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

Example 11 with Resource

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

the class InpatientClaimTransformer method transform.

/**
 * @param metricRegistry the {@link MetricRegistry} to use
 * @param claim the CCW {@link InpatientClaim} to transform
 * @param includeTaxNumbers whether or not to include tax numbers in the result (see {@link
 *     ExplanationOfBenefitResourceProvider#HEADER_NAME_INCLUDE_TAX_NUMBERS}, defaults to <code>
 *     false</code>)
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     InpatientClaim}
 */
@Trace
static ExplanationOfBenefit transform(MetricRegistry metricRegistry, Object claim, Optional<Boolean> includeTaxNumbers) {
    Timer.Context timer = metricRegistry.timer(MetricRegistry.name(InpatientClaimTransformer.class.getSimpleName(), "transform")).time();
    if (!(claim instanceof InpatientClaim))
        throw new BadCodeMonkeyException();
    ExplanationOfBenefit eob = transformClaim((InpatientClaim) claim);
    timer.stop();
    return eob;
}

Example 12 with Resource

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

the class InpatientClaimTransformer method transformClaim.

/**
 * @param claimGroup the CCW {@link InpatientClaim} to transform
 * @return a FHIR {@link ExplanationOfBenefit} resource that represents the specified {@link
 *     InpatientClaim}
 */
private static ExplanationOfBenefit transformClaim(InpatientClaim claimGroup) {
    ExplanationOfBenefit eob = new ExplanationOfBenefit();
    // Common group level fields between all claim types
    TransformerUtils.mapEobCommonClaimHeaderData(eob, claimGroup.getClaimId(), claimGroup.getBeneficiaryId(), ClaimType.INPATIENT, claimGroup.getClaimGroupId().toPlainString(), MedicareSegment.PART_A, Optional.of(claimGroup.getDateFrom()), Optional.of(claimGroup.getDateThrough()), Optional.of(claimGroup.getPaymentAmount()), claimGroup.getFinalAction());
    TransformerUtils.mapEobWeeklyProcessDate(eob, claimGroup.getWeeklyProcessDate());
    // map eob type codes into FHIR
    TransformerUtils.mapEobType(eob, ClaimType.INPATIENT, Optional.of(claimGroup.getNearLineRecordIdCode()), Optional.of(claimGroup.getClaimTypeCode()));
    // set the provider number which is common among several claim types
    TransformerUtils.setProviderNumber(eob, claimGroup.getProviderNumber());
    if (claimGroup.getPatientStatusCd().isPresent()) {
        TransformerUtils.addInformationWithCode(eob, CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, CcwCodebookVariable.NCH_PTNT_STUS_IND_CD, claimGroup.getPatientStatusCd());
    }
    // add EOB information to fields that are common between the Inpatient and SNF claim types
    TransformerUtils.addCommonEobInformationInpatientSNF(eob, claimGroup.getAdmissionTypeCd(), claimGroup.getSourceAdmissionCd(), claimGroup.getNoncoveredStayFromDate(), claimGroup.getNoncoveredStayThroughDate(), claimGroup.getCoveredCareThoughDate(), claimGroup.getMedicareBenefitsExhaustedDate(), claimGroup.getDiagnosisRelatedGroupCd());
    // Claim Operational Indirect Medical Education Amount
    if (claimGroup.getIndirectMedicalEducationAmount().isPresent()) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.IME_OP_CLM_VAL_AMT, claimGroup.getIndirectMedicalEducationAmount());
    }
    // Claim Operational disproportionate Amount
    if (claimGroup.getDisproportionateShareAmount().isPresent()) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.DSH_OP_CLM_VAL_AMT, claimGroup.getDisproportionateShareAmount());
    }
    // TODO If actually nullable, should be Optional.
