Da Vinci Risk Adjustment Implementation Guide
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Da Vinci Risk Adjustment Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ra/ and changes regularly. See the Directory of published versions

: ra-measurereport01-with-remark: Risk Adjustment Measure Report with Condition Category Remark - JSON Representation

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{
  "resourceType" : "MeasureReport",
  "id" : "ra-measurereport01-with-remark",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: MeasureReport ra-measurereport01-with-remark</b></p><a name=\"ra-measurereport01-with-remark\"> </a><a name=\"hcra-measurereport01-with-remark\"> </a><a name=\"ra-measurereport01-with-remark-en-US\"> </a><p><b>Measure Report Category</b>: <span title=\"Codes:{http://hl7.org/fhir/CodeSystem/measurereport-category ra}\">Risk Adjustment</span></p><p><b>Risk Adjustment Clinical Data Collection Deadline</b>: 2022-03-31</p><p><b>status</b>: Complete</p><p><b>type</b>: Individual</p><p><b>measure</b>: <a href=\"Measure-RAModelExample01.html\">Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)</a></p><p><b>subject</b>: <a href=\"Patient-ra-patient01.html\">Eve Everywoman (official) Female, DoB: 1975-01-16 ( Medical record number: 12345\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>date</b>: 2021-10-18</p><p><b>reporter</b>: <a href=\"Organization-ra-payer01.html\">Organization ABC Payer</a></p><p><b>period</b>: 2021-01-01 --&gt; 2021-09-30</p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-001</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-04-01</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><blockquote><p><b>Condition Category Remark</b></p><ul><li>author: <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</li><li>qualifyingDxCode: <span title=\"Codes:{http://snomed.info/sct 422099009}\">Disorder of eye due to type 2 diabetes mellitus (disorder)</span></li></ul></blockquote><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 18}\">HCC 18: Diabetes with Chronic Complications</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-002</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}\">Pending Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-29</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><p><b>Diagnosis Code</b>: <span title=\"Codes:{http://snomed.info/sct 832007}\">Moderate major depression</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 111}\">HCC 111: Chronic Obstructive Pulmonary Disease</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-003</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}\">Open Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2020-07-15</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><blockquote><p><b>Condition Category Remark</b></p><ul><li>author: <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</li><li>text: Diagnosis added</li><li>code: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark assessed-present}\">Assessed and present</span></li><li>relatedDataIdentifier: <code>http://example.org/fhir/myclaimno</code>/CLM23333</li></ul></blockquote><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 59}\">HCC 59: Major Depressive, Bipolar, and Paranoid Disorders</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-004</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-04-27</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-superseded}\">Hierarchies applied and Condition Category is superseded</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 112}\">HCC 112: Fibrosis of lung and other chronic lung disorders</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-005</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}\">Pending Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-27</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-superseded}\">Hierarchies applied and Condition Category is superseded</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 19}\">HCC 19: Diabetes without Complications</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-006</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type historic}\">Historic Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}\">Open Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2020-12-15</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-superseded}\">Hierarchies applied and Condition Category is superseded</span></p><blockquote><p><b>Condition Category Remark</b></p><ul><li>author: <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</li><li>authorDatetime: 2021-11-01</li><li>text: Continue evaluation</li><li>code: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark deferred}\">Deferred</span></li></ul></blockquote><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 84}\">HCC 84: Cardio-Respiratory Failure and Shock</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-007</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}\">Closed Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-03-15</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><blockquote><p><b>Condition Category Remark</b></p><ul><li>author: <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</li><li>authorDatetime: 2021-11-01</li><li>qualifyingDxList: E66.01, E66.2, E66.813</li></ul></blockquote><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 22}\">HCC 22: Morbid Obesity</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-008</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}\">Pending Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-27</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 96}\">HCC 96: Specified Heart Arrhythmias</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-009</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type suspected}\">Suspected Condition Category Gap</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}\">Open Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2020-07-15</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><p><b>Confidence Scale</b>: <span title=\"Codes:{http://snomed.info/sct 255508009}\">Medium</span></p><blockquote><p><b>Condition Category Remark</b></p><ul><li>author: <a href=\"http://terminology.hl7.org/6.0.2/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567890</li><li>authorDatetime: 2021-11-01</li><li>text: Not diagnosed</li><li>code: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark assessed-not-present}\">Assessed and not present</span></li><li>relatedDataIdentifier: <code>http://example.org/fhir/mychart</code>/432203939</li></ul></blockquote><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 110}\">HCC 110: Cystic Fibrosis</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-010</blockquote><p><b>Risk Adjustment Condition Category Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type net-new}\">Net-New Condition Category</span></p><p><b>Evidence Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}\">Pending Condition Category Gap</span></p><p><b>Risk Adjustment Evidence Status Date</b>: 2021-09-28</p><p><b>Hierarchical Status</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status