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

hccinfhir/model_interactions.py

@@ -0,0 +1,342 @@
+from hccinfhir.datamodels import Demographics, ModelName
+from typing import Optional
+
+def has_any_hcc(hcc_list: list[str], hcc_set: set[str]) -> int:
+    """Returns 1 if any HCC in the list is present, 0 otherwise"""
+    return int(bool(set(hcc_list) & hcc_set))
+
+def create_demographic_interactions(demographics: Demographics) -> dict:
+    """Creates common demographic-based interactions"""
+    interactions = {}
+    is_female = demographics.category.startswith('F')
+    is_male = demographics.category.startswith('M')
+    is_aged = not demographics.non_aged
+    
+    # Original Disability interactions
+    if is_aged:
+        interactions['OriginallyDisabled_Female'] = int(demographics.orig_disabled) * int(is_female)
+        interactions['OriginallyDisabled_Male'] = int(demographics.orig_disabled) * int(is_male)
+    else:
+        interactions['OriginallyDisabled_Female'] = 0
+        interactions['OriginallyDisabled_Male'] = 0
+
+    # LTI interactions - used for ESRD models
+    if demographics.lti:
+        interactions['LTI_Aged'] = int(is_aged)
+        interactions['LTI_NonAged'] = int(not is_aged)
+    else:
+        interactions['LTI_Aged'] = 0
+        interactions['LTI_NonAged'] = 0
+        
+    nemcaid = False
+    if demographics.new_enrollee and demographics.dual_elgbl_cd in {'01', '02', '03', '04', '05', '06', '08'}:
+        nemcaid = True
+    ne_origds = int(demographics.age >= 65 and (demographics.orec is not None and demographics.orec == "1"))
+    
+    # Four mutually exclusive groups
+    interactions.update({
+        f'NMCAID_NORIGDIS_{demographics.category}': int(not nemcaid and not ne_origds),
+        f'MCAID_NORIGDIS_{demographics.category}': int(nemcaid and not ne_origds),
+        f'NMCAID_ORIGDIS_{demographics.category}': int(not nemcaid and ne_origds),
+        f'MCAID_ORIGDIS_{demographics.category}': int(nemcaid and ne_origds)
+    })
+
+    return interactions
+
+def create_dual_interactions(demographics: Demographics) -> dict:
+    """Creates dual status interactions"""
+    interactions = {}
+    is_female = demographics.category.startswith('F')
+    is_male = demographics.category.startswith('M')
+    is_aged = not demographics.non_aged
+    
+    if demographics.fbd:
+        interactions.update({
+            'FBDual_Female_Aged': int(is_female) * int(is_aged),
+            'FBDual_Female_NonAged': int(is_female) * int(not is_aged),
+            'FBDual_Male_Aged': int(is_male) * int(is_aged),
+            'FBDual_Male_NonAged': int(is_male) * int(not is_aged)
+        })
+    
+    if demographics.pbd:
+        interactions.update({
+            'PBDual_Female_Aged': int(is_female) * int(is_aged),
+            'PBDual_Female_NonAged': int(is_female) * int(not is_aged),
+            'PBDual_Male_Aged': int(is_male) * int(is_aged),
+            'PBDual_Male_NonAged': int(is_male) * int(not is_aged)
+        })
+        
+    return interactions
+
+def create_hcc_counts(hcc_set: set[str]) -> dict:
+    """Creates HCC count variables"""
+    counts = {}
+    hcc_count = len(hcc_set)
+    
+    for i in range(1, 10):
+        counts[f'D{i}'] = int(hcc_count == i)
+    counts['D10P'] = int(hcc_count >= 10)
+    
+    return counts
+
+def get_diagnostic_categories(model_name: ModelName, hcc_set: set[str]) -> dict:
+    """Creates disease categories based on model version"""
+    if model_name == "CMS-HCC Model V28":
+        return {
+            'CANCER_V28': has_any_hcc(['17', '18', '19', '20', '21', '22', '23'], hcc_set),
+            'DIABETES_V28': has_any_hcc(['35', '36', '37', '38'], hcc_set),
+            'CARD_RESP_FAIL_V28': has_any_hcc(['211', '212', '213'], hcc_set),
+            'HF_V28': has_any_hcc(['221', '222', '223', '224', '225', '226'], hcc_set),
+            'CHR_LUNG_V28': has_any_hcc(['276', '277', '278', '279', '280'], hcc_set),
+            'KIDNEY_V28': has_any_hcc(['326', '327', '328', '329'], hcc_set),
+            'SEPSIS_V28': int('2' in hcc_set),
+            'gSubUseDisorder_V28': has_any_hcc(['135', '136', '137', '138', '139'], hcc_set),
+            'gPsychiatric_V28': has_any_hcc(['151', '152', '153', '154', '155'], hcc_set),
