getFiDocumentClaimControlNumber(), claim.getFiOriginalClaimControlNumber());
    assertTrue(countDiagnosisCodes(claim) >= eob.getDiagnosis().size(), "Expect actual diagnosis count is less than or equal to the claim count");
    if (claim.getProcedure1Code().isPresent()) {
        CCWProcedure ccwProcedure = new CCWProcedure(claim.getProcedure1Code(), claim.getProcedure1CodeVersion(), claim.getProcedure1Date());
        TransformerTestUtils.assertHasCoding(ccwProcedure.getFhirSystem().toString(), claim.getProcedure1Code().get(), eob.getProcedure().get(0).getProcedureCodeableConcept().getCoding());
        assertEquals(claim.getProcedure1Date().get().atStartOfDay(ZoneId.systemDefault()).toInstant(), eob.getProcedure().get(0).getDate().toInstant());
    }
    assertTrue(1 <= eob.getItem().size(), "Expect actual item count is above 0");
    ItemComponent eobItem0 = eob.getItem().get(0);
    OutpatientClaimLine claimLine1 = claim.getLines().get(0);
    assertEquals(new Integer(claimLine1.getLineNumber().intValue()), new Integer(eobItem0.getSequence()));
    assertEquals(claim.getProviderStateCode(), eobItem0.getLocationAddress().getState());
    // TODO re-map as described in CBBF-111
    /*
     * TransformerTestUtils.assertHasCoding(TransformerConstants.CODING_NDC,
     * claimLine1.getNationalDrugCode().get(), eobItem0.getService());
     */
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.REV_CNTR_1ST_ANSI_CD, claimLine1.getRevCntr1stAnsiCd(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.REV_CNTR_2ND_ANSI_CD, claimLine1.getRevCntr2ndAnsiCd(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.REV_CNTR_3RD_ANSI_CD, claimLine1.getRevCntr3rdAnsiCd(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationReasonEquals(CcwCodebookVariable.REV_CNTR_4TH_ANSI_CD, claimLine1.getRevCntr4thAnsiCd(), eobItem0.getAdjudication());
    TransformerTestUtils.assertHcpcsCodes(eobItem0, claimLine1.getHcpcsCode(), claimLine1.getHcpcsInitialModifierCode(), claimLine1.getHcpcsSecondModifierCode(), Optional.empty(), 0);
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.REV_CNTR_IDE_NDC_UPC_NUM, claimLine1.getNationalDrugCode(), eobItem0.getService());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_BLOOD_DDCTBL_AMT, claimLine1.getBloodDeductibleAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_CASH_DDCTBL_AMT, claimLine1.getCashDeductibleAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_COINSRNC_WGE_ADJSTD_C, claimLine1.getWageAdjustedCoinsuranceAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_RDCD_COINSRNC_AMT, claimLine1.getReducedCoinsuranceAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_1ST_MSP_PD_AMT, claimLine1.getFirstMspPaidAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_1ST_MSP_PD_AMT, claimLine1.getSecondMspPaidAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_PRVDR_PMT_AMT, claimLine1.getProviderPaymentAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_BENE_PMT_AMT, claimLine1.getBenficiaryPaymentAmount(), eobItem0.getAdjudication());
    TransformerTestUtils.assertAdjudicationAmountEquals(CcwCodebookVariable.REV_CNTR_PTNT_RSPNSBLTY_PMT, claimLine1.getPatientResponsibilityAmount(), eobItem0.getAdjudication());
    String claimControlNumber = "0000000000";
    // Test to ensure item level fields between Inpatient, Outpatient, HHA, Hopsice
    // and SNF match
    TransformerTestUtils.assertEobCommonItemRevenueEquals(eobItem0, eob, claimLine1.getRevenueCenterCode(), claimLine1.getRateAmount(), claimLine1.getTotalChargeAmount(), claimLine1.getNonCoveredChargeAmount(), claimLine1.getUnitCount(), claimControlNumber, claimLine1.getNationalDrugCodeQuantity(), claimLine1.getNationalDrugCodeQualifierCode(), claimLine1.getRevenueCenterRenderingPhysicianNPI(), 1);
    // Test to ensure item level fields between Outpatient, HHA and Hospice match
    TransformerTestUtils.assertEobCommonItemRevenueOutHHAHospice(eobItem0, claimLine1.getRevenueCenterDate(), claimLine1.getPaymentAmount());
    // verify {@link
    // TransformerUtils#mapEobType(CodeableConcept,ClaimType,Optional,Optional)}
    // method worked as expected for this claim type
    TransformerTestUtils.assertMapEobType(eob.getType(), ClaimType.OUTPATIENT, Optional.of(org.hl7.fhir.dstu3.model.codesystems.ClaimType.PROFESSIONAL), Optional.of(claim.getNearLineRecordIdCode()), Optional.of(claim.getClaimTypeCode()));
    TransformerTestUtils.assertExtensionCodingEquals(CcwCodebookVariable.REV_CNTR_STUS_IND_CD, claimLine1.getStatusCode(), eobItem0.getRevenue());
    // Test lastUpdated
    TransformerTestUtils.assertLastUpdatedEquals(claim.getLastUpdated(), eob);
}