Da Vinci Risk Adjustment Implementation Guide
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## : ra-measurereport04: Risk Adjustment Measure Report for HCC V21 for Patient 03 - JSON Representation

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    {
      "resourceType" : "MeasureReport",
      "id" : "ra-measurereport04",
      "meta" : {
        "profile" : [
          "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport"
        ]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MeasureReport</b><a name=\"ra-measurereport04\"> </a></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 MeasureReport &quot;ra-measurereport04&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ra-measurereport.html\">Risk Adjustment Coding Gap MeasureReport</a></p></div><p><b>Risk Adjustment Clinical Data Collection Deadline</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> &quot; NUCLEAR&quot;</p><p><b>date</b>: 2021-10-18</p><p><b>reporter</b>: <a href=\"Organization-ra-payer01.html\">Organization/ra-payer01</a> &quot;ABC Payer&quot;</p><p><b>period</b>: 2021-01-01 --&gt; 2021-09-30</p><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-001</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#historic)</span></p><p><b>Evidence Status</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 CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</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: Hierarchies applied and Condition Category is not superseded 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 CodeSystem</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 &quot;Artificial Openings for Feeding or Elimination&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-002</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#historic)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Chronic Obstructive Pulmonary Disease&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-003</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#historic)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Protein-Calorie Malnutrition&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-004</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#historic)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Inflammatory Bowel Disease&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-005</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#historic)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Specified Heart Arrhythmias&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-006</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Diabetes with Chronic Complications&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-007</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Dialysis Status&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-008</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Major Depressive, Bipolar, and Paranoid Disorders&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-009</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Diabetes without Complication&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-010</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#pending)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Acute Renal Failure&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-011</blockquote><p><b>Risk Adjustment Suspect Type</b>: Suspected Condition Category Gap <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-suspect-type.html\">Risk Adjustment Suspect Type CodeSystem</a>#suspected)</span></p><p><b>Evidence Status</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 CodeSystem</a>#open-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Chronic Kidney Disease, Stage 5&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-012</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#net-new)</span></p><p><b>Evidence Status</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 CodeSystem</a>#pending)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Vascular Disease with Complications&quot;)</span></p></blockquote><blockquote><p><b>group</b></p><blockquote><p><b>id</b></p>group-013</blockquote><p><b>Risk Adjustment Suspect Type</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 CodeSystem</a>#net-new)</span></p><p><b>Evidence Status</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 CodeSystem</a>#closed-gap)</span></p><p><b>Hierarchical Status</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 CodeSystem</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 &quot;Vascular Disease&quot;)</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>"
      },
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline",
          "valueDate" : "2022-03-31"
        }
      ],
      "status" : "complete",
      "type" : "individual",
      "measure" : "https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample02",
      "subject" : {
        "reference" : "Patient/ra-patient03"
      },
      "date" : "2021-10-18",
      "reporter" : {
        "reference" : "Organization/ra-payer01"
      },
      "period" : {
        "start" : "2021-01-01",
        "end" : "2021-09-30"
      },
      "group" : [
        {
          "id" : "group-001",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type",
                    "code" : "historic"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                    "code" : "closed-gap"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                    "code" : "applied-not-superseded"
                  }
                ]
              }
            }
          ],
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
                "version" : "21",
                "code" : "188",
                "display" : "Artificial Openings for Feeding or Elimination"
              }
            ],
            "text" : "CMS-HCC 188: Artificial Openings for Feeding or Elimination"
          }
        },
        {
          "id" : "group-002",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type",
                    "code" : "historic"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                    "code" : "open-gap"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                    "code" : "applied-not-superseded"
                  }
                ]
              }
            }
          ],
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
                "version" : "21",
                "code" : "111",
                "display" : "Chronic Obstructive Pulmonary Disease"
              }
            ],
            "text" : "CMS-HCC 111: Chronic Obstructive Pulmonary Disease"
          }
        },
        {
          "id" : "group-003",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type",
                    "code" : "historic"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status",
                    "code" : "open-gap"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status",
                    "code" : "applied-not-superseded"
                  }
                ]
              }
            }
          ],
          "code" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/cmshcc",
                "version" : "21",
                "code" : "21",
                "display" : "Protein-Calorie Malnutrition"
              }
            ],
            "text" : "CMS-HCC 21: Protein-Calorie Malnutrition"
          }
        },
        {
          "id" : "group-004",
          "extension" : [
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type",
                    "code" : "historic"
                  }
                ]
              }
            },
            {
              "url" : "http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus",
              "valueCodeableConcept" : {
                "coding" : [
                  {
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