+            'NEURO_V28': has_any_hcc(['180', '181', '182', '190', '191', '192', '195', '196', '198', '199'], hcc_set),
+            'ULCER_V28': has_any_hcc(['379', '380', '381', '382'], hcc_set)
+        }
+    elif model_name == "CMS-HCC Model V24":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL_V24': has_any_hcc(['134', '135', '136', '137', '138'], hcc_set), 
+            'SEPSIS': int('2' in hcc_set),
+            'gSubstanceUseDisorder_V24': has_any_hcc(['54', '55', '56'], hcc_set),
+            'gPsychiatric_V24': has_any_hcc(['57', '58', '59', '60'], hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159'],  hcc_set) # added in 2018-11-20
+        }
+    elif model_name == "CMS-HCC Model V22":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL': has_any_hcc(['134', '135', '136', '137'], hcc_set), 
+            'SEPSIS': int('2' in hcc_set),
+            'gSubstanceUseDisorder': has_any_hcc(['54', '55'], hcc_set),
+            'gPsychiatric': has_any_hcc(['57', '58'], hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158'],  hcc_set) # added in 2012-10-19
+        }
+    elif model_name == "CMS-HCC ESRD Model V24":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),            
+            'gCopdCF': has_any_hcc(['110', '111', '112'], hcc_set),
+            'RENAL_V24': has_any_hcc(['134', '135', '136', '137', '138'], hcc_set),
+            'SEPSIS': int('2' in hcc_set),
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159', '160'], hcc_set), # added in 2018-11-20
+            'gSubstanceUseDisorder_V24': has_any_hcc(['54', '55', '56'], hcc_set),
+            'gPsychiatric_V24': has_any_hcc(['57', '58', '59', '60'], hcc_set)
+        }
+    elif model_name == "CMS-HCC ESRD Model V21":
+        return {
+            'CANCER': has_any_hcc(['8', '9', '10', '11', '12'], hcc_set),
+            'DIABETES': has_any_hcc(['17', '18', '19'], hcc_set),
+            'IMMUNE': int('47' in hcc_set),
+            'CARD_RESP_FAIL': has_any_hcc(['82', '83', '84'], hcc_set),
+            'CHF': int('85' in hcc_set),
+            'COPD': has_any_hcc(['110', '111'], hcc_set),
+            'RENAL': has_any_hcc(['134', '135', '136', '137', '138', '139', '140', '141'], hcc_set),
+            'COMPL': int('176' in hcc_set),
+            'SEPSIS': int('2' in hcc_set), 
+            'PRESSURE_ULCER': has_any_hcc(['157', '158', '159', '160'], hcc_set)
+        }
+    elif model_name == "RxHCC Model V08":
+        # RxModel doesn't seem to have any diagnostic category interactions
+        return {}
+    return {}
+
+def create_disease_interactions(model_name: ModelName, 
+                              diagnostic_cats: dict, 
+                              demographics: Optional[Demographics],
+                              hcc_set: Optional[set[str]]) -> dict:
+    """Creates disease interaction variables based on model version.
+    
+    Args:
+        model_name: The HCC model version being used
+        diagnostic_cats: Dictionary of diagnostic categories
+        demographics: Optional demographic information for age/sex/disability interactions
+        hcc_set: Optional set of HCCs for direct HCC checks
+        
+    Returns:
+        Dictionary containing all disease interaction variables
+    """
+    interactions = {}
+    
+    if model_name == "CMS-HCC Model V28":
+        # Base V28 disease interactions
+        interactions.update({
+            'DIABETES_HF_V28': diagnostic_cats['DIABETES_V28'] * diagnostic_cats['HF_V28'],
+            'HF_CHR_LUNG_V28': diagnostic_cats['HF_V28'] * diagnostic_cats['CHR_LUNG_V28'],
+            'HF_KIDNEY_V28': diagnostic_cats['HF_V28'] * diagnostic_cats['KIDNEY_V28'],
+            'CHR_LUNG_CARD_RESP_FAIL_V28': diagnostic_cats['CHR_LUNG_V28'] * diagnostic_cats['CARD_RESP_FAIL_V28'],
+            'gSubUseDisorder_gPsych_V28': diagnostic_cats['gSubUseDisorder_V28'] * diagnostic_cats['gPsychiatric_V28'],
+            'DISABLED_CANCER_V28': demographics.disabled * diagnostic_cats['CANCER_V28'],
+            'DISABLED_NEURO_V28': demographics.disabled * diagnostic_cats['NEURO_V28'],
+            'DISABLED_HF_V28': demographics.disabled * diagnostic_cats['HF_V28'],
+            'DISABLED_CHR_LUNG_V28': demographics.disabled * diagnostic_cats['CHR_LUNG_V28'],
