hccinfhir 0.0.3__py3-none-any.whl → 0.0.4__py3-none-any.whl

This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
Files changed (38) hide show
  1. hccinfhir/data/ra_coefficients_2025.csv +6352 -0
  2. hccinfhir/data/ra_dx_to_cc_2025.csv +53952 -0
  3. hccinfhir/data/ra_hierarchies_2025.csv +487 -0
  4. hccinfhir/datamodels.py +84 -0
  5. hccinfhir/extractor.py +3 -3
  6. hccinfhir/extractor_837.py +1 -2
  7. hccinfhir/extractor_fhir.py +1 -1
  8. hccinfhir/filter.py +1 -1
  9. hccinfhir/hccinfhir.py +142 -0
  10. hccinfhir/model_calculate.py +50 -0
  11. hccinfhir/model_coefficients.py +143 -0
  12. hccinfhir/model_demographics.py +191 -0
  13. hccinfhir/model_dx_to_cc.py +70 -0
  14. hccinfhir/model_hierarchies.py +70 -0
  15. hccinfhir/model_interactions.py +342 -0
  16. hccinfhir/samples/__init__.py +2 -0
  17. {hccinfhir-0.0.3.dist-info → hccinfhir-0.0.4.dist-info}/METADATA +65 -7
  18. hccinfhir-0.0.4.dist-info/RECORD +39 -0
  19. hccinfhir/models.py +0 -44
  20. hccinfhir-0.0.3.dist-info/RECORD +0 -28
  21. /hccinfhir/{data → samples}/sample_837_0.txt +0 -0
  22. /hccinfhir/{data → samples}/sample_837_1.txt +0 -0
  23. /hccinfhir/{data → samples}/sample_837_10.txt +0 -0
  24. /hccinfhir/{data → samples}/sample_837_11.txt +0 -0
  25. /hccinfhir/{data → samples}/sample_837_2.txt +0 -0
  26. /hccinfhir/{data → samples}/sample_837_3.txt +0 -0
  27. /hccinfhir/{data → samples}/sample_837_4.txt +0 -0
  28. /hccinfhir/{data → samples}/sample_837_5.txt +0 -0
  29. /hccinfhir/{data → samples}/sample_837_6.txt +0 -0
  30. /hccinfhir/{data → samples}/sample_837_7.txt +0 -0
  31. /hccinfhir/{data → samples}/sample_837_8.txt +0 -0
  32. /hccinfhir/{data → samples}/sample_837_9.txt +0 -0
  33. /hccinfhir/{data → samples}/sample_eob_1.json +0 -0
  34. /hccinfhir/{data → samples}/sample_eob_2.json +0 -0
  35. /hccinfhir/{data → samples}/sample_eob_200.ndjson +0 -0
  36. /hccinfhir/{data → samples}/sample_eob_3.json +0 -0
  37. {hccinfhir-0.0.3.dist-info → hccinfhir-0.0.4.dist-info}/WHEEL +0 -0
  38. {hccinfhir-0.0.3.dist-info → hccinfhir-0.0.4.dist-info}/licenses/LICENSE +0 -0
hccinfhir/data/ra_hierarchies_2025.csv ADDED
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hccinfhir/datamodels.py ADDED
@@ -0,0 +1,84 @@
1
+ from pydantic import BaseModel, Field
2
+ from typing import List, Optional, Literal, Dict, Any, TypedDict
3
+
4
+ # Define Model Name literal type
5
+ ModelName = Literal[
6
+ "CMS-HCC Model V22",
7
+ "CMS-HCC Model V24",
8
+ "CMS-HCC Model V28",
9
+ "CMS-HCC ESRD Model V21",
10
+ "CMS-HCC ESRD Model V24",
11
+ "RxHCC Model V08"
12
+ ]
13
+ class ServiceLevelData(BaseModel):
14
+ """
15
+ Represents standardized service-level data extracted from healthcare claims.
16
+
17
+ Attributes:
18
+ claim_id: Unique identifier for the claim
19
+ procedure_code: Healthcare Common Procedure Coding System (HCPCS) code
20
+ ndc: National Drug Code
21
+ linked_diagnosis_codes: ICD-10 diagnosis codes linked to this service
22
+ claim_diagnosis_codes: All diagnosis codes on the claim
23
+ claim_type: Type of claim (e.g., NCH Claim Type Code, or 837I, 837P)
24
+ provider_specialty: Provider taxonomy or specialty code
25
+ performing_provider_npi: National Provider Identifier for performing provider
26
+ billing_provider_npi: National Provider Identifier for billing provider
27
+ patient_id: Unique identifier for the patient
28
+ facility_type: Type of facility where service was rendered
29
+ service_type: Type of service provided (facility type + service type = Type of Bill)
30
+ service_date: Date service was performed (YYYY-MM-DD)
31
+ place_of_service: Place of service code
32
+ quantity: Number of units provided
33
+ quantity_unit: Unit of measure for quantity
34
+ modifiers: List of procedure code modifiers
35
+ allowed_amount: Allowed amount for the service
36
+ """
37
+ claim_id: Optional[str] = None
38
+ procedure_code: Optional[str] = None
39
+ ndc: Optional[str] = None
40
+ linked_diagnosis_codes: List[str] = []
41
+ claim_diagnosis_codes: List[str] = []
42
+ claim_type: Optional[str] = None
43
+ provider_specialty: Optional[str] = None
44
+ performing_provider_npi: Optional[str] = None
45
+ billing_provider_npi: Optional[str] = None
46
+ patient_id: Optional[str] = None
47
+ facility_type: Optional[str] = None
48
+ service_type: Optional[str] = None
49
+ service_date: Optional[str] = None
50
+ place_of_service: Optional[str] = None
51
+ quantity: Optional[float] = None
52
+ modifiers: List[str] = []
53
+ allowed_amount: Optional[float] = None
54
+
55
+ class Demographics(BaseModel):
56
+ """
57
+ Response model for demographic categorization
58
+ """
59
+ age: int = Field(..., description="Beneficiary age")
60
+ sex: Literal['M', 'F', '1', '2'] = Field(..., description="Beneficiary sex")
61
+ dual_elgbl_cd: Literal[None, 'NA', '99', '00', '01', '02', '03', '04', '05', '06', '07', '08', '09', '10'] = Field('NA', description="Dual status code")
62
+ orec: Literal[None, '0', '1', '2', '3'] = Field('0', description="Original reason for entitlement")
63
+ crec: Literal[None, '0', '1', '2', '3'] = Field('0', description="Current reason for entitlement")
64
+ new_enrollee: bool = Field(False, description="True if beneficiary is a new enrollee")
65
+ snp: bool = Field(False, description="True if beneficiary is in SNP")
66
+ version: str = Field("V2", description="Version of categorization used (V2, V4, V6)")
67
+ low_income: bool = Field(False, description="True if beneficiary is in low income; RxHCC only")
68
+ graft_months: Optional[int] = Field(None, description="Number of months since transplant; ESRD Model only")
69
+ category: str = Field(..., description="[derived] Age-sex category code")
70
+ non_aged: bool = Field(False, description="[derived] True if age <= 64")
71
+ orig_disabled: bool = Field(False, description="[derived] True if originally disabled (OREC='1' and not currently disabled)")
72
+ disabled: bool = Field(False, description="[derived] True if currently disabled (age < 65 and OREC != '0')")
73
+ esrd: bool = Field(False, description="[derived] True if ESRD (ESRD Model)")
74
+ lti: bool = Field(False, description="[derived] True if LTI (LTI Model)")
75
+ fbd: bool = Field(False, description="[derived] True if FBD (FBD Model)")
76
+ pbd: bool = Field(False, description="[derived] True if PBD (PBD Model)")
77
+
78
+
79
+ class RAFResult(TypedDict):
80
+ """Type definition for RAF calculation results"""
81
+ risk_score: float
82
+ hcc_list: List[str]
83
+ details: Dict[str, Any]
84
+ service_level_data: List[ServiceLevelData]
hccinfhir/extractor.py CHANGED
@@ -1,7 +1,7 @@
1
1
  from typing import Union, List, Literal
2
- from .models import ServiceLevelData
3
- from .extractor_837 import extract_sld_837
4
- from .extractor_fhir import extract_sld_fhir
2
+ from hccinfhir.datamodels import ServiceLevelData
3
+ from hccinfhir.extractor_837 import extract_sld_837
4
+ from hccinfhir.extractor_fhir import extract_sld_fhir
5
5
 
