Da Vinci Risk Adjustment Implementation Guide
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## : ra-measurereport01-with-annotation: Risk Adjustment Measure Report with Annotation - XML Representation

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    <MeasureReport xmlns="http://hl7.org/fhir">
      <id value="ra-measurereport01-with-annotation"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-measurereport"/>
      </meta>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MeasureReport</b><a name="ra-measurereport01-with-annotation"> </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-measurereport01-with-annotation&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-RAModelExample01.html">Risk Adjustment Model Version 24 - CMS Hierarchical Category Condition (CMS-HCC)</a></p><p><b>subject</b>: <a href="Patient-ra-patient01.html">Patient/ra-patient01</a> &quot; EVERYWOMAN&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>Risk Adjustment Evidence Status Date</b>: 2021-04-01</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: Hierarchies applied and Condition Category is not superseded 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>: HCC 18: Diabetes with Chronic Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#18 &quot;Diabetes with Chronic Complications&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>: 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>Risk Adjustment Evidence Status Date</b>: 2021-09-29</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>: HCC 111: Chronic Obstructive Pulmonary Disease <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#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>Risk Adjustment Evidence Status Date</b>: 2020-07-15</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><blockquote><p><b>Annotation</b></p><blockquote><p><b>url</b></p><code>annotator</code></blockquote><p><b>value</b>: <a href="Practitioner-ra-prac01pat01.html">Practitioner/ra-prac01pat01</a> &quot; HIPPOCRATES&quot;</p><blockquote><p><b>url</b></p><code>annotated</code></blockquote><p><b>value</b>: 2021-11-01</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Diagnosis added</p><blockquote><p><b>url</b></p><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></blockquote><p><b>value</b>: Assessed and present <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-coding-gap-annotation.html">Coding Gap Annotation CodeSystem</a>#assessed-present)</span></p><blockquote><p><b>url</b></p><code>relatedData</code></blockquote><p><b>value</b>: id: CLM23333</p></blockquote><p><b>code</b>: HCC 59: Major Depressive, Bipolar, and Paranoid Disorders <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#59 &quot;Major Depressive, Bipolar, and Paranoid Disorders&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>: 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>Risk Adjustment Evidence Status Date</b>: 2021-04-27</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>: HCC 112: Fibrosis of lung and other chronic lung disorders <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#112 &quot;Fibrosis of lung and other chronic lung disorders&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>: 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>Risk Adjustment Evidence Status Date</b>: 2021-09-27</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>: HCC 19: Diabetes without Complications <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#19 &quot;Diabetes without Complications&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>: 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>Risk Adjustment Evidence Status Date</b>: 2020-12-15</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><blockquote><p><b>Annotation</b></p><blockquote><p><b>url</b></p><code>annotator</code></blockquote><p><b>value</b>: <a href="Practitioner-ra-prac01pat01.html">Practitioner/ra-prac01pat01</a> &quot; HIPPOCRATES&quot;</p><blockquote><p><b>url</b></p><code>annotated</code></blockquote><p><b>value</b>: 2021-11-01</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Continue evaluation</p><blockquote><p><b>url</b></p><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></blockquote><p><b>value</b>: Deferred <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-coding-gap-annotation.html">Coding Gap Annotation CodeSystem</a>#deferred)</span></p></blockquote><p><b>code</b>: HCC 84: Cardio-Respiratory Failure and Shock <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#84 &quot;Cardio-Respiratory Failure and Shock&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>Risk Adjustment Evidence Status Date</b>: 2021-03-15</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>: HCC 22: Morbid Obesity <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#22 &quot;Morbid Obesity&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>: 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>Risk Adjustment Evidence Status Date</b>: 2021-09-27</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>: HCC 96: Specified Heart Arrhythmias <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#96 &quot;Specified Heart Arrhythmias&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>: 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>Risk Adjustment Evidence Status Date</b>: 2020-07-15</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>Confidence Scale</b>: Medium <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#255508009)</span></p><blockquote><p><b>Annotation</b></p><blockquote><p><b>url</b></p><code>annotator</code></blockquote><p><b>value</b>: <a href="Practitioner-ra-prac01pat01.html">Practitioner/ra-prac01pat01</a> &quot; HIPPOCRATES&quot;</p><blockquote><p><b>url</b></p><code>annotated</code></blockquote><p><b>value</b>: 2021-11-01</p><blockquote><p><b>url</b></p><code>text</code></blockquote><p><b>value</b>: Not diagnosed</p><blockquote><p><b>url</b></p><a href="http://hl7.org/fhir/R4/datatypes.html#code">code</a></blockquote><p><b>value</b>: Assessed and not present <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-coding-gap-annotation.html">Coding