+            'DISABLED_ULCER_V28': demographics.disabled * diagnostic_cats['ULCER_V28']
+        })
+            
+    elif model_name == "CMS-HCC Model V24":
+        # Base V24/V22 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal_V24': diagnostic_cats['CHF'] * diagnostic_cats['RENAL_V24'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubstanceAbuse_gPsych': diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24'],
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESS_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'gCopdCF_ASP_SPEC_B_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_B_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'DISABLED_HCC85': demographics.disabled * int('85' in hcc_set),
+            'DISABLED_PRESSURE_ULCER': demographics.disabled * diagnostic_cats['PRESSURE_ULCER'],
+            'DISABLED_HCC161': demographics.disabled * int('161' in hcc_set),
+            'DISABLED_HCC39': demographics.disabled * int('39' in hcc_set),
+            'DISABLED_HCC77': demographics.disabled * int('77' in hcc_set),
+            'DISABLED_HCC6': demographics.disabled * int('6' in hcc_set)
+        })
+    elif model_name == "CMS-HCC Model V22":
+        # Base V24/V22 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'HCC85_gDiabetesMellitus': int('85' in hcc_set) * diagnostic_cats['DIABETES'],
+            'HCC85_gCopdCF': int('85' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal': int('85' in hcc_set) * diagnostic_cats['RENAL'],
+            'gRespDepandArre_gCopdCF': diagnostic_cats['CARD_RESP_FAIL'] * diagnostic_cats['gCopdCF'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubstanceAbuse_gPsychiatric': diagnostic_cats['gSubstanceUseDisorder'] * diagnostic_cats['gPsychiatric'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESSURE_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'gCopdCF_ASP_SPEC_BACT_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_BACT_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'DISABLED_HCC85': demographics.disabled * int('85' in hcc_set),
+            'DISABLED_PRESSURE_ULCER': demographics.disabled * diagnostic_cats['PRESSURE_ULCER'],
+            'DISABLED_HCC161': demographics.disabled * int('161' in hcc_set),
+            'DISABLED_HCC39': demographics.disabled * int('39' in hcc_set),
+            'DISABLED_HCC77': demographics.disabled * int('77' in hcc_set),
+            'DISABLED_HCC6': demographics.disabled * int('6' in hcc_set)
+        })
+    elif model_name == "CMS-HCC ESRD Model V24":
+        # Base ESRD V24 disease interactions
+        interactions.update({
+            'HCC47_gCancer': int('47' in hcc_set) * diagnostic_cats['CANCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_gCopdCF': diagnostic_cats['CHF'] * diagnostic_cats['gCopdCF'],
+            'HCC85_gRenal_V24': int('85' in hcc_set) * diagnostic_cats['RENAL_V24'],
+            'gCopdCF_CARD_RESP_FAIL': diagnostic_cats['gCopdCF'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'HCC85_HCC96': int('85' in hcc_set) * int('96' in hcc_set),
+            'gSubUseDs_gPsych_V24': diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24'],
+            'NONAGED_gSubUseDs_gPsych': demographics.non_aged * (diagnostic_cats['gSubstanceUseDisorder_V24'] * diagnostic_cats['gPsychiatric_V24']),
+            'NONAGED_HCC6': demographics.non_aged * int('6' in hcc_set),
+            'NONAGED_HCC34': demographics.non_aged * int('34' in hcc_set),
+            'NONAGED_HCC46': demographics.non_aged * int('46' in hcc_set),
+            'NONAGED_HCC110': demographics.non_aged * int('110' in hcc_set),
+            'NONAGED_HCC176': demographics.non_aged * int('176' in hcc_set),
+            'SEPSIS_PRESSURE_ULCER_V24': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESS_ULCER_V24': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'gCopdCF_ASP_SPEC_B_PNEUM': diagnostic_cats['gCopdCF'] * int('114' in hcc_set),
+            'ASP_SPEC_B_PNEUM_PRES_ULC_V24': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_gCopdCF': int('57' in hcc_set) * diagnostic_cats['gCopdCF'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'NONAGED_HCC85': demographics.non_aged * int('85' in hcc_set),
+            'NONAGED_PRESSURE_ULCER_V24': demographics.non_aged * diagnostic_cats['PRESSURE_ULCER'],