    if (claimGroup.getPassThruPerDiemAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.CLM_PASS_THRU_PER_DIEM_AMT, claimGroup.getPassThruPerDiemAmount());
    }
    // TODO If actually nullable, should be Optional.
    if (claimGroup.getProfessionalComponentCharge() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.NCH_PROFNL_CMPNT_CHRG_AMT, claimGroup.getProfessionalComponentCharge());
    }
    // TODO If actually nullable, should be Optional.
    if (claimGroup.getClaimTotalPPSCapitalAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.CLM_TOT_PPS_CPTL_AMT, claimGroup.getClaimTotalPPSCapitalAmount());
    }
    if (claimGroup.getIndirectMedicalEducationAmount().isPresent()) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.IME_OP_CLM_VAL_AMT, claimGroup.getIndirectMedicalEducationAmount().get());
    }
    // Claim Uncompensated Care Payment Amount
    if (claimGroup.getClaimUncompensatedCareAmount().isPresent()) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.CLM_UNCOMPD_CARE_PMT_AMT, claimGroup.getClaimUncompensatedCareAmount().get());
    }
    /*
     * add field values to the benefit balances that are common between the
     * Inpatient and SNF claim types
     */
    TransformerUtils.addCommonGroupInpatientSNF(eob, claimGroup.getCoinsuranceDayCount(), claimGroup.getNonUtilizationDayCount(), claimGroup.getDeductibleAmount(), claimGroup.getPartACoinsuranceLiabilityAmount(), claimGroup.getBloodPintsFurnishedQty(), claimGroup.getNoncoveredCharge(), claimGroup.getTotalDeductionAmount(), claimGroup.getClaimPPSCapitalDisproportionateShareAmt(), claimGroup.getClaimPPSCapitalExceptionAmount(), claimGroup.getClaimPPSCapitalFSPAmount(), claimGroup.getClaimPPSCapitalIMEAmount(), claimGroup.getClaimPPSCapitalOutlierAmount(), claimGroup.getClaimPPSOldCapitalHoldHarmlessAmount());
    // TODO If this is actually nullable, should be Optional.
    if (claimGroup.getDrgOutlierApprovedPaymentAmount() != null) {
        TransformerUtils.addAdjudicationTotal(eob, CcwCodebookVariable.NCH_DRG_OUTLIER_APRVD_PMT_AMT, claimGroup.getDrgOutlierApprovedPaymentAmount());
    }
    // Common group level fields between Inpatient, Outpatient and SNF
    TransformerUtils.mapEobCommonGroupInpOutSNF(eob, claimGroup.getBloodDeductibleLiabilityAmount(), claimGroup.getOperatingPhysicianNpi(), claimGroup.getOtherPhysicianNpi(), claimGroup.getClaimQueryCode(), claimGroup.getMcoPaidSw());
    // Common group level fields between Inpatient, Outpatient Hospice, HHA and SNF
    TransformerUtils.mapEobCommonGroupInpOutHHAHospiceSNF(eob, claimGroup.getOrganizationNpi(), claimGroup.getClaimFacilityTypeCode(), claimGroup.getClaimFrequencyCode(), claimGroup.getClaimNonPaymentReasonCode(), claimGroup.getPatientDischargeStatusCode(), claimGroup.getClaimServiceClassificationTypeCode(), claimGroup.getClaimPrimaryPayerCode(), claimGroup.getAttendingPhysicianNpi(), claimGroup.getTotalChargeAmount(), claimGroup.getPrimaryPayerPaidAmount(), claimGroup.getFiscalIntermediaryNumber(), claimGroup.getFiDocumentClaimControlNumber(), claimGroup.getFiOriginalClaimControlNumber());
    // Common group level fields between Inpatient, HHA, Hospice and SNF
    TransformerUtils.mapEobCommonGroupInpHHAHospiceSNF(eob, claimGroup.getClaimAdmissionDate(), claimGroup.getBeneficiaryDischargeDate(), Optional.of(claimGroup.getUtilizationDayCount()));
    for (Diagnosis diagnosis : extractDiagnoses(claimGroup)) TransformerUtils.addDiagnosisCode(eob, diagnosis);