6
6
  def extract_sld(
7
7
  data: Union[str, dict],
hccinfhir/extractor_837.py CHANGED
@@ -1,7 +1,6 @@
1
1
  from typing import List, Optional, Dict
2
2
  from pydantic import BaseModel
3
- from datetime import date
4
- from .models import ServiceLevelData
3
+ from hccinfhir.datamodels import ServiceLevelData
5
4
 
6
5
  CLAIM_TYPES = {
7
6
  "005010X222A1": "837P", # Professional
hccinfhir/extractor_fhir.py CHANGED
@@ -1,7 +1,7 @@
1
1
  from pydantic import BaseModel, ConfigDict, Field, AliasChoices
2
2
  from typing import List, Optional, Literal, Dict
3
3
  from datetime import date
4
- from .models import ServiceLevelData
4
+ from hccinfhir.datamodels import ServiceLevelData
5
5
 
6
6
  SYSTEMS = {
7
7
  'diagnosis': {
hccinfhir/filter.py CHANGED
@@ -1,5 +1,5 @@
1
1
  from typing import List, Set
2
- from .models import ServiceLevelData
2
+ from hccinfhir.datamodels import ServiceLevelData
3
3
  import importlib.resources
4
4
 
5
5
  # use import importlib.resources to load the professional_cpt_fn file as a list of strings