+            'NONAGED_HCC161': demographics.non_aged * int('161' in hcc_set),
+            'NONAGED_HCC39': demographics.non_aged * int('39' in hcc_set),
+            'NONAGED_HCC77': demographics.non_aged * int('77' in hcc_set)
+        })
+    
+    elif model_name == 'CMS-HCC ESRD Model V21':
+        # ESRD Community model interactions
+        interactions.update({
+            'SEPSIS_CARD_RESP_FAIL': diagnostic_cats['SEPSIS'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'CANCER_IMMUNE': diagnostic_cats['CANCER'] * diagnostic_cats['IMMUNE'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'CHF_COPD': diagnostic_cats['CHF'] * diagnostic_cats['COPD'],
+            'CHF_RENAL': diagnostic_cats['CHF'] * diagnostic_cats['RENAL'],
+            'COPD_CARD_RESP_FAIL': diagnostic_cats['COPD'] * diagnostic_cats['CARD_RESP_FAIL'],
+            'NONAGED_HCC6': demographics.non_aged * int('6' in hcc_set),
+            'NONAGED_HCC34': demographics.non_aged * int('34' in hcc_set),
+            'NONAGED_HCC46': demographics.non_aged * int('46' in hcc_set),
+            'NONAGED_HCC54': demographics.non_aged * int('54' in hcc_set),
+            'NONAGED_HCC55': demographics.non_aged * int('55' in hcc_set),
+            'NONAGED_HCC110': demographics.non_aged * int('110' in hcc_set),
+            'NONAGED_HCC176': demographics.non_aged * int('176' in hcc_set),
+            'SEPSIS_PRESSURE_ULCER': diagnostic_cats['SEPSIS'] * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ARTIF_OPENINGS': diagnostic_cats['SEPSIS'] * int('188' in hcc_set),
+            'ART_OPENINGS_PRESSURE_ULCER': int('188' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'DIABETES_CHF': diagnostic_cats['DIABETES'] * diagnostic_cats['CHF'],
+            'COPD_ASP_SPEC_BACT_PNEUM': diagnostic_cats['COPD'] * int('114' in hcc_set),
+            'ASP_SPEC_BACT_PNEUM_PRES_ULC': int('114' in hcc_set) * diagnostic_cats['PRESSURE_ULCER'],
+            'SEPSIS_ASP_SPEC_BACT_PNEUM': diagnostic_cats['SEPSIS'] * int('114' in hcc_set),
+            'SCHIZOPHRENIA_COPD': int('57' in hcc_set) * diagnostic_cats['COPD'],
+            'SCHIZOPHRENIA_CHF': int('57' in hcc_set) * diagnostic_cats['CHF'],
+            'SCHIZOPHRENIA_SEIZURES': int('57' in hcc_set) * int('79' in hcc_set),
+            'NONAGED_HCC85': demographics.non_aged * int('85' in hcc_set),
+            'NONAGED_PRESSURE_ULCER': demographics.non_aged * diagnostic_cats['PRESSURE_ULCER'],
+            'NONAGED_HCC161': demographics.non_aged * int('161' in hcc_set),
+            'NONAGED_HCC39': demographics.non_aged * int('39' in hcc_set),
+            'NONAGED_HCC77': demographics.non_aged * int('77' in hcc_set)
+        })
+            
+    elif model_name == "RxHCC Model V08":
+        # RxHCC NonAged interactions
+        interactions.update({
+            'NonAged_RXHCC1': demographics.non_aged * int('1' in hcc_set),
+            'NonAged_RXHCC130': demographics.non_aged * int('130' in hcc_set),
+            'NonAged_RXHCC131': demographics.non_aged * int('131' in hcc_set),
+            'NonAged_RXHCC132': demographics.non_aged * int('132' in hcc_set),
+            'NonAged_RXHCC133': demographics.non_aged * int('133' in hcc_set),
+            'NonAged_RXHCC159': demographics.non_aged * int('159' in hcc_set),
+            'NonAged_RXHCC163': demographics.non_aged * int('163' in hcc_set)
+        })
+    
+    return interactions
+
+def apply_interactions(demographics: Demographics, 
+                      hcc_set: set[str], 
+                      model_name: ModelName = "CMS-HCC Model V28") -> dict:
+    """
+    Calculate HCC interactions across CMS models. Handles CMS-HCC, ESRD, and RxHCC models.
+    """
+    # Start with demographic interactions
+    interactions = create_demographic_interactions(demographics)
+    
+    # Add dual status interactions
+    interactions.update(create_dual_interactions(demographics))
+    
+    # Get diagnostic categories for the model
+    diagnostic_cats = get_diagnostic_categories(model_name, hcc_set)
+    
+    interactions.update(create_disease_interactions(model_name, diagnostic_cats, demographics, hcc_set))
+        
+    # Add HCC counts
+    interactions.update(create_hcc_counts(hcc_set))
+    
+    return interactions

