Examples with Use org.hl7.fhir.r4.model.ExplanationOfBenefit.Use used on opensource projects

Example 26 with Use

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.Use in project beneficiary-fhir-data by CMSgov.

the class CoverageTransformerV2 method transformPartB.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param beneficiary the {@link Beneficiary} to generate a {@link MedicareSegment#PART_B} {@link
 *     Coverage} resource for
 * @return {@link MedicareSegment#PART_B} {@link Coverage} resource for the specified {@link
 *     Beneficiary}
 */
private static Coverage transformPartB(MetricRegistry metricRegistry, Beneficiary beneficiary) {
    Timer.Context timer = getTimerContext(metricRegistry, "part_b");
    Coverage coverage = new Coverage();
    coverage.getMeta().addProfile(ProfileConstants.C4BB_COVERAGE_URL);
    coverage.setId(TransformerUtilsV2.buildCoverageId(MedicareSegment.PART_B, beneficiary));
    setCoverageStatus(coverage, beneficiary.getPartBTerminationCode());
    TransformerUtilsV2.setPeriodStart(coverage.getPeriod(), beneficiary.getMedicareCoverageStartDate());
    beneficiary.getMedicareBeneficiaryId().ifPresent(value -> coverage.setSubscriberId(value));
    setTypeAndIssuer(coverage);
    setCoverageRelationship(coverage, SubscriberPolicyRelationship.SELF);
    createCoverageClass(coverage, CoverageClass.GROUP, TransformerConstants.COVERAGE_PLAN, Optional.empty());
    createCoverageClass(coverage, CoverageClass.PLAN, TransformerConstants.COVERAGE_PLAN_PART_B, Optional.empty());
    coverage.setBeneficiary(TransformerUtilsV2.referencePatient(beneficiary));
    addCoverageExtension(coverage, CcwCodebookVariable.MS_CD, beneficiary.getMedicareEnrollmentStatusCode());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.B_TRM_CD, beneficiary.getPartATerminationCode());
    addCoverageDecimalExtension(coverage, CcwCodebookVariable.RFRNC_YR, beneficiary.getBeneEnrollmentReferenceYear());
    // Monthly Medicare-Medicaid dual eligibility codes
    transformEntitlementDualEligibility(coverage, beneficiary);
    // Medicare Entitlement Buy In Indicator
    transformEntitlementBuyInIndicators(coverage, beneficiary);
    // update Coverage.meta.lastUpdated
    TransformerUtilsV2.setLastUpdated(coverage, beneficiary.getLastUpdated());
    timer.stop();
    return coverage;
}

Example 27 with Use

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.Use in project beneficiary-fhir-data by CMSgov.

the class CoverageTransformerV2 method transformPartC.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param beneficiary the {@link Beneficiary} to generate a {@link MedicareSegment#PART_C} {@link
 *     Coverage} resource for
 * @return {@link MedicareSegment#PART_C} {@link Coverage} resource for the specified {@link
 *     Beneficiary}
 */
private static Coverage transformPartC(MetricRegistry metricRegistry, Beneficiary beneficiary) {
    Timer.Context timer = getTimerContext(metricRegistry, "part_c");
    Coverage coverage = new Coverage();
    coverage.getMeta().addProfile(ProfileConstants.C4BB_COVERAGE_URL);
    coverage.setId(TransformerUtilsV2.buildCoverageId(MedicareSegment.PART_C, beneficiary));
    coverage.setStatus(CoverageStatus.ACTIVE);
    beneficiary.getMedicareBeneficiaryId().ifPresent(value -> coverage.setSubscriberId(value));
    setTypeAndIssuer(coverage);
    setCoverageRelationship(coverage, SubscriberPolicyRelationship.SELF);
    createCoverageClass(coverage, CoverageClass.GROUP, TransformerConstants.COVERAGE_PLAN, Optional.empty());
    createCoverageClass(coverage, CoverageClass.PLAN, TransformerConstants.COVERAGE_PLAN_PART_C, Optional.empty());
    coverage.setBeneficiary(TransformerUtilsV2.referencePatient(beneficiary));
    // Contract Number
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_01, beneficiary.getPartCContractNumberJanId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_02, beneficiary.getPartCContractNumberFebId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_03, beneficiary.getPartCContractNumberMarId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_04, beneficiary.getPartCContractNumberAprId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_05, beneficiary.getPartCContractNumberMayId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_06, beneficiary.getPartCContractNumberJunId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_07, beneficiary.getPartCContractNumberJulId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_08, beneficiary.getPartCContractNumberAugId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_09, beneficiary.getPartCContractNumberSeptId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_10, beneficiary.getPartCContractNumberOctId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_11, beneficiary.getPartCContractNumberNovId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_CNTRCT_ID_12, beneficiary.getPartCContractNumberDecId());
    // PBP
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_01, beneficiary.getPartCPbpNumberJanId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_02, beneficiary.getPartCPbpNumberFebId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_03, beneficiary.getPartCPbpNumberMarId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_04, beneficiary.getPartCPbpNumberAprId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_05, beneficiary.getPartCPbpNumberMayId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_06, beneficiary.getPartCPbpNumberJunId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_07, beneficiary.getPartCPbpNumberJulId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_08, beneficiary.getPartCPbpNumberAugId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_09, beneficiary.getPartCPbpNumberSeptId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_10, beneficiary.getPartCPbpNumberOctId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_11, beneficiary.getPartCPbpNumberNovId());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PBP_ID_12, beneficiary.getPartCPbpNumberDecId());
    // Plan Type
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_01, beneficiary.getPartCPlanTypeJanCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_02, beneficiary.getPartCPlanTypeFebCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_03, beneficiary.getPartCPlanTypeMarCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_04, beneficiary.getPartCPlanTypeAprCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_05, beneficiary.getPartCPlanTypeMayCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_06, beneficiary.getPartCPlanTypeJunCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_07, beneficiary.getPartCPlanTypeJulCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_08, beneficiary.getPartCPlanTypeAugCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_09, beneficiary.getPartCPlanTypeSeptCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_10, beneficiary.getPartCPlanTypeOctCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_11, beneficiary.getPartCPlanTypeNovCode());
    addCoverageExtension(coverage, CcwCodebookVariable.PTC_PLAN_TYPE_CD_12, beneficiary.getPartCPlanTypeDecCode());
    // Monthly Medicare Advantage (MA) enrollment indicators:
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_01, beneficiary.getHmoIndicatorJanInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_02, beneficiary.getHmoIndicatorFebInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_03, beneficiary.getHmoIndicatorMarInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_04, beneficiary.getHmoIndicatorAprInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_05, beneficiary.getHmoIndicatorMayInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_06, beneficiary.getHmoIndicatorJunInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_07, beneficiary.getHmoIndicatorJulInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_08, beneficiary.getHmoIndicatorAugInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_09, beneficiary.getHmoIndicatorSeptInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_10, beneficiary.getHmoIndicatorOctInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_11, beneficiary.getHmoIndicatorNovInd());
    addCoverageCodeExtension(coverage, CcwCodebookVariable.HMO_IND_12, beneficiary.getHmoIndicatorDecInd());
    // The reference year of the enrollment data
    addCoverageDecimalExtension(coverage, CcwCodebookVariable.RFRNC_YR, beneficiary.getBeneEnrollmentReferenceYear());
    // Monthly Medicare-Medicaid dual eligibility codes
    transformEntitlementDualEligibility(coverage, beneficiary);
    // update Coverage.meta.lastUpdated
    TransformerUtilsV2.setLastUpdated(coverage, beneficiary.getLastUpdated());
    timer.stop();
    return coverage;
}

