diff --git a/client/src/components/c4dic.tsx b/client/src/components/c4dic.tsx index 520b057..0a8e4a3 100644 --- a/client/src/components/c4dic.tsx +++ b/client/src/components/c4dic.tsx @@ -22,6 +22,7 @@ export type CoverageInfo = { status: string, medicaidEligibility: string, referenceYear: string, + entitlementReason: string, colorPalette: { foreground: string, background: string, @@ -65,6 +66,7 @@ export default function InsuranceCard() { status: c.active, medicaidEligibility: c.medicaidEligibility, referenceYear: c.referenceYear, + entitlementReason: c.entitlementReason, colorPalette: { foreground: c.colorPalette.foreground, background: c.colorPalette.background, @@ -170,7 +172,7 @@ export default function InsuranceCard() { {insInfo?.coverages.map(c => { const startDateDiv = (c.startDate !== null && c.startDate !== "") ? ( -
+
Start Date
{c.startDate} @@ -180,7 +182,7 @@ export default function InsuranceCard() { case "Part A": return (
-
+
Coverage
Hospital
{c.coverageClass} @@ -189,14 +191,14 @@ export default function InsuranceCard() {
Entitlement Reason
- {c.contractId} + {c.entitlementReason}
) case "Part B": return (
-
+
Coverage
Medical
{c.coverageClass} @@ -205,37 +207,25 @@ export default function InsuranceCard() {
) case "Part C": - const partCTypeDiv = (c.coverageClass != null) ? - ( -
- Type -
- {c.coverageClass} -
- ) : null + return (
-
+
Coverage
- Advantage
{c.coverageClass} - {partCTypeDiv} + {c.coverageClass}
Plan #
{c.contractId} -
- Organization -
- {c.payer}
) case "Part D": return (
-
+
Coverage
Rx
{c.coverageClass} diff --git a/client/src/components/patientData.tsx b/client/src/components/patientData.tsx index e290d12..a5f857e 100644 --- a/client/src/components/patientData.tsx +++ b/client/src/components/patientData.tsx @@ -7,14 +7,20 @@ import React, { useState } from 'react'; export default function PatientData() { const [header] = useState('Fetch your Coverage and Medicare Prescription Drug data'); const [settingsState] = useState({ - pkce: true, - version: 'v2', - env: 'sandbox' + useDefaultDataButton: false, }); async function goAuthorize() { - const authUrlResponse = await axios.get(`/api/authorize/authurl`, { params: settingsState }); + const authUrlResponse = await axios.get(`/api/authorize/authurl`); window.location.href = authUrlResponse.data || '/'; } + async function goLoadDefaults() { + const loadDefaultsData = await axios.get(`/api/bluebutton/loadDefaults`); + window.location.href = loadDefaultsData.data || '/'; + } + async function goLoadDefaults2() { + const loadDefaultsData = await axios.get(`/api/bluebutton/loadDefaults2`); + window.location.href = loadDefaultsData.data || '/'; + } /* DEVELOPER NOTES: * Here we are hard coding the users information for the sake of saving time @@ -34,7 +40,21 @@ export default function PatientData() {

{ header }

- +
+ +
+ { + settingsState.useDefaultDataButton ? +
+
+ +
+
+ +
+
: + null + }
); diff --git a/client/src/styles/index.scss b/client/src/styles/index.scss index 2453e24..4c29016 100644 --- a/client/src/styles/index.scss +++ b/client/src/styles/index.scss @@ -205,29 +205,37 @@ input[type=number]::-webkit-input-placeholder { } .bb-c-c4dic-coverage-a { - display: grid; - grid-template-columns: 1fr 1fr 2fr; - padding: 10px; + display: flex; + padding: 8px; + align-items: flex-start; + gap: 24px; + align-self: stretch; } .bb-c-c4dic-coverage-b { - display: grid; - grid-template-columns: 1fr 1fr 2fr; - padding: 10px; + display: flex; + padding: 8px; + align-items: flex-start; + gap: 24px; + align-self: stretch; border-top: 0.5px solid } .bb-c-c4dic-coverage-c { - display: grid; - grid-template-columns: 1fr 3fr; - padding: 10px; + display: flex; + padding: 8px; + align-items: flex-start; + gap: 24px; + align-self: stretch; border-top: 0.5px solid } .bb-c-c4dic-coverage-d { - display: grid; - grid-template-columns: 1fr 1fr 2fr; - padding: 10px; + display: flex; + padding: 8px; + align-items: flex-start; + gap: 24px; + align-self: stretch; border-top: 0.5px solid } diff --git a/client/src/types/settings.ts b/client/src/types/settings.ts index a925883..1f261b3 100644 --- a/client/src/types/settings.ts +++ b/client/src/types/settings.ts @@ -1,5 +1,3 @@ export type SettingsType = { - env: 'sandbox' | 'local' | 'production', - version: 'v1' | 'v2', - pkce: boolean, + useDefaultDataButton: boolean, } \ No newline at end of file diff --git a/server/app.py b/server/app.py index 35f4a79..2ea8237 100644 --- a/server/app.py +++ b/server/app.py @@ -14,8 +14,7 @@ C4DIC_LOGO_EXT = "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension" C4DIC_ADDL_CARD_INFO_EXT = "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension" -CMS_VAR_PTC_CNTRCT_ID_01 = "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_01" -CMS_VAR_PTD_CNTRCT_ID_01 = "https://bluebutton.cms.gov/resources/variables/ptdcntrct01" +CMS_VAR_CREC = "https://bluebutton.cms.gov/resources/variables/crec" CMS_VAR_REF_YR="https://bluebutton.cms.gov/resources/variables/rfrnc_yr" BENE_DENIED_ACCESS = "access_denied" @@ -168,6 +167,29 @@ def get_patient_eob(): else: return {} + +@app.route('/api/bluebutton/loadDefaults', methods=['GET']) +def load_default_data(): + logged_in_user['dicPatientData'] = load_data_file("Dataset 1", "c4dicPatient") + logged_in_user['dicCoverageData'] = load_data_file("Dataset 1", "c4dicCoverage") + logged_in_user['eobData'] = load_data_file("Dataset 1", "eobData") + return get_fe_redirect_url() + + +@app.route('/api/bluebutton/loadDefaults2', methods=['GET']) +def load_default_data2(): + logged_in_user['dicPatientData'] = load_data_file("Dataset 2", "c4dicPatient") + logged_in_user['dicCoverageData'] = load_data_file("Dataset 2", "c4dicCoverage") + logged_in_user['eobData'] = load_data_file("Dataset 2", "eobData") + return get_fe_redirect_url() + + +def load_data_file(dataset_name, resource_file_name): + response_file = open("./default_datasets/{}/{}.json".format(dataset_name, resource_file_name), 'r') + resource = json.load(response_file) + response_file.close() + return resource + @app.route('/api/data/insurance', methods=['GET']) def get_patient_insurance(): """ @@ -178,7 +200,6 @@ def get_patient_insurance(): * Coverage (fetched from the BB2 server and cached in logged_in_user), and * sent back to FE to render a CMS insurance 'card' """ - print_setting() ## C4DIC patient and coverage where to extract PII and coverage plans & eligibilities @@ -265,13 +286,13 @@ def get_patient_insurance(): c_contract_id = "" ## Part A and Part B does not have contract number if c_coverageClass == "Part C": c_contract_id = lookup_1_and_get("$.resource.class[?(@.type.coding[0].code=='plan')]", "value", c) - # c_contract_id = lookup_1_and_get(f"$.resource.extension[?(@.url=='{CMS_VAR_PTC_CNTRCT_ID_01}')]", "valueCoding", c).get('code') if c_coverageClass == "Part D": c_contract_id = lookup_1_and_get("$.resource.class[?(@.type.coding[0].code=='plan')]", "value", c) - # c_contract_id = lookup_1_and_get(f"$.resource.extension[?(@.url=='{CMS_VAR_PTD_CNTRCT_ID_01}')]", "valueCoding", c).get('code') coverage['contractId'] = c_contract_id c_reference_year = lookup_1_and_get(f"$.resource.extension[?(@.url=='{CMS_VAR_REF_YR}')]", "valueDate", c) coverage['referenceYear'] = c_reference_year + c_entitlement_reason = lookup_1_and_get(f"$.resource.extension[?(@.url=='{CMS_VAR_CREC}')]", "valueCoding", c).get('display') + coverage['entitlementReason'] = c_entitlement_reason # color palettes extension c_color_palette_ext = lookup_by_path(f"$.resource.extension[?(@.url=='{C4DIC_COLOR_PALETTE_EXT}')]", c) if c_color_palette_ext[0]: diff --git a/server/default_datasets/Dataset 1/c4dicCoverage.json b/server/default_datasets/Dataset 1/c4dicCoverage.json new file mode 100644 index 0000000..86efe19 --- /dev/null +++ b/server/default_datasets/Dataset 1/c4dicCoverage.json @@ -0,0 +1,1821 @@ +{ + "resourceType": "Bundle", + "id": "d0e5a190-e93a-4d27-b1e7-890561c599f4", + "meta": { + "lastUpdated": "2024-12-04T12:02:49.539+00:00" + }, + "type": "searchset", + "total": 4, + "link": [ + { + "relation": "first", + "url": "http://localhost:8000/v2/fhir/Coverage?_format=application%2Fjson%2Bfhir&startIndex=0&_count=10&beneficiary=Patient%2F-88888888888888&_profile=http%3A%2F%2Fhl7.org%2Ffhir%2Fus%2Finsurance-card%2FStructureDefinition%2FC4DIC-Coverage" + }, + { + "relation": "last", + "url": "http://localhost:8000/v2/fhir/Coverage?_format=application%2Fjson%2Bfhir&startIndex=0&_count=10&beneficiary=Patient%2F-88888888888888&_profile=http%3A%2F%2Fhl7.org%2Ffhir%2Fus%2Finsurance-card%2FStructureDefinition%2FC4DIC-Coverage" + }, + { + "relation": "self", + "url": "http://localhost:8000/v2/fhir/Coverage/?_count=10&_format=application%2Fjson%2Bfhir&_profile=http%3A%2F%2Fhl7.org%2Ffhir%2Fus%2Finsurance-card%2FStructureDefinition%2FC4DIC-Coverage&beneficiary=Patient%2F-88888888888888&startIndex=0" + } + ], + "entry": [ + { + "resource": { + "resourceType": "Coverage", + "id": "c4dic-part-a--88888888888888", + "meta": { + "lastUpdated": "2021-05-05T05:52:30.869+00:00", + "profile": [ + "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage|1.1" + ] + }, + "contained": [ + { + "resourceType": "Organization", + "id": "provider-org", + "meta": { + "profile": [ + "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Organization|1.1" + ] + }, + "active": true, + "name": "Centers for Medicare and Medicaid Services", + "contact": [ + { + "purpose": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/contactentity-type", + "code": "PAYOR", + "display": "Payor" + } + ] + }, + "telecom": [ + { + "system": "phone", + "value": "1-800-MEDICARE\n(1-800-633-4227)" + }, + { + "system": "phone", + "value": "TTY: 1-877-486-2048" + }, + { + "system": "url", + "value": "www.medicare.gov" + } + ] + } + ] + } + ], + "extension": [ + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension", + "extension": [ + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ForegroundColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#F4FEFF" + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#092E86" + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#335097" + } + } + ] + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension", + "valueAnnotation": { + "text": "You may be asked to show this card when you get health care services. Only give your personal Medicare information to health care providers, or people you trust who work with Medicare on your behalf. WARNING: Intentionally misusing this card may be considered fraud and/or other violation of federal law and is punishable by law.\n\nEs posible que le pidan que muestre esta tarjeta cuando reciba servicios de cuidado médico. Solamente dé su información personal de Medicare a los proveedores de salud, sus aseguradores o personas de su confianza que trabajan con Medicare en su nombre. ¡ADVERTENCIA! El mal uso intencional de esta tarjeta puede ser considerado como fraude y/u otra violación de la ley federal y es sancionada por la ley." + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension", + "valueString": "https://www.hhs.gov/sites/default/files/logo-white-lg.png" + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "code": "10", + "display": "Aged without end-stage renal disease (ESRD)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/orec", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/orec", + "code": "0", + "display": "Old age and survivor’s insurance (OASI)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/crec", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/crec", + "code": "0", + "display": "Old age and survivor’s insurance (OASI)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/esrd_ind", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/esrd_ind", + "code": "0", + "display": "the beneficiary does not have ESRD" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/a_trm_cd", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/a_trm_cd", + "code": "0", + "display": "Not Terminated" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/rfrnc_yr", + "valueDate": "2020" + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/dual_12", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/dual_12", + "code": "AA" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin01", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin01", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin02", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin02", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin03", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin03", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin04", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin04", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin05", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin05", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin06", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin06", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin07", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin07", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin08", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin08", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin09", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin09", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin10", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin10", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin11", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin11", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin12", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin12", + "code": "C", + "display": "Part A and Part B state buy-in" + } + } + ], + "identifier": [ + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v2-0203", + "code": "MB", + "display": "Member Number" + } + ] + }, + "system": "http://hl7.org/fhir/sid/us-mbi", + "value": "1S00ABBAA00", + "assigner": { + "reference": "#provider-org" + } + } + ], + "status": "active", + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode", + "code": "SUBSIDIZ" + } + ] + }, + "subscriber": { + "reference": "Patient/-88888888888888" + }, + "subscriberId": "1S00ABBAA00", + "beneficiary": { + "reference": "Patient/-88888888888888" + }, + "relationship": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship", + "code": "self", + "display": "Self" + } + ] + }, + "payor": [ + { + "reference": "#provider-org" + } + ], + "class": [ + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/coverage-class", + "code": "group", + "display": "Group" + } + ] + }, + "value": "Medicare" + }, + { + "type": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/coverage-class", + "code": "plan", + "display": "Plan" + } + ] + }, + "value": "Part A" + } + ] + } + }, + { + "resource": { + "resourceType": "Coverage", + "id": "c4dic-part-b--88888888888888", + "meta": { + "lastUpdated": "2021-05-05T05:52:30.869+00:00", + "profile": [ + "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage|1.1" + ] + }, + "contained": [ + { + "resourceType": "Organization", + "id": "provider-org", + "meta": { + "profile": [ + "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Organization|1.1" + ] + }, + "active": true, + "name": "Centers for Medicare and Medicaid Services", + "contact": [ + { + "purpose": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/contactentity-type", + "code": "PAYOR", + "display": "Payor" + } + ] + }, + "telecom": [ + { + "system": "phone", + "value": "1-800-MEDICARE\n(1-800-633-4227)" + }, + { + "system": "phone", + "value": "TTY: 1-877-486-2048" + }, + { + "system": "url", + "value": "www.medicare.gov" + } + ] + } + ] + } + ], + "extension": [ + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ColorPalette-extension", + "extension": [ + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-ForegroundColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#F4FEFF" + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-BackgroundColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#092E86" + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-HighlightColor-extension", + "valueCoding": { + "system": "http://terminology.hl7.org/CodeSystem/IECColourManagement", + "code": "#335097" + } + } + ] + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-AdditionalCardInformation-extension", + "valueAnnotation": { + "text": "You may be asked to show this card when you get health care services. Only give your personal Medicare information to health care providers, or people you trust who work with Medicare on your behalf. WARNING: Intentionally misusing this card may be considered fraud and/or other violation of federal law and is punishable by law.\n\nEs posible que le pidan que muestre esta tarjeta cuando reciba servicios de cuidado médico. Solamente dé su información personal de Medicare a los proveedores de salud, sus aseguradores o personas de su confianza que trabajan con Medicare en su nombre. ¡ADVERTENCIA! El mal uso intencional de esta tarjeta puede ser considerado como fraude y/u otra violación de la ley federal y es sancionada por la ley." + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension", + "valueString": "https://www.hhs.gov/sites/default/files/logo-white-lg.png" + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "code": "10", + "display": "Aged without end-stage renal disease (ESRD)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/b_trm_cd", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/b_trm_cd", + "code": "0", + "display": "Not Terminated" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/rfrnc_yr", + "valueDate": "2020" + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/crec", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/crec", + "code": "0", + "display": "Old age and survivor’s insurance (OASI)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/dual_12", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/dual_12", + "code": "AA" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin01", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin01", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin02", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin02", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin03", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin03", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin04", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin04", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin05", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin05", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin06", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin06", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin07", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/buyin07", + "code": "C", + "display": "Part A and Part B state buy-in" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/buyin08", + 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El mal uso intencional de esta tarjeta puede ser considerado como fraude y/u otra violación de la ley federal y es sancionada por la