hccinfhir/samples/__init__.py

@@ -0,0 +1,2 @@
+# Empty file to make the package importable
+

{hccinfhir-0.0.3.dist-info → hccinfhir-0.0.4.dist-info}/METADATA

@@ -1,6 +1,6 @@
 Metadata-Version: 2.3
 Name: hccinfhir
-Version: 0.0.3
+Version: 0.0.4
 Summary: HCC Algorithm for FHIR Resources
 Project-URL: Homepage, https://github.com/mimilabs/hccinfhir
 Project-URL: Issues, https://github.com/mimilabs/hccinfhir/issues
@@ -45,7 +45,26 @@ sld = [{
 }, ...]
 ```
 
-For more details on the SLD format, see the `models.py` file.
+Or, for direct risk score calculation from a list of diagnosis codes, you only need the model name, diagnosis codes, and basic demographic factors:
+
+```python
+from hccinfhir.model_calculate import calculate_raf
+
+diagnosis_codes = ['E119', 'I509']  # Diabetes without complications, Heart failure
+age = 67
+sex = 'F'
+model_name = "CMS-HCC Model V24"
+
+result = calculate_raf(
+   diagnosis_codes=diagnosis_codes,
+   model_name=model_name,
+   age=age,
+   sex=sex
+)
+```
+
+
+For more details on the SLD format, see the `datamodels.py` file.
 
 ## Core Components
 
@@ -71,21 +90,33 @@ filtered_sld = apply_filter(sld_list)
 ```
 
 
-### 3. Logic Module (In Development)
+### 3. Logic Module 
 Implements core HCC calculation logic:
 - Maps diagnosis codes to HCC categories
 - Applies hierarchical rules and interactions
 - Calculates final RAF scores
 - Integrates with standard CMS data files
 
-## Usage
+```python
+from hccinfhir.model_calculate import calculate_raf
+
+diagnosis_codes = ['E119', 'I509']  # Diabetes without complications, Heart failure
+result = calculate_raf(
+   diagnosis_codes=diagnosis_codes,
+   model_name="CMS-HCC Model V24",
+   age=67,
+   sex='F'
+)
+```
+
+### 4. Running HCC on FHIR data
+
 ```python
 from hccinfhir import HCCInFHIR
 
 hcc_processor = HCCInFHIR()
-sld_list = hcc_processor.extract_sld_list(eob_list)
-filtered_sld = hcc_processor.apply_filters(sld_list)  # future
-raf_details = hcc_processor.calculate_raf(filtered_sld, demographic_data)  # future
+
+result = hcc_processor.run(eob_list, demographic_data)
 ```
 
 ## Testing
@@ -172,6 +203,33 @@ $ python3 -m pytest tests/*
 3. Add support for allowed_amount in 837 if available in different segments
 4. Consider adding more robust error handling in both implementations
 
+## Data Files
+
+`ra_dx_to_cc_mapping_2025.csv`
+```sql
+SELECT diagnosis_code, cc, model_name 
+FROM ra_dx_to_cc_mapping 
+WHERE year = 2025 and model_type = 'Initial';
+```
+
+`ra_hierarchies_2025.csv`
+```sql
+SELECT cc_parent, 
+  cc_child, 
+  model_domain, 
+  model_version, 
+  model_fullname
+FROM ra_hierarchies
+WHERE eff_last_date > '2025-01-01';
+```
+
+`ra_coefficients_2025.csv`
+```sql
+SELECT coefficient, value, model_domain, model_version 
+FROM ra_coefficients 
+WHERE eff_last_date > '2025-01-01';
+```   
+
 ## Contributing
 Join us at [mimilabs](https://mimilabs.ai/signup). Reference data available in MIMILabs data lakehouse.
 

