Da Vinci Risk Adjustment Implementation Guide (STU1 Ballot)
0.1.0 - STU 1 Ballot

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

: ra-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:MeasureReport;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "ra-measurereport05"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><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\">Resource \"ra-measurereport05\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ra-measurereport.html\">Risk Adjustment Coding Gap Report Profile</a></p></div><p><b>Risk Adjustment 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=\"https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample03\">https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample03</a></p><p><b>subject</b>: <a href=\"Patient-ra-patient03.html\">Patient/ra-patient03</a> \" NUCLEAR\"</p><p><b>date</b>: 2021-10-18</p><p><b>reporter</b>: <a href=\"Organization-ra-payer01.html\">Organization/ra-payer01</a> \"ABC Payer\"</p><p><b>period</b>: 2021-01-01 --&gt; 2021-09-30</p><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Historic Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#historic)</span></p><p><b>Evidence Status Extension</b>: Pending Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#pending)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#226 \"Chronic Obstructive Pulmonary Disease and Asthma\")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Suspected Condtion Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#suspected)</span></p><p><b>Evidence Status Extension</b>: Closed Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#closed-gap)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 31: Diabetes without Complication <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#31 \"Diabetes without Complication\")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Suspected Condtion Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#suspected)</span></p><p><b>Evidence Status Extension</b>: Closed Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#closed-gap)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 30: Diabetes with Complications <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#30 \"Diabetes with Complications\")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Suspected Condtion Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#suspected)</span></p><p><b>Evidence Status Extension</b>: Closed Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#closed-gap)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 261: Dialysis Status <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#261 \"Dialysis Status\")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Suspected Condtion Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#suspected)</span></p><p><b>Evidence Status Extension</b>: Open Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#open-gap)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 262: Chronic Kidney Disease Stage 5 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#262 \"Chronic Kidney Disease Stage 5\")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Suspected Condtion Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type Code System</a>#suspected)</span></p><p><b>Evidence Status Extension</b>: Open Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-evidence-status.html\">Risk Adjustment Evidence Status Code System</a>#open-gap)</span></p><p><b>Hierarchical Status Extension</b>: Hierarchies not applied <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-hierarchical-status.html\">Risk Adjustment Hierarchical Status Code System</a>#not-applied)</span></p><p><b>code</b>: CMS-RxHCC 262: Chronic Kidney Disease Stage 5 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (cmsrxhcc[5]#262 \"Chronic Kidney Disease Stage 5\")</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href=\"Condition-ra-condition04pat03.html\">Condition/ra-condition04pat03</a></li><li><a href=\"Condition-ra-condition21pat03.html\">Condition/ra-condition21pat03</a></li><li><a href=\"Condition-ra-condition15pat03.html\">Condition/ra-condition15pat03</a></li><li><a href=\"Condition-ra-condition16pat03.html\">Condition/ra-condition16pat03</a></li><li><a href=\"Condition-ra-condition35pat03.html\">Condition/ra-condition35pat03</a></li><li><a href=\"Encounter-ra-encounter04pat03.html\">Encounter/ra-encounter04pat03</a></li><li><a href=\"Encounter-ra-encounter15pat03.html\">Encounter/ra-encounter15pat03</a></li><li><a href=\"Encounter-ra-encounter16pat03.html\">Encounter/ra-encounter16pat03</a></li><li><a href=\"Encounter-ra-encounter35pat03.html\">Encounter/ra-encounter35pat03</a></li><li><a href=\"Encounter-ra-encounter35pat03.html\">Encounter/ra-encounter35pat03</a></li><li><a href=\"Observation-ra-obs01pat03.html\">Observation/ra-obs01pat03</a></li></ul></div>"
  ];
  fhir:DomainResource.extension [
     fhir:index 0;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline" ];
     fhir:Extension.valueDate [ fhir:value "2022-03-31"^^xsd:date ]
  ];
  fhir:MeasureReport.status [ fhir:value "complete"];
  fhir:MeasureReport.type [ fhir:value "individual"];
  fhir:MeasureReport.measure [
     fhir:value "https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample03";
     fhir:link <https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample03>
  ];
  fhir:MeasureReport.subject [
     fhir:Reference.reference [ fhir:value "Patient/ra-patient03" ]
  ];