ley." + } + }, + { + "url": "http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Logo-extension", + "valueString": "https://www.hhs.gov/sites/default/files/logo-white-lg.png" + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/ms_cd", + "code": "10", + "display": "Aged without end-stage renal disease (ESRD)" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/ptdcntrct01", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/ptdcntrct01", + "code": "Z0000" + } + }, + { + "url": "https://bluebutton.cms.gov/resources/variables/ptdcntrct02", + "valueCoding": { + "system": "https://bluebutton.cms.gov/resources/variables/ptdcntrct02", + "code": "Z0000" + } + }, + { + "url": 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"system": "https://bluebutton.cms.gov/resources/variables/line_prcsg_ind_cd", + "code": "A", + "display": "Allowed" + } + } + ], + "sequence": 6, + "careTeamSequence": [ + 2 + ], + "diagnosisSequence": [ + 1 + ], + "informationSequence": [ + 7 + ], + "category": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/variables/line_cms_type_srvc_cd", + "code": "P", + "display": "Lump sum purchase of DME, prosthetics orthotics" + } + ] + }, + "productOrService": { + "extension": [ + { + "url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason", + "valueCoding": { + "system": "http://hl7.org/fhir/StructureDefinition/data-absent-reason", + "code": "NULL", + "display": "Data Absent Reason" + } + } + ], + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/hcpcs", + "code": "A7035" + } + ] + }, + "servicedPeriod": { + "start": "2021-02-07", + "end": "2021-02-07" + }, + "locationCodeableConcept": { + "extension": [ + { + "url": 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}, + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_alowd_chrg_amt", + "display": "Line Allowed Charge Amount" + } + ] + }, + "amount": { + "value": 0.0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", + "code": "paidtoprovider", + "display": "Paid to provider" + }, + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_bene_pmt_amt", + "display": "Line Payment Amount to Beneficiary" + } + ] + }, + "amount": { + "value": 0.0, + "currency": "USD" + } + }, + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/adjudication", + "code": "submitted", + "display": "Submitted Amount" + }, + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/line_dme_prchs_price_amt", + "display": "Line DME Purchase Price Amount" + } + ] + }, + "amount": { + "value": 0.0, + "currency": "USD" + } + } + ] + } + ], + "total": [ + { + "category": { + "coding": [ + { + "system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudication", + "code": "priorpayerpaid", + "display": "Prior payer paid" + }, + { + "system": "https://bluebutton.cms.gov/resources/codesystem/adjudication", + "code": "https://bluebutton.cms.gov/resources/variables/clm_tot_chrg_amt", + "display": "Claim Total Charge Amount" + } + ] + }, + "amount": { + "value": 7.52, + "currency": "USD" + } + } + ], + "payment": { + "amount": { + "value": 7.52, + "currency": "USD" + } + }, + "benefitBalance": [ + { + "category": { + "coding": [ + { + "system": "http://terminology.hl7.org/CodeSystem/ex-benefitcategory", + "code": "1", + "display": "Medical Care" + } + ] + }, + "financial": [ + { + "type": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/benefit-balance", + "code": "https://bluebutton.cms.gov/resources/variables/carr_clm_cash_ddctbl_apld_amt", + "display": "Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)" + } + ] + }, + "usedMoney": { + "value": 0.0, + "currency": "USD" + } + }, + { + "type": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/benefit-balance", + "code": "https://bluebutton.cms.gov/resources/variables/nch_clm_prvdr_pmt_amt", + "display": "NCH Claim Provider Payment Amount" + } + ] + }, + "usedMoney": { + "value": 7.52, + "currency": "USD" + } + }, + { + "type": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/benefit-balance", + "code": "https://bluebutton.cms.gov/resources/variables/nch_clm_bene_pmt_amt", + "display": "NCH Claim Payment Amount to Beneficiary" + } + ] + }, + "usedMoney": { + "value": 0.0, + "currency": "USD" + } + }, + { + "type": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/benefit-balance", + "code": "https://bluebutton.cms.gov/resources/variables/nch_carr_clm_sbmtd_chrg_amt", + "display": "NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)" + } + ] + }, + "usedMoney": { + "value": 9.4, + "currency": "USD" + } + }, + { + "type": { + "coding": [ + { + "system": "https://bluebutton.cms.gov/resources/codesystem/benefit-balance", + "code": "https://bluebutton.cms.gov/resources/variables/nch_carr_clm_alowd_amt", + "display": "NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)" + } + ] + }, + "usedMoney": { + "value": 7.52, + "currency": "USD" + } + } + ] + } + ] + } + } + ] +} \ No newline at end of file