hccinfhir-0.0.4.dist-info/RECORD

@@ -0,0 +1,39 @@
+hccinfhir/__init__.py,sha256=OCyYCv4jTOlYHZbTw2DTks3e6_YT1N2JXAOuyR03KNE,43
+hccinfhir/datamodels.py,sha256=S-wQQXEyya_RbrMLmHCPWouaFvEflV8762mciwhrtSk,4270
+hccinfhir/extractor.py,sha256=-jHVCIJqFAqvrI9GxkkXZVDQjKDa-7vF7v3PGMGAMnA,1801
+hccinfhir/extractor_837.py,sha256=vkTBCd0WBaJoTrUd-Z-zCIaoLk7KV2n4AGqIORhONIk,7147
+hccinfhir/extractor_fhir.py,sha256=Rg_L0Vg5tz_L2VJ_jvZwWz6RMlPAkHwj4LiK-OWQvrQ,8458
+hccinfhir/filter.py,sha256=tyaK0Ss0rafkDfcCJWUZOAzzFOIYiuf_SuJ4BBiHJ38,2272
+hccinfhir/hccinfhir.py,sha256=IS3Hvm8wnFL785XkANva6qB9kkc54OCFn-KkwuW5BX0,6450
+hccinfhir/model_calculate.py,sha256=EA5JvbB36wrFAt6kD79E8rn9NKntVMJqXHAq_p7duEE,1947
+hccinfhir/model_coefficients.py,sha256=UrDAEWBoqooSC8hy9YSUsLMmmfgIO0YGtVkui6ruOkE,5528
+hccinfhir/model_demographics.py,sha256=LZLlPQOtxPh3Md6q9xwztQ9PwrUo_gloNCYSa2bDirY,6578
+hccinfhir/model_dx_to_cc.py,sha256=foKn2A0ly2TOVKq5qA92CuZSxHPX00cqt5D-DjBm9x4,2348
+hccinfhir/model_hierarchies.py,sha256=e8QtSayTrfPv2wh149FjK7ToiEmU1ISYMA1Pi38iVk0,2700
+hccinfhir/model_interactions.py,sha256=ZLiKJepPjPkYceKDf7dLXoYE0p44I7t9y2sTOlrxojo,20264
+hccinfhir/data/__init__.py,sha256=SGiSkpGrnxbvtEFMMlk82NFHOE50hFXcgKwKUSuVZUg,45
+hccinfhir/data/ra_coefficients_2025.csv,sha256=I0S2hoJlfig-D0oSFxy0b3Piv7m9AzOGo2CwR6bcQ9w,215191
+hccinfhir/data/ra_dx_to_cc_2025.csv,sha256=4N7vF6VZndkl7d3Fo0cGsbAPAZdCjAizSH8BOKsZNAo,1618924
+hccinfhir/data/ra_eligible_cpt_hcpcs_2023.csv,sha256=VVoA4s0hsFmcRIugyFdbvSoeLcn7M7z0DITT6l4YqL8,39885
+hccinfhir/data/ra_hierarchies_2025.csv,sha256=HQSPNloe6mvvwMgv8ZwYAfWKkT2b2eUvm4JQy6S_mVQ,13045
+hccinfhir/samples/__init__.py,sha256=SGiSkpGrnxbvtEFMMlk82NFHOE50hFXcgKwKUSuVZUg,45
+hccinfhir/samples/sample_837_0.txt,sha256=eggrD259uHa05z2dfxWBpUDseSDp_AQcLyN_adpHyTw,5295
+hccinfhir/samples/sample_837_1.txt,sha256=E155MdemSDYoXokuTXUZ6Br_RGGedYv5t5dh-eMRmuk,1322
+hccinfhir/samples/sample_837_10.txt,sha256=zSJXI78vHAksA7FFQEVLvepefdpMM2_AexLyoDimV3Q,1129
+hccinfhir/samples/sample_837_11.txt,sha256=suVxlZEllEOy6dYgbzGIphKW6hDAKdYQTZFM3Ob84q4,817
+hccinfhir/samples/sample_837_2.txt,sha256=2bvXzaiopr7pO3D3pL7nLxcpgqKXrhu3lbulveJDJ-I,1125
+hccinfhir/samples/sample_837_3.txt,sha256=_B1Ktpsg7bOnA5BwZ7AUB0o7MME5AmLGuxzHq42FWok,1113
+hccinfhir/samples/sample_837_4.txt,sha256=jpzyiHKmRGMqN1ij9s1X4zRj0a2PXwtee4mjn4BRF3g,1077
+hccinfhir/samples/sample_837_5.txt,sha256=eYG4URk3zAr5UsnBKO5Wezo8dnL_HXGCMmXWJu0nxPA,1300
+hccinfhir/samples/sample_837_6.txt,sha256=pnKQf2cVcZpUl8PGeYzZxRxjKOMcISN2dBObIMtLx7E,1331
+hccinfhir/samples/sample_837_7.txt,sha256=5Y-x7ZA9d_qGaIrpVGfXKQBXqbxKiQ5CWOwEW1XGlds,1253
+hccinfhir/samples/sample_837_8.txt,sha256=J-zm0fzp6F19r2SWfHcCtab9ezd3c4YaSRO-RatJ-c4,1250
+hccinfhir/samples/sample_837_9.txt,sha256=nIIurZ0tLHw6ZfDM__U-WqV8Q0u4K3WP56-r3BnAEv8,1341
+hccinfhir/samples/sample_eob_1.json,sha256=_NGSVR2ysFpx-DcTvyga6dFCzhQ8Vi9fNzQEMPz5awU,3124
+hccinfhir/samples/sample_eob_2.json,sha256=FcnJcx0ApOczxjJ_uxVLzCep9THfNf4xs9Yf7hxk8e4,1769
+hccinfhir/samples/sample_eob_200.ndjson,sha256=CxpjeQ1DCMUzZILaM68UEhfxO0p45YGhDDoCZeq8PxU,1917986
+hccinfhir/samples/sample_eob_3.json,sha256=4BW4wOMBEEU9RDfJR15rBEvk0KNHyuMEh3e055y87Hc,2306
+hccinfhir-0.0.4.dist-info/METADATA,sha256=_A0qRJoRtyxs2NHjypr8DP-DSIK_bg_sRgBoOMrtSig,8763
+hccinfhir-0.0.4.dist-info/WHEEL,sha256=C2FUgwZgiLbznR-k0b_5k3Ai_1aASOXDss3lzCUsUug,87
+hccinfhir-0.0.4.dist-info/licenses/LICENSE,sha256=xx0jnfkXJvxRnG63LTGOxlggYnIysveWIZ6H3PNdCrQ,11357
+hccinfhir-0.0.4.dist-info/RECORD,,