applied-not-superseded}\">Hierarchies applied and Condition Category is not superseded</span></p><p><b>code</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/cmshcc 83}\">HCC 83: Respiratory Arrest</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Condition-ra-condition02pat01.html\">Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication</a></li><li><a href=\"Condition-ra-condition03pat01.html\">Condition Chronic obstructive pulmonary disease with (acute) exacerbation</a></li><li><a href=\"Condition-ra-condition08pat01.html\">Condition Bipolar disorder, current episode mixed, mild</a></li><li><a href=\"Condition-ra-condition09pat01.html\">Condition Allergic bronchopulmonary aspergillosis</a></li><li><a href=\"Condition-ra-condition10pat01.html\">Condition Long term (current) use of insulin</a></li><li><a href=\"Condition-ra-condition11pat01.html\">Condition Acute pulmonary edema</a></li><li><a href=\"Condition-ra-condition17pat01.html\">Condition Body mass index [BMI] 45.0-49.9, adult</a></li><li><a href=\"Condition-ra-condition18pat01.html\">Condition Longstanding persistent atrial fibrillation</a></li><li><a href=\"Condition-ra-condition33pat01.html\">Condition Respiratory arrest</a></li><li><a href=\"Condition-ra-condition43pat01.html\">Condition Diabetes mellitus due to underlying condition with other diabetic kidney complication</a></li><li><a href=\"Condition-ra-condition44pat01.html\">Condition Allergic bronchopulmonary aspergillosis</a></li><li><a href=\"Encounter-ra-encounter02pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-01-31 --&gt; 2021-01-31</a></li><li><a href=\"Encounter-ra-encounter03pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-09-26 --&gt; 2021-09-26</a></li><li><a href=\"Encounter-ra-encounter08pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-02-03 --&gt; 2017-02-03</a></li><li><a href=\"Encounter-ra-encounter09pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2021-03-27 --&gt; 2021-03-27</a></li><li><a href=\"Encounter-ra-encounter11pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2020-11-02 --&gt; 2020-11-02</a></li><li><a href=\"Encounter-ra-encounter43pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2019-02-10 --&gt; 2019-02-10</a></li><li><a href=\"Encounter-ra-encounter44pat01.html\">Encounter: status = finished; class = ambulatory (ActCode#AMB); type = Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter.; period = 2017-01-18 --&gt; 2017-01-18</a></li><li><a href=\"Observation-ra-obs21pat01.html\">Observation Trypsin [Mass/volume] in Serum or Plasma</a></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/measurereport-category",
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/CodeSystem/measurereport-category",
            "code" : "ra"
          }
        ]
      }
    },
    {
      "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline",
      "valueDate" : "2022-03-31"
    }
  ],
  "status" : "complete",
  "type" : "individual",
  "measure" : "https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample01",
  "subject" : {
    🔗 "reference" : "Patient/ra-patient01"
  },
  "date" : "2021-10-18",
  "reporter" : {
    🔗 "reference" : "Organization/ra-payer01"
  },
  "period" : {
    "start" : "2021-01-01",
    "end" : "2021-09-30"
  },
  "group" : [
    {
      "id" : "group-001",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "closed-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-04-01"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "author",
              "valueIdentifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              }
            },
            {
              "url" : "qualifyingDxCode",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://snomed.info/sct",
                    "code" : "422099009",
                    "display" : "Disorder of eye due to type 2 diabetes mellitus (disorder)"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "18",
            "display" : "Diabetes with Chronic Complications"
          }
        ],
        "text" : "HCC 18: Diabetes with Chronic Complications"
      }
    },
    {
      "id" : "group-002",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "pending"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-09-29"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-dxCode",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "832007",
                "display" : "Moderate major depression"
              }
            ]
          }
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "111",
            "display" : "Chronic Obstructive Pulmonary Disease"
          }
        ],
        "text" : "HCC 111: Chronic Obstructive Pulmonary Disease"
      }
    },
    {
      "id" : "group-003",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "open-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2020-07-15"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "author",
              "valueIdentifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              }
            },
            {
              "url" : "text",
              "valueString" : "Diagnosis added"
            },
            {
              "url" : "code",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
                    "code" : "assessed-present",
                    "display" : "Assessed and present"
                  }
                ]
              }
            },
            {
              "url" : "relatedDataIdentifier",
              "valueIdentifier" : {
                "system" : "http://example.org/fhir/myclaimno",
                "value" : "CLM23333"
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "59",
            "display" : "Major Depressive, Bipolar, and Paranoid Disorders"
          }
        ],
        "text" : "HCC 59: Major Depressive, Bipolar, and Paranoid Disorders"
      }
    },
    {
      "id" : "group-004",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "closed-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-04-27"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-superseded"
              }
            ]
          }
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "112",
            "display" : "Fibrosis of lung and other chronic lung disorders"
          }
        ],
        "text" : "HCC 112: Fibrosis of lung and other chronic lung disorders"
      }
    },
    {
      "id" : "group-005",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "pending"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-09-27"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-superseded"
              }
            ]
          }
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "19",
            "display" : "Diabetes without Complications"
          }
        ],
        "text" : "HCC 19: Diabetes without Complications"
      }
    },
    {
      "id" : "group-006",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "historic"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "open-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2020-12-15"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-superseded"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "author",