Example 28 with Use

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.Use in project beneficiary-fhir-data by CMSgov.

the class DMEClaimTransformerV2 method transform.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param claim the CCW {@link DMEClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     DMEClaim}
 */
@Trace
static ExplanationOfBenefit transform(MetricRegistry metricRegistry, Object claim, Optional<Boolean> includeTaxNumbers) {
    Timer.Context timer = metricRegistry.timer(MetricRegistry.name(DMEClaimTransformerV2.class.getSimpleName(), "transform")).time();
    if (!(claim instanceof DMEClaim)) {
        throw new BadCodeMonkeyException();
    }
    ExplanationOfBenefit eob = transformClaim((DMEClaim) claim, includeTaxNumbers);
    timer.stop();
    return eob;
}

Example 29 with Use

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.Use in project beneficiary-fhir-data by CMSgov.

the class TransformerUtilsV2 method createCodeableConcept.

/**
 * @param rootResource the root FHIR {@link IAnyResource} that the resultant {@link
 *     CodeableConcept} will be contained in
 * @param ccwVariable the {@link CcwCodebookInterface} being coded
 * @param code the value to use for {@link Coding#getCode()} for the resulting (single) {@link
 *     Coding}, wrapped within the resulting {@link CodeableConcept}
 * @return the output {@link CodeableConcept} for the specified input values
 */
static CodeableConcept createCodeableConcept(IAnyResource rootResource, CcwCodebookInterface ccwVariable, Optional<?> code) {
    if (!code.isPresent()) {
        throw new IllegalArgumentException();
    }
    Coding coding = createCoding(rootResource, ccwVariable, code.get());
    CodeableConcept concept = new CodeableConcept();
    concept.addCoding(coding);
    return concept;
}

Example 30 with Use

use of org.hl7.fhir.r4.model.ExplanationOfBenefit.Use in project beneficiary-fhir-data by CMSgov.

the class TransformerUtilsV2 method createCodeableConceptForFieldId.

/**
 * Unlike {@link #createCodeableConcept(IAnyResource, CcwCodebookInterface, Optional)}, this
 * method creates a {@link CodeableConcept} that's intended for use as a field ID/discriminator:
 * the {@link Variable#getId()} will be used for the {@link Coding#getCode()}, rather than the
 * {@link Coding#getSystem()}.
 *
 * @param rootResource the root FHIR {@link IAnyResource} that the resultant {@link
 *     CodeableConcept} will be contained in
 * @param codingSystem the {@link Coding#getSystem()} to use
 * @param ccwVariable the {@link CcwCodebookInterface} being coded
 * @return the output {@link CodeableConcept} for the specified input values
 */
private static CodeableConcept createCodeableConceptForFieldId(IAnyResource rootResource, String codingSystem, CcwCodebookInterface ccwVariable) {
    String code = CCWUtils.calculateVariableReferenceUrl(ccwVariable);
    Coding carinCoding = new Coding().setCode("info").setSystem(TransformerConstants.CARIN_SUPPORTING_INFO_TYPE).setDisplay("Information");
    Coding cmsBBcoding = new Coding(codingSystem, code, ccwVariable.getVariable().getLabel());
    CodeableConcept categoryCodeableConcept = new CodeableConcept();
    categoryCodeableConcept.addCoding(carinCoding);
    categoryCodeableConcept.addCoding(cmsBBcoding);
    return categoryCodeableConcept;
}