hccinfhir/models.py

@@ -1,44 +0,0 @@
-from pydantic import BaseModel
-from typing import List, Optional
-
-class ServiceLevelData(BaseModel):
-    """
-    Represents standardized service-level data extracted from healthcare claims.
-    
-    Attributes:
-        claim_id: Unique identifier for the claim
-        procedure_code: Healthcare Common Procedure Coding System (HCPCS) code
-        ndc: National Drug Code
-        linked_diagnosis_codes: ICD-10 diagnosis codes linked to this service
-        claim_diagnosis_codes: All diagnosis codes on the claim
-        claim_type: Type of claim (e.g., NCH Claim Type Code, or 837I, 837P)
-        provider_specialty: Provider taxonomy or specialty code
-        performing_provider_npi: National Provider Identifier for performing provider
-        billing_provider_npi: National Provider Identifier for billing provider
-        patient_id: Unique identifier for the patient
-        facility_type: Type of facility where service was rendered
-        service_type: Type of service provided (facility type + service type = Type of Bill)
-        service_date: Date service was performed (YYYY-MM-DD)
-        place_of_service: Place of service code
-        quantity: Number of units provided
-        quantity_unit: Unit of measure for quantity
-        modifiers: List of procedure code modifiers
-        allowed_amount: Allowed amount for the service
-    """
-    claim_id: Optional[str] = None
-    procedure_code: Optional[str] = None
-    ndc: Optional[str] = None
-    linked_diagnosis_codes: List[str] = []
-    claim_diagnosis_codes: List[str] = []
-    claim_type: Optional[str] = None
-    provider_specialty: Optional[str] = None
-    performing_provider_npi: Optional[str] = None
-    billing_provider_npi: Optional[str] = None
-    patient_id: Optional[str] = None
-    facility_type: Optional[str] = None
-    service_type: Optional[str] = None
-    service_date: Optional[str] = None
-    place_of_service: Optional[str] = None
-    quantity: Optional[float] = None
-    modifiers: List[str] = []
-    allowed_amount: Optional[float] = None