    for (CCWProcedure procedure : TransformerUtils.extractCCWProcedures(claimGroup.getProcedure1Code(), claimGroup.getProcedure1CodeVersion(), claimGroup.getProcedure1Date(), claimGroup.getProcedure2Code(), claimGroup.getProcedure2CodeVersion(), claimGroup.getProcedure2Date(), claimGroup.getProcedure3Code(), claimGroup.getProcedure3CodeVersion(), claimGroup.getProcedure3Date(), claimGroup.getProcedure4Code(), claimGroup.getProcedure4CodeVersion(), claimGroup.getProcedure4Date(), claimGroup.getProcedure5Code(), claimGroup.getProcedure5CodeVersion(), claimGroup.getProcedure5Date(), claimGroup.getProcedure6Code(), claimGroup.getProcedure6CodeVersion(), claimGroup.getProcedure6Date(), claimGroup.getProcedure7Code(), claimGroup.getProcedure7CodeVersion(), claimGroup.getProcedure7Date(), claimGroup.getProcedure8Code(), claimGroup.getProcedure8CodeVersion(), claimGroup.getProcedure8Date(), claimGroup.getProcedure9Code(), claimGroup.getProcedure9CodeVersion(), claimGroup.getProcedure9Date(), claimGroup.getProcedure10Code(), claimGroup.getProcedure10CodeVersion(), claimGroup.getProcedure10Date(), claimGroup.getProcedure11Code(), claimGroup.getProcedure11CodeVersion(), claimGroup.getProcedure11Date(), claimGroup.getProcedure12Code(), claimGroup.getProcedure12CodeVersion(), claimGroup.getProcedure12Date(), claimGroup.getProcedure13Code(), claimGroup.getProcedure13CodeVersion(), claimGroup.getProcedure13Date(), claimGroup.getProcedure14Code(), claimGroup.getProcedure14CodeVersion(), claimGroup.getProcedure14Date(), claimGroup.getProcedure15Code(), claimGroup.getProcedure15CodeVersion(), claimGroup.getProcedure15Date(), claimGroup.getProcedure16Code(), claimGroup.getProcedure16CodeVersion(), claimGroup.getProcedure16Date(), claimGroup.getProcedure17Code(), claimGroup.getProcedure17CodeVersion(), claimGroup.getProcedure17Date(), claimGroup.getProcedure18Code(), claimGroup.getProcedure18CodeVersion(), claimGroup.getProcedure18Date(), claimGroup.getProcedure19Code(), claimGroup.getProcedure19CodeVersion(), claimGroup.getProcedure19Date(), claimGroup.getProcedure20Code(), claimGroup.getProcedure20CodeVersion(), claimGroup.getProcedure20Date(), claimGroup.getProcedure21Code(), claimGroup.getProcedure21CodeVersion(), claimGroup.getProcedure21Date(), claimGroup.getProcedure22Code(), claimGroup.getProcedure22CodeVersion(), claimGroup.getProcedure22Date(), claimGroup.getProcedure23Code(), claimGroup.getProcedure23CodeVersion(), claimGroup.getProcedure23Date(), claimGroup.getProcedure24Code(), claimGroup.getProcedure24CodeVersion(), claimGroup.getProcedure24Date(), claimGroup.getProcedure25Code(), claimGroup.getProcedure25CodeVersion(), claimGroup.getProcedure25Date())) TransformerUtils.addProcedureCode(eob, procedure);
    for (InpatientClaimLine claimLine : claimGroup.getLines()) {
        ItemComponent item = eob.addItem();
        item.setSequence(claimLine.getLineNumber().intValue());
        TransformerUtils.mapHcpcs(eob, item, Optional.empty(), claimLine.getHcpcsCode(), Collections.emptyList());
        item.setLocation(new Address().setState((claimGroup.getProviderStateCode())));
        // Common item level fields between Inpatient, Outpatient, HHA, Hospice and SNF
        TransformerUtils.mapEobCommonItemRevenue(item, eob, claimLine.getRevenueCenter(), claimLine.getRateAmount(), claimLine.getTotalChargeAmount(), claimLine.getNonCoveredChargeAmount(), claimLine.getUnitCount(), claimLine.getNationalDrugCodeQuantity(), claimLine.getNationalDrugCodeQualifierCode(), claimLine.getRevenueCenterRenderingPhysicianNPI());
        // Common group level field coinsurance between Inpatient, HHA, Hospice and SNF
        TransformerUtils.mapEobCommonGroupInpHHAHospiceSNFCoinsurance(eob, item, claimLine.getDeductibleCoinsuranceCd());
    }
    TransformerUtils.setLastUpdated(eob, claimGroup.getLastUpdated());
    return eob;
}

