Da Vinci Risk Adjustment Implementation Guide
1.0.0 - STU 1 US

This page is part of the Da Vinci Risk Adjustment FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: ra-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03 - XML Representation

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<MeasureReport xmlns="http://hl7.org/fhir">
  <id value="ra-measurereport04"/>
  <meta>
    <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><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-measurereport04" </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="Measure-RAModelExample02.html">Risk Adjustment Model Version 21 - CMS Hierarchical Category Condition (CMS-HCC)</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>: 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: Hierarchies applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 188: Artificial Openings for Feeding or Elimination <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#188 "Artificial Openings for Feeding or Elimination")</span></p></blockquote><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>: 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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 111: Chronic Obstructive Pulmonary Disease <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#111 "Chronic Obstructive Pulmonary Disease")</span></p></blockquote><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>: 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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 21: Protein-Calorie Malnutrition <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#21 "Protein-Calorie Malnutrition")</span></p></blockquote><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>: 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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 35: Inflammatory Bowel Disease <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#35 "Inflammatory Bowel Disease")</span></p></blockquote><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>: 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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 96: Specified Heart Arrhythmia <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#96 "Specified Heart Arrhythmias")</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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 18: Diabetes with Chronic Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#18 "Diabetes with Chronic 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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 134: Dialysis Status <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#134 "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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 58: Major Depressive, Bipolar, and Paranoid Disorders <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#58 "Major Depressive, Bipolar, and Paranoid Disorders")</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 applied and Condition Category is superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-superseded)</span></p><p><b>code</b>: CMS-HCC 19: Diabetes without Complication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#19 "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>: 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 applied and Condition Category is superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-superseded)</span></p><p><b>code</b>: CMS-HCC 135: Acute Renal Failure <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#135 "Acute Renal Failure")</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 applied and Condition Category is superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-superseded)</span></p><p><b>code</b>: CMS-HCC 136: Chronic Kidney Disease, Stage 5 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#136 "Chronic Kidney Disease, Stage 5")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Net-New Condition Category <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type Code System</a>#net-new)</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 applied and Condition Category is not superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-not-superseded)</span></p><p><b>code</b>: CMS-HCC 107: Vascular Disease with Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#107 "Vascular Disease with Complications")</span></p></blockquote><blockquote><p><b>group</b></p><p><b>Risk Adjustment Suspect Type Extension</b>: Net-New Condition Category <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-suspect-type.html">Risk Adjustment Suspect Type Code System</a>#net-new)</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 applied and Condition Category is superseded <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-hierarchical-status.html">Risk Adjustment Hierarchical Status Code System</a>#applied-superseded)</span></p><p><b>code</b>: CMS-HCC 108: Vascular Disease <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[21]#108 "Vascular Disease")</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href="Condition-ra-condition01pat03.html">Condition/ra-condition01pat03</a></li><li><a href="Condition-ra-condition04pat03.html">Condition/ra-condition04pat03</a></li><li><a href="Condition-ra-condition05pat03.html">Condition/ra-condition05pat03</a></li><li><a href="Condition-ra-condition06pat03.html">Condition/ra-condition06pat03</a></li><li><a href="Condition-ra-condition07pat03.html">Condition/ra-condition07pat03</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-condition21pat03.html">Condition/ra-condition21pat03</a></li><li><a href="Condition-ra-condition22pat03.html">Condition/ra-condition22pat03</a></li><li><a href="Condition-ra-condition32pat03.html">Condition/ra-condition32pat03</a></li><li><a href="Condition-ra-condition35pat03.html">Condition/ra-condition35pat03</a></li><li><a href="Condition-ra-condition42pat03.html">Condition/ra-condition42pat03</a></li><li><a href="Encounter-ra-encounter01pat03.html">Encounter/ra-encounter01pat03</a></li><li><a href="Encounter-ra-encounter04pat03.html">Encounter/ra-encounter04pat03</a></li><li><a href="Encounter-ra-encounter05pat03.html">Encounter/ra-encounter05pat03</a></li><li><a href="Encounter-ra-encounter06pat03.html">Encounter/ra-encounter06pat03</a></li><li><a href="Encounter-ra-encounter07pat03.html">Encounter/ra-encounter07pat03</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-encounter19pat03.html">Encounter/ra-encounter19pat03</a></li><li><a href="Encounter-ra-encounter21pat03.html">Encounter/ra-encounter21pat03</a></li><li><a href="Encounter-ra-encounter22pat03.html">Encounter/ra-encounter22pat03</a></li><li><a href="Encounter-ra-encounter01pat03.html">Encounter/ra-encounter01pat03</a></li><li><a href="Encounter-ra-encounter35pat03.html">Encounter/ra-encounter35pat03</a></li><li><a href="Encounter-ra-encounter42pat03.html">Encounter/ra-encounter42pat03</a></li><li><a href="Observation-ra-obs01pat03.html">Observation/ra-obs01pat03</a></li><li><a href="Observation-ra-obs02pat03.html">Observation/ra-obs02pat03</a></li></ul></div>
  </text>
  <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="https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample02"/>