hccinfhir-0.0.3.dist-info/RECORD

@@ -1,28 +0,0 @@
-hccinfhir/__init__.py,sha256=OCyYCv4jTOlYHZbTw2DTks3e6_YT1N2JXAOuyR03KNE,43
-hccinfhir/extractor.py,sha256=IHKxHEsuU5JIPnScv8x9v_L28aG5F6edZZ0VeYpBF6Y,1770
-hccinfhir/extractor_837.py,sha256=84OeYB1nXl329osWagkkuX0q4MVATnHGk7VZa9p6zoI,7160
-hccinfhir/extractor_fhir.py,sha256=Yu6Ce-2iKvn0j21t_EJUeXjwjZYbTh5HgqChMz8KkjI,8445
-hccinfhir/filter.py,sha256=C05uFhqSVb0J7BpKPGt4hwQrCd0_HbGSmrxKHIZLg4w,2259
-hccinfhir/models.py,sha256=dH0qICn8yjsqc35INYSG4HbvYyegRCPtQOPTJf5Qozw,2033
-hccinfhir/data/__init__.py,sha256=SGiSkpGrnxbvtEFMMlk82NFHOE50hFXcgKwKUSuVZUg,45
-hccinfhir/data/ra_eligible_cpt_hcpcs_2023.csv,sha256=VVoA4s0hsFmcRIugyFdbvSoeLcn7M7z0DITT6l4YqL8,39885
-hccinfhir/data/sample_837_0.txt,sha256=eggrD259uHa05z2dfxWBpUDseSDp_AQcLyN_adpHyTw,5295
-hccinfhir/data/sample_837_1.txt,sha256=E155MdemSDYoXokuTXUZ6Br_RGGedYv5t5dh-eMRmuk,1322
-hccinfhir/data/sample_837_10.txt,sha256=zSJXI78vHAksA7FFQEVLvepefdpMM2_AexLyoDimV3Q,1129
-hccinfhir/data/sample_837_11.txt,sha256=suVxlZEllEOy6dYgbzGIphKW6hDAKdYQTZFM3Ob84q4,817
-hccinfhir/data/sample_837_2.txt,sha256=2bvXzaiopr7pO3D3pL7nLxcpgqKXrhu3lbulveJDJ-I,1125
-hccinfhir/data/sample_837_3.txt,sha256=_B1Ktpsg7bOnA5BwZ7AUB0o7MME5AmLGuxzHq42FWok,1113
-hccinfhir/data/sample_837_4.txt,sha256=jpzyiHKmRGMqN1ij9s1X4zRj0a2PXwtee4mjn4BRF3g,1077
-hccinfhir/data/sample_837_5.txt,sha256=eYG4URk3zAr5UsnBKO5Wezo8dnL_HXGCMmXWJu0nxPA,1300
-hccinfhir/data/sample_837_6.txt,sha256=pnKQf2cVcZpUl8PGeYzZxRxjKOMcISN2dBObIMtLx7E,1331
-hccinfhir/data/sample_837_7.txt,sha256=5Y-x7ZA9d_qGaIrpVGfXKQBXqbxKiQ5CWOwEW1XGlds,1253
-hccinfhir/data/sample_837_8.txt,sha256=J-zm0fzp6F19r2SWfHcCtab9ezd3c4YaSRO-RatJ-c4,1250
-hccinfhir/data/sample_837_9.txt,sha256=nIIurZ0tLHw6ZfDM__U-WqV8Q0u4K3WP56-r3BnAEv8,1341
-hccinfhir/data/sample_eob_1.json,sha256=_NGSVR2ysFpx-DcTvyga6dFCzhQ8Vi9fNzQEMPz5awU,3124
-hccinfhir/data/sample_eob_2.json,sha256=FcnJcx0ApOczxjJ_uxVLzCep9THfNf4xs9Yf7hxk8e4,1769
-hccinfhir/data/sample_eob_200.ndjson,sha256=CxpjeQ1DCMUzZILaM68UEhfxO0p45YGhDDoCZeq8PxU,1917986
-hccinfhir/data/sample_eob_3.json,sha256=4BW4wOMBEEU9RDfJR15rBEvk0KNHyuMEh3e055y87Hc,2306
-hccinfhir-0.0.3.dist-info/METADATA,sha256=Ekro5D_Wg4htDTmM1NDJOE03Z9BSggoQEdHKSsv1DY8,7654
-hccinfhir-0.0.3.dist-info/WHEEL,sha256=C2FUgwZgiLbznR-k0b_5k3Ai_1aASOXDss3lzCUsUug,87
-hccinfhir-0.0.3.dist-info/licenses/LICENSE,sha256=xx0jnfkXJvxRnG63LTGOxlggYnIysveWIZ6H3PNdCrQ,11357
-hccinfhir-0.0.3.dist-info/RECORD,,