Gap Annotation CodeSystem</a>#assessed-not-present)</span></p><blockquote><p><b>url</b></p><code>relatedData</code></blockquote><p><b>value</b>: id: 432203939</p></blockquote><p><b>code</b>: HCC 110: Cystic Fibrosis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#110 &quot;Cystic Fibrosis&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>: 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>Risk Adjustment Evidence Status Date</b>: 2021-09-28</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>: HCC 83: Respiratory Arrest <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (CMS Hierarchical Condition Categories[24]#83 &quot;Respiratory Arrest&quot;)</span></p></blockquote><p><b>evaluatedResource</b>: </p><ul><li><a href="Condition-ra-condition02pat01.html">Condition/ra-condition02pat01</a></li><li><a href="Condition-ra-condition03pat01.html">Condition/ra-condition03pat01</a></li><li><a href="Condition-ra-condition08pat01.html">Condition/ra-condition08pat01</a></li><li><a href="Condition-ra-condition09pat01.html">Condition/ra-condition09pat01</a></li><li><a href="Condition-ra-condition10pat01.html">Condition/ra-condition10pat01</a></li><li><a href="Condition-ra-condition11pat01.html">Condition/ra-condition11pat01</a></li><li><a href="Condition-ra-condition17pat01.html">Condition/ra-condition17pat01</a></li><li><a href="Condition-ra-condition18pat01.html">Condition/ra-condition18pat01</a></li><li><a href="Condition-ra-condition33pat01.html">Condition/ra-condition33pat01</a></li><li><a href="Condition-ra-condition43pat01.html">Condition/ra-condition43pat01</a></li><li><a href="Condition-ra-condition44pat01.html">Condition/ra-condition44pat01</a></li><li><a href="Encounter-ra-encounter02pat01.html">Encounter/ra-encounter02pat01</a></li><li><a href="Encounter-ra-encounter03pat01.html">Encounter/ra-encounter03pat01</a></li><li><a href="Encounter-ra-encounter08pat01.html">Encounter/ra-encounter08pat01</a></li><li><a href="Encounter-ra-encounter09pat01.html">Encounter/ra-encounter09pat01</a></li><li><a href="Encounter-ra-encounter11pat01.html">Encounter/ra-encounter11pat01</a></li><li><a href="Encounter-ra-encounter43pat01.html">Encounter/ra-encounter43pat01</a></li><li><a href="Encounter-ra-encounter44pat01.html">Encounter/ra-encounter44pat01</a></li><li><a href="Observation-ra-obs21pat01.html">Observation/ra-obs21pat01</a></li></ul></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-clinicalDataCollectionDeadline">
        <valueDate value="2022-03-31"/>
      </extension>
      <status value="complete"/>
      <type value="individual"/>
      <measure
               value="https://build.fhir.org/ig/HL7/davinci-ra/Measure-RAModelExample01"/>
      <subject>
        <reference value="Patient/ra-patient01"/>
      </subject>
      <date value="2021-10-18"/>
      <reporter>
        <reference value="Organization/ra-payer01"/>
      </reporter>
      <period>
        <start value="2021-01-01"/>
        <end value="2021-09-30"/>
      </period>
      <group id="group-001">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-04-01"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="18"/>
            <display value="Diabetes with Chronic Complications"/>
          </coding>
          <text value="HCC 18: Diabetes with Chronic Complications"/>
        </code>
      </group>
      <group id="group-002">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-29"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="111"/>
            <display value="Chronic Obstructive Pulmonary Disease"/>
          </coding>
          <text value="HCC 111: Chronic Obstructive Pulmonary Disease"/>
        </code>
      </group>
      <group id="group-003">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-07-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation">
          <extension url="annotator">
            <valueReference>
              <reference value="Practitioner/ra-prac01pat01"/>
            </valueReference>
          </extension>
          <extension url="annotated">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="text">
            <valueString value="Diagnosis added"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-annotation"/>
                <code value="assessed-present"/>
                <display value="Assessed and present"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="relatedData">
            <valueIdentifier>
              <system value="http://example.org/fhir/myclaimno"/>
              <value value="CLM23333"/>
            </valueIdentifier>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="59"/>
            <display value="Major Depressive, Bipolar, and Paranoid Disorders"/>
          </coding>
          <text
                value="HCC 59: Major Depressive, Bipolar, and Paranoid Disorders"/>
        </code>
      </group>
      <group id="group-004">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-04-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="112"/>
            <display value="Fibrosis of lung and other chronic lung disorders"/>
          </coding>
          <text
                value="HCC 112: Fibrosis of lung and other chronic lung disorders"/>
        </code>
      </group>
      <group id="group-005">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="19"/>
            <display value="Diabetes without Complications"/>
          </coding>
          <text value="HCC 19: Diabetes without Complications"/>
        </code>
      </group>
      <group id="group-006">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="historic"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-12-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation">
          <extension url="annotator">
            <valueReference>
              <reference value="Practitioner/ra-prac01pat01"/>
            </valueReference>
          </extension>
          <extension url="annotated">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="text">
            <valueString value="Continue evaluation"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-annotation"/>