              "valueIdentifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              }
            },
            {
              "url" : "authorDatetime",
              "valueDateTime" : "2021-11-01"
            },
            {
              "url" : "text",
              "valueString" : "Continue evaluation"
            },
            {
              "url" : "code",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
                    "code" : "deferred",
                    "display" : "Deferred"
                  }
                ]
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "84",
            "display" : "Cardio-Respiratory Failure and Shock"
          }
        ],
        "text" : "HCC 84: Cardio-Respiratory Failure and Shock"
      }
    },
    {
      "id" : "group-007",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "suspected"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "closed-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-03-15"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "author",
              "valueIdentifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              }
            },
            {
              "url" : "authorDatetime",
              "valueDateTime" : "2021-11-01"
            },
            {
              "url" : "qualifyingDxList",
              "valueString" : "E66.01, E66.2, E66.813"
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "22",
            "display" : "Morbid Obesity"
          }
        ],
        "text" : "HCC 22: Morbid Obesity"
      }
    },
    {
      "id" : "group-008",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "suspected"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "pending"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-09-27"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "96",
            "display" : "Specified Heart Arrhythmias"
          }
        ],
        "text" : "HCC 96: Specified Heart Arrhythmias"
      }
    },
    {
      "id" : "group-009",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "suspected"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "open-gap"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2020-07-15"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://snomed.info/sct",
                "code" : "255508009",
                "display" : "Medium"
              }
            ]
          }
        },
        {
          "extension" : [
            {
              "url" : "author",
              "valueIdentifier" : {
                "system" : "http://hl7.org/fhir/sid/us-npi",
                "value" : "1234567890"
              }
            },
            {
              "url" : "authorDatetime",
              "valueDateTime" : "2021-11-01"
            },
            {
              "url" : "text",
              "valueString" : "Not diagnosed"
            },
            {
              "url" : "code",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark",
                    "code" : "assessed-not-present"
                  }
                ]
              }
            },
            {
              "url" : "relatedDataIdentifier",
              "valueIdentifier" : {
                "system" : "http://example.org/fhir/mychart",
                "value" : "432203939"
              }
            }
          ],
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark"
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "110",
            "display" : "Cystic Fibrosis"
          }
        ],
        "text" : "HCC 110: Cystic Fibrosis"
      }
    },
    {
      "id" : "group-010",
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type",
                "code" : "net-new"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                "code" : "pending"
              }
            ]
          }
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate",
          "valueDate" : "2021-09-28"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
          "valueCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                "code" : "applied-not-superseded"
              }
            ]
          }
        }
      ],
      "code" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
            "version" : "24",
            "code" : "83",
            "display" : "Respiratory Arrest"
          }
        ],
        "text" : "HCC 83: Respiratory Arrest"
      }
    }
  ],
  "evaluatedResource" : [
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-001"
        }
      ],
      "reference" : "Condition/ra-condition02pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-002"
        }
      ],
      "reference" : "Condition/ra-condition03pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-003"
        }
      ],
      "reference" : "Condition/ra-condition08pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-004"
        }
      ],
      "reference" : "Condition/ra-condition09pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-005"
        }
      ],
      "reference" : "Condition/ra-condition10pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-006"
        }
      ],
      "reference" : "Condition/ra-condition11pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-007"
        }
      ],
      "reference" : "Condition/ra-condition17pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-008"
        }
      ],
      "reference" : "Condition/ra-condition18pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-010"
        }
      ],
      "reference" : "Condition/ra-condition33pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-001"
        }
      ],
      "reference" : "Condition/ra-condition43pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-004"
        }
      ],
      "reference" : "Condition/ra-condition44pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-001"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-007"
        }
      ],
      "reference" : "Encounter/ra-encounter02pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-002"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-005"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-008"
        },
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-010"
        }
      ],
      "reference" : "Encounter/ra-encounter03pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-003"
        }
      ],
      "reference" : "Encounter/ra-encounter08pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-004"
        }
      ],
      "reference" : "Encounter/ra-encounter09pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-006"
        }
      ],
      "reference" : "Encounter/ra-encounter11pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-001"
        }
      ],
      "reference" : "Encounter/ra-encounter43pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-004"
        }
      ],
      "reference" : "Encounter/ra-encounter44pat01"
    },
    {
      🔗 "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference",
          "valueString" : "group-009"
        }
      ],
      "reference" : "Observation/ra-obs21pat01"
    }
  ]
}