Da Vinci Risk Adjustment Implementation Guide
2.1.0 - STU 2.1

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 2.1.0 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 MeasureReport with Remark Example (ra-measurereport01-with-remark) - XML Representation

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    <MeasureReport xmlns="http://hl7.org/fhir">
      <id value="ra-measurereport01-with-remark"/>
      <meta>
        <extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
          <valueString
                       value="RA MeasureReport with Remark Example (ra-measurereport01-with-remark)"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/instance-description">
          <valueMarkdown
                         value="This is an example for the Risk Adjustment Coding Gap MeasureReport profile that shows using the Condition Category Remark extension. The remark is added to MeasureReport."/>
        </extension>
        <profile
                 value="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport"/>
      </meta>
      <text>
        <status value="extensions"/>
        <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><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ra-measurereport.html">Risk Adjustment Coding Gap MeasureReport</a></p></div><p><b>Measure Report Category</b>: <span title="Codes:{http://hl7.org/fhir/CodeSystem/measurereport-category ra}">Risk Adjustment</span></p><p><b>Clinical Data Collection Deadline Extension</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 (use: usual, ))</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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}">Closed Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-04-01</p><p><b>Hierarchical Status Extension</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 Extension</b></p><ul><li>author: <a href="http://terminology.hl7.org/5.5.0/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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}">Pending Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-09-29</p><p><b>Hierarchical Status Extension</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 Extension</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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}">Open Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2020-07-15</p><p><b>Hierarchical Status Extension</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 Extension</b></p><ul><li>author: <a href="http://terminology.hl7.org/5.5.0/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>relatedData: <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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}">Closed Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-04-27</p><p><b>Hierarchical Status Extension</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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}">Pending Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-09-27</p><p><b>Hierarchical Status Extension</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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}">Open Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2020-12-15</p><p><b>Hierarchical Status Extension</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 Extension</b></p><ul><li>author: <a href="http://terminology.hl7.org/5.5.0/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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status closed-gap}">Closed Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-03-15</p><p><b>Hierarchical Status Extension</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 Extension</b></p><ul><li>author: <a href="http://terminology.hl7.org/5.5.0/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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}">Pending Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-09-27</p><p><b>Hierarchical Status Extension</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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status open-gap}">Open Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2020-07-15</p><p><b>Hierarchical Status Extension</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 Extension</b>: <span title="Codes:{http://snomed.info/sct 255508009}">Medium</span></p><blockquote><p><b>Condition Category Remark Extension</b></p><ul><li>author: <a href="http://terminology.hl7.org/5.5.0/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>relatedData: <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>Condition Category Type Extension</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 Extension</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status pending}">Pending Condition Category Gap</span></p><p><b>Evidence Status Date Extension</b>: 2021-09-28</p><p><b>Hierarchical Status Extension</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>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/measurereport-category">
        <valueCodeableConcept>
          <coding>
            <system
                    value="http://hl7.org/fhir/CodeSystem/measurereport-category"/>
            <code value="ra"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline">
        <valueDate value="2022-03-31"/>
      </extension>
      <status value="complete"/>
      <type value="individual"/>
      <measure
               value="http://hl7.org/fhir/us/davinci-ra/Measure/RAModelExample01"/>
      <subject>🔗
        <reference value="Patient/ra-patient01"/>
      </subject>
      <date value="2021-10-18"/>
      <reporter>🔗
        <reference value="Organization/ra-payer01"/>
      </reporter>
      <period>
        <start value="2021-01-01"/>
        <end value="2021-09-30"/>
      </period>
      <group id="group-001">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-04-01"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark">
          <extension url="author">
            <valueIdentifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567890"/>
            </valueIdentifier>
          </extension>
          <extension url="qualifyingDxCode">
            <valueCodeableConcept>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="422099009"/>
                <display
                         value="Disorder of eye due to type 2 diabetes mellitus (disorder)"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="18"/>
            <display value="Diabetes with Chronic Complications"/>
          </coding>
          <text value="HCC 18: Diabetes with Chronic Complications"/>
        </code>
      </group>
      <group id="group-002">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-29"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-dxCode">
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="832007"/>
              <display value="Moderate major depression"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="111"/>
            <display value="Chronic Obstructive Pulmonary Disease"/>
          </coding>
          <text value="HCC 111: Chronic Obstructive Pulmonary Disease"/>
        </code>
      </group>
      <group id="group-003">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-07-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark">
          <extension url="author">
            <valueIdentifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567890"/>
