HL7.FHIR.US.DAVINCI-RA\ra-measurereport05: Risk Adjustment Measure Report for RxHCC V5 for Patient03 - XML Representation

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

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<MeasureReport xmlns="http://hl7.org/fhir">
  <id value="ra-measurereport05"/>
  <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-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="Measure-RAModelExample03.html">Risk Adjustment Model Version 5 - CMS Prescribing Drug 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>: 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"> (CMS Prescription Drug Hierarchical Condition Categories[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"> (CMS Prescription Drug Hierarchical Condition Categories[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"> (CMS Prescription Drug Hierarchical Condition Categories[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"> (CMS Prescription Drug Hierarchical Condition Categories[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"> (CMS Prescription Drug Hierarchical Condition Categories[5]#262 "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>: 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 216: Peripheral Vascular Disease <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Prescription Drug Hierarchical Condition Categories[5]#216 "Peripheral Vascular Disease")</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-encounter21pat03.html">Encounter/ra-encounter21pat03</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="Observation-ra-obs01pat03.html">Observation/ra-obs01pat03</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-RAModelExample03"/>
  <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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="226"/>
        <display value="Chronic Obstructive Pulmonary Disease and Asthma"/>
      </coding>
      <text
            value="CMS-RxHCC 226: Chronic Obstructive Pulmonary Disease and Asthma"/>
    </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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="31"/>
        <display value="Diabetes without Complication"/>
      </coding>
      <text value="CMS-RxHCC 31: Diabetes without Complication"/>
    </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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="30"/>
        <display value="Diabetes with Complications"/>
      </coding>
      <text value="CMS-RxHCC 30: Diabetes with Complications"/>
    </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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="261"/>
        <display value="Dialysis Status"/>
      </coding>
      <text value="CMS-RxHCC 261: Dialysis Status"/>
    </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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="262"/>
        <display value="Chronic Kidney Disease Stage 5"/>
      </coding>
      <text value="CMS-RxHCC 262: Chronic Kidney Disease Stage 5"/>
    </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="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="not-applied"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <code>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/cmsrxhcc"/>
        <version value="5"/>
        <code value="216"/>
        <display value="Peripheral Vascular Disease"/>
      </coding>
      <text value="CMS-RxHCC 216: Peripheral 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-condition04pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-002"/>
    </extension>
    <reference value="Condition/ra-condition21pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-003"/>
    </extension>
    <reference value="Condition/ra-condition15pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-004"/>
    </extension>
    <reference value="Condition/ra-condition16pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-006"/>
    </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="Encounter/ra-encounter04pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-002"/>
    </extension>
    <reference value="Encounter/ra-encounter21pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-003"/>
    </extension>
    <reference value="Encounter/ra-encounter15pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-004"/>
    </extension>
    <reference value="Encounter/ra-encounter16pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-006"/>
    </extension>
    <reference value="Encounter/ra-encounter35pat03"/>
  </evaluatedResource>
  <evaluatedResource>
    <extension
               url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
      <valueString value="group-005"/>
    </extension>
    <reference value="Observation/ra-obs01pat03"/>
  </evaluatedResource>
</MeasureReport>