Example 13 with Resource

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

the class TransformerUtilsV2 method findOrCreateContainedOrg.

/**
 * Looks for an {@link Organization} with the given resource ID in {@link
 * ExplanationOfBenefit#getContained()} or adds one if it doesn't exist
 *
 * @param eob the {@link ExplanationOfBenefit} to modify
 * @param id The resource ID
 * @return The found or new {@link Organization} resource
 */
static Resource findOrCreateContainedOrg(ExplanationOfBenefit eob, String id) {
    Optional<Resource> org = eob.getContained().stream().filter(r -> r.getId() == id).findFirst();
    // If it isn't there, add one
    if (!org.isPresent()) {
        org = Optional.of(new Organization().setId(id));
        org.get().getMeta().addProfile(ProfileConstants.C4BB_ORGANIZATION_URL);
        eob.getContained().add(org.get());
    }
    return org.get();
}

Example 14 with Resource

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

the class AbstractR4ResourceProvider method createBundleFor.

/**
 * Creates a Bundle of resources for the given data using the given {@link ResourceTypeV2}.
 *
 * @param resourceTypes The {@link ResourceTypeV2} data to retrieve.
 * @param mbi The mbi to look up associated data for.
 * @param isHashed Denotes if the given mbi is hashed.
 * @param lastUpdated Date range of desired lastUpdate values to retrieve data for.
 * @param serviceDate Date range of the desired service date to retrieve data for.
 * @return A Bundle with data found using the provided parameters.
 */
@VisibleForTesting
Bundle createBundleFor(Set<ResourceTypeV2<T>> resourceTypes, String mbi, boolean isHashed, boolean excludeSamhsa, DateRangeParam lastUpdated, DateRangeParam serviceDate) {
    List<T> resources = new ArrayList<>();
    for (ResourceTypeV2<T> type : resourceTypes) {
        List<?> entities;
        entities = claimDao.findAllByMbiAttribute(type.getEntityClass(), type.getEntityMbiRecordAttribute(), mbi, isHashed, lastUpdated, serviceDate, type.getEntityEndDateAttribute());
        resources.addAll(entities.stream().filter(e -> !excludeSamhsa || hasNoSamhsaData(metricRegistry, e)).map(e -> type.getTransformer().transform(metricRegistry, e)).collect(Collectors.toList()));
    }
    Bundle bundle = new Bundle();
    resources.forEach(c -> {
        Bundle.BundleEntryComponent entry = bundle.addEntry();
        entry.setResource((Resource) c);
    });
    return bundle;
}

Example 15 with Resource

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

the class PatientResourceProvider method queryDatabaseByHash.