  fhir:MeasureReport.date [ fhir:value "2021-10-18"^^xsd:date];
  fhir:MeasureReport.reporter [
     fhir:Reference.reference [ fhir:value "Organization/ra-payer01" ]
  ];
  fhir:MeasureReport.period [
     fhir:Period.start [ fhir:value "2021-01-01"^^xsd:date ];
     fhir:Period.end [ fhir:value "2021-09-30"^^xsd:date ]
  ];
  fhir:MeasureReport.group [
     fhir:index 0;
     fhir:Element.id [ fhir:value "group-001" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "historic" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "pending" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "226" ];
         fhir:Coding.display [ fhir:value "Chronic Obstructive Pulmonary Disease and Asthma" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma" ]     ]
  ], [
     fhir:index 1;
     fhir:Element.id [ fhir:value "group-002" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "suspected" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "closed-gap" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "31" ];
         fhir:Coding.display [ fhir:value "Diabetes without Complication" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 31: Diabetes without Complication" ]     ]
  ], [
     fhir:index 2;
     fhir:Element.id [ fhir:value "group-003" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "suspected" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "closed-gap" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "30" ];
         fhir:Coding.display [ fhir:value "Diabetes with Complications" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 30: Diabetes with Complications" ]     ]
  ], [
     fhir:index 3;
     fhir:Element.id [ fhir:value "group-004" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "suspected" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "closed-gap" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "261" ];
         fhir:Coding.display [ fhir:value "Dialysis Status" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 261: Dialysis Status" ]     ]
  ], [
     fhir:index 4;
     fhir:Element.id [ fhir:value "group-005" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "suspected" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "open-gap" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "262" ];
         fhir:Coding.display [ fhir:value "Chronic Kidney Disease Stage 5" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 262: Chronic Kidney Disease Stage 5" ]     ]
  ], [
     fhir:index 5;
     fhir:Element.id [ fhir:value "group-006" ];
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type" ];
           fhir:Coding.code [ fhir:value "suspected" ]         ]       ]     ], [
       fhir:index 1;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status" ];
           fhir:Coding.code [ fhir:value "open-gap" ]         ]       ]     ], [
       fhir:index 2;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus" ];
       fhir:Extension.valueCodeableConcept [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status" ];
           fhir:Coding.code [ fhir:value "not-applied" ]         ]       ]     ];
     fhir:MeasureReport.group.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/cmsrxhcc" ];
         fhir:Coding.version [ fhir:value "5" ];
         fhir:Coding.code [ fhir:value "262" ];
         fhir:Coding.display [ fhir:value "Chronic Kidney Disease Stage 5" ]       ];
       fhir:CodeableConcept.text [ fhir:value "CMS-RxHCC 262: Chronic Kidney Disease Stage 5" ]     ]
  ];
  fhir:MeasureReport.evaluatedResource [
     fhir:index 0;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-001" ]     ];
     fhir:Reference.reference [ fhir:value "Condition/ra-condition04pat03" ]
  ], [
     fhir:index 1;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-002" ]     ];
     fhir:Reference.reference [ fhir:value "Condition/ra-condition21pat03" ]
  ], [
     fhir:index 2;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-003" ]     ];
     fhir:Reference.reference [ fhir:value "Condition/ra-condition15pat03" ]
  ], [
     fhir:index 3;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-004" ]     ];
     fhir:Reference.reference [ fhir:value "Condition/ra-condition16pat03" ]
  ], [
     fhir:index 4;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-006" ]     ];
     fhir:Reference.reference [ fhir:value "Condition/ra-condition35pat03" ]
  ], [
     fhir:index 5;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-001" ]     ];
     fhir:Reference.reference [ fhir:value "Encounter/ra-encounter04pat03" ]
  ], [
     fhir:index 6;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-002" ]     ];
     fhir:Reference.reference [ fhir:value "Encounter/ra-encounter15pat03" ]
  ], [
     fhir:index 7;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-003" ]     ];
     fhir:Reference.reference [ fhir:value "Encounter/ra-encounter16pat03" ]
  ], [
     fhir:index 8;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-004" ]     ];
     fhir:Reference.reference [ fhir:value "Encounter/ra-encounter35pat03" ]
  ], [
     fhir:index 9;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-006" ]     ];
     fhir:Reference.reference [ fhir:value "Encounter/ra-encounter35pat03" ]
  ], [
     fhir:index 10;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference" ];
       fhir:Extension.valueString [ fhir:value "group-005" ]     ];
     fhir:Reference.reference [ fhir:value "Observation/ra-obs01pat03" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.