  <subject>
    <reference value="Patient/ra-patient03"/>
  </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-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="188"/>
        <display value="Artificial Openings for Feeding or Elimination"/>
      </coding>
      <text value="CMS-HCC 188: Artificial Openings for Feeding or Elimination"/>
    </code>
  </group>
  <group id="group-002">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="111"/>
        <display value="Chronic Obstructive Pulmonary Disease"/>
      </coding>
      <text value="CMS-HCC 111: Chronic Obstructive Pulmonary Disease"/>
    </code>
  </group>
  <group id="group-003">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="21"/>
        <display value="Protein-Calorie Malnutrition"/>
      </coding>
      <text value="CMS-HCC 21: Protein-Calorie Malnutrition"/>
    </code>
  </group>
  <group id="group-004">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="35"/>
        <display value="Inflammatory Bowel Disease"/>
      </coding>
      <text value="CMS-HCC 35: Inflammatory Bowel Disease"/>
    </code>
  </group>
  <group id="group-005">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="96"/>
        <display value="Specified Heart Arrhythmias"/>
      </coding>
      <text value="CMS-HCC 96: Specified Heart Arrhythmia"/>
    </code>
  </group>
  <group id="group-006">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="18"/>
        <display value="Diabetes with Chronic Complications"/>
      </coding>
      <text value="CMS-HCC 18: Diabetes with Chronic Complications"/>
    </code>
  </group>
  <group id="group-007">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="134"/>
        <display value="Dialysis Status"/>
      </coding>
      <text value="CMS-HCC 134: Dialysis Status"/>
    </code>
  </group>
  <group id="group-008">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="58"/>
        <display value="Major Depressive, Bipolar, and Paranoid Disorders"/>
      </coding>
      <text
            value="CMS-HCC 58: Major Depressive, Bipolar, and Paranoid Disorders"/>
    </code>
  </group>
  <group id="group-009">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="19"/>
        <display value="Diabetes without Complication"/>
      </coding>
      <text value="CMS-HCC 19: Diabetes without Complication"/>
    </code>
  </group>
  <group id="group-010">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="135"/>
        <display value="Acute Renal Failure"/>
      </coding>
      <text value="CMS-HCC 135: Acute Renal Failure"/>
    </code>
  </group>
  <group id="group-011">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="136"/>
        <display value="Chronic Kidney Disease, Stage 5"/>
      </coding>
      <text value="CMS-HCC 136: Chronic Kidney Disease, Stage 5"/>
    </code>
  </group>
  <group id="group-012">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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-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="21"/>
        <code value="107"/>
        <display value="Vascular Disease with Complications"/>
      </coding>
      <text value="CMS-HCC 107: Vascular Disease with Complications"/>
    </code>
  </group>
  <group id="group-013">
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
      <valueCodeableConcept>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-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="closed-gap"/>
        </coding>
      </valueCodeableConcept>
    </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="21"/>
        <code value="108"/>
        <display value="Vascular Disease"/>
      </coding>
      <text value="CMS-HCC 108: Vascular Disease"/>
    </code>
  </group>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-001"/>
    </extension>
    <reference value="Condition/ra-condition01pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-002"/>
    </extension>
    <reference value="Condition/ra-condition04pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-003"/>
    </extension>
    <reference value="Condition/ra-condition05pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-004"/>
    </extension>
    <reference value="Condition/ra-condition06pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-005"/>
    </extension>
    <reference value="Condition/ra-condition07pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-006"/>
    </extension>
    <reference value="Condition/ra-condition15pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-007"/>
    </extension>
    <reference value="Condition/ra-condition16pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-009"/>
    </extension>
    <reference value="Condition/ra-condition21pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-010"/>
    </extension>
    <reference value="Condition/ra-condition22pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-012"/>
    </extension>
    <reference value="Condition/ra-condition32pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-013"/>
    </extension>
    <reference value="Condition/ra-condition35pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-001"/>
    </extension>
    <reference value="Condition/ra-condition42pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-001"/>
    </extension>
    <reference value="Encounter/ra-encounter01pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-002"/>
    </extension>
    <reference value="Encounter/ra-encounter04pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-003"/>
    </extension>
    <reference value="Encounter/ra-encounter05pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-004"/>
    </extension>
    <reference value="Encounter/ra-encounter06pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-005"/>
    </extension>
    <reference value="Encounter/ra-encounter07pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-006"/>
    </extension>
    <reference value="Encounter/ra-encounter15pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-007"/>
    </extension>
    <reference value="Encounter/ra-encounter16pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-008"/>
    </extension>
    <reference value="Encounter/ra-encounter19pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-009"/>
    </extension>
    <reference value="Encounter/ra-encounter21pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-010"/>
    </extension>
    <reference value="Encounter/ra-encounter22pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-012"/>
    </extension>
    <reference value="Encounter/ra-encounter01pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-013"/>
    </extension>
    <reference value="Encounter/ra-encounter35pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-001"/>
    </extension>
    <reference value="Encounter/ra-encounter42pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-011"/>
    </extension>
    <reference value="Observation/ra-obs01pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-008"/>
    </extension>
    <reference value="Observation/ra-obs02pat03"/>
  </evaluatedResource>
</MeasureReport>