/**
 * @param hash the {@link Beneficiary} hash value to match
 * @param hashType a string to represent the hash type (used for logging purposes)
 * @param requestHeader the {@link #RequestHeaders} where resource request headers are
 *     encapsulated
 * @param beneficiaryHashField the JPA location of the beneficiary hash field
 * @param beneficiaryHistoryHashField the JPA location of the beneficiary history hash field
 * @return a FHIR {@link Patient} for the CCW {@link Beneficiary} that matches the specified
 *     {@link Beneficiary} hash value
 * @throws NoResultException A {@link NoResultException} will be thrown if no matching {@link
 *     Beneficiary} can be found
 */
@Trace
private Patient queryDatabaseByHash(String hash, String hashType, SingularAttribute<Beneficiary, String> beneficiaryHashField, SingularAttribute<BeneficiaryHistory, String> beneficiaryHistoryHashField, RequestHeaders requestHeader) {
    if (hash == null || hash.trim().isEmpty())
        throw new IllegalArgumentException();
    /*
     * Beneficiaries' HICN/MBIs can change over time and those past HICN/MBIs may land in
     * BeneficiaryHistory records. Accordingly, we need to search for matching HICN/MBIs in both the
     * Beneficiary and the BeneficiaryHistory records.
     *
     * There's no sane way to do this in a single query with JPA 2.1, it appears: JPA doesn't
     * support UNIONs and it doesn't support subqueries in FROM clauses. That said, the ideal query
     * would look like this:
     *
     * SELECT * FROM ( SELECT DISTINCT "beneficiaryId" FROM "Beneficiaries" WHERE "hicn" =
     * :'hicn_hash' UNION SELECT DISTINCT "beneficiaryId" FROM "BeneficiariesHistory" WHERE "hicn" =
     * :'hicn_hash') AS matching_benes INNER JOIN "Beneficiaries" ON matching_benes."beneficiaryId"
     * = "Beneficiaries"."beneficiaryId" LEFT JOIN "BeneficiariesHistory" ON
     * "Beneficiaries"."beneficiaryId" = "BeneficiariesHistory"."beneficiaryId" LEFT JOIN
     * "MedicareBeneficiaryIdHistory" ON "Beneficiaries"."beneficiaryId" =
     * "MedicareBeneficiaryIdHistory"."beneficiaryId";
     *
     * ... with the returned columns and JOINs being dynamic, depending on IncludeIdentifiers.
     *
     * In lieu of that, we run two queries: one to find HICN/MBI matches in BeneficiariesHistory,
     * and a second to find BENE_ID or HICN/MBI matches in Beneficiaries (with all of their data, so
     * we're ready to return the result). This is bad and dumb but I can't find a better working
     * alternative.
     *
     * (I'll just note that I did also try JPA/Hibernate native SQL queries but couldn't get the
     * joins or fetch groups to work with them.)
     *
     * If we want to fix this, we need to move identifiers out entirely to separate tables:
     * BeneficiaryHicns and BeneficiaryMbis. We could then safely query these tables and join them
     * back to Beneficiaries (and hopefully the optimizer will play nice, too).
     */
    CriteriaBuilder builder = entityManager.getCriteriaBuilder();
    // First, find all matching hashes from BeneficiariesHistory.
    CriteriaQuery<String> beneHistoryMatches = builder.createQuery(String.class);
    Root<BeneficiaryHistory> beneHistoryMatchesRoot = beneHistoryMatches.from(BeneficiaryHistory.class);
    beneHistoryMatches.select(beneHistoryMatchesRoot.get(BeneficiaryHistory_.beneficiaryId));
    beneHistoryMatches.where(builder.equal(beneHistoryMatchesRoot.get(beneficiaryHistoryHashField), hash));
    List<String> matchingIdsFromBeneHistory = null;
    Long hicnsFromHistoryQueryNanoSeconds = null;