            </valueIdentifier>
          </extension>
          <extension url="text">
            <valueString value="Diagnosis added"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark"/>
                <code value="assessed-present"/>
                <display value="Assessed and present"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="relatedData">
            <valueIdentifier>
              <system value="http://example.org/fhir/myclaimno"/>
              <value value="CLM23333"/>
            </valueIdentifier>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="59"/>
            <display value="Major Depressive, Bipolar, and Paranoid Disorders"/>
          </coding>
          <text
                value="HCC 59: Major Depressive, Bipolar, and Paranoid Disorders"/>
        </code>
      </group>
      <group id="group-004">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-04-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="112"/>
            <display value="Fibrosis of lung and other chronic lung disorders"/>
          </coding>
          <text
                value="HCC 112: Fibrosis of lung and other chronic lung disorders"/>
        </code>
      </group>
      <group id="group-005">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="19"/>
            <display value="Diabetes without Complications"/>
          </coding>
          <text value="HCC 19: Diabetes without Complications"/>
        </code>
      </group>
      <group id="group-006">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-12-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark">
          <extension url="author">
            <valueIdentifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567890"/>
            </valueIdentifier>
          </extension>
          <extension url="authorDatetime">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="text">
            <valueString value="Continue evaluation"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark"/>
                <code value="deferred"/>
                <display value="Deferred"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="84"/>
            <display value="Cardio-Respiratory Failure and Shock"/>
          </coding>
          <text value="HCC 84: Cardio-Respiratory Failure and Shock"/>
        </code>
      </group>
      <group id="group-007">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-03-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark">
          <extension url="author">
            <valueIdentifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567890"/>
            </valueIdentifier>
          </extension>
          <extension url="authorDatetime">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="qualifyingDxList">
            <valueString value="E66.01, E66.2, E66.813"/>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="22"/>
            <display value="Morbid Obesity"/>
          </coding>
          <text value="HCC 22: Morbid Obesity"/>
        </code>
      </group>
      <group id="group-008">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="96"/>
            <display value="Specified Heart Arrhythmias"/>
          </coding>
          <text value="HCC 96: Specified Heart Arrhythmias"/>
        </code>
      </group>
      <group id="group-009">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-07-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale">
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="255508009"/>
              <display value="Medium"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccRemark">
          <extension url="author">
            <valueIdentifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567890"/>
            </valueIdentifier>
          </extension>
          <extension url="authorDatetime">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="text">
            <valueString value="Not diagnosed"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-remark"/>
                <code value="assessed-not-present"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="relatedData">
            <valueIdentifier>
              <system value="http://example.org/fhir/mychart"/>
              <value value="432203939"/>
            </valueIdentifier>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="110"/>
            <display value="Cystic Fibrosis"/>
          </coding>
          <text value="HCC 110: Cystic Fibrosis"/>
        </code>
      </group>
      <group id="group-010">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-ccType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/cc-type"/>
              <code value="net-new"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-28"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="83"/>
            <display value="Respiratory Arrest"/>
          </coding>
          <text value="HCC 83: Respiratory Arrest"/>
        </code>
      </group>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Condition/ra-condition02pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-002"/>
        </extension>
        <reference value="Condition/ra-condition03pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-003"/>
        </extension>
        <reference value="Condition/ra-condition08pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Condition/ra-condition09pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-005"/>
        </extension>
        <reference value="Condition/ra-condition10pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-006"/>
        </extension>
        <reference value="Condition/ra-condition11pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-007"/>
        </extension>
        <reference value="Condition/ra-condition17pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-008"/>
        </extension>
        <reference value="Condition/ra-condition18pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-010"/>
        </extension>
        <reference value="Condition/ra-condition33pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Condition/ra-condition43pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Condition/ra-condition44pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-007"/>
        </extension>
        <reference value="Encounter/ra-encounter02pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-002"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-005"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-008"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-010"/>
        </extension>
        <reference value="Encounter/ra-encounter03pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-003"/>
        </extension>
        <reference value="Encounter/ra-encounter08pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Encounter/ra-encounter09pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-006"/>
        </extension>
        <reference value="Encounter/ra-encounter11pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Encounter/ra-encounter43pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Encounter/ra-encounter44pat01"/>
      </evaluatedResource>
      <evaluatedResource>🔗
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-009"/>
        </extension>
        <reference value="Observation/ra-obs21pat01"/>
      </evaluatedResource>
    </MeasureReport>