                <code value="deferred"/>
                <display value="Deferred"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="84"/>
            <display value="Cardio-Respiratory Failure and Shock"/>
          </coding>
          <text value="HCC 84: Cardio-Respiratory Failure and Shock"/>
        </code>
      </group>
      <group id="group-007">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="closed-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-03-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="22"/>
            <display value="Morbid Obesity"/>
          </coding>
          <text value="HCC 22: Morbid Obesity"/>
        </code>
      </group>
      <group id="group-008">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-27"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="96"/>
            <display value="Specified Heart Arrhythmias"/>
          </coding>
          <text value="HCC 96: Specified Heart Arrhythmias"/>
        </code>
      </group>
      <group id="group-009">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="suspected"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="open-gap"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2020-07-15"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-confidenceScale">
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="255508009"/>
              <display value="Medium"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-annotation">
          <extension url="annotator">
            <valueReference>
              <reference value="Practitioner/ra-prac01pat01"/>
            </valueReference>
          </extension>
          <extension url="annotated">
            <valueDateTime value="2021-11-01"/>
          </extension>
          <extension url="text">
            <valueString value="Not diagnosed"/>
          </extension>
          <extension url="code">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/coding-gap-annotation"/>
                <code value="assessed-not-present"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension url="relatedData">
            <valueIdentifier>
              <system value="http://example.org/fhir/mychart"/>
              <value value="432203939"/>
            </valueIdentifier>
          </extension>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="110"/>
            <display value="Cystic Fibrosis"/>
          </coding>
          <text value="HCC 110: Cystic Fibrosis"/>
        </code>
      </group>
      <group id="group-010">
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-suspectType">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/suspect-type"/>
              <code value="net-new"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/evidence-status"/>
              <code value="pending"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-evidenceStatusDate">
          <valueDate value="2021-09-28"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-hierarchicalStatus">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/us/davinci-ra/CodeSystem/hierarchical-status"/>
              <code value="applied-not-superseded"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <code>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/cmshcc"/>
            <version value="24"/>
            <code value="83"/>
            <display value="Respiratory Arrest"/>
          </coding>
          <text value="HCC 83: Respiratory Arrest"/>
        </code>
      </group>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Condition/ra-condition02pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-002"/>
        </extension>
        <reference value="Condition/ra-condition03pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-003"/>
        </extension>
        <reference value="Condition/ra-condition08pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Condition/ra-condition09pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-005"/>
        </extension>
        <reference value="Condition/ra-condition10pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-006"/>
        </extension>
        <reference value="Condition/ra-condition11pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-007"/>
        </extension>
        <reference value="Condition/ra-condition17pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-008"/>
        </extension>
        <reference value="Condition/ra-condition18pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-010"/>
        </extension>
        <reference value="Condition/ra-condition33pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Condition/ra-condition43pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Condition/ra-condition44pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-007"/>
        </extension>
        <reference value="Encounter/ra-encounter02pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-002"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-005"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-008"/>
        </extension>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-010"/>
        </extension>
        <reference value="Encounter/ra-encounter03pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-003"/>
        </extension>
        <reference value="Encounter/ra-encounter08pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Encounter/ra-encounter09pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-006"/>
        </extension>
        <reference value="Encounter/ra-encounter11pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-001"/>
        </extension>
        <reference value="Encounter/ra-encounter43pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-004"/>
        </extension>
        <reference value="Encounter/ra-encounter44pat01"/>
      </evaluatedResource>
      <evaluatedResource>
        <extension
                   url="http://hl7.org/fhir/us/davinci-ra/StructureDefinition/ra-groupReference">
          <valueString value="group-009"/>
        </extension>
        <reference value="Observation/ra-obs21pat01"/>
      </evaluatedResource>
    </MeasureReport>