    Timer.Context beneHistoryMatchesTimer = metricRegistry.timer(MetricRegistry.name(getClass().getSimpleName(), "query", "bene_by_" + hashType, hashType + "s_from_beneficiarieshistory")).time();
    try {
        matchingIdsFromBeneHistory = entityManager.createQuery(beneHistoryMatches).getResultList();
    } finally {
        hicnsFromHistoryQueryNanoSeconds = beneHistoryMatchesTimer.stop();
        TransformerUtils.recordQueryInMdc("bene_by_" + hashType + "." + hashType + "s_from_beneficiarieshistory", hicnsFromHistoryQueryNanoSeconds, matchingIdsFromBeneHistory == null ? 0 : matchingIdsFromBeneHistory.size());
    }
    // Then, find all Beneficiary records that match the hash or those BENE_IDs.
    CriteriaQuery<Beneficiary> beneMatches = builder.createQuery(Beneficiary.class);
    Root<Beneficiary> beneMatchesRoot = beneMatches.from(Beneficiary.class);
    beneMatchesRoot.fetch(Beneficiary_.skippedRifRecords, JoinType.LEFT);
    if (requestHeader.isHICNinIncludeIdentifiers())
        beneMatchesRoot.fetch(Beneficiary_.beneficiaryHistories, JoinType.LEFT);
    if (requestHeader.isMBIinIncludeIdentifiers())
        beneMatchesRoot.fetch(Beneficiary_.medicareBeneficiaryIdHistories, JoinType.LEFT);
    beneMatches.select(beneMatchesRoot);
    Predicate beneHashMatches = builder.equal(beneMatchesRoot.get(beneficiaryHashField), hash);
    if (matchingIdsFromBeneHistory != null && !matchingIdsFromBeneHistory.isEmpty()) {
        Predicate beneHistoryHashMatches = beneMatchesRoot.get(Beneficiary_.beneficiaryId).in(matchingIdsFromBeneHistory);
        beneMatches.where(builder.or(beneHashMatches, beneHistoryHashMatches));
    } else {
        beneMatches.where(beneHashMatches);
    }
    List<Beneficiary> matchingBenes = Collections.emptyList();
    Long benesByHashOrIdQueryNanoSeconds = null;
    Timer.Context timerHicnQuery = metricRegistry.timer(MetricRegistry.name(getClass().getSimpleName(), "query", "bene_by_" + hashType, "bene_by_" + hashType + "_or_id")).time();
    try {
        matchingBenes = entityManager.createQuery(beneMatches).getResultList();
    } finally {
        benesByHashOrIdQueryNanoSeconds = timerHicnQuery.stop();
        TransformerUtils.recordQueryInMdc(String.format("bene_by_" + hashType + ".bene_by_" + hashType + "_or_id.include_%s", String.join("_", (List<String>) requestHeader.getValue(HEADER_NAME_INCLUDE_IDENTIFIERS))), benesByHashOrIdQueryNanoSeconds, matchingBenes.size());
    }
    // Then, if we found more than one distinct BENE_ID, or none, throw an error.
    long distinctBeneIds = matchingBenes.stream().map(Beneficiary::getBeneficiaryId).filter(Objects::nonNull).distinct().count();
    Beneficiary beneficiary = null;
    if (distinctBeneIds <= 0) {
        throw new NoResultException();
    } else if (distinctBeneIds > 1) {
        MDC.put("database_query.by_hash.collision.distinct_bene_ids", Long.toString(distinctBeneIds));
        throw new ResourceNotFoundException("By hash query found more than one distinct BENE_ID: " + Long.toString(distinctBeneIds));
    } else if (distinctBeneIds == 1) {
        beneficiary = matchingBenes.get(0);
    }
    // Null out the unhashed HICNs if we're not supposed to be returning them
    if (!requestHeader.isHICNinIncludeIdentifiers()) {
        beneficiary.setHicnUnhashed(Optional.empty());
    }
    // Null out the unhashed MBIs if we're not supposed to be returning
    if (!requestHeader.isMBIinIncludeIdentifiers()) {
        beneficiary.setMedicareBeneficiaryId(Optional.empty());
    }
    Patient patient = BeneficiaryTransformer.transform(metricRegistry, beneficiary, requestHeader);
    return patient;
}